National Surveillance of

Asthma: United States,

2001–2010

Series 3, Number 35 November 2012

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Center for Health Statistics 
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Suggested citation

Moorman JE, Akinbami LJ, Bailey CM, et al. National Surveillance of Asthma:

United States, 2001–2010. National Center for Health Statistics. Vital Health

Stat 3(35). 2012.

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National surveillance of asthma: United States, 2001–2010.

p. ; cm. — (Vital and health statistics. Series 3, Analytical and epidemiological

studies ; Number 35) (HHS publication ; no. (PHS) 2013–1419)

‘‘November 2012.’’

Includes bibliographical references.

ISBN 0-8406-0657-5 (alk.paper)

I. National Center for Health Statistics (U.S.) II. Series: Vital & health statistics.

Series 3, Analytical and epidemiological studies ; no. 35. III. Series: HHS

publication ; no. (PHS) 2013–1419.

[DNLM: 1. Asthma—epidemiology—United States. 2. Asthma—mortality—

United States. 3. Health Services—utilization—United States. W2 A N148vc

no.35 2012]

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Series 3, Number 35

National Surveillance of Asthma:

United States, 2001–2010

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Hyattsville, Maryland

November 2012

DHHS Publication No. (PHS) 2013–1419
National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate Director for Science

Office of Analysis and Epidemiology

Jennifer H. Madans, Ph.D., Acting Co-Director

James M. Craver, M.A.A, Acting Co-Director
Contents
 

Abstract ................................................................................................. 1 
 

Introduction .............................................................................................. 1 
 

Methods ................................................................................................. 2 
 

Data Sources............................................................................................ 2 
 

Analytic Methods ....................................................................................... 2 
 

Current Asthma Prevalence and Asthma Attack Prevalence ........................................................ 3 
 

Current Asthma Prevalence Trends.......................................................................... 3 
 

Current Asthma Prevalence by Selected Characteristics ......................................................... 4 
 

Asthma Attack Prevalence Trends .......................................................................... 5 
 

Asthma Attack Prevalence by Selected Characteristics.......................................................... 6 
 

Asthma Attack Prevalence Trends Among Children and Adults................................................... 7 
 

Asthma Attack Prevalence Among Persons With Current Asthma ................................................. 8 
 

Physician Office Visits and Hospital Outpatient Department Visits .................................................. 9 
 

Physician Office Visit Trends .............................................................................. 9 
 

Hospital Outpatient Department Visit Trends ................................................................. 10 
 

Physician Office Visits by Selected Characteristics............................................................. 11 
 

Hospital Outpatient Department Visits by Selected Characteristics ................................................ 12 
 

Physician Office Visits by Age Group ....................................................................... 12 
 

Hospital Outpatient Department Visits by Age Group........................................................... 13 
 

Physician Office and Hospital Outpatient Department Visit Trends by Race ........................................ 13 
 

Emergency Department Visits................................................................................ 14 
 

ED Visit Trends......................................................................................... 14 
 

ED Visits by Selected Characteristics........................................................................ 15 
 

ED Visit Trends by Race ................................................................................. 15 
 

ED Visits by Age Group .................................................................................. 16 
 

Hospital Inpatient Stays .................................................................................... 17 
 

Hospitalization Trends.................................................................................... 17 
 

Hospitalizations by Selected Characteristics .................................................................. 18 
 

Hospitalizations by Race.................................................................................. 18 
 

Hospitalizations by Age .................................................................................. 19 
 

Deaths .................................................................................................. 20 
 

Trends in Deaths ........................................................................................ 20 
 

Deaths by Selected Characteristics.......................................................................... 21 
 

Deaths by Race and Ethnicity.............................................................................. 21 
 

Deaths by Age .......................................................................................... 22 
 

Asthma Trends in the United States From 1980 ................................................................. 23 
 

Historical Perspective .................................................................................... 23 
 

Disparities in Asthma Hospitalization and Death Rates ......................................................... 24 
 

Other Measures of Asthma Morbidity ....................................................................... 27 
 

Recent Trends in Use of Asthma Management Tools ........................................................... 27 
 

Federal Efforts to Address Asthma.......................................................................... 28 
 

iii
Conclusion ............................................................................................... 28 
 

References ............................................................................................... 28 
 

Appendix I: Data Sources and Limitations ..................................................................... 51 
 

Appendix II: Technical Notes................................................................................ 54 
 

Appendix III: Definition of Terms ............................................................................ 56 
 

Text Figures

1.	 Current asthma prevalence: United States, 2001–2010...................................................... 3 
 

2.	 Current asthma prevalence, by age group, sex, race and ethnicity, poverty status, geographic region, and urbanicity:
 

United States, average annual 2008–2010................................................................ 4 
 

3.	 Asthma attack prevalence (population-based): United States, 2001–2010....................................... 5 
 

4.	 Asthma attack prevalence (population-based), by age group, sex, race and ethnicity, poverty status, geographic region,
 

and urbanicity: United States, average annual 2008–2010 ................................................... 6 
 

5.	 Asthma attack prevalence among children and adults with current asthma (risk-based): United States, 2001–2010 ..... 7 
 

6.	 Asthma attack prevalence among persons with current asthma (risk-based), by age group, sex, race and ethnicity,
 

poverty status, and geographic region: United States, average annual 2008–2010................................ 8 
 

7.	 Asthma physician office visits: United States, 2001–2009................................................... 9 
 

8.	 Asthma hospital outpatient department visits: United States, 2001–2009 ....................................... 10 
 

9.	 Asthma physician office visit rates (risk-based), by age group, sex, race and ethnicity, and geographic region:
 

United States, average annual 2007–2009................................................................ 11 
 

10.	 Asthma hospital outpatient department visit rates (risk-based), by age group, sex, race and ethnicity, and geographic
 

region: United States, average annual 2007–2009 ......................................................... 12 
 

11.	 Asthma physician office visit rates (risk-based), by detailed age group: United States, average annual 2007–2009 ..... 12 
 

12.	 Asthma hospital outpatient department visit rates (risk-based), by detailed age group: United States, average annual
 

2007–2009......................................................................................... 13 
 

13.	 Asthma physician office visit rates and hospital outpatient department visit rates (risk-based), by race: United States,
 

2001–2009......................................................................................... 13 
 

14.	 Asthma emergency department visits: United States, 2001–2009 ............................................. 14 
 

15.	 Asthma emergency department visit rates (risk-based), by age group, sex, race and ethnicity, and geographic region:
 

United States, average annual 2007–2009................................................................ 15 
 

16.	 Asthma emergency department visit rates (risk-based), by race: United States, 2001–2009 ........................ 15 
 

17.	 Asthma emergency department visit rates (risk-based), by detailed age group: United States, average annual
 

2007–2009......................................................................................... 16 
 

18.	 Asthma hospitalizations: United States, 2001–2009 ........................................................ 17 
 

19.	 Asthma hospitalization rates (risk-based), by age group, sex, race, and geographic region: United States, average
 

annual 2007–2009................................................................................... 18 
 

20.	 Asthma hospitalization rates (risk-based), by race: United States, 2001–2009 ................................... 18 
 

21.	 Asthma hospitalization rates (risk-based), by detailed age group: United States, average annual 2007–2009 .......... 19 
 

22.	 Asthma deaths: United States, 2001–2009 ............................................................... 20 
 

23.	 Asthma death rates (risk-based), by age group, sex, race and ethnicity, and geographic region: United States, average
 

annual 2007–2009................................................................................... 21 
 

24.	 Asthma death rates (risk-based), by race and ethnicity: United States, 2001–2009 ............................... 21 
 

25.	 Asthma death rates (risk-based), by detailed age group: United States, average annual 2007–2009.................. 22 
 

26.	 Asthma period prevalence and current asthma prevalence: United States, 1980–2010 ............................ 23 
 

27.	 Asthma hospitalization rates and asthma death rates (population-based): United States, 1980–2009 ................. 24 
 

28.	 Asthma hospitalization rates and asthma death rates (population-based), by race: United States, 1980–2009 .......... 25 
 

29.	 Asthma hospitalization rates and asthma death rates (population-based), by sex: United States, 1980–2009........... 26 
 

30.	 Asthma physician office visit rates, hospital outpatient department visit rates, emergency department visit rates, and
 

hospitalization rates (risk-based), by age, sex, and race: United States, average annual 2007–2009.................. 26 
 

Text Tables

A.	 School and work absences and percentage with activity limitation caused by asthma, among persons with at least
 

one asthma attack in the past year: United States, 2008 .................................................... 27 
 

B.	 Percentage ever receiving asthma self-management education among persons with current asthma: percent
 

(standard error): United States, 2003 and 2008 ........................................................... 27 
 

iv
Detailed Tables

1.	 Percentage with current asthma, by year and selected characteristics: United States, 2001–2010.................... 30 
 

2.	 Percentage with current asthma, by detailed age group and selected characteristics: United States, average annual
 

2008–2010......................................................................................... 31 
 

3.	 Percentage with one or more asthma attacks in the past 12 months, by year and selected characteristics:
 

United States, 2001–2010............................................................................. 32 
 

4.	 Percentage with one or more asthma attacks in the past 12 months, by detailed age group and selected characteristics:
 

United States, average annual 2008–2010................................................................ 33 
 

5.	 Percentage with one or more asthma attacks in the past 12 months among those with current asthma, by year and
 

selected characteristics: United States, 2001–2010 ......................................................... 34 
 

6.	 Percentage with one or more asthma attacks in the past 12 months among those with current asthma, by detailed age
 

group and selected characteristics: United States, average annual 2008–2010 ................................... 35 
 

7.	 Rate of physician office visits with asthma as the first-listed diagnosis per 10,000 population, by year and selected
 

patient characteristics: United States, 2001–2009 .......................................................... 36 
 

8.	 Rate of physician office visits with asthma as the first-listed diagnosis per 100 persons with current asthma, by year
 

and selected patient characteristics: United States, 2001–2009 ............................................... 37 
 

9.	 Rate of outpatient department visits with asthma as the first-listed diagnosis per 10,000 population, by year and
 

selected patient characteristics: United States, 2001–2009................................................... 38 
 

10.	 Rate of outpatient department visits with asthma as the first-listed diagnosis per 100 persons with current asthma,
 

by year and selected patient characteristics: United States, 2001–2009 ........................................ 39 
 

11.	 Rate of physician office visits with asthma as the first-listed diagnosis per 100 persons with current asthma, by
 

detailed age group and selected patient characteristics: United States, average annual 2007–2009 .................. 40 
 

12.	 Rate of outpatient department visits with asthma as the first-listed diagnosis per 100 persons with current asthma,
 

by detailed age group and selected patient characteristics: United States, average annual 2007–2009 ................ 41 
 

13.	 Rate of emergency department visits with asthma as the first-listed diagnosis per 10,000 population, by year and
 

selected patient characteristics: United States, 2001–2009................................................... 42 
 

14.	 Rate of emergency department visits with asthma as the first-listed diagnosis per 100 persons with current asthma,
 

by year and selected patient characteristics: United States, 2001–2009 ........................................ 43 
 

15.	 Rate of emergency department visits with asthma as the first-listed diagnosis per 100 persons with current asthma,
 

by detailed age group and selected patient characteristics: United States, average annual 2007–2009 ................ 44 
 

16.	 Rate of hospital discharges with asthma as the first-listed diagnosis per 10,000 population, by year and selected
 

patient characteristics: United States, 2001–2009 .......................................................... 45 
 

17.	 Rate of hospital discharges with asthma as the first-listed diagnosis per 100 persons with current asthma, by year
 

and selected patient characteristics: United States, 2001–2009 ............................................... 46 
 

18.	 Rate of hospital discharges with asthma as the first-listed diagnosis per 100 persons with current asthma, by detailed
 

age group and selected patient characteristics: United States, average annual 2007–2009 ......................... 47 
 

19.	 Rate of deaths with asthma as the underlying cause per million population, by year and selected characteristics:
 

United States, 2001–2009............................................................................. 48 
 

20.	 Rate of deaths with asthma as the underlying cause per 10,000 persons with current asthma, by year and selected
 

characteristics: United States, 2001–2009 ................................................................ 49 
 

21.	 Rate of deaths with asthma as the underlying cause per 10,000 persons with current asthma, by detailed age group
 

and selected characteristics: United States, average annual 2007–2009 ........................................ 50 
 

Appendix Table

Summary of definitions for asthma items .............................................................. 57 
 

v
Background

Asthma is prevalent but treatable:

adherence to evidence-based treatment

lessens impairment and lowers the risk

of future exacerbations.

Objective

This report details recent trends in

asthma prevalence, health care use,

and mortality since 2001 and presents

an overview of trends since 1980.

Methods

Asthma prevalence estimates were

obtained from the National Health

Interview Survey (2001–2010).

Physician office visit data were obtained

from the National Ambulatory Medical

Care Survey, hospital outpatient

department and emergency department

(ED) visit data from the National

Hospital Ambulatory Medical Care

Survey, hospitalization data from the

National Hospital Discharge Survey,

and death data from the National Vital

Statistics System (2001–2009). Two

types of rates were calculated:

population-based rates based on the

total population and risk-based rates

based on the population with asthma.

