Examine the trend in asthma prevalence, outcomes and mortality in Nebraska, 1999–2010

Background: Asthma is a common chronic disease and persistent public health challenge in Nebraska. We analyzed statewide asthma prevalence, outcomes and mortality over the past decade, hoping to contribute to effective strategies to improve asthma outcomes. Methods: We analyzed asthma prevalence for adults and children in Nebraska from 1999 to 2010 using the Behavioral Risk Factor Surveillance System data. The Asthma Call-back Survey data was used to analyze asthma-related healthcare use and cost barrier. Finally, we obtained information on asthma deaths from official death certificate files in Nebraska during the 1999-2010 period. Results: Adult asthma prevalence increased from 6.5% in 1999 to 7.8% in 2010, while childhood asthma prevalence remained steady at around 6%. Asthma prevalence was significantly higher among females, the poorest, the unemployed, and the obese people in 2010. Adults who were not insured for the full year were more likely to have emergency room visits due to asthma (24%v.s. 5.4%) and report cost barrier of seeing primary care doctors (40.0% v.s. 4.8%), of seeing specialists (30.0% v.s. 1.8%), and of buying medication (44.9% v.s. 7.4%), than adults who were insured for the full year. In Nebraska, a total of 397 deaths were caused directly by asthma from 1999 to 2010, with more than 60% occurred to people age 65 and older. Age-adjusted mortality rates in Nebraska declined from 22.0 per million population (1999–2001) to 15.1 per million population (2008-2010). Conclusions: Asthma disparity persisted among disadvantaged populations Expanding insurance coverage and improving socio-economic status may help to improve the outcomes.