National Asthma Control Program
At A Glance
CDC-Funded Asthma Activities by State and Type of Funding
"Much of what is known about controlling asthma is not being
applied. This is the challenge that we have taken on. CDC is supporting
asthma data tracking, interventions, and partnerships nationwide in
order to bridge this gap and to help people with asthma live
symptom-free."
Julie Louise Gerberding, MD, MPH
Director, Centers for Disease Control and Prevention
Asthma Control: Improving Quality of Life and Reducing Costs
Despite evidence that asthma death rates are leveling off and asthma
hospitalization rates are declining, asthma’s impact on health, quality
of life, and the economy remain substantial. Rates of severe asthma
continue to disproportionately affect poor, minority, inner-city
populations. For example, African Americans visit emergency departments,
are hospitalized, and die due to asthma at rates three times higher than
rates for white Americans.
The initial onset of asthma cannot yet be prevented or cured.
However, asthma can be controlled, and people who have asthma still can
lead quality, productive lives. Asthma can be controlled by following a
medical management plan and by avoiding contact with environmental
“triggers.” These environmental triggers include cockroaches, dust
mites, furry pets, mold, tobacco smoke, and certain chemicals.
Asthma’s Impact on the U. S. Population
In 2001, an estimated
- 31.3 million people had been diagnosed with asthma during their
lifetime
- 20.3 million people currently were diagnosed with asthma
- 12 million people experienced an asthma attack in the previous
year
In 2000, asthma accounted for
- 10.4 million outpatient visits
- 1.8 million emergency department visits
- 465,000 hospitalizations
- 4,487 deaths
Source:
CDC National Center for Health Statistics
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CDC’s National Asthma Control Program
CDC created the National Asthma Control Program in 1999. The program
supports the goals and objectives of Healthy People 2010 for
asthma and is based on the following three public health principles:
- Tracking: collecting and analyzing data on an ongoing basis
to understand the “who, what, and where” of asthma
- Interventions: ensuring that scientific information is
translated into public health practices and programs to reduce the
burden of asthma
- Partnerships: ensuring that all stakeholders have the
opportunity to be involved in developing, implementing, and evaluating
local asthma control programs
The goals of the program are to reduce the number of deaths,
hospitalizations, emergency department visits, school or work days
missed, and limitations on activity due to asthma.
With appropriations of $35.2 million in fiscal year 2002, CDC funded
11 asthma tracking projects, 48 asthma interventions, and 33 asthma
partnership projects under its National Asthma Control Program for
activities to be conducted in 2003. CDC also funded six urban school
districts, one state education agency, and six national nongovernment
organizations to support and address asthma control within a coordinated
school health program.
Major Data Collection Systems
CDC supports a number of major asthma data collection efforts, including
(1) collection of state-level adult asthma prevalence rates for detailed
subgroups in 50 states, 3 territories (Puerto Rico, Guam, and the Virgin
Islands), and Washington, D.C., through the Behavioral Risk Factor
Surveillance System Survey; (2) collection of data on days of restricted
activity, days in bed, days of work or school lost, physician visits,
and hospitalizations due to asthma through the National Health Interview
Survey; and (3) collection of in-depth state and local asthma data
through development and testing of a National Asthma Survey module in
Alabama, California, Illinois, New York, and Texas. See the “Data”
section at http://www.cdc.gov/asthma/default.htm
for more information.
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Asthma Control Program Highlights
Tracking
Enhanced surveillance of asthma deaths.
To understand the circumstances surrounding asthma deaths and determine
whether these deaths were preventable, CDC is funding state health
departments in California and Michigan to develop, implement, and
evaluate a rapid asthma death notification and investigation system.
Population-based models to establish surveillance for asthma
incidence in defined geographic areas.
To better estimate asthma rates, CDC is funding the Kaiser Foundation
Research Institute (Portland, Oregon) and the Miami-Dade County Health
Department (Miami, Florida) to develop models for identifying new asthma
cases.
Interventions
Controlling asthma in American cities.
To decrease asthma-related morbidity, CDC is funding grantees in seven
urban communities (New York City, Philadelphia, Chicago, Richmond,
Oakland, St. Louis, and Minneapolis/St. Paul) to use innovative
collaborative approaches to improve overall asthma management among
urban children up to 18 years of age.
Enabling the nation’s schools to prevent asthma attacks and
absences.
CDC will fund six urban school districts and one state education agency
in 2003 to develop or implement exemplary local education agency
policies and programs to reduce asthma episodes and related absences.
