Disparities persist in prevalence of asthma in US

Despite some improvements in asthma outcomes, data from a 2006 to 2018 report show that disparities persisted by demographic characteristics, economic level and geographic location.

According to the study, published in the Morbidity and Mortality Weekly Report Surveillance Summaries, asthma affects approximately 8% of the U.S. population. Among those aged younger than 18 years, asthma is more prevalent in families with low-income levels and among non-Hispanic Black children and those of Puerto Rican descent compared with non-Hispanic white children.

To compare asthma-related outcomes according to socioeconomic characteristics, Cynthia A. Pate, MPH, and colleagues from the CDC’s National Center for Environmental Health, analyzed 2006 to 2018 data from the National Health Interview Survey.

During the study period, asthma prevalence did not change significantly among all ages. However, there was a decrease in overall trend among children (annual percent change, –1.6).

By age groups, the prevalence of asthma was higher among boys than girls aged 0 to 17 years (9% vs. 7.1%) and higher among women than men aged 18 years and older (10% vs. 5.7%). Prevalence was lowest among children aged up to 4 years (4%) and highest among those aged 12 to 17 years (10.5%).

Among all ages, prevalence was higher among Black individuals (10.7%) and those of multiple races (13.1%) and lower among Asian (4.5%), Hispanic (6.5%) and white individuals (8%).

Asthma appeared more prevalent among families with incomes less than 100% of the federal poverty level (FPL; 11.4%) and among families with incomes between 100% and less than 250% of the FPL (8.3%) compared with those with incomes at or higher than 450% of the FPL (6.8%).

Asthma prevalence also differed by geographic location, with higher rates in the Northeast (8.9%) than in the South (7.6%) and the West (7.7%). The prevalence was also higher in small metropolitan statistical areas (MSAs) for all ages (8.4%) and for adults (8.3%) compared with large MSAs for all ages and adults (7.7% for both).

Prevalence of ED and urgent care center visits related to asthma appeared significantly higher in the South for all ages (14.2%) and for adults (12.6%) compared with the Northeast (all ages, 10.8%; adults, 8.8%) and the Midwest (all ages, 9.7%; adults, 7.9%). The percentages also were higher in large MSAs than in smaller or more rural areas (all ages, 13.1% vs. 8.7%; children, 20.1% vs. 12.2%).

The asthma-related mortality rate during this period was 10.8 per million among all ages, with adults having a mortality rate almost four times higher than children (13.2 vs. 2.7 per million). Asthma-related mortality rates also differed significantly between women and men (13 vs. 8.5 per million).

Asthma-related mortality rates were significantly higher among Black individuals (22.2 per million) and significantly lower among Asian individuals (7.9 per million) and Hispanic persons (5.9 per million) compared with white individuals (10 per million).

“Findings from this report can aid public health programs in directing resources and interventions to improve asthma-related health outcomes and health care use, developing strategic goals, and achieving the [Controlling Childhood Asthma and Reducing Emergencies (CCARE)] initiative to reduce childhood asthma hospitalizations and ED visits,” Pate and colleagues concluded.