District of Columbia

DATA FACT SHEET

ASTHMA IN CHILDREN

Asthmaistheleading seriouschronicillnessofchildrenintheU.S.Asthma isachronichealthconditionthatcausesinflammationandswellingofthe airways.Characteristicsymptomsofasthmainclude:wheezing,coughing, difficultybreathing,andtighteningofthechest.Sometriggersofasthma symptomsare:pollen,dust,mold,coldair,viralinfections,chemicalsintheair, andcigarettesmoke(includingsecondhandsmoke). Asthmacanbealifethreateningillness,andsofarthereisnocure.Appropriate self care and medical treatment, including proper use of medications and environmentalchanges,caneliminatemostoftheactivitylimitations,asthma episodesorflareups,andurgentcarecostsassociatedwithasthma.

ASTHMA PREVALENCE
Data on the proportion of District children who have asthma at a specific point in time (prevalence) was calculatedusingdatafromastandardizedquestionnaire theBehavioralRiskFactorSurveillanceSystem(BRFSS) survey.Asthmaprevalencewasgroupedintolifetimeand currentasthma.Lifetimeasthmaestimatestheproportion ofthepopulationwhoansweredyestothequestion, Hasadoctor,nurseorotherhealthprofessionaleversaid thatthechildhasasthma?Currentasthmaisestimated bytheproportionofthepopulationwhoansweredyes tothequestion,Doesthechildstillhaveasthma?
Figure 1: Asthma prevalence among children (0-17 yrs) in the District of Columbia, 2005-2007
30 Lifetime 25 P e rc e n t (% ) 20 15 15 10 5 0 2005
Source: Behavioral Risk Factor Surveillance System (BRFSS)

increased by about 27% from 2005 to 2007 among the Districtschildren(Figure1). Current Asthma: In 2007, about 15% of District childrenunderage18yearswerereportedtohavecurrent asthma. The prevalence rate of current asthma among childrenincreasedbyabout36%from2005to2007 (Figure1).
Figure 2: Asthma prevalence among children (0-17 yrs) by gender in the District of Columbia, 2007
30 25 P e rc e n t (% ) 20 15 10 5 0 Male Female Total
Source: Behavioral Risk Factor Surveillance System (BRFSS)

Lifetime 22 17 17 14 Current 19 15

Current 19 14 11 19 15

2006

2007

Lifetime Asthma: More District boys (22%) were reportedtohavelifetimeasthmathangirls(17%)in2007 (Figure2). Current Asthma: Districtboysexperiencedahigher currentprevalenceofasthma(17%)ascomparedtogirls (14%)(Figure2).

Lifetime Asthma: In 2007, about 19% of District children under age 18 experienced asthma sometime duringtheirlife.Therateoflifetimeasthmainchildren

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

Figure 3: Asthma prevalence among children (0-17 yrs) by age-group in the District of Columbia, 2007
30 25 P erc ent (% ) 20 15 10 18 15 24 18 19 16 14 11 Lifetime Current

childrenhadcurrentasthmaascomparedtononHispanic whitechildren(Figure4).
Figure 5: Asthma prevalence among children (0-17 yrs) by Ward in the District of Columbia, 2007
40 35 30 Lifetime Current
25 26 26 22 17 13 10 7 7 13 9 11 10 19 32 24

Percent (%)
0-4 5-9 10-14 15-17
Source: Behavioral Risk Factor Surveillance System (BRFSS)

25 20 15 10 5 0

5 0

Lifetime Asthma: In2007,Districtchildren5to9 yearsoldhadthehighestlifetimeasthmaprevalencerate (24%) followed by children under 5 years old (18%) (Figure3). Current Asthma: In2007,Districtchildren5to9 yearsoldhadthehighestcurrentasthmaprevalencerate (18%) followed by children 10 to 14 years old (16%) (Figure3).
Figure 4: Asthma prevalence among children (0-17 yrs) by race/ethnicity in the District of Columbia, 2007
30 25 P e rc e n t (% ) 20 15 10 5 0 White Black Hispanic Total
Source: Behavioral Risk Factor Surveillance System (BRFSS)