Results

Current asthma prevalence

increased from 2001 to 2010. There

were no significant changes in rates for

hospital outpatient department visits,

ED visits, or hospitalizations, whereas

risk-based rates for private physician

office visits declined. Asthma death

rates decreased from 2001 to 2009.

Over the long term, asthma prevalence

rose more slowly after 2001 than during

1980–1996, asthma hospitalizations

declined since 1984 and deaths

declined since 1999. Disparities by race

and sex for adverse outcomes

remained high despite these declines.

Conclusion

Since 2001, asthma prevalence

increased, risk-based rates for visits to

private physician offices and deaths

declined, and risk-based rates for other

types of ambulatory visits and for

hospitalizations showed no clear trend.

Keywords: prevalence c health care

use c morbidity c mortality

National Surveillance of

Asthma: United States,

2001–2010

by Jeanne E. Moorman, M.S., National Center for Environmental

Health; Lara J. Akinbami, M.D., National Center for Health

Statistics; Cathy M. Bailey, M.S., National Center for Environmental

Health; Hatice S. Zahran, M.D., National Center for Environmental

Health; Michael E. King, Ph.D., National Center for Environmental

Health; Carol A. Johnson, M.P.H., National Center for Environmental

Health; and Xiang Liu, M.Sc., National Center for Health Statistics

Introduction
 

Asthma is a common chronic

disorder of the airways characterized by

periods of reversible airflow obstruction

known as asthma exacerbations or

attacks (1,2). Airflow is obstructed by

factors which narrow airways in the

lungs, including inflammation and

airway hyperreactivity (contraction of

the small muscles surrounding the

airways), in reaction to certain

exposures. Exposures may include

exercise; airway infections; airborne

allergens (e.g., pollen, mold, animal

dander, dust mite, and cockroach

allergens); occupational exposures (e.g.,

sensitizing chemicals or dusts); and

airborne irritants (e.g., particulate matter

and environmental tobacco smoke).

Symptoms during an asthma attack may

include wheezing, coughing, shortness

of breath, and chest tightness or pain.

Attacks can range from a nuisance to a

life-threatening event. Although many

people with asthma have only

occasional mild symptoms, others have

severe asthma that interferes with daily

activity (1). Although causal

occupational exposures have been

identified, it is not clear how to prevent

asthma from developing and there is no

cure (1,3). Yet, the means to control and

prevent exacerbations in persons who

have asthma are well established (1).

Once an exacerbation begins,

treatment for short-term relief includes

medication to relax the small muscles in

the airways and to decrease

inflammation. The cornerstone of

treatment, however, is long-term

prevention to control inflammation and

airway hyperreactivity (1). Asthma

management strategies include adequate

patient education, consistent use of

preventive medication, and control of

environmental factors that affect asthma

(home-based, multi-trigger multicomponent interventions). These

strategies have been shown to be

effective in improving the health of

individuals affected by asthma and are

integral to reducing the impact of

asthma in the United States (1,2,4).

Public health goals for asthma,

outlined in the Healthy People

objectives, focus on mitigating the

impact of asthma rather than on

reducing asthma incidence or prevalence

(5). Public health efforts, therefore,

include interventions to reduce asthma

deaths, hospitalizations, and emergency

department (ED) visits, and to increase

the proportion of persons who receive

health care consistent with the

Guidelines for the Diagnosis and

Management of Asthma (1). This report

is the fourth in a series of national

asthma surveillance summaries (2,7,8).

It presents data from national health

surveys conducted by the Centers for

Page 1
Page 2 [ Series 3, No. 35

Disease Control and Prevention’s (CDC)

National Center for Health Statistics

(NCHS), and describes the overall

asthma surveillance picture for the

United States since 2001. Two types of

rates for asthma outcomes are presented:

population-based rates that indicate the

rate for the entire U.S. population and

population subgroups (e.g., race and

ethnic group, sex, and geographic

region) and reflect the overall burden on

the general population; and risk-based

rates for which the denominator is

restricted to estimates of the number of

persons who have asthma and are at risk

for asthma-related outcomes. Risk-based

measures control for differences in

asthma prevalence among population

subgroups and across time so that the

magnitude of the outcome and the

trends among people with asthma can be

seen more clearly. The measures and

definitions used are consistent with

those presented in the 2007 surveillance

summary so that the historic estimates

in that previous report can be directly

compared with estimates in this report

(2). An overview of long-term trends

from 1980 for asthma prevalence, health

care use, and mortality is also presented.

Methods

Data Sources

Asthma prevalence and morbidity

data are obtained from national surveys

conducted by NCHS. Asthma prevalence

data are self-reported by respondents to

the National Health Interview Survey

(NHIS) 2001–2010; asthma office visit

data are obtained from the National

Ambulatory Medical Care Survey

(NAMCS) 2001–2009; hospital

outpatient department visits and ED data

are obtained from the National Hospital

Ambulatory Medical Care Survey

(NHAMCS) 2001–2009; asthma

hospitalization data are obtained from

the National Hospital Discharge Survey

(NHDS) 2001–2009; and asthma death

data are obtained from the National

Vital Statistics System (NVSS),

Underlying Cause of Death files

2001–2009. Details on each data source

can be found in Appendix I: Data

Sources and Limitations.

Analytic Methods

For all survey data, survey weights

were used to calculate population-based

estimates. With the exception of death

record data from 1980–2009 and

hospitalization data from 1980–1987,

standard errors were calculated using

SUDAAN software to account for each

survey’s complex sample design (9).

Standard errors for death rates were

based on the number of deaths (10). For

hospitalizations between 1980 and 1987,

standard errors were estimated using

relative standard error tables provided

by NCHS’ Division of Health Care

Statistics (11). Reliability of estimates

was based on the relative standard error

(RSE), which is calculated by dividing

the estimate into its standard error and

multiplying by 100. Estimates with an

RSE between 30% and 50% are noted.

Estimates with an RSE greater than 50%

are not shown. For mortality data,

estimates based on fewer than 20 deaths

are also not shown.

Significance testing for trends was

performed with Joinpoint software (12).

Joinpoint regression characterizes trends

as joined linear segments on a

logarithmic scale. A joinpoint is the year

when two segments with different slopes

meet. Average annual percentage change

for each segment was estimated based

on the natural logarithm of rates. A 95%

confidence interval around the annual

percent change was used to determine

whether the annual percent change for

each segment is significantly different

from zero.

Data on demographic characteristics

(age, sex, race and ethnicity, and

geographic region) were standardized

across all data sources to the extent

possible. Poverty status and detailed

race and ethnicity groups were only

available for prevalence data (NHIS).

Age groups 15–19, 20–24, and 25–34

are not shown separately for hospital

outpatient (NHAMCS) and office visits

(NAMCS)

due to small sample sizes. Hispanic

ethnicity was not available for hospital

discharge data (NHDS).

To obtain sufficient sample sizes to

produce stable estimates for

demographic subgroups, 3 years of data

for the most recent period were

combined and presented as 3-year

average annual estimates. For NHIS,

data are presented for 2008–2010, and

for the remaining data sources, data are

presented for 2007–2009. Risk-based

rates were calculated by dividing

estimates of the number of events

(office visits, hospital outpatient visits,

ED visits, and hospitalizations) and the

number of deaths by the estimated

number of persons with current asthma

from NHIS for the same demographic

group and the same year or the same

3-year period. Population-based rates

were calculated by dividing estimates of

the number of events (office visits,

hospital outpatient visits, ED visits, and

hospitalizations) and the number of

deaths by the estimated population size

for the same demographic group and the

same year or the same 3-year period.

Age-adjusted estimates are provided

only for population-based rates to

account for age-related differences over

time and between population subgroups.

Risk-based rates are not age adjusted

because they already account for asthma

prevalence differences. Comparisons can

be made between groups without

concern that variations in asthma

prevalence are contributing to observed

differences. Additionally, there were no

substantial changes in the age

distribution among the population with

current asthma or with at least one

asthma attack in the previous year.

Additional details on methods can

be found in Appendix II: Technical

Notes. Additional details on each

demographic characteristic and each

asthma-specific measure can be found in

Appendix III: Definition of Terms.
Current Asthma

Prevalence and

Asthma Attack

Prevalence

Estimates of asthma prevalence

indicate the number of persons and

percentage of the population with

asthma at a given point in time. Current

asthma prevalence estimates, available

from 2001 through 2010, indicate the

number and percentage of people who

reported receiving a diagnosis of asthma

and still having asthma at the time of

the health survey. Asthma attack

prevalence estimates, available from

1997 through 2010, indicate the number

and percentage of people with an

asthma diagnosis who reported having at

least one asthma attack in the previous

12 months. This measure is an indicator

of suboptimal asthma control. Those

who report experiencing an attack are at

risk for additional adverse outcomes

such as missing work or school, or

requiring acute medical treatment or

hospitalization.

This section analyzes trends for

2001–2010 for current asthma

prevalence and asthma attack prevalence

for population-based rates, risk-based

rates, and counts of persons with current

asthma or at least one asthma attack

within the past year. Differences

between population subgroups are

assessed over this time period, and

increased demographic detail using

average annual estimates is presented

for the period 2008–2010. Additional

details not included in the figures can be

found in Tables 1–6.

Current Asthma

Prevalence Trends

Number of persons with asthma—The

number of persons with asthma increased

2.9% each year, from 20.3 million persons

in 2001 to 25.7 million persons in 2010

(Figure 1). Of the 25.7 million, 7.0 million

Series 3, No. 35 [ Page 3

were children and 18.7 million were

adults. Among adults, 3.1 million people

aged 65 and over had asthma. By race,

19.1 million were white, 4.7 million were i

black, and 1.9 million were of other races.

By ethnicity, 3.6 million were Hispanic

and 22.1 million were non-Hispanic. i

Trends in current asthma prevalence a overall, by age group and sex—Current

asthma prevalence increased at a rate of

1.5% per year to a prevalence of 8.4%

in 2010 (Figure 1). Among children

aged 0–17 years, current asthma ( prevalence increased at a rate of 1.4%

per year, and among adults aged 18 and

over, prevalence increased at a rate of

2.1% per year. Current asthma

prevalence increased at a rate of 1.8%

per year among males and females

(Table 1).

Trends in current asthma prevalence,

by race and ethnicity—Among white

persons, current asthma prevalence

ncreased at a rate of 1.4% per year to a

prevalence of 7.8% in 2010. Among

black persons, current asthma prevalence

ncreased at a rate of 3.2% per year to

11.9% in 2010. By ethnicity, current

sthma prevalence rose among Hispanic

persons at a rate of 3.2% per year to

7.2% in 2010. Among non-Hispanic

persons, prevalence rose at a rate of

1.9% per year to 8.7% in 2010

Table 1).

0 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

0 

2 

4 

6 

8 

10 

12 

14 

16 

18 

20 

22 

24 

26 

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 

Percent 

Total number of persons in millions 

Year 

Total number of persons 

Percent 

NOTES: Percentages are age adjusted to the standard 2000 U.S. population. See Table 1 for underlying data. 

SOURCE: CDC/NCHS, National Health Interview Survey. 

Figure 1. Current asthma prevalence: United States, 2001–2010
Page 4 [ Series 3, No. 35

Current Asthma

Prevalence by Selected

Characteristics

Age group and sex differences in

2008–2010 current asthma

prevalence—For the period 2008–2010,

average annual current asthma

prevalence was higher in children aged

0–17 years (9.5%) than in adults aged

18 and over (7.7%), and was higher in

females (9.2%) than in males (7.0%)

(Figure 2). However, the difference in

prevalence between males and females

varied by age group. Among children,

boys had higher prevalence than girls

(11.1% compared with 7.8%) whereas

among adults, men had lower prevalence

than women (5.7% compared with

9.7%) (Table 2).

Race differences in 2008–2010 current

asthma prevalence—Current asthma

prevalence was higher in black persons

(11.2%) than in white persons (7.7%)

(Figure 2, Table 2).

Ethnicity differences in 2008–2010

current asthma prevalence—Among

Hispanic persons, Puerto Rican persons

had higher prevalence (16.1%)

compared with Mexican persons (5.4%)

(Figure 2, Table 2).

Differences by poverty status in

2008–2010 current asthma

prevalence—Current asthma was more

prevalent among persons with family

income below 100% of the federal

poverty threshold (11.2%) than among

persons with family income at or above

the federal poverty threshold (8.5% for

100% to less than 250% of the poverty

threshold, 7.8% for 250% to less than

450% of the poverty threshold, and

6.7% for at or above 450% of the

poverty threshold). Asthma prevalence

was significantly lower for each

successively higher poverty level group

(Figure 2, Table 2).

Differences by geographic region and

urbanicity in 2008–2010 current

asthma prevalence—The current asthma

prevalence rate was higher in the

Northeast (8.8%) than in the South

(7.6%) or in the West (8.0%), and was

higher in the Midwest (8.7%) than in

the South (7.6%). Current asthma

prevalence did not differ between

metropolitan and nonmetropolitan areas

(Figure 2, Table 2).

Percent 

0 2 4 6 8 10 12 14 16 18 20 

Children 

Adults 

Male 

Female 

White 

Black 

American Indian/Alaska Native 

Asian 

Multiple race 

Total Hispanic 

Puerto Rican 

Mexican 

Below 100% of poverty level 

100% to less than 250% of poverty level 

250% to less than 450% of poverty level 

450% of poverty level or higher 

Northeast 

Midwest 

South 

West 

Metropolitan 

Nonmetropolitan 

NOTES: Crude (unadjusted) percentages are presented. See Table 2 for underlying data. The categories “Puerto Rican” and “Mexican” are subcategories of “Hispanic.” 

