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Epidemiology of Asthma Among Children in the U.S.

Epidemiology of Asthma Among Children in the U.S. Jo ä n Patterson, Ph.D. Maternal and Child Health Program University of Minnesota. Definition of Asthma. Chronic inflammatory disease of the lungs Airways are constricted from inflammation and hyper-responsiveness to asthma “triggers”.

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Epidemiology of Asthma Among Children in the U.S.

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  1. Epidemiology of Asthma Among Children in the U.S. Joän Patterson, Ph.D. Maternal and Child Health Program University of Minnesota

  2. Definition of Asthma • Chronic inflammatory disease of the lungs • Airways are constricted from inflammation and hyper-responsiveness to asthma “triggers”

  3. Potential Asthma Triggers • Allergens • Infections • Exercise • Abrupt changes in the weather • Exposure to airway irritants, such as tobacco smoke

  4. Asthma Exacerbations • Recurrent asthma episodes, involving • Shortness of breath • Coughing • Wheezing • Chest pain or tightness • Range in severity from • Mild intermittent • Severe persistent

  5. Epidemiology of Asthma • Asthma is the most common chronic disease among children • It has increased at epidemic rates since the early 1980s • From 37 of every 1000 children in 1980 • To 69 of every 1000 children in 1995

  6. Asthma Prevalence in U.S.1980-1996 Source: MMWR

  7. Asthma Attack Prevalence in U.S. 1997-2000 Source: MMWR

  8. Variability in Asthma Prevalence • By gender • Males 0 – 17 years are more likely than girls to have asthma or experience an asthma attack • By race/ethnicity • Higher for Black non-Hispanic children • Higher for Hispanic children

  9. Asthma Prevalence by Race/Ethnicity 1980 - 1996 Source: MMWR

  10. What Accounts for this Epidemic? • Etiology of asthma is due to the interaction of environmental and genetic factors • Atopy, the genetically inherited susceptibility to asthma, cannot account for epidemic • Probably NOT due to outdoor air quality • Indoor air contaminants may be a factor • Tighter construction trapping contaminants • Children spending more time indoors

  11. Burden of Asthma • Increases risk for early death • Compromises child’s quality of life • Affects family’s quality of life • Increased costs associated with increased utilization of health care

  12. Asthma Deaths by Race/Ethnicity per 1,000,000 Children 1980 - 1998 Source: National Vital Statistics System, NCHS, CDC

  13. Asthma Deaths by Age per 1,000,000 Children 1980 - 1998 Source: National Vital Statistics System, NCHS, CDC

  14. Asthma and Quality of Life • Most common cause of school absence • An average of 9.7 days per year for asthma • Most prevalent cause of childhood disability (long-term reduction in ability to do normal activities) • In 1994-95, 1.4% of U.S. children experienced some disability due to asthma • This is 21% of all children with asthma • SES disadvantage doubles rate of disability • Children with asthma have higher rates of social and emotional problems

  15. Healthcare Costs and Utilization • For all individuals with asthma in 1998, estimated costs were: • $7.5 billion for direct costs • $3.8 billion for indirect costs – lost work days and lifetime earnings lost due to mortality from asthma • Overuse of emergency care by some groups, increasing costs • Greater use of doctor’s office visits and adherence to a written asthma action plan would reduce mortality, improve quality of life, and reduce costs

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