The Center for Disease Control just released their National Surveillance of Asthma Report, with data from 2001 to 2010. We are losing ground to this disease and the statistics aren’t good.
What does the CDC report tell us? Here are a few chief observations, based on my perspective of working both in the field and at the policy-level, with certain at-risk asthma populations:
- The epidemic of asthma continues. The percentage of persons with asthma continued to rise in the ten-year period, increasing an average of 2.9% per year. To put it in perspective, in 2001, we could fill 290 NFL football stadiums, the size of CenturyLink field, with asthma patients. We can now fill 367 stadiums, each holding 70,000 people. If you are a person of color in those stadiums, you are 2-3 times more likely to end up in the emergency room. Although overall mortality rates from asthma declined, a black person is still more than twice as likely to die from the disease.
- The disparity of asthma continues. In black, Hispanic and native communities, the average increases were double that of white populations. New cases of asthma were being diagnosed at twice the rate (1.4% vs. 3.2%) in some of these at-risk populations. The race and ethnicity data illustrate that asthma continues to be, as I call it, a “marker of access” in our country. Rates continue to rise in those populations with the least access: access to primary health care, access to safe, hazard-free housing, and access to toxin-free ambient air.
- The reactive approach to asthma continues. Our principal public health response continues to be disease “control”. We rely on patient education, pharmacological control and trigger reduction as our three pillars. In theory, these evidence-based practices should have demonstrated better results. In practice, however, the number of persons with at least one asthma attack increased 2.6% per year from 11.0 million in 2003 to 13.9 million in 2010. More people in those 367 stadiums now experience annual asthma attacks, than they did ten years ago.
- While these controls may be effective for individual patients, from a population-based perspective, we are still missing the mark. Only a third of those surveyed (34%) reported receiving an asthma action plan. Only half (48%–51%) reported receiving advice on environmental control at home, school, or work. Only half (49%) of children and adults with persistent asthma use controller medications*
- The enormous household and societal-level costs to control asthma attacks – and the understandable urgency – continues to draw our resources and attention away from Primary Prevention – in which we find the mechanisms that induce disease onset. From the state and tribal perspective in which I work, I would argue that until we focus on primary prevention, we are chasing our tail – and frankly, not even catching it.
- The disease is epidemic in Washington State. More than a half million Washingtonians have asthma.
Nearly 120,000 of these people are children – one of the highest rates in the US. More than 5,000 people with asthma are hospitalized each year and 100 of those die from asthma.