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AsthmaAsthma is a common and costly health condition. More than 30 million people in the United States have asthma. More women than men suffer from asthma and have a much higher death rate. |
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Every year, asthma is responsible for about:
The increase in the numbers of men, women, and children with asthma is of great concern. The number of people with asthma increased by 102 percent between 1979–1980 and 1993–1994. What Is Asthma? Asthma is a chronic respiratory disease characterized by episodes or attacks of inflammation and narrowing of small airways in response to asthma “triggers.” Asthma attacks can vary from mild to life threatening. Asthma attacks can involve:
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Many factors can trigger an asthma attack, including:
Although no cure exists for asthma, these four management strategies are essential in controlling the disease: |
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Asthma: A Women's Issue Baseline data for all five of the Healthy People 2010 asthma objectives targeted for women support the statement that asthma is a women’s health issue. And, it’s an issue for women of color. Although asthma is a problem among all races, blacks have more asthma attacks and are more likely than whites to be hospitalized for asthma attacks and to die from asthma. Age differences are also part of the asthma problem. The asthma death rate for women aged 35 to 64 years is 22.3 per million, compared to 13.0 for men. The difference becomes more dramatic for women aged 65 years and older: 99.1 per million compared to 68.1 per million for men. When death rates are examined by age, race and |
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ethnicity, the 130.4 per million rate for African American adults aged 65 years and older is considerably higher than that for white adults aged 65 years and older. The pattern of disparities by gender and race/ethnicity continues with the objectives for reducing hospitalizations for asthma, hospital emergency department (ED) visits or asthma, and activity limitations among persons with asthma. The death, hospitalization, and ED-visit rates for nonwhites are more than twice those for whites.2 Compounding the disparities is the economic burden of asthma. Socioeconomic status, particularly poverty, appears to be an important contributing factor to asthma illness, disability, and death. Geography seems to have an influence on asthma death rates, as shown in the map Asthma Death Rates for Women by State. The highest rates, 2.8 and 2.7 per 100,000 females, are reported for South Dakota and Utah. The national rate of deaths for women of all ages is 1.8 per 100,000 population for 1997–2001. The rates for females in specific age groups are:
Asthma is not just a gender issue. It’s also a mother’s issue: Childhood asthma is considered an epidemic:
Access to and quality of health care are factors in asthma management. Women and African Americans have higher asthma death rates. Even among patients with health insurance, disparities in asthma care for African Americans compared with whites exist and may contribute to race disparities in outcomes. Of adults who presented to the emergency department with acute asthma, women were almost twice as common as men. Although men received less outpatient care and had worse pulmonary function, women were more likely to be admitted to the hospital and to report an ongoing exacerbation at follow up. Further studies are needed to better understand the complex relationship between gender and acute asthma.4
Reducing the Problem of Asthma
The Steps initiative focuses on reducing
the complications of asthma in the
Cost of AsthmaIn 1998, asthma in the United States accounted for an estimated $12.7 billion annually.6 Direct medical expenditures accounted for most of the costs, with medications the single largest cost component. Indirect costs, especially lost work days, also represented an important social effect. According to a study reported in 2003, the estimate of total per-person annual costs of asthma averaged $4,912, with direct and indirect costs accounting for $3,180 (65 percent) and $1,732 (35 percent), respectively. The largest components within direct costs were:
Within indirect costs, total cessation of work accounted for $1,062 (61 percent), and the loss of entire work days among those accounted for another $486 (28 percent). Total per-person costs were $2,646, $4,530, and $12,813 for persons self-reporting mild, moderate, and severe asthma, respectively.7
1 U.S. Department of Health and Human Services. Action Against Asthma: A Strategic Plan. 2000. 2 Mannino, D.M.; Homa, D.M.; Pertowski C.A.; et al. Surveillance for asthma—United States, 1960–1995. Morbidity and Mortality Weekly Report CDC Surveillance Summaries 47(1)1-27, 1998. 3 Centers for Disease Control and Prevention (CDC). Asthma's Impact on Children and Adolescents. 4 Sign, A.K.; Cydulka, R.K.; Stahmer, S.A.; et al., for the Multicenter Asthma Research Collaboration Investigators. Sex differences among adults presenting to the emergency department with acute asthma. Archives of Internal Medicine 159:1237-1243, 1999. 5 Camargo, C.A., Jr.; Weiss, S.T.; Zhang, S.; Willett, W.C.; Speizer, F.E. Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Archives of Internal Medicine 159: 2582-2588, 1999.
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Weiss, K.B., and Sullivan, S.D. The health economics of asthma and
rhinitis. I. Assessing the economic impact. Journal of Allergy
and Clinical Immunology |
Last updated June 2004
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