SOURCES: CDC/NCHS, National Health Interview Survey and Health Data Interactive (13). 

95% confidence interval. 

Figure 2. Current asthma prevalence, by age group, sex, race and ethnicity, poverty status, geographic region, and urbanicity:

United States, average annual 2008–2010
Asthma Attack Prevalence

Trends

Number of persons with an asthma

attack in the previous 12 months—The

number of persons with at least one

asthma attack in the previous 12 months

was stable from 2001 to 2003 then

increased 2.6% per year from 11.0

million in 2003 to 13.9 million in 2010

(Figure 3). Among this number, 4.3

million were children and 9.6 million

were adults; 5.4 million were males and

8.5 million were females. By race, 10.4

million were white, 2.3 million were

black, and 1.2 million were of another

race. By ethnicity, 2.0 million were

Hispanic and 11.9 million were

non-Hispanic.

Trends in population-based asthma

attack prevalence overall, by age group

and sex—The percentage of people with

at least one asthma attack in the

previous 12 months remained level

during the period from 2001 to 2003

(range: 3.9% to 4.3%) but increased

1.6% per year from 2003 to 2010, from

3.9% to 4.6% (Figure 3, Table 3).

Children had asthma attack prevalence

rates (range: 5.2% to 5.8%) that were

higher than adult rates (range: 3.3% to

4.2%). Females had higher asthma

attack prevalence (range: 4.4% to 5.4%)

compared with males (range: 3.1% to

3.7%) (Table 3).

Series 3, No. 35 [ Page 5

Trends in population-based asthma

attack prevalence, by race and

ethnicity—Black persons had higher

asthma attack prevalence (range: 4.6%

to 5.8%) compared with white persons

(range: 3.7% to 4.3%) in most years

during the period. In 2005 and 2006

there was no significant difference

between black and white persons. For

race and Hispanic groups except white

persons, asthma attack prevalence rates

remained level for the period. For white

persons, asthma attack prevalence

increased 1.6% per year from 2003 to

2010 (Table 3).

26
 

24
 

22
 

20
 

18
 

16
 

14
 

12
 

10
 

8
 

6
 

4
 

2
 

0 

Total number of persons in millions

10
 

8
 

6
 

4
 

2
 

0 

Percent 

Total number of persons Percent 

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
 

Year 

NOTES: Percentages are age adjusted to the standard 2000 U.S. population. See Table 3 for underlying data. 

SOURCE: CDC/NCHS, National Health Interview Survey. 

Figure 3. Asthma attack prevalence (population-based): United States, 2001–2010
Page 6 [ Series 3, No. 35

Asthma Attack Prevalence

by Selected Characteristics

Asthma attack prevalence 2008–2010—

Differences by age, gender, race and

ethnicity, and poverty for populationbased asthma attack rates were similar

to those found for current asthma

prevalence (Figure 2). Children had

higher rates than adults, females had

higher rates than males, black persons

had higher rates than white persons,

persons of Puerto Rican descent had

higher rates than those of Mexican

descent, and those below the poverty

level had higher rates than those above

the poverty level. However, unlike

current asthma prevalence, populationbased asthma attack prevalence rates for

the South, the Northeast, and the

Midwest were similar (Figure 4,

Table 4).

Children
 

Adults
 

Male
 

Female
 

White
 

Black
 

American Indian/Alaska Native
 

Asian
 

Multiple race
 

Total Hispanic 

Puerto Rican 

Mexican 

Below 100% of poverty level 

100% to less than 250% of poverty level 

250% to less than 450% of poverty level 

450% of poverty level or higher 

Northeast
 

Midwest
 

South
 

West
 

Metropolitan
 

Nonmetropolitan
 

Percent 

95% confidence interval. 

NOTES: Crude (unadjusted) percentages are presented. See Table 4 for underlying data. The categories “Puerto Rican” and “Mexican” are subcategories of “Hispanic.” 

SOURCES: CDC/NCHS, National Health Interview Survey and Health Data Interactive (13). 

0 2 4 6 8 10 12 14 16 18 

Figure 4. Asthma attack prevalence (population-based), by age group, sex, race and ethnicity, poverty status, geographic region, and

urbanicity: United States, average annual 2008–2010

20 
Series 3, No. 35 [ Page 7

Asthma Attack Prevalence

Trends Among Children

and Adults

Trends in asthma attack prevalence

among persons with current asthma—

Asthma attack prevalence among

persons with current asthma decreased

from 55.8% in 2001 to 51.9% in 2010,

at a rate of 1.0% per year. This decrease

in the proportion reporting an attack in

the past 12 months represents progress

in asthma management (Figure 5,

Table 5). However, Figure 3 shows an

increasing trend in asthma attack

prevalence among the general

population from 2003 to 2010

(population-based rate). The populationbased asthma attack prevalence rate

increased because current asthma

prevalence increased (see Figure 1).

That is, a larger proportion of the

population had asthma and was at risk

for an asthma attack, which outweighed

the lower risk among people with

asthma of having an asthma attack. The

result was that for asthma attack

prevalence, the population-based rate

increased even while the risk-based rate

declined.

Risk-based asthma attack prevalence

among children—In 2001, 61.7% of

children with current asthma had at least

one asthma attack in the previous 12

months compared with 58.3% in 2010;

the rate of decrease per year from 2001 Risk-based asthma attack prevalence

to 2010 was 1.5% (Table 5). In each among adults—In 2001, 53.8% of

year from 2001 to 2010, a higher adults with asthma had at least one

percentage of children with current asthma attack in the previous 12 months

asthma had at least one attack in the compared with 49.1% in 2010. Asthma

previous 12 months compared with attack prevalence among adults with

adults with current asthma. current asthma declined from 2001 to

2010 at a rate of 1.0% per year

(Table 5).

70 

60 Children aged 0–17 years 

50 

Adults aged 18 and over 

40 

30 

Percent 

20 

10 

0 

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 

Year 

NOTES: Crude (unadjusted) percentages are presented. See Table 5 for underlying data. 

SOURCE: CDC/NCHS, National Health Interview Survey. 

Figure 5. Asthma attack prevalence among children and adults with current asthma

(risk-based): United States, 2001–2010
Page 8 [ Series 3, No. 35

Asthma Attack Prevalence

Among Persons With

Current Asthma

Age group differences in 2008–2010

asthma attack prevalence among

persons with current asthma—Overall,

an average annual 51.2% of persons

with current asthma reported having at

least one asthma attack during the

previous 12 months. Children aged 0–17

years with current asthma were more

likely to have had at least one attack

during the previous 12 months (56.5%)

than adults aged 18 and over (49.1%)

(Figure 6, Table 6).

Differences by sex and race and

ethnicity in 2008–2010 asthma attack

prevalence among persons with current

asthma—Females with current asthma

were more likely to have had an attack

during the previous 12 months (52.7%)

than males (49.2%). Asthma attack

prevalence among persons with asthma

did not vary significantly by race or

ethnicity (Figure 6, Table 6).

Differences by poverty status in

2008–2010 asthma attack prevalence

among persons with current

asthma—Among persons with current

asthma, having at least one asthma

attack in the previous 12 months was

more prevalent among those with family

income less than 100% of the federal

poverty threshold (55.1%) than among

persons with family income between

250% and less than 450% of the poverty

threshold (47.9%) (Figure 6, Table 6).

Differences by geographic region in

2008–2010 asthma attack prevalence

among persons with current

asthma—The risk-based asthma attack

prevalence rate was higher in the South

(52.2%) and the West (54.1%) than in

the Northeast (47.3%) (Figure 6,

Table 6). This regional difference is the

reverse of that seen for asthma

prevalence. Current asthma prevalence

was lower in the South and the West

than in the Northeast (Figure 2, Table 2).

Percent 

NOTES: Crude (unadjusted) percentages are presented. See Table 6 for underlying data. The categories “Puerto Rican” and “Mexican” are subcategories of “Hispanic.” 

SOURCE: CDC/NCHS, National Health Interview Survey. 

0 10 20 30 40 50 60 70 

95% confidence interval. 

Children 

Adults 

Male 

Female 

White 

Black 

Total Hispanic 

Puerto Rican 

Mexican 

Northeast 

Midwest 

South 

West 

Below 100% of poverty level 

100% to less than 250% of poverty level 

250% to less than 450% of poverty level 

450% of poverty level or higher 

Figure 6. Asthma attack prevalence among persons with current asthma (risk-based), by age group, sex, race and ethnicity, poverty status,

and geographic region: United States, average annual 2008–2010
Physician Office

Visits and Hospital

Outpatient Department

Visits

Estimates for asthma physician

office and hospital outpatient visits

include the number of visits, the rate of

visits for the general population

(population-based rates), and the rate of

visits for the population with current

asthma (risk-based rates). Routine visits

to a physician office or hospital

outpatient clinic for preventive asthma

care is a key component of asthma

management and maintaining good

asthma control (1). However,

ambulatory care estimates based on

visits to physician offices or hospital

outpatient departments also include

visits for patients with exacerbations of

their asthma. To the extent that

worsening symptoms are reversed and

asthma control is improved, ambulatory

visits in these nonacute settings may

avert more severe outcomes such as

asthma ED visits or hospitalizations.

This section presents 2001–2009

trends for asthma visits to private

physician offices and hospital outpatient

departments for population-based rates,

risk-based rates, and counts of visits.

Differences between detailed

demographic subgroups are assessed

using average annual estimates for the

period 2007–2009. Additional detail not

included in the figures can be found in

Tables 7–12.

Physician Office Visit

Trends

Number of physician office visits—

There was fluctuation in the number of

asthma physician office visits from 2001

to 2009, but no clear trend. In 2009,

there were 10.6 million asthma

physician office visits (Figure 7).

Series 3, No. 35 [ Page 9

F

Population-based rate of physician

office visits—The population-based rate

of physician office visits for asthma

fluctuated but did not follow a

significant trend from 2001 to 2009. In

2009, there were 351.2 visits per 10,000

population (Figure 7, Table 7).

Risk-based rate of physician office

visits—From 2001 to 2009, there was a

5.5% decrease per year in the risk-based

rate of physician office visits for

asthma. In 2009, there were 43.0 visits

per 100 persons with asthma (Figure 7,

Table 8). Total number of visits in millions 

20 500 

18 450 

16 400 

14 350 

12 300 

10 250 

8 200 

6 150 

4 100 

2 50 

0 0 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

Total number of visits 

Rate per 10,000 

population 

Rate per 100 persons with asthma 

Rate 

Year 

NOTES: Total numbers and crude (unadjusted) risk-based rates (per 100 persons with asthma) are presented. 

Population-based rates (per 10,000 population) are age adjusted to the 2000 standard population. See Tables 7 

and 8 for underlying data. 

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey. 

igure 7. Asthma physician office visits: United States, 2001–2009
Page 10 [ Series 3, No. 35

Hospital Outpatient

Department Visit Trends

Number of hospital outpatient

department visits—There was no

significant trend in the number of

asthma hospital outpatient department

visits from 2001 to 2009. In 2009, there

were 1.2 million asthma hospital

outpatient department visits (Figure 8).

Population-based rate of hospital

outpatient department visits—The

population-based rate of asthma hospital

outpatient department visits for asthma

fluctuated but did not follow a

significant trend from 2001 to 2009. In

2009, there were 39.6 visits per 10,000

population (Figure 8, Table 9).

Risk-based rate of hospital outpatient

department visits—From 2001 to 2009,

there was no significant trend in the

risk-based rate of hospital outpatient

department visits for asthma. In 2009,

there were 4.8 visits per 100 persons

with asthma (Figure 8, Table 10).

Total number of visits in thousands 

1,800 

1,600 

1,400 

1,200 

1,000 

800 

600 

400 

200 

0 

Rate 

Total number of visits 

Rate per 10,000 population 

Rate per 100 persons with asthma 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

70 

60 

50 

40 

30 

20 

10 

0 

Year 

NOTES: Total numbers and crude (unadjusted) risk-based rates (per 100 persons with asthma) are presented.
 

Population-based rates (per 10,000 population) are age adjusted to the 2000 standard population. See Tables 9
 

and 10 for underlying data.
 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
 

Figure 8. Asthma hospital outpatient department visits: United States, 2001–2009
Series 3, No. 35 [ Page 11

Physician Office Visits by

Selected Characteristics

Differences in risk-based rates of

physician office visits, by age group

and sex—For the period 2007–2009, the

average annual rate of physician office

visits for asthma was higher for children

aged 0–17 years compared with adults

aged 18 and over (66.9 compared with

38.9 visits per 100 persons with

asthma). Males and females had similar

rates (Figure 9, Table 11).

Differences in risk-based rates of

physician office visits, by race and

ethnicity—For the period 2007–2009,

the average annual rate of physician

office visits for asthma for white and

black persons was similar. The rate for

Hispanic persons was higher than the

rate for non-Hispanic persons (72.6

compared with 43.5 per 100 persons

with asthma) (Figure 9, Table 11).