CDC also is funding six national nongovernment organizations (American
Lung Association, Asthma and Allergy Foundation of America, STARBRIGHT
Foundation, National Association of School Nurses, American Academy of
Pediatrics, and American Association of School Administrators) to
support and address asthma control within a coordinated school health
program. For updates on school-related asthma activities, go to
http://www.cdc.gov/healthyyouth/healthtopics/asthma.
Inner-city asthma intervention.
CDC is funding 23 sites in 15 states (Alabama, Arizona, California,
Florida, Illinois, Massachusetts, Minnesota, Missouri, Mississippi,
North Carolina, New Jersey, New York, Ohio, Oregon, and Texas) to
provide inner-city families with asthma education and individualized
asthma control plans.
Replication and implementation of scientifically proven asthma
interventions.
CDC is funding grantees to implement the following two scientifically
evaluated asthma interventions shown to decrease acute care visits,
decrease hospitalizations, and increase compliance with asthma care
plans: the Asthma and Allergy Foundation of America’s “Asthma Care
Training for Kids” ([ACT], grantees in Illinois [two sites], New York,
Pennsylvania, Texas, and Washington) and the American Lung Association’s
“Open Airways for Schools” ([OAS], grantees in California [two sites],
Colorado, Illinois, New Jersey [two sites], and New York). The goals for
ACT are to increase asthma control compliance behaviors and to decrease
emergency department visits and number of days spent in the hospital.
The goals for OAS are to improve school performance and self-management
behaviors and to decrease the number of asthma episodes.
Partnerships
Addressing asthma from a public health perspective.
CDC is funding state health departments in Colorado, Connecticut,
Georgia, Hawaii, Idaho, Indiana, Iowa, Maine, Maryland, Missouri,
Nebraska, New Hampshire, New Jersey, New Mexico, Oklahoma, Rhode Island,
Texas, Utah, Virginia, Vermont, Washington, West Virginia, Wisconsin,
and Washington, D.C., to develop asthma control plans that include
disease tracking, intervention, and occupational components. CDC also is
funding California, Illinois, Michigan, Minnesota, New York, and Oregon
to implement the states’ comprehensive asthma control plans.
National asthma health education enhancement program.
CDC is funding the Allergy and Asthma Network/Mothers of Asthmatics,
American Lung Association, and Asthma and Allergy Foundation of America
to conduct activities related to asthma education. These activities
range from identifying effective educational programs for adults that
can be adapted for nationwide use to educating children with asthma and
their families and caregivers.
Examples of CDC's National Asthma Control Partners
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State Activity Highlights
California
With support from CDC, the California Department of Health Services has
worked with leading asthma organizations, agencies, and public interest
groups throughout the state to develop an integrated plan (The
Strategic Plan for Asthma in California) to address the asthma
epidemic in California. A diverse advisory committee, consisting of
California asthma professionals, coalitions, local public health
agencies, educational agencies and schools, and health-care plans, is
guiding the plan’s implementation in the state. Major components of the
strategic plan include epidemiology and evaluation, public education,
asthma treatment and management, secondary prevention of asthma, and
policy. California will support and expand its asthma partnerships and
provide technical assistance to local coalitions and public health
departments in monitoring and reducing the asthma burden.
New York
In collaboration with several community health centers and after-school
programs, the Bronx Lebanon Hospital Center is implementing two asthma
interventions for children aged 8 to 12 who have persistent asthma
problems. Through the Asthma Care Training for Kids (ACT) intervention,
children and their families will be taught asthma-management skills that
can help reduce the frequency and severity of asthma episodes. Through
the Open Airways for School (OAS) intervention, children will be taught
to detect warning signs of and identify environmental factors that can
trigger an attack. The program has been shown to significantly increase
asthma management skills, reduce symptoms of asthma, and improve
academic performance. In 2003, 160 children and their parents are
expected to complete the ACT program and 160 children are expected to
complete the OAS program.
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Future Directions
With continued and increased funding, CDC will (1) work with state
and local health departments and other partners to improve asthma
tracking, (2) identify and develop population-based and individual
solutions for controlling asthma, (3) help more partner organizations
implement and evaluate programs to reduce the incidence and severity of
asthma, and (4) build capacity of educational agencies and national
nongovernment organizations to address asthma in schools.
For more information or additional copies of this document, please
contact:
Centers for Disease Control and Prevention
National Center for Environmental Health, MS F-52
4770 Buford Hwy, Atlanta, GA 30341
1-888-232-6789
EHHEinq@cdc.gov
http://www.cdc.gov/asthma/default.htm
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