District of Columbia

DATA FACT SHEET

ASTHMA IN OLDER ADULTS

Asthma is a chronic health condition that causes inflammation and swelling of the airways. Characteristic symptoms of asthma include: wheezing, coughing, difficulty breathing, and tightening of the chest. Asthma continues to be a public health concern in older adults. Some triggers of asthma symptoms are: pollen, dust, mold, cold air, viral infections, chemicals in the air, and cigarette smoke (including secondhand smoke). Asthma can be a life threatening illness, and so far there is no cure. Appropriate self care and medical treatment, including proper use of medications and environmental changes, can eliminate most of the activity limitations, asthma episodes or flare-ups, and urgent care costs associated with asthma.

ASTHMA PREVALENCE
Data on the proportion of older adults in the District of Columbia who have asthma at a specific point in time (prevalence) was calculated using data from a standardized questionnaire - the Behavioral Risk Factor Surveillance System (BRFSS) survey. Asthma prevalence was grouped into lifetime and current asthma. Lifetime asthma estimates the proportion of the population who answered yes to the question, Has a doctor ever told you that you have asthma? Current asthma is estimated as the proportion of the population who answered yes to the question, Do you still have asthma?
Figure 1: Asthma prevalence among older adults (55+ yrs) in the District of Columbia, 2005-2007
20 Lifetime 15 P erc en t (% ) 12 10 Current

Figure 2: Asthma prevalence among older adults (55+ yrs) by gender in the District of Columbia, 2007
20 Lifetime 15 P e rc e n t (% ) 15 12 10 8 5 8

12 8

12

Current

10

0 2005
Source: Behavioral Risk Factor Surveillance System (BRFSS)

0
2006 2007

Male
Source: Behavioral Risk Factor Surveillance System (BRFSS)

Female

Total

Lifetime Asthma: In 2007, about 12% of District residents 55 years or older had lifetime asthma. The rate of older adults who have lifetime asthma has remained the same from 2005 to 2007 (Figure 1). Current Asthma: In 2007, about 8% of District residents over the age of 54 years currently had asthma. The prevalence rate of asthma among older adults who report having asthma currently has not changed from 2005 to 2007 (Figure 1).

Lifetime Asthma: More District women over the age of 54 (15%) were reported to have lifetime asthma than men (8%) in 2007 (Figure 2). Current Asthma: Twice as many District women over the age of 54 (10 %) were reported as currently having asthma than men (5%) in 2007 (Figure 2).

Government of the District of Columbia Adrian M. Fenty, Mayor

Figure 3: Asthma prevalence among older adults (55+ yrs) by age-group in the District of Columbia, 2007
20 Lifetime 15 P e rc e n t (% ) 13 13 10 10 8 5 5 9 6 9 Current

older adults had current asthma as compared to the Hispanic population (Figure 4).
Figure 5: Asthma prevalence among older adults (55+ yrs) by Ward in the District of Columbia, 2007
25 22 20

Lifetime Current
12 9 8 7 5 13 12 10 10 7 8 9 8 12 16

P e rce n t (% )

15 10

0 55-64 65-74 75-84 85+

5 0
Source: Behavioral Risk Factor Surveillance System (BRFSS)

Lifetime Asthma: In 2007, District residents 55 to 74 years old had the highest lifetime asthma prevalence rate among the Districts older adult population (Figure. 3). Current Asthma: In 2007, among the Districts older adult population, residents 65 to 74 years old had the highest current asthma prevalence rate (9%) followed by residents 55 to 64 years old (8%) (Figure 3).
Figure 4: Asthma prevalence among older adults (55+ yrs) by race/ethnicity in the District of Columbia, 2007
20 Lifetime 15 P e rc e n t (% ) 13 12 8 7 5 6 4 Current 12

Ward
Source: Behavioral Risk Factor Surveillance System (BRFSS)

Lifetime Asthma: In 2007, older adults living in Ward 8 (22%) had the highest lifetime asthma prevalence rate followed by Ward 4 (16%). Ward 2 (8%) had the lowest lifetime asthma prevalence rate (Figure 5). Current Asthma: In 2007, older adults living in Ward 8 (12%) had the highest current asthma prevalence rate, followed by Ward 4 (10%) and Ward 1(9%). Older adults in Ward 2 (5%) had the lowest lifetime asthma prevalence rate (Figure 5).

Asthma Emergency Department Visits

7

10

Emergency department (ED) information below includes visits among older adults over the age of 54 years with diagnoses of asthma. The ED data presented below includes only District residents that visited hospital emergency departments in the District.
Figure 6: Asthma ED visit rate among older adults (55+ yrs) in the District of Columbia, 2005- 2007
180 160 R a te (p e r 1 0 ,0 0 0 ) 140 120 100 80 60 40 20 0 2005 2006 2007
Source: IMPACT DC *Rates w ere age-adjusted using the US 2000 Census population

0 White Black Hispanic Total

Source: Behavioral Risk Factor Surveillance System (BRFSS)

Lifetime Asthma: In 2007, about 13% of nonHispanic white, 12% of non-Hispanic black, and 6% of Hispanic older adults had asthma in their lifetime. The lifetime asthma prevalence for non-Hispanic black and white District older adults is double the lifetime asthma as compared to those in the Hispanic population (Figure 4). Current Asthma: In 2007, about 8% of nonHispanic black, 7% of non-Hispanic white and 4% of Hispanic older adults experienced current asthma. About twice as many non-Hispanic black and white