Ward
Source: Behavioral Risk Factor Surveillance System (BRFSS)

Lifetime Asthma: In2007,childrenlivinginWard6 (32%) had the highest lifetime asthma prevalence rate, followedbyWard5(26%)andWard4(24%).Ward2(7%) hadthelowestlifetimeasthmaprevalencerate(Figure5). Current Asthma:In2007,childrenlivinginWard5 (26%) had the highest current asthma prevalence rate, followedbyWard6(22%)andWard7(19%).Ward2(7%) hadthelowestcurrentasthmaprevalencerate(Figure5).

Lifetime Current

24 20 18 14 19 15

ASTHMA EMERGENCY DEPARTMENT VISITS

Emergencydepartment(ED)informationbelowincludes visitswithdiagnosesofasthmaamongchildrenunderthe ageof18years.TheEDdatapresentedbelowincludes only District residents that visited hospital emergency departmentsintheDistrict.
Figure 6: Asthma ED visit rate among children (0-17 yrs) in the District of Columbia, 2002-2007
500 450 400 352 R a te (p er 10 ,0 0 0) 350 300 250 200 150 100 50 0 2002 2003 2004 2005 2006 2007
Source: IMPACT DC *Rates w ere age-adjusted using the US 2000 Census population

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437 378 403 368 338

Lifetime Asthma: In 2007, about 24% of non Hispanicblack,18%ofHispanicand12%ofnonHispanic whiteDistrictchildrenreportedlifetimeasthma.Twiceas manynonHispanicblackDistrictchildrenhadlifetime asthma as compared to nonHispanic white children. About50%moreHispanicchildrenhadlifetimeasthmaas comparedtononHispanicwhitechildren(Figure4). Current Asthma: In 2007, about t 20% of non Hispanicblack,14%ofHispanicand8%ofnonHispanic white District children reported current asthma. More thantwiceasmanynonHispanicblackDistrictchildren experiencedcurrentasthmaascomparedtononHispanic whitechildren.AlmosttwiceasmanyHispanicDistrict

In2007,theasthmaEDvisitrateforDistrictchildren under18yearswas338per10,000people(Figure6). TheasthmaEDvisitrateforDistrictchildrenunder theageof18yearshasdecreasedbyabout4%from2002 (352 per 10,000 people) to 2007 (338 per 10,000 people) (Figure6).

DISTRICT OF COLUMBIA DATA FACT SHEET 2009

ASTHMA IN CHILDREN PAGE 2

Figure 7: Asthma ED visit rate among children (0-17 yrs) by gender in the District of Columbia, 2007
700 600 R a te (p e r 1 0 ,0 0 0 ) 500 399 400 300 200 100 0 Female Male Total
Source: IMPACT DC *Rates w ere age-adjusted using the US 2000 Census population

ASTHMA HOSPITALIZATION
Data are reported by local acute care hospitals in the Districtincludingoneveteranshospital,butexcludingall military hospital facilities. Hospital discharge data representsthenumberofinpatienthospitalizations,not thenumberofindividualshospitalized.Apersoncanbe hospitalizedmultipletimesforthesamecondition.The informationbelowrepresentshospitalizationsofchildren undertheageof18yearsresidingintheDistrictwitha primarydiagnosisofasthma.
Figure 12: Asthma hospitalization rate among children (0-17 yrs) in the District of Columbia, 2006
40 35 R a te (pe r 1 0 ,00 0 ) 30 25 20 15 10 5 33 29 27 21 23

338 275

Boys(399per10,000people)hadanapproximately 45%higherasthmaEDvisitratethangirls(275per 10,000people)(Figure7).

