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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
SUPPLEMENT ARTICLE

Status of Childhood Asthma in the United States, 1980–2007

Lara J. Akinbami, Jeanne E. Moorman, Paul L. Garbe and Edward J. Sondik
Pediatrics March 2009, 123 (Supplement 3) S131-S145; DOI: https://doi.org/10.1542/peds.2008-2233C
Lara J. Akinbami
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Jeanne E. Moorman
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Paul L. Garbe
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Edward J. Sondik
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  • FIGURE 1
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    FIGURE 1

    Asthma prevalence among children 0 to 17 years of age in the United States, in 1980–2007. The dashed line represents the optimal trend fitted by Joinpoint for 1980–1996 asthma period prevalence data. The optimal model included no joinpoints and yielded an estimated annual rate of change of 4.6% (statistically significant). The available data years for current asthma prevalence estimates (2001–2007) were insufficient for Joinpoint model fitting.

  • FIGURE 2
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    FIGURE 2

    Current asthma prevalence among children 0 to 17 years of age in the United States in 2003. The states were divided into approximate quartiles to construct categories of current asthma prevalence.

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    FIGURE 3

    Numbers of asthma-related ambulatory care visits per 1000 children 0 to 17 years of age in the United States in 1980–2006, according to site. The dashed line represents the optimal trend fitted by Joinpoint for 1992–2006 total ambulatory care visit rates. The optimal model included no joinpoints and yielded an estimated annual rate of change of 2.1% for the period 1992–2006 (statistically significant).

  • FIGURE 4
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    FIGURE 4

    Numbers of asthma-related ED visits per 10000 children 0 to 17 years of age in the United States in 1992–2006. The dashed line represents the optimal trend fitted by Joinpoint for 1992–2006. The optimal model included no joinpoints and yielded an estimated annual rate of change of −0.8% (statistically significant).

  • FIGURE 5
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    FIGURE 5

    Numbers of asthma-related hospitalizations per 10000 children 0 to 17 years of age in the United States in 1980–2006. The dashed line represents the optimal trend fitted by Joinpoint for 1980–2006. a The joinpoint year for the trend was 1991. The estimated annual rate of change for 1980–1991 was 2.9% (statistically significant). The estimated annual rate of change for 1991–2006 was −1.2% (not statistically significant).

  • FIGURE 6
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    FIGURE 6

    Numbers of asthma-related deaths per 1 million children 0 to 17 years of age in the United States in 1980–2005.1 Beginning with data year 1999, cause-of-death statistics published by the National Center for Health Statistics were classified according to the ICD-10. The comparability ratio for asthma between the ICD-9 and ICD-10 for children 0 to 17 years of age is 1.02. The dashed line represents the optimal trend fitted by Joinpoint for 1980–2005. a The joinpoint year for the overall trend from 1980–2005 was 1996. The estimated annual rate of change for 1980–1996 was 3.2% (statistically significant). The estimated annual rate of change for 1995–2004 was −3.9% (statistically significant). A separate trend analysis limited to death rates categorized with ICD-9 codes from 1980 to 1998 yielded an annual rate increase of 2.8% (data not shown). There were insufficient data available after 1998 to analyze separately trends in asthma-related death rates with ICD-10 codes.

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    FIGURE 7

    A, Relative risks for boys, compared with girls, for asthma prevalence and outcomes, determined by using population-based rates for 2004–2005. B, Results adjusted for asthma prevalence, showing relative risks for boys, compared with girls, for asthma prevalence and outcomes, determined by using at-risk approach-based rates for 2004–2005.

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    FIGURE 8

    A, Relative risks for asthma prevalence and adverse outcomes for non-Hispanic black and Hispanic children, compared with non-Hispanic white children (using population-based rates for 2004–2005). B, Results adjusted for asthma prevalence, showing relative risks for asthma prevalence and adverse outcomes for non-Hispanic black and Hispanic children, compared with non-Hispanic white children (using at-risk approach-based rates for 2003–2004). NH indicates non-Hispanic. a Estimate for Hispanic ethnicity was unreliable; b data on Hispanic ethnicity were not available. Comparisons were made between black and white children (reference) without regard to Hispanic ethnicity.

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    FIGURE 9

    A, Numbers of asthma-related hospitalizations and deaths per 1 million children 0 to 17 years of age, according to race. B, Numbers of asthma-related hospitalizations and deaths per 1 million children with current asthma, according to race. Because NHIS estimates for the numbers of children with current asthma are not available for the years before 2001, B includes only 2001–2005. B/W indicates black/white; hosp, hospital.

Tables

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    TABLE 1

    Asthma Prevalence, Health Care Use, and Mortality Rates in the United States, in 2004–2005, Among Children 0 to 17 Years of Age, According to Age Group and Gender

