Asthma Burden Report- Indiana

You can download the ‘2011 Asthma Burden Report’ for our state (Indiana) and see what is going on in the world of asthma viz Indiana. I have a vested interest in asthma and have been a part of many community/public health initiatives regarding asthma. As such I have always been interested to see what is happing with asthma and if any of our efforts to manage this chronic condition have made any difference.

The document I am going to review is ‘2011 Burden of Asthma in Indiana’ from the Indiana State Department of Health (ISDH).

Writer’s note- as I reviewed this I got confused and I was not sure what year I was looking at. The same concerns may occur with your reading. The basis for the confusion is that this is the 2011 Asthma Burden Report. The first sentence in the Introduction says it is the 2010 Indiana Asthma Burden Report, yet all the data is 2009? Since it takes time to collect information and to run an analysis, my guess is that this is the Burden of Asthma in the State of Indiana in 2009 with some 2007 information included. Just watch the dates on the data.

A few facts regarding asthma in Indiana-in children;

  • Asthma is the third leading cause of hospitalization for children under the age of 17 years.
  • In 2009, an estimated 150,000 children (9.9%) reported currently having asthma.
  • Nearly 15% of children reported having been diagnosed with asthma at some point during their lifetime.
  • Nearly 24% of high school students reported having asthma at some time in their lives and 12.2% reported having current asthma in 2009.

The information in the report comes from a questionnaire, the Behavioral Risk Factor Surveillance System (BRFSS). This is a telephone survey. Using 2009 (the ISDH website as of 5-23-2011), there were 9,288 randomly selected individuals who were called and asked to participate. The response rate was just over 47%. What follows is asthma information for the state of Indiana regarding children (17 years of age or younger) from the BRFSS 2009 and a few interesting points regarding the entire sample.

            Since 2007 the lifetime and current rates of asthma have increased significantly. The prevalence of lifetime asthma is close to 15% and is above the national average for the year 2009. The prevalence of current asthma is also higher than the national average in 2009 (just under 10%). 

            The hospitalization rate for asthma (age-adjusted) has increased since 2007 and is 13.9 hospitalizations/10,000 residents in 2009.

            Age-adjusted emergency department visits for asthma have increased significantly since 2004; 30.4/10,000 residents to the 2009 rate of 49.7/10,000.

            Asthma mortality- death due to asthma is rare and are below national averages and continues to decline (end point was 2007).

            The highest rate of hospitalizations in Indiana was found among boy’s ages 0-4 years – 36.5/10,000 residents. Boys tended to have higher hospitalization rates until age 14 years at which time girls and women had significantly higher rates of hospitalization. Emergency department visits followed the same trend- more seen in boys less than 15 years of age then females more than males after age 15 years.

            Asthma can and does affect people of all races and ethnicities. This information was not broken down for children. The report is only on adults but does show which groups tend to be more or less affected. Hispanic adults had the lowest rate of asthma prevalence at 4.3% as well as the lowest rate of emergency department visits and hospitalizations. The white population had a prevalence of 9.2% and the black population had 12% asthma prevalence. Hospitalization occurred three times more often in the black population when compared to the white population.

            The report also looked at income, education, and geographic variation (county prevalence).

            There is a very interesting page on risk factors or behaviors associated with asthma. This however is not from 2009. This is information from the 2007 BRFSS. The following is a selection from that 2007 listing of behaviors reported by adults with asthma in Indiana.

  • 40% were advised about changing the environment
  • 10% had seen, smelled, or suspected mold in their environment
  •   4% had seen cockroaches
  •    5% had seen mice/rats in their homes
  •  20% used a house dust mite cover on their bedding
  •  80% had carpeting or rugs in their bedrooms
  •  27% used a dehumidifier to reduce moisture
  •  34% used an air purifier
  •  57% had pets
  •  28% had someone smoke in their home within the past week
  •  29% were smokers

Writer’s note; look at all the allergy potential in this listing. Allergen triggers for asthma would include mold, roach, mice, dust mites, and pets.

Protecting them against asthma. This also comes from 2007 and deals with adults with asthma.

  • 69% reported on getting instruction on how to recognize signs of an attack
  • 77% were taught what to do during an asthma attack
  • 33% received an asthma action plan
  •   6% had taken a course on how to manage asthma

Health Interventions

            The document lists a number of endeavors out there to help with education including the ISDH Asthma Program and the Indiana Joint Asthma Coalition (InJAC).

 

 Reviewers Notes

These reports are notable. My tendency is to pick away at details and ask questions. There is a wealth of information within the report, however it can be confusing and sometimes it is not totally clear why something appears and for what year. A suggestion would be to make sure the reader knows the ‘when’ of the information- 2011, 2010, or 2009, or even 2007. You can see this report on the ISDH website. There are links to background information. However, the final document should be considered a ‘stand alone’ document and should mention the methodology and specifics of the population. I was also not clear about information that clearly was not from 2009. There were presentations of information from 2007. Was this new for a burden report? Was this a re-iteration from a past report? These reports follow a format; Introduction, Goals, Trends, Disparities, Risk & Protective Factors, Conclusion, Resources, References, and Appendices. Was all the information available from the 2009 BRFSS? Will we see 2009 data later? There should have been some explanation as to why the timeline skipped around so much. That would have been very helpful for this reader.

This is the state of asthma within our state. Clearly more needs to be done. There is clearly more ‘asthma’ out there. We are higher than the national average for children. There are more emergency department visits for asthma. There are a number of possible allergy issues involved.

The ISDH has a state asthma plan and a partner organization InJAC that is looking for interested partners to help make a difference. Checkout the InJAC website and join us.

FEL

May 24, 2011 · fleickly · No Comments
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