Asthma in Ohio

Size of the Problem

·        Current prevalence estimates for the state of Ohio indicate that 10.3% of adults have been told by a doctor that they have asthma (872,153 adults)  - compared to 7.7% with diabetes, 5.4% who have experienced myocardial infarction and 2.5% who have experienced stroke

·        The National Health Interview Survey (2002) reports a prevalence rate for children aged 0-17 of 13%.  According to the USEPA, asthma is the most common long-term childhood disease, affecting 6.3 million children. Nearly one in 13 school-aged children have asthma, and the rate is rising more rapidly in preschool-aged children than in any other age group.  Approximately 4.2 million children had an asthma attack in the last year.

·        Health disparities are large.  Prevalence rates for black residents of Ohio are 44% higher than for white residents.  There is an inverse relationship between income and asthma.  Those making $15,000 or less were 64% more likely to have been told they have asthma than those making over $50,000 (BRFSS 2002)

·        Healthy People 2010 goals target reduction of hospitalization for asthma.  Ohio rates, in all age groups, exceed 2010 targets by at least 40%.  According to the CDC, asthma is the third-ranking cause of hospitalization among those younger than 15 years of age.

Seriousness of Problem

·        Asthma is the number one cause of school absenteeism due to chronic illness resulting in approximately 14 million missed school days and an estimated $957 million loss from caretakers time off work

·        BRFSS data for Ohio indicate that nearly 40% of adults who have asthma say that it has rendered them unable to work or carry out usual activities at some point during the 12 months prior to the interview

·        Asthma accounts for many nights of interrupted sleep, limitation of activity, and disruptions of family and care-giver routines. Asthma symptoms that are not severe enough to require a visit to an emergency room or to a physician can still be severe enough to prevent a person with asthma from living a fully active life.  For example, the Women &Asthma in America Study found that more than one in four women with asthma report having symptoms everyday in the past four weeks.

·        According to Ohio Hospital Association Data in 2001, total hospital charges for individuals with a primary diagnosis of asthma were $100,023,421.

Effectiveness of Interventions

Currently, there are no preventive measures or cure for asthma; however, people 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.   Prevention efforts, therefore, must focus on assuring adequate treatment according to National Asthma Education and Prevention Program (NAEPP) Guidelines and on controlling exposure.

·        NAEPP demonstrates that use of the standard guidelines improves symptoms scores, results in fewer courses of oral corticosteroids, and fewer urgent care visits or hospitalizations.  According to the most recent Asthma in America study, nine out of ten doctors say they are aware of the guidelines, approximately half (48%) say they follow the guidelines some of the time.  The Ohio asthma program focuses on activities that will increase physician and patient adherence to NAEPP guidelines.

·        The effectiveness of exposure limitation strategies in reducing exposures and asthma development or exacerbation has, in general, been inadequately studied.  CDC and the USEPA have recommended the promotion of exposure limitation strategies as a prevention strategy.  The Indoor Environments Program promotes and supports the implementation of prevention and control of environmental exposures in homes, schools, and work places.

·        Because resources are limited within the health department to address this issue, mobilization of partnerships continues to be a primary focus of activity.  The Ohio Asthma Coalition met in general session for the first time in 2003 and has just completed The Ohio Statewide Asthma Plan.  The plan focuses on areas for intervention and was developed and will be implemented by over 40 organizations and agencies throughout the state.

*Information provided by the Ohio Department of Health, Ohio Surveillance System for Asthma, part of the Asthma Program.