Background: Asthma remains an ongoing public health and medical problem. Nearly 20 million people currently have asthma and 1.7 million had an ED visit (MMWR 2018). The CDC notes that hospitalizations and deaths due to asthma are 3 times higher among African Americans than Whites.

Method: Adult asthma measures from the 2017 NHQDR were analyzed by insurance status, income, and race/ethnicity. Significant differences require a minimum relative difference 10%, and statistical significance with p-value < 0.05. Trends were assessed using weighted least squares regression of change where average annual rate of change is ≥1% per year and statistically significant (p-value < 0.05).

Findings:

Prevalence: From 2003-2015, the percentage of people with asthma increased overall and for income and race/ethnicity sub-populations:

• Income: High (5.5% to 7.2%) and Poor (9.8% to 11.0%).
• Race/Ethnicity: Hispanics (5.0% to 6.9%), Whites (6.5% to 8.0%), and Blacks (8.2% to 11.9%).

Prevention

In 2013, 68.7% of persons with asthma received education about appropriate responses to an asthma episode. Disparities were observed among the following populations:

• Insurance: Public (68.0%) and uninsured (61.2%) less likely than private (74.3%).
• Income: Poor (64.0%), low (65.4%) and middle (68.0%) less likely than high (75.4%).

Outcome:

In 2016, overall hospital admission for asthma was 34.4/100,000 and ED visits for asthma was 407.9/100,000 population. Disparities were observed by income.

Conclusion: Asthma can be reduced by promoting strategies, including trigger reduction, appropriate guidelines-based medical management, and education. Resources such as AHRQ's Asthma Care Quality Improvement: A Resource Guide for State Action supports quality improvement efforts.