Spotlight on Key Indicators: Asthma

Learn More About Asthma

Air Quality
Characteristics of Children with Special Needs
Access to Services for Children with Special Health Care Needs
Insurance Coverage for Children with Special Health Care Needs
Impact of Special Health Care Needs on Children & Families
Quality of Care for Children with Special Health Care Needs
Pupil Support Service Personnel
Health Care
Why This Topic Is Important
Asthma is one of the most common chronic diseases among children in the U.S. and a leading cause of hospitalizations and absences from school (1, 2). Asthma rates vary by region, demographics, the environment, physician diagnostic practices, and access to care. Although identifying the impact of independent risk factors for asthma is difficult, low-income and minority children are at a disproportionately high risk for severe symptoms, missed school days, and emergency room visits due to asthma (1, 2, 3).

Asthma sufferers often manage symptoms with medication, trigger avoidance, and regular medical monitoring (1, 2). However, children who face cost barriers to care and/or medication are less likely to have well controlled asthma than children with access to regular medical care and may repeatedly be absent from school when their asthma flares up (1, 2, 3).
For more information on asthma, see’s Research & Links section.

Sources for this narrative:

1.  U.S. Environmental Protection Agency. (2013). America’s children and the environment (3rd ed.). Retrieved from:

2.  California Environmental Health Tracking Program. (2015). Costs of environmental health conditions in California children. Public Health Institute. Retrieved from:

3.  Milet, M., et al. (2013). Asthma in California: A surveillance report. California Department of Public Health, Environmental Health Investigations. Retrieved from:
How Children Are Faring
In California, about 15% of children ages 1-17 have been diagnosed with asthma at some point in their lives, according to 2013-14 data. Among counties with data, estimates ranged from about 7% to 30% of children diagnosed with asthma. While asthma does not result in hospitalization for most children, 10.9 of every 10,000 children/youth ages 0-17 in California were hospitalized due to asthma in 2014, down from a 17-year high of 17.7 per 10,000 in 2000. Asthma hospitalization rates are highest for the youngest children, ages 0-4.
Policy Implications
While asthma can be debilitating, or even life-threatening, it usually is a controllable disease. Asthma can be triggered by environmental conditions, such as outdoor air pollution, tobacco smoke, and poor indoor air quality, among other triggers such as viral infections, animal dander, and exercise (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.

California Health and Safety Codes address most asthma causes and triggers and also have improved some aspects of health care (2). For example, regulations include increased health care coverage for asthma equipment, provision of asthma care by designated school personnel, second-hand smoke bans in public and work buildings, and codes preventing school placement near air/water pollution sources. In addition, the state implements air quality regulations such as burning prohibitions and vehicle idling emission reductions (3).

According to research and subject experts, policy options that could influence asthma rates, treatment, and health consequences include:
  • Ensuring that all children have adequate, accessible, and affordable health care and insurance coverage for effective prevention and treatment of asthma, which includes coverage for asthma medications and supplies, e.g., inhaler spacers (4)
  • Enforcing laws and regulations limiting vehicle emissions, agricultural practices that generate dust and particulates, and industrial practices that generate air pollution (1, 5)
  • Promoting school policies (including asthma education) that: improve indoor air quality; help staff, students, and their parents understand asthma management; make it easy for students to manage their asthma at school; and facilitate communication among parents, schools, and health care providers, e.g., shared records and use of evidence-based telemedicine approaches (1, 6)
  • Promoting community-wide, integrated interventions to decrease the burden of asthma on high-risk populations, including education and outreach, home visiting, and the reduction of asthma triggers in schools, child care centers, homes, and workplaces (1, 4)
  • 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 (4, 7)
For more policy ideas, see's Research & Links section or visit California Breathing. Also see the following topics on Hospitalizations and Air Quality.

Sources for this narrative:

1.  Milet, M., et al. (2013). Asthma in California: A surveillance report. California Department of Public Health, Environmental Health Investigations. Retrieved from:

2.  California Department of Public Health. (n.d.). California codes addressing asthma. Retrieved from:

3.  California Environmental Protection Agency, Air Resources Board. (2013). Heavy-duty vehicle idling emission reduction program. Retrieved from:

4.  California Department of Public Health. (2015). Strategic plan for asthma in California: 2015-2019. Retrieved from:

5.  McConnell, R., et al. (2010). Childhood incident asthma and traffic-related air pollution at home and school. Environmental Health Perspectives, 118(7), 1021-1026. Retrieved from:

6.  Wheeler, L., et al. (2010). Working with schools to improve pediatric asthma management. Pediatric Asthma, Allergy & Immunology, 22(4), 197-208. Retrieved from:

7.  Kit, B. K., et al. (2013). U.S. prevalence and trends in tobacco smoke exposure among children and adolescents with asthma. Pediatrics, 131(3), 407-414. Retrieved from:
Websites with Related Information
Key Reports
County/Regional Reports
More Data Sources For Asthma