161 147 125

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In 2007, the ED visit rate for older adults (55 + years) living in the District was about 161 per 10,000 people (Figure 6). The asthma ED visit rate for older adults (55 + years) in the District increased by about twenty-nine (29%) from 2005 (125 per 10,000 people) to 2007 (161 per 10,000 people) (Figure 6).
Figure 7: Asthma ED visit rate among older adults (55+ yrs) by gender in the District of Columbia, 2007
250 200 R a te ( p e r 1 0 ,0 0 0 ) 150 116 100 50 0 Female Male Total
Source: IMPACT DC *Rates w ere age-adjusted using the US 2000 Census population

Figure 9: Asthma ED visit rate among older adults (55+ yrs) by zip code (with Ward boundaries overlaid) in the District of Columbia, 2007

4 3

1 2

5 7

193 161

Ward Boundaries Waterbodies Emercency Department Visit Rate (per 10,000) No Data 10 - 75 75 - 140 140 - 205 205 - 270 270 - 335

In 2007, the ED visit rate for asthma among the Districts older adult population was highest at the intersection of Wards 1, 2, 5, and 6 (Figure 9). The second highest asthma ED visit rates was seen in parts of Wards 1, 5, 6, 7 and 8 (Figure 9).

In the District, women (193 per 10,000 people) over the age of 54 years had approximately a 66% higher ED visit rate than their male counterparts (116 per 10,000 people) (Figure 7).
Figure 8: Asthma ED visit rate among older adults (55+ yrs) by age-group in the District of Columbia, 2007
300 250 R a te (p e r 1 0 ,0 0 0 ) 200 150 100 50 133 106 81 225

Asthma Hospitalization
Data are reported by local acute care hospitals in the District including one veterans hospital, but excluding all military hospital facilities. Hospital discharge data represent the number of inpatient hospitalizations, not the number of individuals hospitalized. A person can be hospitalized multiple times for the same condition. The information below represents hospitalizations for a diagnosis of asthma of older adults over the age of 54 years residing in the District.
Figure 10: Asthma hospitalization rate among older adults (55+ yrs) in the District of Columbia, 2002-2006
45 40 38 33 32 34 31

0 55-64 65-74 75-84 85+

Rate (per 10,000)
Source: IMPACT DC *Rates w ere age-adjusted using the US 2000 Census population

35 30 25 20 15 10 5 0

In 2007, the 55 to 64 year old population had the highest (225 per 10,000 people) ED visit rate among the entire older adult (55+ years) District population (Figure 8). The ED visit rate decreased with increasing age-group.

2002

2003

2004

2005

2006

Source: District of Columbia Hospital Association (DCHA) *Rates w ere age-adjusted using the US 2000 Census population

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In 2006, the inpatient asthma hospitalization rate due to asthma among adults over the age of 54 years was 34 per 10,000 people (Figure 10). The asthma hospitalization rate increased by 3% from 2002 (33 per 10,000 people) to 2006 (34 per 10,000 people) among District older adults (55+ years) (Figure 10).
Figure 11: Asthma hospitalization rate among older adults (55+ yrs) by gender and race in the District of Columbia, 2006
50 45 40 Rate (per 10,000) 35 30 25 20 15 10 5 0 Male Female White Black Total
Source: District of Columbia Hospital Association (DCHA) *Rates w ere age-adjusted using the US 2000 Census population

Figure 13: Asthma hospitalization rate among older adults (55+ yrs) by zip code (with Ward boundaries overlaid) in the District of Columbia, 2002-2006
W E

4 3 2
Ward Boundaries Waterbodies Hospitalization ate (per 10,000) No Data 30 - 100 100 - 170 170 - 240 240 - 310 310 - 380

5 6 7

40

42 34

25

In the years 2002 to 2006, the asthma hospitalization rate among the Districts older adult population (55+ years) was highest at the intersection of Wards 1, 2, 5 and 6 (Figure 13). The second highest asthma hospitalization rate among older adults was in parts of Ward 8 (Figure 13). The findings above confirm that in the District of Columbia asthma affects about one in twelve older adults. Non-Hispanic blacks experience current asthma prevalence at rates 12.5% and 50% higher than their non-Hispanic white and Hispanic older adult peers. Older adult women visit local EDs for treatment of asthma almost 40% more often than older men, and likewise about 38% more hospitalizations occur among older women than older men. Equally significant is the approximately 40% higher proportion of older adults between the ages of 55 and 64 who receive treatment at local EDs and hospitals as compared to persons in older age-groups.
FOR MORE INFORMATION CONTACT: DC Control Asthma Now (DC CAN) Community Health Administration, District of Columbia Department of Health, 825 North Capitol Street, NE, Third Floor Washington, DC 20002 202-442-5925 We gratefully acknowledge the Centers for Disease Control and Prevention, National Center for Environmental Health, Air Pollution, and Respiratory Health Branch for their continued support and funding to the District of Columbia Department of Health Asthma Program. This publication was supported by Cooperative Agreement Number U59EH32408-05 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

In 2006, the asthma hospitalization rate for District women (40 per 10,000 people) over the age of 54 was about 60% higher than the hospitalization rate for men (25 per 10,000 people) (Figure 11). In 2006, the asthma hospitalization rate for nonHispanic black older adults (55+ years) was about 6 times higher (42 per 10,000 people) than hospitalization among non-Hispanic white older adults (7 per 10,000 people) (Figure 11).
Figure 12: Asthma hospitalization rate among older adults (55+ yrs) by age-group in the District of Columbia, 2006
45 40 35 Rate (per 10,000) 30 25 20 15 10 5 0 55-64 65-74 75-84 85+
Source: District of Columbia Hospital Association (DCHA) *Rates w ere age-adjusted using the US 2000 Census population

36

36 32

21

In 2006, the asthma hospitalization rate among older adults was the highest for the 55 to 64 and 65 to 74 year old age-groups (36 per 10,000 people) population. The hospitalization rate decreased with increasing age (Figure 12).

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