Differences in risk-based rates of

physician office visits, by geographic

region—The average annual rate of

physician office visits for asthma for

persons living in the South (56.6 visits

per 100 persons with asthma) was

higher than for those living in the

Midwest (33.9 per 100 persons with

asthma) (Figure 9, Table 11).

Children 

Adults 

Male 

Female 

White 

Black 

Hispanic 

Non-Hispanic 

Northeast 

Midwest 

South 

West 

0 10 20 30 40 50 60 70 80 90 100 

Rate per 100 persons with asthma 

95% confidence interval. 

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 11 for underlying data. 

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey. 

Figure 9. Asthma physician office visit rates (risk-based), by age group, sex, race and

ethnicity, and geographic region: United States, average annual 2007–2009
Page 12 [ Series 3, No. 35

Hospital Outpatient

Department Visits by

Selected Characteristics

Differences in risk-based rates of

hospital outpatient department visits, by

age group and sex—For the period

2007–2009, the average annual rate of

hospital outpatient department visits for

asthma was higher for children aged

0–17 years compared with adults aged

18 and over (11.8 compared with 3.6

visits per 100 persons with asthma).

There was no difference by sex

(Figure 10, Table 12).

Differences in risk-based rates of

hospital outpatient department visits, by

race and ethnicity—The average annual

rate of hospital outpatient department

visits for asthma was lower for white

persons (5.1 visits per 100 persons with

asthma) compared with black persons

(11.1 visits per 100 persons with

asthma). Compared with non-Hispanic

persons with current asthma, Hispanic

persons had a higher average annual rate

of hospital outpatient department visits

for asthma (9.9 compared with 5.4 per

100 persons with asthma) (Figure 10,

Table 12).

Differences in risk-based rates of

hospital outpatient department visits, by

geographic region—There were no

significant differences in risk-based rates

of hospital outpatient department visits

by geographic region (Figure 10,

Table 12).

Physician Office Visits by

Age Group

Differences in risk-based rates of

physician office visits, by detailed age

group—The average annual asthma

physician office visit rate for children

aged 0–4 years was the highest at 117.2

per 100 persons with asthma. For

persons aged 15–34, the rate was the

lowest at 27.2 per 100 persons with

asthma (Figure 11, Table 11).

Children 

Adults 

Male 

Female 

White 

Black 

Hispanic 

Non-Hispanic 

Northeast 

Midwest 

South* 

West* 

*Estimate is considered unreliable. The relative standard error is between 30% and 50%. 

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 12 for underlying data. 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey. 

Rate per 100 persons with asthma 

0 2 4 6 8 10 12 14 16 18 

95% confidence interval. 

Figure 10. Asthma hospital outpatient department visit rates (risk-based), by age group,

sex, race and ethnicity, and geographic region: United States, average annual 2007–2009

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 11 for underlying data. 

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey. 

0 

20 

40 

60 

80 

100 

120 

140 

160 

180 

0–4 years 5–14 years 15–34 years 35–64 years 65 years 

or over 

Rate per 100 persons with asthma 

95% confidence interval. 

Figure 11. Asthma physician office visit rates (risk-based), by detailed age group:

United States, average annual 2007–2009
Series 3, No. 35 [ Page 13

Hospital Outpatient

Department Visits by Age

Group

Differences in risk-based rates of

hospital outpatient department visits, by

detailed age group—Average annual

asthma hospital outpatient department

visit rates for children aged 0–4 years

were the highest at 21.8 per 100 persons

with asthma. Visit rates were also higher

for children aged 5–14 years (10.6)

compared with older age groups (4.7 for

those aged 15–34, 3.3 for those aged

35–64, and 3.1 for those aged 65 or

over) (Figure 12, Table 12).

Physician Office and

Hospital Outpatient

Department Visit Trends

by Race

Trends for health care encounter rates

for persons with asthma in primary

care settings (risk-based), by race—At

the beginning of the period 2001–2009,

black persons had lower visit rates for

primary health care for asthma. Given

their higher rates of adverse outcomes

relative to white persons, the lower

primary visit rates among black persons

could indicate underutilization of

preventive services. However,

encounters in primary care settings

increased for black persons with asthma

relative to white persons so that during

the latter part of the period, total

primary care encounter rates were

similar by race (Figure 13).

0–4 years 5–14 years 15–34 years 35–64 years *65 years 

or over 

Rate per 100 persons with asthma 

0 

5 

10 

15 

20 

25 

30 

35 

*Estimate is considered unreliable. The relative standard error is between 30% and 50%. 

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 12 for underlying data. 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey. 

95% confidence interval. 

Figure 12. Asthma hospital outpatient department visit rates (risk-based), by detailed age

group: United States, average annual 2007–2009

NOTES: Crude (unadjusted) rates are presented. Estimates for visits by black persons to physician offices (2001, 2005, 

2006) and to hospital outpatient departments (OPD) (2007, 2009) are unreliable: the relative standard error is between 30% 

and 50%. See Tables 8 and 10 for underlying data. 

SOURCES: CDC/NCHS, National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. Rate per 100 persons with asthma 

0 

10 

20 

30 

40 

50 

60 

70 

80 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

White—physician office 

White—hospital OPD 

Black—physician office 

Black—hospital OPD 

Year 

Figure 13. Asthma physician office visit rates and hospital outpatient department visit

rates (risk-based), by race: United States, 2001–2009
Page 14 [ Series 3, No. 35

Emergency

Department Visits

Asthma ED measures include the

count of visits, the rate of visits for the

general population (population-based

rates,) and the rate for the population

with current asthma (risk-based rates).

Visiting the ED for an asthma

exacerbation is a key indicator of poorly

controlled asthma and of risk for future

asthma exacerbations (1). There are

specific recommendations for patient

education to help prevent future ED

visits, including focused and targeted

patient education in the physician office

and ED setting (assessing inhaler

technique, instructions for medication,

and steps to follow for worsening

symptoms) and referral for follow-up

asthma care (1).

This section presents 2001–2009

trends for asthma ED visits for

population-based rates, risk-based rates,

and counts of visits. Differences

between population subgroups are

assessed over this period, and more

detailed demographic groups are

compared using average annual

estimates for the period 2007–2009.

Additional detail not provided in the

figures can be found in Tables 13–15.

ED Visit Trends

Number of asthma ED visits—Over the

period 2001 through 2009, the number

of ED visits fluctuated without a clear

trend. In 2009, there were 2.1 million

asthma ED visits (Figure 14).

Population-based rates of asthma ED

visits—The ED visit rate per 10,000

population fluctuated but did not follow

a consistent trend. In 2009, there were

69.7 ED visits per 10,000 population

(Figure 14, Table 13).

Risk-based rates of asthma ED

visits—There was also no significant

trend in the risk-based based rates of

ED visits. In 2009, there were 8.4 ED

visits per 100 persons with asthma; a

similar rate persisted throughout the

period (Figure 14, Table 14).

Total number of visits in thousands 

2,200 80 

1,800 

2,000 

70 

1,600 

60 

1,400 50 

1,000 

1,200 

40 

800 30 

600 

20 

200 

400 

10 

0 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

0 

Total number of visits 

Rate per 10,000 population 

Rate per 100 persons with asthma 

Year 

NOTES: Total numbers and crude (unadjusted) risk-based rates (per 100 persons with asthma) are presented.
 

Population-based rates (per 10,000 population) are age adjusted to the 2000 standard population.
 

See Tables 13 and 14 for underlying data.
 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
 

Figure 14. Asthma emergency department visits: United States, 2001–2009

Rate 
Series 3, No. 35 [ Page 15

ED Visits by Selected

Characteristics

Differences in risk-based rates of ED

visits, by age group and sex—For the

period 2007–2009, children aged 0–17

years had a higher ED visit rate

compared with adults aged 18 and over

(10.7 compared with 7.0 per 100

persons with asthma). There was no

difference in ED rates by sex (8.7 and

7.6 per 100 persons with asthma for

males and females, respectively)

(Figure 15, Table 15).

Differences in risk-based rates of ED

visits, by race and ethnicity—Black

persons had an ED visit rate three times

as high as white persons (18.3 compared

with 6.1 per 100 persons with asthma).

Hispanic persons had a higher ED visit

rate than non-Hispanic persons (10.8

compared with 7.7 per 100 persons with

asthma) (Figure 15, Table 15).

Differences in risk-based rates of ED

visits, by geographic region—Among

geographic regions, the ED visit rate

was higher in the Northeast (10.2 per

100 persons with asthma) and in the

South (8.7) than in the West (5.5)

(Figure 15, Table 15).

ED Visit Trends by Race

Differences in risk-based rates of ED

visits, by race—The ED visit rate per

100 persons with asthma for black

persons was more than twice as high as

the rate for white persons during each

year from 2001 to 2009 (Figure 16,

Table 14).

Trends in risk-based rates of ED visits,

by race—There was fluctuation but no

significant trend in the ED visit rate per

100 persons with asthma for white and

black persons from 2001 through 2009

(Figure 16, Table 14).

Children 

Adults 

Male 

Female 

White 

Black 

Hispanic 

Non-Hispanic 

Northeast 

Midwest 

South 

West 

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 15 for underlying data. 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey. 

Rate per 100 persons with asthma 

0 5 10 15 20 25 

95% confidence interval. 

Figure 15. Asthma emergency department visit rates (risk-based), by age group, sex, race

and ethnicity, and geographic region: United States, average annual 2007–2009

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 14 for underlying data. 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey. 

0 

5 

10 

15 

20 

25 

30 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

Rate per 100 persons with asthma

Black 

White 

Year 

Figure 16. Asthma emergency department visit rates (risk-based), by race: United States,

2001–2009
Page 16 [ Series 3, No. 35

ED Visits by Age Group

Differences in risk-based rates of ED

vsits, by detailed age group—The

asthma ED visit rate was the highest for

children aged 0–4 years (20.8 visits per

100 persons with asthma) and lowest for

adults aged 65 or over (4.0 visits per

100 persons with asthma) (Figure 17,

Table 15).

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 15 for underlying data. 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey. 

0–4 

years 

65 years 

or over 

Rate per 100 persons with asthma 

0 

5 

10 

15 

20 

25 

30 

5–14 

years 

15–19 

years 

20–24 

years 

25–34 

years 

35–64 

years 

95% confidence interval. 

Figure 17. Asthma emergency department visit rates (risk-based), by detailed age group:

United States, average annual 2007–2009
Series 3, No. 35 [ Page 17

Hospital Inpatient

Stays

Asthma hospitalization measures

include the numbers and rates

(population-based rates and risk-based

rates) of discharges from nonfederal

short-stay hospitals. Asthma

hospitalizations represent a serious

adverse outcome that is theoretically

preventable with high-quality health

care, patient education, and optimal

management of asthma. Furthermore, an

asthma hospitalization is a marker for

increased risk of future asthma

exacerbations (1).

This section presents 2001–2009

trends for asthma hospital inpatient stays

for population-based rates, risk-based

rates, and counts of hospitalizations.

Differences between population

subgroups are assessed over this period

and for additional demographic detail

using average annual estimates for the

period 2007–2009. Additional detail not

included in the figures can be found in

Tables 16–18.

Hospitalization Trends

Number of asthma hospitalizations—

There was no significant trend in the

total number of asthma hospitalizations

from 2001 through 2009. In 2009, there

were 479,300 hospitalizations for asthma

(Figure 18).

Population-based rate of asthma

hospitalizations—From 2001 through

2009, the trend in hospitalization rates

was not significant (Figure 18,

Table 16).

Risk-based rate of asthma

hospitalizations—Hospitalization rates

for persons with asthma did not follow a

significant trend from 2001 through

2009 (Figure 18, Table 17).

Rate 

Total number of persons in thousands 

0 

2 

4 

6 

8 

10 

12 

14 

16 

18 

20 

0 

100 

200 

300 

400 

500 

600 

700 

800 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

Total number of 

hospitalizations 

Rate per 10,000 population 

Rate per 100 persons with asthma 

Year 

NOTES: Total numbers and crude (unadjusted) risk-based rates (per 100 persons with asthma) are presented. Populationbased rates (per 10,000 population) are age adjusted to the 2000 standard population. See Tables 16 and 17 for 

underlying data. 

SOURCE: CDC/NCHS, National Hospital Discharge Survey. 

Figure 18. Asthma hospitalizations: United States, 2001–2009
Page 18 [ Series 3, No. 35

Hospitalizations by

Selected Characteristics

Differences in risk-based rates of

asthma hospitalizations, by age group

and sex—For the period 2007–2009,

average annual asthma hospitalizations

rates were similar between children aged

0–17 years and adults aged 18 and over

(2.1 and 1.9 per 100 persons with

asthma), and were similar between

males and females (1.8 and 2.1 per 100

persons with asthma) (Figure 19,

Table 18).

Differences in risk-based rates of

asthma hospitalizations, by race—Black

persons had an asthma hospitalization

rate more than twice as high as white

persons (2.8 compared with 1.3

hospitalizations per 100 persons with

asthma) (Figure 19, Table 18).

Differences in risk-based rates of

asthma hospitalizations, by geographic

region—The rate of hospitalizations in

the Northeast (2.7 per 100 persons with

asthma) was higher than the rate in the

Midwest (1.4 per 100 persons with

asthma). There were no other

statistically significant differences in

hospitalization risk-based rates by

geographic region (Figure 19, Table 18).

