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

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.

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).

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).

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).

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.

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.

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.