LIVING WITH ASTHMA IN NEW ENGLAND Results of 2006 Asthma Call Back Surveys Asthma Regional Council - PowerPoint PPT Presentation

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LIVING WITH ASTHMA IN NEW ENGLAND Results of 2006 Asthma Call Back Surveys Asthma Regional Council

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Title: LIVING WITH ASTHMA IN NEW ENGLAND Results of 2006 Asthma Call Back Surveys Asthma Regional Council


1
LIVING 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

2
Regional 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

3
BRFSS 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)

4
Methods
  • 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

5
Key Findings-Overall TrendAdults- BRFSS, 6 NE
statesCurrent Asthma
6
Key Findings-GenderAdults- BRFSS, 6 NE states
7
Key FindingsAdults- 2006 BRFSS, 50 states DC
8
NE Adult Asthma Rates
9
Key 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

10
Key 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

11
Key FindingsCall-Back Surveys 5 NE StatesJob
Related Asthma
12
NE Child Asthma Rates
13
Key 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.

14
Methods 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

15
Measures 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

16
Key FindingsCall-Back Surveys 5 NE StatesAsthma
Severity
17
Key FindingsCall-Back Surveys 5 NE StatesAsthma
Control
18
New 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

19
Recommendations
  • 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

20
Other 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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