Meredith G. Hennon, MPH and the Supercourse team in Pittsburgh

Background  Asthma is a chronic lung-disease that inflames and narrows the airways (tubes that bring air into and out of an individual’s lungs).  Asthma is the most common chronic disease among children.

Symptoms  Common symptoms of asthma include: Coughing Wheezing Tightness in the chest Shortness of breath

Causes  While the exact cause of asthma is not known, it is thought that a variety of factors interacting with one another, early in life, result in the development of asthma.

Causes  Parents with asthma  Atopy  Childhood respiratory infections  Exposure to allergens or infections while the immune system is developing

Diagnosis  Based on: Medical history Physical examination Test results

Asthma Triggers  A variety of things can cause asthma symptoms to appear: ○ Allergens ○ Irritants ○ Food and drinks ○ Medicines ○ Physical activity ○ Upper respiratory infections (viral)

Asthma prevalence  In the United States: More females than males have asthma. Blacks and American Indian/Alaska natives have higher percentages of asthma than Whites, Hispanics, and Asians.

Asthma prevalence, 2005

Lifetime asthma diagnosis, 2005

Asthma disparities  Death from asthma is 3 times more likely to occur among Blacks than Whites.  Among adults, women of all races have higher rates of illness and death from asthma than men.  Rates of hospitalization for asthma for Blacks are almost triple those for Whites.

Number of asthma deaths per 100,000 population, 2003

Increasing rates  Asthma rates have been increasing in the United States for both adults and children, males and females, and in the different races and ethnicities.  It is estimated that the number of people with asthma worldwide will increase by 25% in the next 15 years.

Child and Adult Asthma Prevalence United States, Month Lifetime Child  Adult Source: National Health Interview Survey; CDC National Center for Health Statistics Current

Asthma Prevalence by Sex United States, Month Lifetime Female  Male Source: National Health Interview Survey; CDC National Center for Health Statistics Current

Asthma Prevalence by Race/Ethnicity United States, Lifetime Current ▲ Black NH  White NH  Hispanic Source: National Health Interview Survey; National Center for Health Statistics

Worldwide Burden of Asthma  300 million people suffer from asthma worldwide. 255,000 asthma deaths in ○ ~3,500 in the United States. Over 80% of asthma deaths occur in low and lower-middle income countries.

Treatment  While asthma cannot be cured, it can be controlled: Medications ○ Long term ○ Quick relief ○ Bronchial thermoplasty Learning to recognize one’s own triggers and taking steps to avoid them.

Treatment  Medication Long term ○ Inhaled corticosteroid ○ Leukotriene modifiers ○ Long-acting beta agonists ○ Combination inhalers

Treatment Quick relief (rescue) medications ○ Short-acting beta agonists ○ Ipratropium ○ Oral and intravenous corticosteroids Bronchial thermoplasty Recognizing, tracking, and avoiding triggers

Review Questions (Developed by the Supercourse team)  What are some of the common asthma triggers?  Which age, sex, and/or racial groups see disparities in asthma prevalence rates, as well as hospitalizations and deaths?  Describe the process of asthma diagnosis.