# Presentation: 040736

## Focus Area 24Respiratory DiseasesProgress Review

**Focus Area 24****Respiratory Diseases****Progress Review**

**June 29, 2004**

## Burden of Respiratory Diseases

- _Prevalence (self or proxy-reported)_
- 3.6 million children
- 22 million adults
- _Annual Burden (estimated) _
- 20 million physician and outpatient visits
- 3.5 million hospital emergency visits
- 1.2 million hospitalizations
- 124,000 deaths

## Respiratory Diseases Objectives

- Children 5-14 years
- Adolescents and adults 15-34 years
- Adults 35-64 years
- Adults 65 years and over

**24-1 Deaths from Asthma**

- Children under 5 years
- Children and adults 5-64 years
- Adults 65 years and over

**24-2 Hospitalizations for Asthma**

**24-4 Activity Limitations**
**24-5 *****School or Work Days Lost***
**24-6 Patient Education**
**24-7 Appropriate Asthma Care**

*Written asthma management plans*
- Persons with prescribed inhalers who .......receive instruction
- Education about recognizing early signs
*Medication regimens*
- Followup medical care
*Assistance with assessing*
*...**....**environmental risks*

**24-8 Surveillance Systems**

- Children under 5 years
- Children and adults 5-64 years
- Adults 65 years and over

**24-3 Hospital Emergency Department Visits for Asthma**

**Asthma**

**Respiratory Diseases Objectives**

## Respiratory Diseases Objectives

**24-10 Deaths from COPD**

- Seek medical evaluation
- Receive follow-up care

**24-11 Medical Evaluation and Followup**

**Chronic Obstructive Pulmonary Disease (COPD)**

**Obstructive Sleep Apnea (OSA)**

**24-12 Vehicular Crashes Related to Excessive Sleepiness**

**Respiratory Diseases Objectives**

## COPD
24-9.	Activity limitations 
24-10.	Deaths

**24-9.****	****Activity limitations **
**24-10.****	****Deaths**

_**Asthma**_
**24-1.****	****Deaths **
**24-2.****	****Hospitalizations**
**24-4.****	****Activity limitations**
**24-5.****	****School or work days lost**
**24-6.****	****Patient education**

**Highlighted Objectives**

## Asthma Facts

- Chronic condition occurring among both children and adults
- 74% increase in self-reported asthma from 1980 to 1996
- 85% increase in physician visits from 1980 to 1999
- 18 days of school or work lost due to asthma per person with asthma
- 75 emergency department visits and 18 hospitalizations for asthma per 10,000 population
- Evidence of some declines in recent years (except young children)

## Asthma Deaths

- 0               20              40              60             80

- Deaths per Million

- Under 5 years
- 5-14 years
- 15-34 years
- 35-64 years
- 65 years and over

- Obj. 24-1a-e

-  Source: National Vital Health Statistics System, NCHS, CDC.

**Asthma Deaths**

- Age-adjusted death rate per million

## Asthma Deaths

- Deaths per Million

- Note: Black and white exclude persons of Hispanic  origin.
- Persons of Hispanic origin may be any race. Persons were asked to select only one race; selection of more than one race was not an option.
- Source: National Vital Health Statistics System, NCHS, CDC.

- Asian or Pacific Islander
- Black
- White
- Hispanic
- Female
- Male

- 0           10         20          30          40         50

**2010 Target**

- Obj. 24-1d

**Asthma Deaths**

**Ages 35 – 64 Years**

- 1999
- 2001

**Notes:**
Target = 9.0

## Asthma Hospitalizations

** **

- Hospitalizations per 10,000

**Asthma Hospitalizations**

- Note:  Data for ages 5-64 and 65 and over are age-adjusted to the 2000 standard population.
- Source: National Hospital Discharge Survey, NCHS, CDC.

- Under 5 years
- 5-64 years
- 65 years and over

- 0             20            40            60           80

- Obj. 24-2a-c

## Ages 65 Years and Over

- Hospitalizations per 10,000

**Ages 65 Years and Over**

- Note:  Data are age adjusted to the 2000 standard population. Black and white include persons of Hispanic or non-Hispanic origin. Persons were asked to select only one race category; selection of more than one race category was not an option in 1998.  In 2001, persons reported one or more races.  Data by race are shown for persons who reported one racial group.
- Source: National Hospital Discharge Survey, NCHS, CDC.

