Asthma is a chronic respiratory condition that is increasing in children throughout the country. On kidsdata.org, asthma is measured by the percentage of children ages 1-17 whose parents report that their child has been diagnosed with asthma; and the number and rate of asthma hospitalizations per 10,000 children ages 0-4, 5-17, 0-17, and for all ages (children and adults). Asthma hospitalization rates reflect the most severe episodes; most asthmatic children never need to be hospitalized.
Asthma is the most common chronic disease among children in the U.S. and a leading cause of absences from school. Asthma rates are particularly high among homeless children and those in crowded, inner-city environments. However, incidence also is on the rise generally, with children under age 5 experiencing the highest rates of increase. The reasons for the increasing prevalence are not well understood, although environmental toxins, air pollution, and secondhand smoke are considered contributing factors.
Asthma rates vary by local geographic areas depending on many factors, such as: demographics, socioeconomics, the environment, physician diagnostic practices, and access to care.
Asthma often can be managed with medication and regular medical monitoring. However, children with asthma may experience repeated absences from school when their asthma flares up. Children without access to regular medical care are more likely to suffer from serious episodes that may result in trips to the emergency room and even hospitalization.
See kidsdata.org's Research & Links section for more information about this topic.
While asthma can be debilitating, or even life-threatening, it often is a controllable disease. Asthma can be triggered by environmental conditions, such as outdoor air pollution, tobacco smoke, and poor indoor air quality (1). State, local, and school policies that reduce asthma causes and triggers, and that facilitate effective management and treatment of asthma, can have a beneficial effect on asthma rates and health impacts.
According to research and subject experts, policy options that could influence asthma rates, health consequences, and treatment include:
- Ensuring that all children have adequate, accessible, and affordable health care and pharmacy benefits to promote prevention and treatment of asthma (2)
- Enforcing laws and regulations limiting vehicle emissions, agricultural practices that generate dust and particulates, and industrial practices that generate air pollution (3)
- Ensuring that schools have good indoor air quality, and promoting asthma-friendly policies (including asthma education) that help school staff, parents, and students understand asthma management, make it easy for students to manage their asthma at school, and facilitate communication between parents, schools, and health care providers, e.g. evidence-based telemedicine approaches (4)
- Promoting community-wide, integrated interventions to decrease the burden of asthma on high-risk populations; this includes strategies to improve health insurance coverage of the uninsured and underinsured, education and outreach, home visiting; and reduction of asthma triggers in schools, child care centers, homes, and workplaces (2)
- Promoting and funding tobacco control efforts, including restricting access to cigarettes, increasing availability and use of smoking cessation programs, and limiting smoking in multi-unit housing, as smoking and exposure to second-hand smoke harms lung function and can increase asthmatic symptoms (2, 5, 6, 7)
For more policy ideas about asthma, see kidsdata.org's Research & Links section or California Breathing. Also see the topics Hospitalizations and Environmental Health on kidsdata.org.
Sources for this narrative:
- California Department of Health Services. (2007). The Burden of Asthma in California: A Surveillance Report. http://www.californiabreathing.org/phocadownload/asthmaburdenreport.pdf
- California Department of Public Health. (2008). Strategic Plan for Asthma in California (2008-2012). http://www.cdph.ca.gov/programs/caphi/Documents/AsthmaStrategicPlan.5-5-08.pdf
- Salam, et al. (2008). Recent Evidence for Adverse Effects of Residential Proximity to Traffic Sources on Asthma. (Current Opinion in Pulmonary Medicine). http://sunscreamer.com/publiccomment/Documents/salam%20mt%20traffic%20asthma%20pulm%20opin%202008.pdf
- Wheeler, et al. (2006). Managing Asthma in Schools: Lessons Learned and Recommendations. Journal of School Health, 76(6), 341-44. http://www.ashaweb.org/files/public/JOSH_806/Wheelerrecomendations_josh766.pdf
- U.S. Department of Health and Human Services. (2006). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. http://www.surgeongeneral.gov/library/secondhandsmoke/report/index.html
- Gold, et al. (1996). Effects of Cigarette Smoking on Lung Function in Adolescent Boys and Girls. New England Journal of Medicine, 335(13), 931-937. http://www.nejm.org/doi/full/10.1056/NEJM199609263351304
- Centers for Disease Control and Prevention. (2007). Best Practices for Comprehensive Tobacco Control Programs. http://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2007/BestPractices_Complete.pdf
In California, about 14% of children ages 1-17 had been diagnosed with asthma in 2009. At the county/regional level, estimates ranged from about 8% to 31% of children diagnosed with asthma in 2009. In California, the asthma hospitalization rate for children ages 0-17 declined from 16.2 per 10,000 in 1998 to 10.3 in 2008, but rose to 11.7 in 2009. Asthma hospitalization rates generally are higher for the youngest children, ages 0-4.