Hospitalizations by Race

Differences in annual risk-based rates

of asthma hospitalization, by race—The

hospitalization rate per 100 persons with

asthma among black persons was

between 1.9 and 2.5 times higher than

the rate for white persons during each

year from 2001 to 2009 (Figure 20,

Table 17).

Trends in risk-based rates of asthma

hospitalization, by race—For black

persons, the asthma hospitalization rate

per 100 persons with asthma declined

by an average rate of 6.3% per year

from 2001 to 2009. For white persons,

the asthma hospitalization rate declined

by an average rate of 3.7% per year

from 2001 to 2009 (Figure 20,

Table 17).

Children 

Adults 

Male 

Female 

White 

Black 

Northeast 

Midwest 

South 

West* 

*Estimate is considered unreliable. The relative standard error is between 30% and 50%. 

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 18 for underlying data. 

SOURCE: CDC/NCHS, National Hospital Discharge Survey. 

Rate per 100 persons with asthma 

0 1 2 3 4 

95% confidence interval. 

Figure 19. Asthma hospitalization rates (risk-based), by age group, sex, race, and

geographic region: United States, average annual 2007–2009

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 17 for underlying data. 

SOURCE: CDC/NCHS, National Hospital Discharge Survey. 

0 

1 

2 

3 

4 

5 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

Rate per 100 persons with asthma

White 

Black 

Year 

Figure 20. Asthma hospitalization rates (risk-based), by race: United States, 2001–2009
Hospitalizations by Age

Differences in risk-based rates of

asthma hospitalizations, by detailed age

group—Children aged 0–4 years and

adults aged 65 or over had higher

asthma hospitalization rates (5.2 and 3.7

per 100 persons with asthma) than all

other age groups. Persons aged 15–19

and 20–24 had similar rates, and both

these age groups had lower rates than

all older age groups. (Figure 21,

Table 18).

Series 3, No. 35 [ Page 19

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 18 for underlying data. 

SOURCE: CDC/NCHS, National Hospital Discharge Survey. 

0–4 

years 

65 years 

or over 

Rate per 100 persons with asthma 

5–14 

years 

15–19 

years 

20–24 

years 

25–34 

years 

35–64 

years 

0 

1 

2 

3 

4 

5 

6 

7 

8 

95% confidence interval. 

Figure 21. Asthma hospitalization rates (risk-based), by detailed age group: United States,

average annual 2007–2009
Page 20 [ Series 3, No. 35

Deaths
 

The number of asthma deaths and

death rates (population-based rates and

risk-based rates) are compiled from the

complete set of death certificates filed in

the 50 states and the District of

Columbia. Asthma deaths are

uncommon, especially among children

and young adults, but they remain a

focus of preventive efforts because highquality health care and patient education

should theoretically prevent asthmarelated deaths (1). National asthma

guidelines recommend early treatment

and special attention to patients who are

at high risk of asthma-related death (1).

Predictors of death due to asthma

include three or more ED visits for

asthma in the past year, an asthma

hospitalization or ED visit in the past

month, overuse of short-acting beta

agonist (short-term relief medication), a

history of intubation or stay in an

intensive care unit for asthma, difficulty

perceiving asthma symptoms, lack of a

written asthma action plan, certain

patient characteristics (low

socioeconomic status, female, nonwhite,

current smoker, or major psychosocial

problems), and the presence of other

medical conditions such as

cardiovascular disease (1).

This section presents 2001–2009

trends for asthma deaths for populationbased rates, risk-based rates, and counts

of deaths. Differences between

population subgroups are assessed over

this period and for additional

demographic groups using the average

annual estimates for the period

2007–2009. Additional detail not shown

in the figures can be found in

Tables 19–21.

Rate 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

0 

2 

4 

6 

8 

10 

12 

14 

16 

0 

1 

2 

3 

4 

5 

6 

Rate per million population 

Total number of deaths in thousands 

Total number of deaths 

Rate per 10,000 persons with asthma 

Year 

NOTES: Total numbers and crude (unadjusted) risk-based rates (per 10,000 persons with asthma) are presented. 

Population-based rates (per million population) are age adjusted to the 2000 standard population. See tables 19 and 20 

for underlying data. 

SOURCE: CDC/NCHS, National Vital Statistics System. 

Figure 22. Asthma deaths: United States, 2001–2009

Trends in Deaths

Number of asthma deaths—The

number of asthma deaths declined

steadily from 2001 (4,269) to 2009

(3,388) at a rate of 3.3% per year

(Figure 22).

Population-based rate of deaths—

Asthma deaths per million population

declined 4.9% per year from 15.0 deaths

per million population in 2001 to 10.5

deaths per million population in 2009

(Figure 22, Table 19).

Risk-based rate of deaths—Asthma

deaths per 10,000 persons with asthma

declined at a rate of 5.6% per year from

2.1 per 10,000 persons with asthma in

2001 to 1.4 per 10,000 persons with

asthma in 2009 (Figure 22, Table 20).
Series 3, No. 35 [ Page 21

Deaths by Selected

Characteristics

Differences in risk-based rates of

asthma deaths, by age group—Adults

aged 18 and over had a higher asthma

death rate (1.9 per 10,000 persons with

asthma) compared with children aged

0–17 years (0.3 per 10,000 persons with

asthma) (Figure 23, Table 21).

Differences in risk-based rates of

asthma deaths, by sex—The death rate

for females (1.6 per 10,000 persons with

asthma) was higher compared with

males (1.2 per 10,000 persons with

asthma). This difference is driven

primarily by the higher death rate for

women than men among adults aged 65

and over (6.6 compared with 4.4 per

10,000 persons with asthma). For

younger age groups, death rates for

males were similar to or higher than

rates for females (Figure 23, Table 21).

Differences in risk-based rates of

asthma deaths, by race and ethnicity—

Black persons had a higher asthma

death rate compared with white persons

(2.3 compared with 1.3 per 10,000

persons with asthma). Non-Hispanic

persons had a higher death rate

compared with Hispanic persons (1.5

compared with 0.9 per 10,000 persons

with asthma) (Figure 23, Table 21).

Differences in risk-based rates of

asthma deaths, by geographic

region—The asthma death rates in the

West and the South (1.5 and 1.6 per

10,000 persons with asthma) were

higher than the asthma death rate in the

Midwest region (1.3 per 10,000 persons

with asthma) (Figure 23, Table 21).

Deaths by Race and

Ethnicity

Differences in annual risk-based rates

of asthma deaths, by race and ethnicity

The death rate per 10,000 persons

with asthma for black persons was 1.6

to 2.0 times higher than the rate for

white persons during each year from 2001

to 2009. The asthma death rate for

non-Hispanic persons was 1.3 to 2.0 times

higher than the rate for Hispanic persons

during each year (Figure 24, Table 20).

Children 

Adults 

Male 

Female 

White 

Black 

Hispanic 

Non-Hispanic 

Northeast 

Midwest 

South 

West 

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 21 for underlying data. 

SOURCE: CDC/NCHS, National Vital Statistics System. 

Rate per 10,000 persons with asthma 

0 1 2 3 

95% confidence interval. 

Figure 23. Asthma death rates (risk-based), by age group, sex, race and ethnicity, and

geographic region: United States, average annual 2007–2009

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 20 for underlying data. Categories are not mutually 

exclusive: Persons are identified as either black or white and either as Hispanic or non-Hispanic. 

SOURCE: CDC/NCHS, National Vital Statistics System. 

0 

1 

2 

3 

4 

5 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

Rate per 10,000 persons with asthma

White 

Black 

Hispanic 

Non-Hispanic 

Year 

Figure 24. Asthma death rates (risk-based), by race and ethnicity: United States,

2001–2009
Page 22 [ Series 3, No. 35

Trends in risk-based rates of asthma

deaths, by race and ethnicity—From

2001 to 2009, asthma death rates per

10,000 persons with asthma declined at

a rate of 6.7% per year for black

persons, and at a rate of 5.6% per year

for white persons. During this same

period, death rates declined at a rate of

5.8% for non-Hispanic persons and

7.1% per year for Hispanic persons

(Figure 24, Table 20).

Deaths by Age

Differences in risk-based rates of

asthma deaths, by detailed age

group—For the period 2007–2009, the

average annual asthma death rates for

the three youngest age groups (0–4,

5–14, and 15–19 years) were the same

(0.3 per 10,000 persons with asthma).

The asthma death rate for adults aged

65 or over was the highest at 5.8 per

10,000 persons with asthma. The rate

for adults aged 35–64 (1.5 per 10,000

persons with asthma) was higher

compared with all younger age groups,

as were the rates for adults aged 25–34

(0.7 per 10,000 persons with asthma)

and adults aged 20–24 (0.5 per 10,000

persons with asthma) (Figure 25,

Table 21).

NOTES: Crude (unadjusted) risk-based rates are presented. See Table 21 for underlying data. 

SOURCE: CDC/NCHS, National Vital Statistics System. 

0–4 

years 

65 years 

or over 

5–14 

years 

15–19 

years 

20–24 

years 

25–34 

years 

35–64 

years 

0 

1 

2 

3 

4 

5 

6 

7 

Rate per 10,000 persons with asthma 

95% confidence interval. 

Figure 25. Asthma death rates (risk-based), by detailed age group: United States, average

annual 2007–2009
Asthma Trends in the

United States From

1980

Over the past two decades,

advances in research, medications,

treatment approach, public health

interventions, and public awareness have

all affected how asthma is diagnosed,

managed, and perceived. This section

presents trends from 1980 in asthma

prevalence, hospitalizations, and deaths

to provide greater context for the trends

(since 2001) presented in the preceding

sections. Disparities by sex and race are

also shown for long-term trends for

asthma hospitalizations and deaths. The

most recent data for morbidity measures

and asthma management strategies used

to track Healthy People 2020 objectives

are also discussed.

Historical Perspective

The long-term trend in asthma

prevalence from 1980 to 2010 is shown

in Figure 26. Asthma period prevalence

was the original measure of U.S. asthma

prevalence and estimated the percentage

of the population that had asthma in the

previous 12 months. Estimates were

based on the question, ‘‘In the past 12

months, did anyone in the family have

asthma?’’ Estimates rose from 3.1% in

1980 to 5.5% in 1996. In 1997, a major

redesign of NHIS resulted in a break in

the trend data due to a change in the

questions used to estimate asthma

prevalence (14). Beginning in 1997, two

questions were used to measure the

percentage of the population affected by

asthma. The first question asked if a

physician had ever diagnosed asthma.

The second question asked about the

occurrence of an asthma attack in the

past 12 months (asthma attack

prevalence). From 1997 to 2000, the

measure of asthma attack prevalence

was the available estimate of recent,

active asthma but it excluded persons

with well-controlled asthma. In 2001,

current asthma prevalence (measured by

the question, ‘‘Do you still have

asthma?’’ for those with an asthma

diagnosis) was introduced to include all

persons with asthma. However, current

asthma prevalence estimates from 2001

onward are point prevalence estimates

and therefore are not directly

comparable with asthma period

prevalence estimates from 1980 to 1996

(see table in Appendix III for NHIS

question wording for each type of

prevalence estimate). Current asthma

prevalence estimates are considered more

valid than asthma period prevalence

because they rely on receiving a diagnosis

of asthma from a health professional.

Current asthma prevalence increased from

7.3% in 2001 to 8.4% in 2010, an

increase of 1.5% per year. This rate of

increase was lower than the rate of

increase for asthma period prevalence

from 1980 to 1996 (3.8% per year).

Population-based outcome rates

show the overall trend and impact on

the general population. Risk-based rates

are informative because they control for

prevalence differences between groups.

However, analyses of risk-based rates

over longer periods are complicated by

the change in asthma prevalence

NOTES: Percentages are age adjusted to the 2000 standard population. Light blue lines show the modeled trend estimated 

by Joinpoint. 

SOURCE: CDC/NCHS, National Health Interview Survey. 

Year 

0 

2 

4 

6 

8 

10 

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 

Percent 

Current asthma prevalence, 2001–2010 

Asthma period prevalence, 1980–1996 

Figure 26. Asthma period prevalence and current asthma prevalence: United States,

1980–2010

Series 3, No. 35 [ Page 23

measurement over time, as discussed

above. These changes preclude direct

comparison of risk-based rates over the

period 1980–2009. Therefore,

population-based rates are presented in

the following discussion.
Page 24 [ Series 3, No. 35

During the rise of asthma

prevalence in the 1980s and 1990s,

adverse outcomes were also increasing.

The increase in asthma mortality in the

1980s led to a major public health

response, including the formulation and

dissemination of asthma treatment

guidelines, asthma surveillance, and

coordinated interventions on local and

state levels (1,7,15,16). Figure 27 shows

the long-term trends in population-based

rates of asthma hospitalizations and

deaths. Asthma hospitalization rates

increased at an average rate of 2.9% per

year from 1980 to 1984 and then

decreased by an average rate of 1.2%

per year from 1984 to 2009. Asthma

death rates increased by an average rate

of 4.6% per year from 1980 to 1989 and

then remained stable from 1989 to 1998.

