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California Environmental Health Tracking Program

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Last Edited: 9/29/2010

Asthma: Who is at Risk?

Asthma impacts a population in many ways.  Since many people are able to manage their symptoms or no longer experience symptoms, the number of people who have been diagnosed with asthma is different from the number of people who currently experience severe symptoms.

To understand the complete asthma burden in California, it’s important to look at how many people have actually been diagnosed with asthma (lifetime asthma prevalence), how many are currently experiencing asthma attacks (current asthma prevalence), how people are using the healthcare system to manage their asthma, and the economic costs associated with asthma.

 


Asthma is not distributed equally

Different segments of the population bear a disproportionate burden of asthma. These disparities are significant by race and ethnicity, income, gender, age, and geographic location. For example, in 2005, rates of lifetime asthma prevalence varied significantly by race and ethnicity:

 

Lifetime Asthma Prevalence in California, 2005

Race/Ethnicity

%

95% C.I.

American Indian/Alaskan Native

22.8

18.0 - 27.6

Black

19.3 17.2 - 21.5

White

15.5 15.0 - 16.1

Asian/Pacific Islander

10.8 8.8 - 11.2

Hispanic

9.8 9.0 - 10.6

Data Source: California Health Interview Survey 2005

 

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Racial and ethnic disparities in asthma

In California,

  • American Indian/Alaskan Natives have an asthma prevalence two times greater than Hispanics and Asian/Pacific Islanders
    • Since little is known about what causes people to develop asthma, the reason for this disparity is not well understood
  • It has been well-established that Blacks bear a disproportionate share of the asthma burden
    • In addition to having a higher prevalence, Blacks have much higher rates of asthma ED visits, hospitalizations, and mortality than Whites 1,2

Asthma disparities also exist within subgroups of these broader race/ethnicity categories.

  • Among Hispanic school-aged children in California, asthma prevalence ranged from 13.2% for Mexican American students to 22.8% for Puerto Rican students
  • Among Asian/Pacific Islander school-aged children, asthma prevalence ranged from 10.9% for Korean American students to 23.8% for Filipino American students

The reasons for disparities within the race/ethnic groups are not fully understood. They may be influenced by characteristics related to country of birth, residential history, generational status, and/or degree of acculturation 3.

 

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Income disparities in asthma

Although the prevalence of asthma does not vary by income in California, people with lower incomes tend to have more severe symptoms, higher rates of asthma hospitalizations, and are more likely to have repeat visits to the hospital.

 

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Geographic disparities in asthma

Asthma also varies widely by geographic area.  Causes for this might include differences in population demographic.

 

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Asthma is on the rise

Nationwide, the prevalence of asthma has been on the rise 4.

In California, the lifetime prevalence for asthma is higher than the national prevalence and has increased over the past decade (1995-2005) 5.

  • Over 5 million Californians, or 13 %, have been diagnosed with asthma at some point in their lives
  • Among California adults, 2.1 million (7.6%) currently have asthma
  • Among California children, 827,000 (8.6%) currently have asthma
  • About a third of children with asthma have had an asthma attack in the past year 5

 

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Need for better asthma management

When asthma is not properly controlled, symptoms may be exacerbated and can result in an emergency department (ED) visit, hospitalization, or death.

  • In 2006, there were about 98,995 asthma-related visits to the ED in California 5
  • In 2006, there were about 21,818 asthma-related hospitalizations in California5
  • In 2004, there were 450 deaths due to asthma (13 deaths per every 1 million California residents) 5

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Asthma is costly

In addition to the impact on the health of Californians, there are enormous direct and indirect economic costs associated with asthma.

  • In 2005, asthma hospitalizations in California cost $763 million5
  • Between 1995 and 2005, the average charge per asthma hospitalization more than doubled from $9,277 to $23,953 5

 

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1. Stockman JK, Garcia K, Von Behren J, Bembom O, Shaikh N, Kreutzer R. “Asthma Disparities Among African Americans”. California Asthma Facts, Volume 2, Issue 1. March 2004. Environmental Health Investigations Branch, California Department of Health Services.
2. National Center for Health Statistics: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/ashtma03-05/asthma03-05.htm#fig5
3. Davis A, Kreutzer R, Lipsett M, King G, Shaikh N. Asthma Prevalence in Hispanic and Asian American Ethnic Subgroups: Results from the California Healthy Kids Survey. Pediatrics. 2006;118(2):e363-e378.
4. Moorman JE, Rudd RA, et al. National Surveillance for Asthma --- United States, 1980-2004. MMWR. Oct. 19, 2007; 56 (S S08); 1-14; 18-54.
5. Milet M, Tran S, Eatherton M, Flattery J, Kreutzer R. “The Burden of Asthma in California: A Surveillance Report.” Richmond, CA: California Department of Health Services, Environmental Health Investigations Branch, June 2007. Available at:http://www.californiabreathing.org/images/stories/publications/asthmaburdenreport.pdf