- Black
- White
- Female
- Male

- 0               10               20              30             40

- Obj. 24-2c

**2010 Target**

**Asthma Hospitalizations**

- 1998
- 2001

## Activity Limitations Among Persons with Asthma

- Percent

- Note:  Data are age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. In 1997, persons reported one or more races and identified one race as best representing their race. Data by single race category are for persons who reported only one racial group.
- Source: National Health Interview Survey, NCHS, CDC.

- Total
- Asian or Pacific Islander
- Black
- White
- Hispanic

- 0               5              10             15            20

**Activity Limitations Among Persons with Asthma**

- Obj. 24-4

**2010 Target**

## Activity Limitations Among Persons with Asthma

- Note:  Data are age adjusted to the 2000 standard population.
- Source: National Health Interview Survey, NCHS, CDC..

- Female
- Male
- Poor
- Near poor
- Middle/high income

- 0                  10                 20                 30

**Activity Limitations Among Persons with Asthma**

- Obj. 24-4

**2010 Target**

## School or Work Days Lost Among Persons with Asthma, 2002

- Number of Days Lost

- Total
- Black
- White
- Hispanic
- Female
- Male

- 0              10              20              30             40

- Note:  Data are age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races.  Data by single race category are for persons who reported only one racial group.
- Source: National Health Interview Survey, NCHS, CDC.

- Obj. 24-5

## Patient Education Among Adults with Asthma

- Percent

- Total
- Black
- White
- Hispanic
- Female
- Male

- 0                   10                   20                   30

**2010 Target**

- Note:  Data are for ages 18 and over and age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races. Data by single race category are for persons who reported only one racial group.
- Source: National Health Interview Survey, NCHS, CDC.

- Obj. 24-6

## Chronic Obstructive Pulmonary Disease (COPD) Facts

- _Prevalence_ - COPD is under-diagnosed
- 10 million adults reported physician-diagnosed COPD
- 24 million adults have evidence of impaired lung function according to NHANES III
- _Annual Burden (estimated) _
- 8 million physician and outpatient visits
- 1.5 million hospital emergency visits
- 726,000 hospitalizations
- 119,000 deaths
- Increasing trend in recent decades with some evidence of recent declines

## Estimated Prevalence of COPD1988 - 94

- Note:  NHIS and NHANES data are based on self-reports.  Mild and moderate COPD is defined by spirometric ratio of FEV1 (forced expiratory volume in 1 second) to FVC (forced vital capacity) less than 70%.
- Source: Mannino, et al.  MMWR 2002 / 51(SS06);1-16.

**Per 100,000**

- Percent

- 50
- 40
- 30
- 20
- 10
- 0

## COPD Deaths

- Note:  COPD is defined as ICD-9 codes 490-492 and 496 for 1980 data and ICD-10 codes J40-J44 for 2000 data, and excludes asthma.  Data are age adjusted to 2000 standard population
- Source: Mannino, et al.  MMWR 2002 / 51(SS06);1-16.

**Per 100,000**

- Female                        Male

- Deaths per 100,000

- 100
- 80
- 60
- 40
- 20
- 0

**COPD Deaths**
**Ages 25 Years and Over**
**  **

## COPD Deaths

** **

**COPD Deaths**
**  **

- American Indian
- Asian or Pacific Islander
- Black
- White
- Hispanic

- Note: COPD is defined as ICD-10 J40-J44, and excludes asthma.  Data are for ages 45 years and over and age adjusted to 2000 standard population. American Indian includes Alaska Native. Black and white exclude persons of Hispanic  origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race; selection of more than one race was not an option.
- Source: National Vital Statistics System, NCHS, CDC.

**2010 Target**

- Obj. 24-10

## Activity Limitations Due toChronic Lung and Breathing Problems

- Percent

- Note:  Data are for ages 45 years and over and age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races. Data by single race category are for persons who reported only one racial group.
- Source: National Health Interview Survey, NCHS, CDC.

- Total
- Black
- White
- Hispanic

- 0            1             2            3            4            5

**2010 Target**

- Obj. 24-9

**Activity Limitations Due to****Chronic Lung and Breathing Problems**

## Activity Limitations Due toChronic Lung and Breathing Problems

- Percent

- Note:  Data are for ages 45 years and over and age adjusted to the 2000 standard population.
- Source: National Health Interview Survey, NCHS, CDC.

- Female
- Male
- Poor
- Near poor
- Middle/high income

- 0       1       2       3       4       5       6      7

**2010 Target**

- Obj. 24-9

**Activity Limitations Due to****Chronic Lung and Breathing Problems**

## http://www.cdc.gov/nchs/hphome.htm

**Progress review data and slides**
**can be found on the web at:**

**http://www.cdc.gov/nchs/hphome.htm**