Asthma death rates decreased by an

average rate of 4.9% per year from 1999

to 2009. Death rates from before and

after 1999 are not directly comparable

due to the transition from International

Classification of Diseases, Ninth

Revision (ICD–9) to ICD–10 in 1999

(see Appendix III: Definition of Terms

for details). Analysis of the impact of

the transition to ICD–10 indicated that

an estimated 11% of the decline in

deaths between 1998 and 1999 could be

attributed to the coding change alone.

The continuing decline after 1999

should not have been influenced by the

change in the classification system.

Analyses of trends since 2001 in

earlier sections of this report show that

both population-based rates and

risk-based rates for asthma

hospitalizations, hospital outpatient

department visits, and ED visits did not

change significantly over this recent

period, whereas both population-based

rates and risk-based rates for asthma

hospitalizations and deaths declined.

These trends indicate that on a national

level, earlier progress in reducing the

impact of these serious asthma outcomes

has continued. Reducing the less severe,

but vastly more common morbidity

associated with asthma remains a

challenge. The Guidelines for the

Diagnosis and Management of Asthma

recommend routine visits every 6

months, regardless of asthma severity, as

a means to continually assess and

improve asthma control (1).

Disparities in Asthma

Hospitalization and Death

Rates

Racial disparities in asthma

hospitalizations and deaths have been

historically large (two to three times

higher among black persons compared

with white persons) and remain so

despite progress in lowering these

adverse outcomes for the overall

population. Figure 28 shows trends by

race in population-based hospitalization

and death rates.

From 1980 to 1985, there was no

significant trend in the asthma

hospitalization rate for white persons.

From 1985 to 2009, the rate for white

persons decreased 2.7% per year. For

black persons, the asthma hospitalization

rate increased 2.6% per year from 1980

to 1990, and then decreased 1.2% per

year from 1990 to 2009. At the end of

the period in 2009, the rate ratio for

NOTES: Population-based rates are age adjusted to the 2000 standard population. Light blue lines show the modeled trend estimated by Joinpoint. Inflection points represent a change in the 

annual percent change. 

SOURCES: CDC/NCHS, National Hospital Discharge Survey and National Vital Statistics System. 

0 

5 

10 

15 

20 

25 

1980 1985 1990 1995 2000 2005 

Rate per 10,000 population 

Year 

0 

5 

10 

15 

20 

25 

1980 1985 1990 1995 2000 2005 

Rate per million population 

Year 

Asthma hospitalizations Asthma deaths 

2009 2009 

Change from 

ICD–9 to ICD–10 

Figure 27. Asthma hospitalization rates and asthma death rates (population-based): United States, 1980–2009
Series 3, No. 35 [ Page 25

black to white hospitalization rates was

3.0 compared with a black to white rate

ratio of 3.0 in 2000, 2.9 in 1990, and

1.8 in 1980. Although hospitalization

rates decreased for both black and white

persons after 1990, the relative

difference in the rate for black persons

compared with white persons was about

the same in 2009 as it was in 2000 and

in 1990. The absolute difference in 2009

was larger than it was in 1980 because

of the increase in rates for black persons

between 1980 and 1990.

Asthma death rates for black

persons increased by an average rate of

5.8% per year from 1980 to 1988; the

trend from 1988 to 1998 did not reach

statistical significance. For white

persons, asthma death rates increased by

an average rate of 3.9% per year from

1980 to 1990, and remained stable from

1990 to 1998. After implementation of

ICD–10 in 1999, asthma death rates for

black persons decreased by an average

rate of 4.9% per year, and decreased for

white persons by 5.2% per year (note

that although the absolute decline in the

asthma death rate for black persons was

greater than for white persons, the

average percent change was smaller).

The asthma death rate was three times

higher for black persons compared with

white persons in 2009.

These patterns show that much

progress has been made in lowering

asthma death rates overall. However,

black persons continue to have a much

higher risk of hospitalization and death

from asthma compared with white

persons.

Differences also existed in rates for

asthma outcomes by sex. Females had

higher rates of asthma hospitalizations

and deaths compared with males

(Figure 29). Asthma hospitalization rates

for females increased by an average rate

of 4.9% per year from 1980 to 1983,

then decreased by an average rate of

0.9% per year from 1983 to 2009. For

males, the asthma hospitalization rate

increased by an average rate of 1.0%

per year from 1980 to 1986, and then

decreased by an average rate of 1.6%

per year from 1986 to 2009. The

hospitalization rate for females was 40%

higher compared with the rate for males

in 2009.

Prior to the 1999 implementation of

ICD–10 for cause of death classification,

asthma death rates increased by an

average rate of 5.3% per year for

females from 1980 to 1989, but there

was no statistically significant change

from 1989 to 1998. For males, asthma

death rates increased by an average rate

of 3.0% per year from 1980 to 1990,

and then decreased by an average rate

of 1.1% per year from 1990 to 1998.

From 1999 to 2009, asthma death rates

declined by an average rate of 4.9% per

year for females, and by an average rate

of 5.0% per year for males. In 2009, the

ratio of female to male asthma death

rates was 1.4. Thus, the relative

disparity between females and males

that developed in the 1980s remains,

despite progress in reducing asthma

death rates for both sexes over the past

decade.

NOTES: Population-based rates are age adjusted to the 2000 standard population. Light blue and gray lines show the modeled trend estimated by Joinpoint. Inflection points represent a 

change in the annual percent change. 

SOURCES: CDC/NCHS, National Hospital Discharge Survey and National Vital Statistics System. 

Year Year 

Asthma hospitalizations Asthma deaths 

2009 2009 

Change from 

ICD–9 to ICD–10 

0 

10 

20 

30 

40 

50 

1980 1985 1990 1995 2000 2005 

Rate per 10,000 population 

Black 

White 

0 

10 

20 

30 

40 

50 

1980 1985 1990 1995 2000 2005 

Rate per million population 

Black 

White 

Figure 28. Asthma hospitalization rates and asthma death rates (population-based), by race: United States, 1980–2009
Page 26 [ Series 3, No. 35

Although progress has been made in

decreasing rates for asthma

hospitalizations and asthma deaths, and

in decreasing absolute race and sex

disparities, relative disparities persist.

Some, but not all, of the disparities by

race and sex are explained by higher

current asthma prevalence among black

persons and females. For example, for

asthma hospitalization rates in 2008, the

risk-based rate ratio of black to white

persons with asthma was 2.4, compared

with the population-based rate ratio of

3.6. For asthma death rates, the 2008

risk-based rate ratio of black to white

persons with asthma was 2.3, compared

with the population-based rate ratio of 2.9.

Yet, even after accounting for differences

in asthma prevalence between groups by

assessing rate ratios for risk-based rates

for the most recently available data, the

relative disparities persist.

Risk-based rates for each type of

asthma health care encounter for the three

main disparate groups (adult and child,

male and female, and white and black

persons) provide a perspective on the

relative burden for each type of encounter

(Figure 30). Hospitalizations represent

NOTES: Population-based rates are age adjusted to the 2000 standard population. Light blue and gray lines show the modeled trend estimated by Joinpoint. Inflection points represent a 

change in the annual percent change. 

SOURCES: CDC/NCHS, National Hospital Discharge Survey and National Vital Statistics System. 

Asthma hospitalizations Asthma deaths 

Change from 

ICD–9 to ICD–10 

Rate per 10,000 population

Rate per million population 

0 

10 

20 

30 

40 

50 

1980 1985 1990 1995 2000 2005 

Year 

Male 

Female 

0 

10 

20 

30 

40 

50 

1980 1985 1990 1995 2000 2005 

Year 

Male 

Female 

2009 2009 

Figure 29. Asthma hospitalization rates and asthma death rates (population-based), by sex: United States, 1980–2009

100 

90

80

Hospital 

Rate per 100 persons with asthma 70 

Emergency 

50 outpatient 

department 

60 

Hospital 

department 

office 

20 

40 

30 

Physician 

10 

0
 

Total Child Adult Male Female White Black
 

NOTES: Crude (unadjusted) rates are presented. See Tables 11, 12, 15, and 18 for underlying data.
 

SOURCES: CDC/NCHS, National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey,
 

and National Hospital Discharge Survey.
 

Figure 30. Asthma physician office visit rates, hospital outpatient department visit rates,

emergency department visit rates, and hospitalization rates (risk-based), by age, sex, and

race: United States, average annual 2007–2009
Series 3, No. 35 [ Page 27

the most costly encounter and indicate a

severe exacerbation, but are the least

common type of encounter. ED visits

also represent potentially severe

exacerbations but could include visits

for primary care as well. Visits to

primary care settings (physician offices

and hospital outpatient departments)

represent the vast majority of health

care use for persons with asthma. There

was an average of 63.2 health care

encounters per 100 persons with asthma

for the period 2007–2009. Of these, 47.1

were visits to physician offices, 6.0

were visits to hospital outpatient

departments, 8.1 were visits to EDs, and

2.0 were hospitalizations. Children aged

0–17 years had more health care visits

than adults aged 18 and over (91.5 and

51.4 per 100, respectively). Except for

asthma hospitalizations, children aged

0–17 years had significantly higher

risk-based visit rates in every setting

compared with adults aged 18 and over.

Males and females had a similar number

of health care visits (68.1 and 59.4 per

100, respectively), and there were no

differences in rates of health care

encounters by sex for any setting. Black

and white persons had a similar overall

number of health care visits (77.2 and

62.4 per 100, respectively), but black

persons had higher ED visit and

hospitalization rates per 100 persons

with asthma compared with white

persons. This pattern was also reported

in the previous asthma surveillance

report (2). Risk-based rates for visits in

primary care settings overall (physician

offices and hospital outpatient

departments) were similar by race, but

black persons had higher visit rates to

hospital outpatient departments and

lower visit rates to private physician

offices compared with white persons.

The recent pattern of similar primary

care visit rates between races differs

from patterns observed in earlier periods

with higher primary care visit rates

among white persons compared with

black persons with asthma (2).

Other Measures of Asthma

Morbidity

In addition to health care utilization

rates, estimates of school and work

absences and activity limitations caused

by asthma provide measures of the

impact of asthma in the United States.

Table A shows school and work

absences among persons with at least

one asthma attack in the previous 12

months for 2008. There were 10.5

million school days missed due to

asthma among children aged 5–17 years,

14.2 million work days missed among

currently employed adults aged 18 and

over, and 22.0 million missed days of

housework and other activity among

adults not currently employed.

Recent Trends in Use of

Asthma Management Tools

An important strategy to prevent

asthma exacerbations and morbidity is

asthma education. The percentage of

persons with current asthma who

reported receipt of asthma selfmanagement education and tools for

2003 and 2008 is shown in Table B.

These data are from periodic NHIS

asthma supplements, which are used to

measure progress meeting Healthy

People respiratory health objectives. The

2008 supplement is the most recent.

There was little change in these

proportions between 2003 and 2008.

The National Asthma Education and

Prevention Program (NAEPP) guidelines

recommend that all asthma patients have

written instructions for daily

management of asthma, for how to

recognize and respond to worsening

asthma symptoms, and for medication

dosage and frequency of its

administration, but only 34% of persons

with current asthma reported receiving

an asthma action plan (1). About 12% of

persons with current asthma had taken a

Table A. School and work absences and percentage with activity limitation caused by asthma, among persons with at least one asthma

attack in the past year: United States, 2008

Percentage with 1 or more Percentage with activity

Population in millions Total days missed1 asthma absence days in limitation caused by asthma

Population (weighted estimate) in millions (standard error) the past year1 (standard error) or breathing problem (standard error)

Children aged 5–17 years ........ 3.3 10.5 (1.3) 58.7 (3.6) 5.5 (1.2) 
 

Adults aged 18 or over, currently

employed .................. 4.9 14.2 (4.7) 33.5 (2.8) 6.2 (1.3)

Adults aged 18 or over, not currently

employed .................. 3.8 22.0 (5.9) 29.1 (3.1) 26.5 (2.7) 
 

1

Excludes records with missing responses for days of school (1.0% among children aged 5–17 years), work (0.4% among adults currently employed), or household or other activity missed due to

asthma (25.1% among adults not currently employed).

SOURCE: CDC/NCHS National Health Interview Survey.

Table B. Percentage ever receiving asthma self-management education among persons

with current asthma: percent (standard error): United States, 2003 and 2008

Management Strategy 2003 2008

Given an asthma action plan .................. 33.6 (1.2) 34.2 (1.2)

Taken a class to learn how to manage asthma ....... 12.4 (0.9) 12.2 (0.8)

Taught to recognize early signs and symptoms of an

asthma attack........................... 55.1 (1.3) 59.9 (1.3)

1

Taught to respond to an asthma attack ............ 64.8 (1.3) 68.2 (1.3)

Taught how to use a peak flow meter ............. 45.1 (1.3) 42.2 (1.3)

Given advice on environmental control2 ........... 48.3 (1.3) 50.9 (1.4)

1

Differs from 2003 value (chi square test p value < 0.05).
 

2

Percentage reporting that a health professional gave them advice on how to change things in their home, school, or work
 

environment to improve their asthma symptoms.

SOURCE: CDC/NCHS, National Health Interview Survey.
Page 28 [ Series 3, No. 35

class to learn how to manage asthma.

Higher percentages were taught how to

recognize (55%–60%) and respond

(65%–68%) to signs and symptoms of

an asthma attack, and these indicators of

asthma education increased between

2003 and 2008. A lower percentage

reported being taught how to use a peak

flow meter (42%–45%) and receiving

advice on environmental control at

home, school, or work (48%–51%).

