Asthma’s Impact on Children
And Adolescents
Asthma is a major
public health problem of increasing concern in the United States. From
1980 to 1996, asthma prevalence among children increased by an average
of 4.3% per year, from 3.6% to 6.2%. Low-income populations, minorities,
and children living in inner cities experience disproportionately higher
morbidity and mortality due to asthma. Asthma’s effects on children and
adolescents include the following:
- Asthma accounts
for 14 million lost days of school missed annually.
- Asthma is the
third-ranking cause of hospitalization among those younger than 15
years of age.
- The number of
children dying from asthma increased almost threefold from 93 in 1979
to 266 in 1996.
- The estimated cost
of treating asthma in those younger than 18 years of age is $3.2
billion per year.
Currently, there are
no preventive measures or cure for asthma; however, children and
adolescents who have asthma can still lead quality, productive lives if
they control their asthma. Asthma can be controlled by taking medication
and by avoiding contact with environmental "triggers" for asthma.
Environmental triggers include cockroaches, dust mites, furry pets,
mold, tobacco smoke, and certain chemicals.
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CDC Asthma Control
Programs And Activities
The Centers for
Disease Control and Prevention (CDC) conducts a number of child- and
adolescent-related asthma control programs and activities throughout
many of its centers, institutes, and offices. Following are examples of
some major ongoing efforts.
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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
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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.
All of the following
National Asthma Control Program projects include an emphasis on children
and adolescents:
- 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.
- 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.
- 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.
- 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.
- 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.
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School Health
CDC also has a
program that focuses specifically on improving asthma management in
schools and increasing the number of asthma-friendly schools nationwide.
Three strategies for accomplishing this are:
-
Data collection
-
Science-based guidance
-
Support for State and Local Education Agencies and National
Non-Governmental Organizations (NGOs)
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- Data
Collection:
CDC funds the inclusion of school asthma management questions in the
National Youth Risk Behavior Survey (YRBS), School Health Education
Profiles (SHEP), and the School Health Policies and Programs Study
(SHPPS).
- Science-Based
Guidance:
The CDC document "Strategies for Addressing Asthma Within a
Coordinated School Health Program" provides a concise list of
strategies
with accompanying actions for schools to take to help students manage
asthma through a coordinated approach.
- Support for
State and Local Education Agencies and National Non-Governmental
Organizations:
Since 1999, with funding of $3.4 million in fiscal year 2003, CDC has
funded demonstration school asthma management projects at 13 local
school districts and one state education agency, and has funded 11
national non-governmental organizations to develop materials and
deliver trainings on school-based asthma management for key target
audiences.
CDC is currently funding seven urban school districts and one state
education agency: Albuquerque, Baltimore, Charlotte, Detroit, Los
Angeles, Memphis, Philadelphia, and Oregon to implement strategies to
reduce asthma-related illnesses and absences.
CDC is currently funding six national non-governmental organizations:
American Academy of Pediatrics, American Association of School
Administrators, American Lung Association, Asthma and Allergy
Foundation of America, National Association of School Nurses, and
STARBRIGHT Foundation to develop materials and deliver trainings on
school-based asthma management for key target audiences.
CDC's Division of
Adolescent and School Health (DASH) works with schools nationwide to
help students manage their asthma by making schools "asthma-friendly,"
by supporting staff and students with asthma, adopting asthma-friendly
policies and procedures, coordinating services to serve students with
asthma, and providing asthma education for students and staff. For a
summary of DASH's efforts please go to:
http://www.cdc.gov/nccdphp/dash/asthma.htm.
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Major Asthma Data
Tracking Systems
CDC supports the
collection of data on self-reported lifetime and current asthma
prevalence data for adults through the state-based
Behavioral Risk Factor Surveillance System
(BRFSS). CDC also collects data on asthma prevalence, mortality, and
health care use through various data tracking systems. For a summary of
and access to CDC’s asthma tracking data, see the "Data" section at
http://www.cdc.gov/nceh/airpollution/
asthma/default.htm
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Other Organizations
Offering Child- and Adolescent-Related Asthma Information
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