Summary: Asthma
Learn More About Asthma
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- Asthma
- Air Quality
- Characteristics of Children with Special Needs
- Access to Services for Children with Special Needs
- Pupil Support Services
- Impacts of Special Health Care Needs on Children and Families
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- School Days Missed Among Children with Special Health Care Needs (California & U.S. Only)
- Repeated Grades in School, by Special Needs Status (California & U.S. Only)
- Children Whose Parents Feel Aggravation from Parenting, by Special Needs Status (California & U.S. Only)
- Children with Special Health Care Needs Whose Family Members Avoid Changing Jobs to Maintain Health Insurance (California & U.S. Only)
- Children with Special Health Care Needs Whose Health Impacts Family Members' Employment (California & U.S. Only)
- Quality of Care for Children with Special Health Care Needs
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- Adequacy of Health Insurance Coverage, by Special Health Care Needs Status (California & U.S. Only)
- Consistency of Health Insurance Coverage, by Special Health Care Needs Status (California & U.S. Only)
- Receipt of Care Within a Medical Home, by Special Health Care Needs Status (California & U.S. Only)
- Receipt of Family-Centered Care, by Special Health Care Needs Status (California & U.S. Only)
- Receipt of Needed Care Coordination, by Special Health Care Needs Status (California & U.S. Only)
- School Attendance and Discipline
- Health Care
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- Health Insurance Coverage, by Type and Age Group
- Health Insurance Coverage Status, by Race/Ethnicity
- Medicaid (Medi-Cal) or Children's Health Insurance Program (CHIP) Coverage
- Medicaid (Medi-Cal) or CHIP Coverage, by Age Group (California & U.S. Only)
- Medicaid (Medi-Cal) and CHIP Yearly Enrollment (California & U.S. Only)
- Medi-Cal Average Monthly Enrollment
- Uninsured at Any Point in Past Year
- Medical Care Delayed or Forgone in Past Year
- Length of Time Since Teen's Last Check-Up
- Usual Source of Health Care
- School Health Centers
- School Provides Adequate Health Services (Staff Reported)
- Hospital Use
- Why This Topic Is Important
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Asthma is one of the most common chronic diseases among children in the U.S. and a leading cause of pediatric hospitalization (1). It also is the top reason for missed school days, accounting for more than 5.2 million absences annually (1, 2). Asthma affects around 6 million children nationwide, at an average annual health care cost of more than $1,700 per child (2).
Asthma rates vary by region, demographics, environment, physician diagnostic practices, and access to care. Although identifying the impact of independent risk factors for asthma is difficult, children of color and those from low-income families are at disproportionately high risk for severe symptoms, missed school days, and hospital visits due to asthma (1, 3, 4). In particular, African American/black and Puerto Rican children experience a greater asthma burden compared with white children in the U.S. (1).
Asthma can be life-threatening when it is not managed properly. The CDC estimates that approximately 40% of children with asthma do not have their disease under control (5). Symptoms can be managed with regular medical monitoring and personalized action plans that help children use medicine as prescribed and to avoid asthma triggers (5, 6). However, children who face difficulty accessing quality health care are less likely to have well-controlled asthma (4, 5).For more information, see kidsdata.org’s Research & Links section.