Figure 8: Asthma ED visit rate among children (0-17 yrs) by age-group in the District of Columbia, 2007
700 600 R a te (p e r 1 0 ,0 0 0 ) 500 400 300 200 100 0 0-4 5-9 10-14 15-17
Source: IMPACT DC *Rates w ere age-adjusted using the US 2000 Census population

571

272

239

247

0 2002 2003 2004 2005 2006

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

Districtchildrenunder5yearsoldhadthehighest asthmaEDvisitrate(571per10,000people)in2007 (Figure8).

Figure 9: Asthma ED visit rate among children (0-17 yrs) by zip code (with Ward boundaries overlaid) in the District of Columbia, 2007
N W S E

In2006,theinpatientasthmahospitalizationratedue to asthma among District children under the age of 18 yearswas33per10,000people(Figure10). Thehospitalizationrateincreasedby14%from2002 (29 per 10,000 people) to 2006 (33 per 10,000 people) amongDistrictchildren(Figure10). Thechildhoodasthmahospitalizationrateappeared tobeonadownwardtrendfrom2002to2004butseems tohaveincreasedfrom2004to2006(Figure10).
Figure 11: Asthma hospitalization rate among children (0-17 yrs) by gender and race in the District of Columbia, 2006

4 3

1 2

5 7

45 40 35 R a te (p e r 1 0 ,0 0 0 ) 30 25 20 15 10 5 0 2 Male Female White Black Total 27 39 38 33

Ward Boundaries Waterbodies Emercency Department Visit Rate (per 10,000) No Data 1 - 95 95 - 190 190 - 285 285 - 380 380 - 475

In 2007, the asthma ED visit rate among District childrenunder18yearswashighestinpartsofWards1,5, 6,7and8(Figure9).

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

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In2006,theasthmahospitalizationrateforDistrict boyswasabout44%higherthanhospitalizationsforgirls (Figure11). In 2006, the asthma hospitalization rate for non Hispanicblackchildrenwasabout19timeshigherthan hospitalizationsamongnonHispanicwhitechildren (Figure11).
Figure 12: Asthma hospitalization rate among children (0-17 yrs) by age-group in the District of Columbia, 2006
60 50 R a te ( p e r 1 0 ,0 0 0 ) 40 30 23 20 10 0 0-4 5-9 10-14 15-17
Source: District of Columbia Hospital Association (DCHA) *Rates w ere age-adjusted using the US 2000 Census population

Thechildhoodasthmahospitalizationratewasalso highinpartsofWards4,5,6,and7(Figure13). ThefindingsaboveconfirmthatintheDistrictofColum biacurrentasthmaaffectsaboutoneinsixchildrenunder 18years,whilealmostonein5childrenhadasthmaat some time during their lifetime. NonHispanic black children experience current asthma prevalence at rates 30%and60%higherthantheirnonHispanicwhiteand Hispanic peers, respectively. Younger children,age04 years,visitlocalEDsfortreatmentofasthmaatleast50% moreoftenthanolderchildrenage5to17years.Equally significant is the 30% higher proportion of ED and hospitalasthmavisitsthatoccurinboysascomparedto girls. 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.

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In 2006, the asthma hospitalization rate was the highestamongchildrenunder5yearsold(49per10,000 people).Thehospitalizationratedecreasedwithincreas ingage(Figure12).
Figure 13: Asthma hospitalization rate among children (0-17 yrs) by zip code (with Ward boundaries overlaid) in the District of Columbia, 2005-2006
N W S E

4 3

1 2

5 7

Ward Boundaries Waterbodies Hospitalization Rate (per 10,000) No Data 1 - 20 20 - 40 40 - 60 60 - 80 80 - 100

Inyears2005to2006,theasthmahospitalizationrate amongDistrictchildrenwashighestinpartsofWards1 and5(Figure13).

DISTRICT OF COLUMBIA DATA FACT SHEET 2009

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