Title: LIVING WITH ASTHMA IN NEW ENGLAND Results of 2006 Asthma Call Back Surveys Asthma Regional Council
1LIVING WITH ASTHMA IN NEW ENGLANDResults of
2006 Asthma Call Back Surveys Asthma Regional
Council
- Laurie Stillman, MM
- The Medical Foundation
- Mary Adams, MPH
- On Target Health Data LLC
2Regional Surveillance Rationale
- Determine if asthma in New England is different
than other U.S. regions - Look at trends to see if progress is being made
over time - Understand how and where, as a region, we can
tackle the epidemic most effectively together
3BRFSS Regional Analysis
- BRFSS-On-going state based telephone survey of
adults (child add-on) re. health conditions - Source of adult asthma prevalence data, trends
comparisons - Coordinated regional child analysis in 2001
- Funded by DHHS-Reg. I (New England) all 3 years-
support also from EPA Reg I and Cox - Data Analysis 2001, 2003-2004 (NSCH), 2006
- Past observations
- -NE has among the highest rates of adult child
asthma - -1 million adults 330,000 children current
asthma (2004) - -Lifetime Prevalence Adults (15) Child (14)
4Methods
- Standard 2006 BRFSS Included adult data from
all 50 states plus DC, not territories - (data from all 6 New England states).
- Call-Back 2006 Surveys 5 New England States (no
RI) - 1,986 adults (range 235 in ME to 572 in VT)
- 516 children (range 39 in ME to 124 in VT)
- Participation of state asthma program BRFSS
staff was key - Public use data from www.cdc.gov/brfss
5Key Findings-Overall TrendAdults- BRFSS, 6 NE
statesCurrent Asthma
6Key Findings-GenderAdults- BRFSS, 6 NE states
7Key FindingsAdults- 2006 BRFSS, 50 states DC
8NE Adult Asthma Rates
9Key Findings-Adults w/ current asthma
- Highest Risk smokers, obese, low
income/education, those unable to work. - Adults with current asthma were more than 3 times
as likely to be unable to work as those without
the disease - 2-3x more likely to be in fair/poor health,
activity limitations, poor mental health - 1 in 5 reported having significant activity
limitations because of their asthma - Racial minority groups higher hospitalizations
10Key Findings-Adults w/ asthma (contd)
- 10 visited E.R./urgent care 3 hospitalized
- 14 (28 poorly controlled) reported cost barrier
to getting needed meds. - 30 had asthma management plan
- 50 had a flu shot
11Key FindingsCall-Back Surveys 5 NE StatesJob
Related Asthma
12NE Child Asthma Rates
13Key Findings-Children w/ current asthma
- About half (of children with current asthma had
an asthma attack, 14.1 had an urgent care or
emergency room visit, and 4.3 were hospitalized
for their asthma in the past year. - 44 of children had Asthma Mgmt. Plan
- Half of children had flu shot.
14Methods Call Back
- Key Concepts
- Severity vs. Control
- Severity the intrinsic intensity of the disease
process. Severity is measured most easily and
directly in a patient not receiving
long-term-control therapy. - Control the degree to which the manifestations
of asthma are minimized and the goals of therapy
are met. - CDC definitions
15Measures Used (NAEPP EP2)
- Severity
- Frequency of daytime nighttime symptoms
- Days activity limited/yr
- ER urgent care visits/yr
- Control -
- Frequency of daytime nighttime symptoms
- Degree of activity limitation
- Frequency of rescue medication (SABA) use
- No measure of lung function for either
16Key FindingsCall-Back Surveys 5 NE StatesAsthma
Severity
17Key FindingsCall-Back Surveys 5 NE StatesAsthma
Control
18New England Summary
- Current asthma rates higher in NE than in rest of
US (adults) - Rates appear to be increasing, but only for women
(NE adults). - Most asthma diagnosed as adults
- Income, education, smoking status, obesity
- Severe asthma highly correlated with smoker in
home - Job related asthma is significant
- Most NE adults and children have mild asthma
symptoms - Asthma apparently not well controlled in NE
children or adults
19Recommendations
- More research on NE rates
- Disparities need to be specifically addressed
through proactive identification and intensified
interventions in clinic, home and communities - Occupational asthma needs to be better understood
- Need better proactive disease management,
including reimbursement for education, home
visits, and varied providers - ETS, especially in the home
20Other topics in report(Call-back - 5 states)
- Age of diagnosis
- Health care, barriers to care, management plans,
use of alternative therapy - Home environment (ETS)
- Functional status/quality of life measures for
persons with asthma - Co-morbidities, depression
- Healthy People 2010 measures (5)
- Results for all children combined
- Detailed Recommendations
- www.asthmaregionalcouncil.org for report
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