Sources for this narrative:
1. Rozwadowski, F. M., et al. (2019). Assessing indoor environmental control practices by race/ethnicity among children with asthma in 14 U.S. states and Puerto Rico, 2013–2014. Preventing Chronic Disease, 16, 190199. Retrieved from: https://www.cdc.gov/pcd/issues/2019/19_0199.htm
2. Nurmagambetov, T., et al. (2018). The economic burden of asthma in the United States, 2008–2013. Annals of the American Thoracic Society, 15(3), 348-356. Retrieved from: https://www.atsjournals.org/doi/10.1513/AnnalsATS.201703-259OC
3. Assari, S., & Moghani Lankarani, M. (2018). Poverty status and childhood asthma in white and black families: National Survey of Children's Health. Healthcare, 6(2), 62. Retrieved from: https://www.mdpi.com/2227-9032/6/2/62/htm
4. Johnson, S. B., et al. (2019). Asthma and attendance in urban schools. Preventing Chronic Disease, 16, 190074. Retrieved from: https://www.cdc.gov/pcd/issues/2019/19_0074.htm
5. Hsu, J., et al. (2018). EXHALE: A technical package to control asthma. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/asthma/pdfs/EXHALE_technical_package-508.pdf
6. CDC Vital Signs. (2018). Asthma in children: Working together to get it under control. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/vitalsigns/childhood-asthma
- How Children Are Faring
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In 2019-2020, an estimated 12% of California children ages 1-17 had been diagnosed with asthma at some point in their lives, down from 16% in 2005. While asthma does not result in hospitalization for most children, there were 7,670 hospitalizations for asthma among children ages 0-17 statewide in 2019, a rate of 8.3 hospitalizations per 10,000 children. Rates of asthma hospitalization are higher for children ages 0-4 (14.8 hospitalizations per 10,000 in 2019) than for older children ages 5-17 (6 per 10,000 in 2019). Across counties with data, 2019 asthma hospitalization rates among young children ages 0-4 ranged from fewer than 5 per 10,000 to more than 35 per 10,000.
- Policy Implications
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Asthma is major public health problem in the U.S., affecting an estimated 6.1 million children and 16.5 million adults, at an annual cost of more than $80 billion (1, 2). It is a leading cause of childhood hospitalizations and missed school days, with children of color—particularly African American/black children—and those from low-income families disproportionately affected by the disease (2, 3, 4). While asthma can be debilitating, even life-threatening, it usually is controllable (5). Asthma can be triggered by environmental conditions such as outdoor air pollution, tobacco smoke, and poor indoor air quality, as well as by other causes such as viral infections, exercise, and stress (2, 5). State, local, and school policies that reduce asthma triggers and that facilitate effective management and treatment of asthma can have positive effects on controlling the disease (2, 5). Effective asthma control strategies also require collaboration and commitment across multiple sectors (e.g., health care, public health, education, social services, community organizations, etc.) focused on multiple levels, including individuals, families, communities, providers, and systems (2, 5).
Policy and practice options that could influence asthma rates, management, and disparities include:- Ensuring that all children have adequate, accessible, and affordable health care and insurance coverage for effective prevention and treatment of asthma, including coverage for asthma medications and supplies; as part of this, ensuring that health care providers deliver coordinated care and adhere to guidelines-based management practices (2, 5)
- Enforcing and strengthening laws and regulations that limit air pollution from vehicles, agricultural and industrial practices, and other sources; also, promoting clean diesel school buses and reducing student exposure to exhaust (2, 5)
- Strengthening school policies to improve indoor air quality, facilitate communication and record sharing among families, schools, and health care providers, and educate students, staff, and parents on asthma care—including asthma self-management education (5)
- Promoting integrated, community-wide interventions that decrease the burden of asthma on populations at highest risk, including outreach and education, home visiting, and reduction of asthma triggers in homes, schools, child care centers, and workplaces (5)
- Advancing policies that go beyond poverty reduction to address structural and environmental factors associated with asthma and disproportionately experienced by some groups, such as African American/black families (4)
- Funding local and state tobacco control efforts to reduce secondhand smoke exposure, particularly in multi-unit housing settings, restrict access to cigarettes, and increase the availability and use of smoking cessation programs (5, 6)
- Promoting effective strategies to decrease exposure to wildfire smoke in vulnerable communities, such as providing cleaner air shelters and public education on wildfire preparedness and appropriate use of air conditioners and filters (7)
For more information, see kidsdata.org’s Research & Links section or visit California Breathing. Also see the following topics on kidsdata.org: Hospital Use and Air Quality.
