Vital Signs

Vital Signs: Asthma in Children — United States, 2001–2016

Hatice S. Zahran, MD; Cathy M. Bailey, PhD; Scott A. Damon, MAIA; Paul L. Garbe, DVM; Patrick N. Breysse, PhD

Disclosures

Morbidity and Mortality Weekly Report. 2018;67(5):149-155. 

In This Article

Abstract and Introduction

Abstract

Background: Asthma is the most common chronic lung disease of childhood, affecting approximately 6 million children in the United States. Although asthma cannot be cured, most of the time, asthma symptoms can be controlled by avoiding or reducing exposure to asthma triggers (allergens and irritants) and by following recommendations for asthma education and appropriate medical care.

Methods: CDC analyzed asthma data from the 2001–2016 National Health Interview Survey for children aged 0–17 years to examine trends and demographic differences in health outcomes and health care use.

Results: Asthma was more prevalent among boys (9.2%) than among girls (7.4%), children aged ≥5 years (approximately 10%) than children aged <5 years (3.8%), non-Hispanic black (black) children (15.7%) and children of Puerto Rican descent (12.9%) than among non-Hispanic white (white) children (7.1%), and children living in low income families (10.5%) than among those living in families with income ≥250% of the Federal Poverty Level (FPL) (approximately 7%). Asthma prevalence among children increased from 8.7% in 2001 to 9.4% in 2010, and then decreased to 8.3% in 2016. Although not all changes were statistically significant, a similar pattern was observed among subdemographic groups studied, with the exception of Mexican/Mexican-American children, among whom asthma prevalence increased from 5.1% in 2001 to 6.5% in 2016.

Among children with asthma, the percentage who had an asthma attack in the past 12 months declined significantly from 2001 to 2016. Whereas asthma prevalence was lower among children aged 0–4 years than among older children, the prevalence of asthma attacks (62.4%), emergency department or urgent care center (ED/UC) visits (31.1%), and hospitalization (10.4%) were higher among children with asthma aged 0–4 years than among those aged 12–17 years (44.8%, 9.6%, and 2.8%, respectively).

During 2013, children with asthma aged 5–17 years missed 13.8 million days of school per year (2.6 days per child). Compared with 2003, in 2013, the prevalence of adverse health outcomes and health care use were significantly lower and the prevalence of having an action plan to manage asthma was higher.

Conclusions and Implications for Public Health Practice: Asthma remains an important public health and medical problem. The health of children with asthma can be improved by promoting asthma control strategies, including asthma trigger reduction, appropriate guidelines-based medical management, and asthma education for children, parents, and others involved in asthma care.

Introduction

Asthma is a common chronic lung disease of children that causes repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing.[1] These symptoms can often be controlled by avoiding or reducing asthma triggers (allergens and irritants) and by following recommendations for appropriate medical care (initiating asthma control medications or adjusting the current treatment regimen when needed).[1,2]

A 2012 CDC National Surveillance of Asthma report showed an increasing trend in asthma prevalence among children between 2001 and 2010, with children experiencing more asthma attacks and emergency visits than did adults.[3] Asthma is more common among some children than others. Boys, children aged ≥5 years, black children and children of Puerto Rican descent, and children living in households with income of <100% of FPL had higher prevalence than did girls, children aged <5 years, white children, and children living in households with income >250% FPL.[3,4] Asthma-related hospitalizations were 3.6 times higher and emergency department visits were 3 times higher among black children than among white children.[4]

Uncontrolled asthma results in significant costs to families and society when asthma exacerbations result in medical encounters, lost school days, and reduced productivity. The cost of asthma for children varies by state. In 2012, the median annual medical cost of asthma was $983 per child (ranging from $833 in Arizona to $1,121 in Michigan) for all payers.[5]

Because of changing physical, social, and economic environments and medical management of asthma at individual and population levels over time,[6,7] there is a need to update prevalence estimates and to reassess demographic differences in health outcomes and health care use to better define the current burden of asthma overall and among subpopulations. This report reviews the current state of asthma among U.S. children aged 0–17 years and related health outcomes, health care use, and asthma care and management.

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