    Current Prevalence, (SE) %Ambulatory Care Visits, (SE) No. per 1000 ChildrenaED Visits, (SE) No. per 10 000 ChildrenHospital Discharges, (SE) No. per 10 000 ChildrenDeaths, (SE) No. per 1 Million Children
    0–4 y6.2 (0.3)112.8 (18.4)165.1 (18.9)45.4 (6.1)1.9 (0.2)
        Male7.4 (0.5)173.2 (32.0)203.4 (27.1)55.3 (7.6)2.5 (0.4)
        Female5.0 (0.4)50.0 (13.6)125.0 (21.3)35.1 (5.2)1.3 (0.3)
    5–10 y9.3 (0.4)89.2 (20.0)102.6 (12.3)26.5 (3.6)2.3 (0.2)
        Male11.1 (0.6)96.7 (21.4)108.6 (16.0)34.4 (5.2)2.7 (0.3)
        Female7.4 (0.5)81.2 (23.4)96.4 (16.6)18.2 (2.6)1.7 (0.3)
    11–17 y10.0 (0.4)73.4 (11.8)59.7 (7.7)9.2 (1.4)2.8 (0.2)
        Male11.1 (0.5)78.5 (14.0)52.1 (10.7)10.8 (1.9)3.6 (0.3)
        Female8.8 (0.5)68.2 (16.2)67.7 (11.6)7.5 (1.1)2.0 (0.3)
    Total8.7 (0.2)89.4 (13.0)102.3 (9.3)24.7 (3.2)2.4 (0.1)
    • ↵a Includes visits to physicians' offices and hospital outpatient departments.

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    TABLE 2

    At-Risk Analysis of Asthma-Related Health Care Use and Mortality Rates in the United States, in 2004–2005, Among Children 0 to 17 Years of Age With Current Asthma, According to Age Group and Gender

    Ambulatory Care Visits, (SE) No. per 1000 Children With Current AsthmaaED Visits, (SE) No. per 10 000 Children With Current AsthmaHospital Discharges, (SE) No. per 10 000 Children With Current AsthmaDeaths, (SE) No. per 1 Million Children With Current Asthma
    0–4 y1827 (314)2676 (340)736 (106)31 (4)
        Male2353 (464)2764 (415)751 (116)34 (5)
        Female1004 (290)2538 (489)712 (123)26 (6)
    5–10 y963 (221)1109 (143)286 (42)25 (3)
        Male879 (201)988 (157)313 (51)24 (3)
        Female1092 (324)1296 (243)244 (39)26 (4)
    11–17 y739 (122)604 (81)93 (15)29 (2)
        Male703 (130)471 (100)98 (15)33 (4)
        Female786 (197)783 (141)87 (14)23 (3)
    Total1029 (152)1183 (112)285 (38)28 (2)
    • ↵a Includes visits to physicians' offices and hospital outpatient departments.

    • View popup
    TABLE 3

    Asthma Prevalence, Health Care Use, and Mortality Rates in the United States, in 2004–2005, Among Children 0 to 17 Years of Age, According to Race and Ethnicity

    Current Prevalence, (SE) %Ambulatory Care Visits, (SE) No. per 1000 ChildrenaED Visits, (SE) No. per 10 000 ChildrenHospital Discharges, (SE) No. per 10 000 ChildrenDeaths, (SE) No. per 1 Million Children
    Total8.7 (0.2)89.4 (13.0)102.3 (9.3)24.7 (3.2)2.4 (0.1)
    Race
        Black12.8 (0.7)85.7 (21.5)274.1 (34.2)46.8 (8.3)9.0 (0.6)
        White7.9 (0.3)92.5 (14.4)75.6 (8.3)14.9 (2.6)1.3 (0.1)
        American Indian/Alaska Native9.9 (2.5)————
        Asian4.9 (0.8)————
    Race/ethnicity
        Hispanic7.8 (0.4)—120.1 (23.5)NA1.5 (0.2)
        Puerto Rican19.2 (2.1)NANANA—
        Mexican6.4 (0.4)NANANA1.3 (0.3)
        Non-Hispanic black12.7 (0.7)70.3 (16.4)263.7 (33.4)NA8.8 (0.6)
        Non-Hispanic white8.0 (0.3)86.3 (14.4)64.7 (8.0)NA1.2 (0.1)
    • NA indicates not available; —, estimate was unreliable.

    • ↵a Includes visits to physicians' offices and hospital outpatient departments.

    • View popup
    TABLE 4

    At-Risk Analysis of Asthma-Related Health Care Use and Mortality Rates in the United States, in 2003–2004, Among Children 0 to 17 Years of Age With Current Asthma, According to Race and Ethnicity

    Ambulatory Care Visits, Mean (SE), No. per 1000 Children With Current AsthmaaED Visits, Mean (SE), No. per 10 000 Children With Current AsthmaHospital Discharges, Mean (SE), No. per 10 000 Children With Current AsthmaDeaths, Mean (SE), No. per 1 Million Children With Current Asthma
    Total1029 (152)1183 (112)285 (38)28 (2)
    Race
        Black678 (174)2179 (301)372 (69)68 (6)
        White1162 (184)951 (108)187 (34)16 (1)
    Race/ethnicityb
        Hispanic—1606 (325)NA20 (3)
        MexicanNANANA21 (4)
        Non-Hispanic black552 (133)2084 (293)NA70 (7)
        Non-Hispanic white1062 (181)798 (103)NA14 (2)
    • NA indicates not available; —, estimate was unreliable.

    • ↵a Includes visits to physicians' offices and hospital outpatient departments.

    • ↵b Data for Puerto Rican children were either unavailable or unreliable.

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Status of Childhood Asthma in the United States, 1980–2007
Lara J. Akinbami, Jeanne E. Moorman, Paul L. Garbe, Edward J. Sondik
Pediatrics Mar 2009, 123 (Supplement 3) S131-S145; DOI: 10.1542/peds.2008-2233C

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Status of Childhood Asthma in the United States, 1980–2007
Lara J. Akinbami, Jeanne E. Moorman, Paul L. Garbe, Edward J. Sondik
Pediatrics Mar 2009, 123 (Supplement 3) S131-S145; DOI: 10.1542/peds.2008-2233C
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