Data about use of evidence-based

asthma management strategies were not

collected in NHIS before the release of

the 1991 NAEPP guidelines, which

focused treatment on the central role of

inflammation in asthma morbidity.

Therefore, longer-term changes in

treatment as reported by people with

asthma cannot be directly analyzed with

NHIS data.

Federal Efforts to Address

Asthma

Asthma has been a focus for public

health action after increasing asthma

prevalence and mortality rates were

recognized in the 1980s. Healthy People

goals for asthma have been expanded

over three decades. Asthma-specific

Healthy People 2020 Objectives include:

1) reducing asthma deaths, 2) reducing

hospitalizations for asthma, 3) reducing

ED visits for asthma, 4) reducing

activity limitations among persons with

current asthma, 5) reducing the

proportion of persons with asthma who

miss school or work days, 6) increasing

the proportion of persons with current

asthma who receive formal patient

education, 7) increasing the proportion

of persons with current asthma who

receive appropriate asthma care

according to NAEPP, and 8) increasing

the number of states and territories

(including the District of Columbia)

with a comprehensive surveillance

system for tracking asthma cases,

illness, and disability at the state level.

Federal agencies have developed a

collaborative approach to address these

objectives.

NAEPP was established in 1989 by

the National Heart, Lung and Blood

Institute (NHLBI) as a collaborative

effort between major scientific,

professional, governmental, and

voluntary organizations. NAEPP was

designed to increase awareness of

asthma as a significant public health

problem, to educate the public and

health professionals about asthma, to

develop clinical treatment guidelines,

and to promote research. NAEPP

guidelines have been periodically

updated since their first publication in

1991, and most recently in 2007.

CDC’s National Asthma Control

Program (NACP) was created in 1999 to

align public health initiatives with

Healthy People objectives. NACP has

three major activities: conducting

surveillance, promoting evidence-based

interventions, and building partnerships.

Surveillance activities include

building systems to provide detailed and

local data on asthma prevalence, impact,

and management such as including

asthma modules in the Behavioral Risk

Factor Surveillance System (17);

developing the National Asthma survey

(http://www.cdc.gov/asthma/ACBS.htm)

(18); and funding (with the NHLBI) the

periodic inclusion of asthma questions

in NHIS to monitor progress toward

Healthy People goals (19). NACP works

to establish and maintain a network of

asthma public health partners, including

state health departments, local entities

(schools, city health departments, and

hospitals), and other federal agencies to

achieve asthma control objectives (6).

Conclusion

Over the past few decades, the

prevalence of asthma in the United

States has grown. Since 2001, the

number of persons with asthma has

continued to increase. There have not,

however, been comparable increases in

the number of health care encounters for

asthma. Since rising asthma mortality

was first recognized in the 1980s, the

number and rate for this most severe

adverse asthma outcome have declined

dramatically. Population-based rates for

asthma hospitalizations have declined

since the mid-1980s and rates for deaths

have declined since 1999.

However, for many outcomes, racial

and gender disparities remain, and in

some cases have increased. In addition

to disparities in outcomes, there are

other areas of asthma care that still

require concerted public health attention.

The prevalence of asthma attacks among

persons with asthma, although declining,

remains above 50%, with only one in

eight persons reporting taking a formal

asthma management education course

and only one in three reporting having

asthma management plans. There are an

estimated 46.7 million lost school, work,

and activity days per year. The more

recent plateau in the uptake of effective

asthma-management strategies highlights

remaining challenges in addressing the

burden of asthma in the United States.

References

1.	 U.S. Department of Health and Human

Services (HHS). Expert panel report 3:

Guidelines for the diagnosis and

management of asthma. Bethesda, MD:

HHS, National Heart, Lung and Blood

Institute, National Institutes of Health.

Publication No. 07–4051. 2007.

2.	 Moorman JE, Rudd RA, Johnson CA,

et al. National surveillance for

asthma—United States, 1980–2004.

Atlanta, GA: Centers for Disease

Control and Prevention. Report No.

56(SS08). 2007.

3.	 U.S. Department of Health and Human

Services (HHS), Centers for Disease

Control and Prevention, National

Institute for Occupational Safety and

Health. Prevention of occupational

asthma: Primer. Atlanta, GA:

HHS.2011. Available from: http://

www.cdc.gov/niosh/topics/asthma/

OccAsthmaPrevention-primer.html

[Accessed May 29, 2011].

4.	 Guide to Community Preventive

Services. Asthma control: Home-based

multi-trigger, multicomponent

environmental interventions. 2011.

Available from: http://www.

thecommunityguide.org/asthma/

multicomponent.html [Accessed May

29, 2011]

5.	 U.S. Department of Health and Human

Services. Healthy People 2010. 2nd ed.

Objectives for improving health.

Washington, DC: U.S. Government

Printing Office. 2000.
Series 3, No. 35 [ Page 29

6. Madden J, Boss L, Kownaski M, et al. 18. Centers for Disease Control and

Guide for state health agencies in the

development of asthma programs.

Atlanta, GA: U.S. Department of

Prevention. State and local area

integrated telephone survey (SLAITS)

national asthma survey (NAS). U.S.

Health and Human Services, Centers

for Disease Control and Prevention.

Department of Health and Human

Services. 2011. Available from:

7.

2003.

Mannino DM, Homa DM, Pertowski 19.

http://www.cdc.gov/nchs/slaits.htm.

U.S. Department of Health and Human

CA, et al. Surveillance for asthma—

United States, 1960–1995. MMWR

Services. Healthy People 2020

Respiratory diseases [online]. 2010.

8.

CDC Surveill Summ 47(1). 1998.

Mannino DM, Homa DM, Akinbami

Available from: http://www.

healthypeople.gov/2020/

LJ, Moorman JE, Gwynn C, Redd SC.

Surveillance for asthma—United States,

1980–1999. MMWR Surveill Summ

topicsobjectives2020/

objectiveslist.aspx?topicId=36

[Accessed October 21, 2011].

9.

51(1). 2002.

SUDAAN (Release 10.0) [computer

20. Herman EJ, Garbe PL, McGeehin MA.

Assessing community-based approaches

10.

program]. 2008.

Xu JQ, Kochanek KD, Murphy SL,

to asthma control: The controlling

asthma in American cities project. J

Tejada-Vera B. Deaths: final data for

2007. National vital statistics reports; 21.

Urban Health 88 (Suppl) 1. 2011.

Schenker N, Raghunathan TE, Chiu

vol 58 no 19. Hyattsville, MD:

National Center for Health Statistics.

PL, Makuc DM, Zhang G, Cohen AJ.

Multiple imputation of family income

11.

2010.

National Center for Health Statistics

and personal earnings in the National

Health Interview Survey: Methods and

(NCHS). National Hospital Discharge

Survey 1979–2006 multi-year public

use data file documentation.

examples. Hyattsville, MD: National

Center for Health Statistics. 2008.

Available from: http://www.cdc.gov/

Hyattsville, MD: NCHS, Centers for

Disease Control and Prevention. 2008. 22.

nchs/data/nhis/tecdoc.pdf.

Kozak LJ. Underreporting of race in

12. National Cancer Institute. Joinpoint

regression program. 2010. Available

the National Hospital Discharge Survey.

Advance Data from vital and health

13.

from: http://srab.cancer.gov/joinpoint/.

National Center for Health Statistics

statistics; no 265. Hyattsville, MD:

National Center for Health Statistics.

(NCHS). Health data interactive.

Hyattsville, MD: NCHS. 2010. 23.

1995.

Klein RJ, Schoenborn CA. Age

Available from: http://www.cdc.gov/

nchs/hdi.htm [Accessed October 21,

adjustment using the 2000 projected

U.S. population. Healthy People 2010

14.

2011].

Akinbami LJ, Schoendorf KC, Parker J.

U.S. childhood asthma prevalence

estimates: The impact of the 1997

National Health Interview Survey

redesign. Am J Epidemiol 158(2):99–

104. 2003.

24.

25.

Stat Notes (20). 2001.

Kish L. Survey Sampling. 1st ed. New

York, NY: John Wiley & Sons, Inc.

1995.

U.S. Office of Management and

Budget. Revisions to the standards for

the classification of federal data on race

15. National Center for Environmental

Health, Centers for Disease Control and

and ethnicity. Washington, DC: Report

No. 62FR58782 (58790). 1997.

Prevention (CDC). America breathing

easier. Atlanta, GA: CDC. 2010.

26. Anderson RN, Miniño AM, Hoyert DL,

Rosenberg HM. Comparability of cause

16. Szefler SJ. Advancing asthma care: The

glass is only half full! J Allergy Clin

of death between ICD-9 and ICD-10:

preliminary estimates. National vital

17.

Immunol 128(3):485–94. 2011.

Centers for Disease Control and

statistics reports; vol 49 no 2.

Hyattsville, MD: National Center for

Prevention, U.S. Department of Health

and Human Services (HHS). Behavioral

Health Statistics. 2001.

risk factor surveillance system (BRFSS)

prevalence data. Atlanta, GA: HHS.

2011. Available from: http://www.cdc.

gov/asthma/brfss/default.htm.
Page 30 [ Series 3, No. 35

Table 1. Percentage with current asthma, by year and selected characteristics: United States, 2001–2010

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Percent (standard error)1

Total ..................... 7.3 (0.1) 7.2 (0.2) 6.9 (0.2) 7.1 (0.2) 7.7 (0.2) 7.8 (0.2) 7.7 (0.2) 7.8 (0.2) 8.2 (0.2) 8.4 (0.2)

Sex

Male ..................... 6.3 (0.2) 6.1 (0.2) 5.8 (0.2) 6.3 (0.2) 6.4 (0.2) 7.0 (0.3) 6.5 (0.2) 7.1 (0.3) 7.1 (0.3) 7.0 (0.2)

Female ................... 8.3 (0.2) 8.1 (0.2) 7.9 (0.2) 7.8 (0.2) 8.8 (0.2) 8.6 (0.3) 8.8 (0.3) 8.5 (0.3) 9.2 (0.3) 9.8 (0.3)

Race2

White. . . . . . . . . . . . . . . . . . . . . 7.2 (0.2) 6.9 (0.2) 6.6 (0.2) 6.9 (0.2) 7.4 (0.2) 7.6 (0.2) 7.4 (0.2) 7.4 (0.2) 7.8 (0.2) 7.8 (0.2)

Black ..................... 8.4 (0.4) 9.2 (0.4) 8.8 (0.4) 8.9 (0.5) 9.5 (0.4) 9.0 (0.4) 9.8 (0.5) 10.0 (0.5) 10.8 (0.6) 11.9 (0.5)

Other races ................. 7.2 (0.5) 6.3 (0.5) 6.4 (0.6) 6.3 (0.5) 7.1 (0.6) 8.3 (0.7) 6.9 (0.6) 7.9 (0.7) 7.6 (0.7) 8.1 (0.6)

Ethnicity3

Hispanic or Latino ............. 5.8 (0.3) 4.7 (0.3) 5.4 (0.3) 5.2 (0.3) 6.2 (0.3) 6.2 (0.4) 6.9 (0.4) 5.9 (0.4) 6.4 (0.4) 7.2 (0.4)

Not Hispanic or Latino .......... 7.6 (0.2) 7.5 (0.2) 7.2 (0.2) 7.5 (0.2) 7.9 (0.2) 8.1 (0.2) 7.9 (0.2) 8.2 (0.2) 8.6 (0.2) 8.7 (0.2)

Age

Children (0–17) .............. 8.7 (0.3) 8.3 (0.3) 8.5 (0.3) 8.5 (0.3) 8.9 (0.3) 9.3 (0.4) 9.1 (0.4) 9.4 (0.4) 9.6 (0.4) 9.3 (0.3)

Adults (18 or over) ............ 6.9 (0.2) 6.8 (0.2) 6.4 (0.2) 6.7 (0.2) 7.2 (0.2) 7.3 (0.2) 7.3 (0.2) 7.3 (0.2) 7.7 (0.2) 8.2 (0.2)

Age group

0–4 years .................. 5.7 (0.4) 6.0 (0.5) 5.9 (0.5) 5.6 (0.4) 6.8 (0.5) 5.8 (0.6) 6.8 (0.6) 6.2 (0.6) 6.3 (0.6) 6.0 (0.6)

5–14 years ................. 9.9 (0.4) 9.2 (0.4) 9.5 (0.4) 9.1 (0.4) 9.8 (0.4) 10.9 (0.6) 9.4 (0.5) 10.9 (0.6) 11.2 (0.5) 10.7 (0.5)

15–34 years ................ 8.0 (0.3) 7.6 (0.3) 7.2 (0.3) 7.1 (0.3) 7.5 (0.3) 7.8 (0.4) 8.4 (0.4) 8.1 (0.4) 7.8 (0.4) 8.6 (0.3)

35–64 years ................ 6.7 (0.2) 6.8 (0.2) 6.4 (0.2) 6.8 (0.2) 7.1 (0.2) 7.3 (0.3) 6.9 (0.3) 7.1 (0.3) 7.9 (0.3) 8.1 (0.3)

65 years or over .............. 6.0 (0.4) 5.9 (0.4) 5.8 (0.3) 7.0 (0.4) 7.6 (0.4) 7.0 (0.5) 7.5 (0.5) 7.2 (0.4) 7.7 (0.5) 8.1 (0.4)