Sources for this narrative:
1. Nurmagambetov, T., et al. (2018). The economic burden of asthma in the United States, 2008–2013. Annals of the American Thoracic Society, 15(3), 348-356. Retrieved from: https://www.atsjournals.org/doi/10.1513/AnnalsATS.201703-259OC
2. Patel, S. J., & Teach, S. J. (2019). Asthma. Pediatrics in Review, 40(11), 549-567. Retrieved from: https://publications.aap.org/pediatricsinreview/article-abstract/40/11/549/35239/Asthma
3. Johnson, S. B., et al. (2019). Asthma and attendance in urban schools. Preventing Chronic Disease, 16, 190074. Retrieved from: https://www.cdc.gov/pcd/issues/2019/19_0074.htm
4. Assari, S., & Moghani Lankarani, M. (2018). Poverty status and childhood asthma in white and black families: National Survey of Children's Health. Healthcare, 6(2), 62. Retrieved from: https://www.mdpi.com/2227-9032/6/2/62/htm
5. Hsu, J., et al. (2018). EXHALE: A technical package to control asthma. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/asthma/pdfs/EXHALE_technical_package-508.pdf
6. Vuong, T. D., et al. (2019). California tobacco facts and figures 2019. California Department of Public Health. Retrieved from: https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/ResearchandEvaluation/FactsandFigures/CATobaccoFactsandFigures2019.pdf
7. Stone, S. L., et al. (2019). Wildfire smoke: A guide for public health officials. California Air Resources Board, et al. Retrieved from: https://www.airnow.gov/wildfire-smoke-guide-publications - Research & Links
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- Websites with Related Information
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- AsthmaCommunityNetwork.org
- California Air Resources Board: Asthma and Air Pollution
- California Breathing. California Dept. of Public Health.
- Centers for Disease Control and Prevention: Asthma
- MedlinePlus: Asthma in Children. U.S. National Library of Medicine.
- Regional Asthma Management and Prevention. Public Health Institute.
- State of the Air. American Lung Association.
- Tracking California: Asthma
- Key Reports and Research
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- Air Pollution and Family Related Determinants of Asthma Onset and Persistent Wheezing in Children: Nationwide Case-Control Study. (2020). BMJ. Holst, G. J., et al.
- Assessing Indoor Environmental Control Practices by Race/Ethnicity Among Children with Asthma in 14 U.S. States and Puerto Rico, 2013–2014. (2019). Preventing Chronic Disease. Rozwadowski, F. M., et al.
- Association of Changes in Air Quality with Incident Asthma in Children in California, 1993–2014. (2019). JAMA. Garcia, E., et al.
- Asthma and Academic Performance in Urban Children. (2019). Annals of Allergy, Asthma and Immunology. Koinis-Mitchell, D., et al.
- Asthma and Attendance in Urban Schools. (2019). Preventing Chronic Disease. Johnson, S. B., et al.
- Asthma Prevalence in California: A Surveillance Report. (2017). California Dept. of Public Health. Milet, M.
- Estimated Prevalence of Asthma in U.S. Children with Developmental Disabilities. (2020). JAMA Network Open. Xie, L., et al.
- EXHALE: A Technical Package to Control Asthma. (2018). Centers for Disease Control and Prevention. Hsu, J., et al.
- Poverty Status and Childhood Asthma in White and Black Families: National Survey of Children's Health. (2018). Healthcare. Assari, S., & Moghani Lankarani, M.
- Secondhand Smoke Exposure and Asthma Outcomes Among African-American and Latino Children with Asthma. (2018). Thorax. Neophytou, A. M., et al.
- Strategies for Addressing Asthma in Schools. (2017). Centers for Disease Control and Prevention.
- The Economic Burden of Asthma in the United States, 2008–2013. (2018). Annals of the American Thoracic Society. Nurmagambetov, T., et al.
- County/Regional Reports
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- Community Health Improvement Plan for Los Angeles County. Los Angeles County Dept. of Public Health.
- Key Indicators of Health by Service Planning Area. (2017). Los Angeles County Dept. of Public Health.
- San Mateo County All Together Better. San Mateo County Health.
- More Data Sources For Asthma
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- America’s Children and the Environment. U.S. Environmental Protection Agency.
- Asthma Surveillance Data. Centers for Disease Control and Prevention.
- California Health and Human Services Open Data Portal. California Health and Human Services Agency.
- California Health Interview Survey. UCLA Center for Health Policy Research.
- County Asthma Dashboard. California Breathing.
- Health, United States – Data Finder. National Center for Health Statistics.
- National Environmental Public Health Tracking Network. Centers for Disease Control and Prevention.
- Tracking California: Asthma Data Query
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