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


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

In This Article

Conclusions and Comments

Although asthma still affects some children more than others, the findings in this report are somewhat encouraging. The prevalence of asthma and asthma attacks have decreased in recent years (since 2010 and 2001, respectively), fewer children with asthma reported missed school days and hospitalizations because of asthma, and more children with asthma received a written asthma action plan during 2013 than did during 2003. Among children with asthma, asthma attacks, hospitalizations, and ED/UC visits were more prevalent among children aged 0–4 years than among children aged 12–17 years. This might be partially explained by more frequent viral respiratory infections among this age group. These infections are the most common precipitants of asthma symptoms and hospitalizations among this age group.[9]

The findings in this report indicate that more children with asthma received an asthma action plan, were taught how to recognize early signs of an asthma attack, and were taught how to respond to an asthma attack in 2013 than in 2003. However, in 2013 only half (51%) of children with asthma received an asthma action plan and less than half (46%) received advice on environmental control, indicating a need for further improvement in these areas, given that multicomponent self-management education programs, including an written asthma action plan;[1,10,11] educating healthcare providers[12] can improve asthma-related health outcomes and reduce unnecessary health care use.

Access to and adherence to guidelines-based medical care, including prescribing inhaled corticosteroids, is a key component of effective asthma care.[1,13,14] The findings show that just over half (54.5%) of children with asthma who were taking asthma control medications were taking them regularly as prescribed, indicating a need for further improvement in medication adherence.

The findings in this report are subject to at least two limitations. First, because NHIS is a cross-sectional survey, it provides prevalence estimates and associations, but cannot determine causal associations. Second, NHIS data are based on adult proxy responses for children; therefore, the findings might be biased because of inaccurate recall or the social desirability of providing positive responses.

Asthma remains an important public health and medical problem. Some progress has been made in providing asthma education and in decreasing adverse health outcomes. The health of children with asthma can be further 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. The CDC National Asthma Control Program ( works with 25 funded state and territorial grantees and four nongovernmental organizations to engage persons with asthma, their families, schools, communities, and health care providers to achieve better care and better health outcomes and to decrease unnecessary asthma-related emergency department and urgent care visits and hospitalizations.