Region

Northeast .................. 8.3 (0.4) 8.2 (0.4) 7.7 (0.4) 7.4 (0.4) 8.7 (0.4) 9.1 (0.5) 8.5 (0.5) 8.2 (0.5) 9.4 (0.5) 8.8 (0.5)

Midwest ................... 7.5 (0.3) 7.3 (0.3) 7.6 (0.3) 7.6 (0.3) 7.7 (0.3) 8.3 (0.5) 8.2 (0.5) 8.6 (0.4) 8.9 (0.5) 8.6 (0.4)

South .................... 7.1 (0.2) 6.7 (0.2) 6.3 (0.2) 6.7 (0.2) 7.2 (0.2) 7.3 (0.3) 7.3 (0.3) 7.0 (0.3) 7.5 (0.3) 8.3 (0.3)

West ..................... 6.7 (0.3) 7.1 (0.3) 6.5 (0.3) 7.3 (0.3) 7.5 (0.3) 7.2 (0.4) 7.4 (0.4) 8.1 (0.4) 7.8 (0.4) 8.3 (0.4)

Federal poverty threshold4

Below 100% ................ 9.9 (0.5) 10.2 (0.5) 9.4 (0.4) 9.5 (0.5) 10.4 (0.5) 11.8 (0.6) 10.8 (0.6) 11.0 (0.6) 11.7 (0.6) 11.2 (0.5)

100% to less than 250% ......... 7.7 (0.3) 7.4 (0.3) 7.5 (0.3) 7.4 (0.3) 8.2 (0.3) 8.0 (0.4) 8.4 (0.4) 8.2 (0.4) 8.5 (0.4) 8.7 (0.3)

250% to less than 450% ......... 6.8 (0.3) 6.4 (0.3) 6.4 (0.3) 6.6 (0.3) 7.3 (0.3) 7.3 (0.4) 7.0 (0.4) 7.6 (0.4) 7.5 (0.4) 8.2 (0.4)

450% or above............... 6.6 (0.3) 6.4 (0.3) 6.0 (0.3) 6.5 (0.3) 6.6 (0.3) 6.1 (0.3) 6.6 (0.3) 6.8 (0.4) 7.2 (0.4) 7.1 (0.3)

1

Percentage is for the civilian noninstitutionalized population; except for age-specific estimates, percentages are age adjusted to the 2000 U.S. standard population.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Hawaiian and Other Pacific Islander, those
 

with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

4

The federal poverty threshold includes persons with reported and missing family income based on imputed income values using multiple imputation.
 

SOURCE: CDC/NCHS, National Health Interview Survey.
 
Series 3, No. 35 [ Page 31

Table 2. Percentage with current asthma, by detailed age group and selected characteristics: United States, average annual 2008–2010

0–17 18 years 0–4 5–14 15–34 15–19 20–24 25–34 35–64 65 years

Characteristic Total years or over years years years years years years years or over

Percent (standard error)1

Total ................ 8.2 (0.1) 9.5 (0.2) 7.7 (0.1) 6.2 (0.4) 11.0 (0.3) 8.2 (0.2) 9.7 (0.4) 9.1 (0.5) 6.9 (0.3) 7.7 (0.2) 7.7 (0.3)

Sex

Male ................ 7.0 (0.1) 11.1 (0.3) 5.7 (0.2) 7.8 (0.5) 12.8 (0.5) 6.9 (0.3) 9.3 (0.7) 7.6 (0.6) 5.2 (0.4) 5.2 (0.2) 6.2 (0.4)

Female. . . . . . . . . . . . . . . 9.2 (0.2) 7.8 (0.3) 9.7 (0.2) 4.4 (0.4) 9.0 (0.4) 9.5 (0.3) 10.2 (0.6) 10.7 (0.8) 8.5 (0.4) 10.1 (0.3) 8.8 (0.4)

Race2

White ................ 7.7 (0.1) 8.2 (0.3) 7.5 (0.1) 4.7 (0.4) 9.4 (0.3) 8.0 (0.2) 9.4 (0.5) 8.6 (0.5) 6.8 (0.3) 7.5 (0.2) 7.7 (0.3)

Male ............... 6.5 (0.2) 9.7 (0.4) 5.5 (0.2) 6.1 (0.5) 11.3 (0.6) 6.6 (0.3) 8.9 (0.8) 7.0 (0.7) 5.2 (0.4) 5.1 (0.2) 6.2 (0.4)

Female ............. 8.8 (0.2) 6.5 (0.3) 9.5 (0.2) 3.2 (0.4) 7.4 (0.4) 9.4 (0.4) 10.1 (0.7) 10.3 (0.9) 8.6 (0.5) 9.8 (0.3) 8.8 (0.4)

Black ................ 11.2 (0.3) 16.0 (0.7) 9.2 (0.4) 12.3 (1.2) 18.8 (0.8) 9.7 (0.5) 12.1 (0.9) 11.8 (1.2) 7.3 (0.6) 9.5 (0.5) 8.4 (0.7)

Male ............... 10.4 (0.5) 18.3 (1.0) 6.8 (0.5) 15.1 (1.8) 21.4 (1.3) 8.7 (0.8) 11.6 (1.4) 11.8 (2.1) 5.3 (0.9) 6.2 (0.6) 6.5 (1.0)

Female ............. 11.8 (0.4) 13.7 (0.8) 11.1 (0.5) 9.4 (1.5) 16.1 (1.2) 10.7 (0.7) 12.6 (1.4) 11.9 (1.8) 9.0 (0.8) 12.1 (0.7) 9.6 (1.0)

Other races ............ 8.0 (0.4) 9.5 (0.7) 7.3 (0.4) 7.7 (1.1) 11.3 (1.1) 7.4 (0.7) 8.0 (1.2) 9.0 (1.9) 6.4 (0.8) 7.3 (0.6) 6.4 (1.0)

Male ............... 7.0 (0.5) 10.7 (0.9) 5.3 (0.5) 9.5 (1.6) 12.1 (1.4) 6.7 (0.9) 9.1 (1.9) 6.1 (1.8) 5.7 (1.0) 4.5 (0.6) 5.6 (1.2)

Female ............. 8.9 (0.6) 8.3 (1.0) 9.1 (0.7) 5.8 (1.3) 10.4 (1.6) 8.2 (1.1) 6.8 (1.6) 11.6 (3.0) 7.1 (1.3) 9.9 (1.0) 7.1 (1.5)

Ethnicity3

Hispanic or Latino ........ 6.5 (0.2) 7.5 (0.4) 6.0 (0.3) 5.3 (0.6) 9.5 (0.6) 5.7 (0.3) 6.4 (0.6) 5.6 (0.7) 5.4 (0.5) 5.8 (0.3) 7.3 (0.9)

Male ............... 5.9 (0.3) 8.7 (0.5) 4.4 (0.3) 6.6 (0.9) 10.8 (0.8) 4.9 (0.5) 6.7 (1.0) 4.1 (0.9) 4.5 (0.8) 3.8 (0.5) 6.2 (1.5)

Female ............. 7.1 (0.3) 6.3 (0.5) 7.6 (0.4) 4.0 (0.7) 8.2 (0.8) 6.6 (0.5) 6.0 (0.9) 7.3 (1.3) 6.5 (0.6) 7.9 (0.5) 8.2 (1.0)

Puerto Rican ........... 16.1 (1.0) 16.9 (1.8) 15.7 (1.3) 13.8 (2.7) 20.6 (2.6) 14.8 (1.7) 14.4 (3.8) 12.7 (3.2) 16.2 (3.1) 16.2 (1.7) 12.6 (2.9)

Male ............... 15.6 (1.6) 21.5 (2.9) 12.2 (2.1) 17.1 (3.8) 27.0 (4.3) 15.1 (3.2) *20.1 (7.8) *13.2 (5.5) *13.4 (5.4) 9.7 (2.5) *10.6 (4.6)

Female ............. 16.6 (1.1) 12.2 (1.6) 18.7 (1.7) 10.2 (2.9) 13.9 (2.7) 14.5 (1.7) 10.0 (2.1) *12.4 (4.5) 19.0 (3.1) 22.0 (2.6) 14.4 (3.2)

Mexican .............. 5.4 (0.2) 6.5 (0.5) 4.8 (0.3) 4.6 (0.7) 8.2 (0.7) 4.4 (0.3) 4.8 (0.6) 5.0 (0.8) 4.0 (0.5) 4.9 (0.4) 6.6 (1.3)

Male ............... 4.7 (0.3) 7.2 (0.6) 3.3 (0.4) 5.7 (1.1) 8.6 (0.8) 3.3 (0.4) 5.1 (0.9) 3.1 (0.8) 2.5 (0.6) 3.3 (0.5) *5.7 (1.8)

Female ............. 6.2 (0.4) 5.7 (0.6) 6.5 (0.5) 3.4 (0.9) 7.7 (0.9) 5.7 (0.6) 4.5 (0.9) 7.0 (1.6) 5.7 (0.7) 6.7 (0.7) 7.4 (1.5)

Not Hispanic or Latino ..... 8.5 (0.1) 10.0 (0.3) 8.0 (0.1) 6.4 (0.4) 11.4 (0.4) 8.8 (0.2) 10.5 (0.5) 9.9 (0.6) 7.2 (0.3) 8.0 (0.2) 7.7 (0.3)

Male ............... 7.3 (0.2) 11.8 (0.4) 5.9 (0.2) 8.3 (0.6) 13.4 (0.6) 7.4 (0.3) 9.9 (0.8) 8.4 (0.8) 5.4 (0.4) 5.4 (0.2) 6.2 (0.4)

Female ............. 9.6 (0.2) 8.2 (0.3) 10.0 (0.2) 4.5 (0.5) 9.2 (0.5) 10.1 (0.4) 11.2 (0.7) 11.3 (0.8) 9.0 (0.5) 10.4 (0.3) 8.8 (0.4)

Region

Northeast ............. 8.8 (0.3) 10.2 (0.5) 8.4 (0.3) 5.9 (0.7) 11.5 (0.6) 9.9 (0.5) 11.9 (1.0) 9.6 (1.4) 9.0 (0.7) 8.1 (0.4) 7.8 (0.6)

Midwest .............. 8.7 (0.2) 10.4 (0.6) 8.1 (0.2) 7.4 (1.0) 11.5 (0.6) 9.2 (0.5) 10.9 (1.0) 10.4 (1.1) 7.7 (0.6) 8.2 (0.4) 6.8 (0.5)

South. . . . . . . . . . . . . . . . 7.6 (0.2) 10.0 (0.4) 6.8 (0.2) 6.9 (0.6) 11.7 (0.5) 6.9 (0.3) 8.8 (0.7) 8.1 (0.7) 5.4 (0.4) 6.9 (0.3) 7.4 (0.5)

West ................ 8.0 (0.3) 7.4 (0.5) 8.2 (0.3) 4.1 (0.5) 8.9 (0.7) 7.9 (0.4) 8.4 (0.7) 9.1 (1.1) 7.0 (0.6) 8.3 (0.4) 9.0 (0.7)

Federal poverty threshold4

Below 100% ........... 11.2 (0.3) 12.4 (0.5) 10.6 (0.4) 9.6 (1.0) 14.4 (0.8) 9.1 (0.5) 9.3 (0.9) 9.6 (0.8) 8.5 (0.7) 12.7 (0.6) 9.9 (0.8)

100% to less than 250% .... 8.5 (0.2) 9.4 (0.4) 8.2 (0.2) 5.5 (0.5) 11.0 (0.6) 8.3 (0.4) 9.9 (1.0) 9.0 (0.8) 7.0 (0.5) 8.3 (0.4) 8.4 (0.5)

250% to less than 450% .... 7.7 (0.2) 8.4 (0.4) 7.5 (0.3) 4.9 (0.7) 9.7 (0.6) 7.7 (0.4) 10.0 (0.9) 7.9 (0.9) 6.7 (0.6) 7.7 (0.4) 7.4 (0.6)

450% or above .......... 6.7 (0.2) 8.1 (0.4) 6.4 (0.2) 4.5 (0.6) 9.2 (0.6) 7.8 (0.5) 9.6 (1.0) 10.6 (1.6) 6.1 (0.5) 6.2 (0.2) 6.1 (0.6)

* Estimate is considered unreliable. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over 50%.
 

1

Percent is for the civilian noninstitutionalized population; crude percents are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

4

The federal poverty threshold includes persons with reported and missing family income based on imputed income values using multiple imputation.
 

SOURCE: CDC/NCHS, National Health Interview Survey.
Page 32 [ Series 3, No. 35

Table 3. Percentage with one or more asthma attacks in the past 12 months, by year and selected characteristics: United States, 2001–2010

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Percent (standard error)1

Total ..................... 4.3 (0.1) 4.3 (0.1) 3.9 (0.1) 4.1 (0.1) 4.2 (0.1) 4.2 (0.1) 4.2 (0.2) 4.3 (0.1) 4.3 (0.1) 4.6 (0.1)

Sex

Male ..................... 3.5 (0.1) 3.5 (0.1) 3.1 (0.1) 3.6 (0.2) 3.4 (0.2) 3.4 (0.2) 3.3 (0.2) 3.7 (0.2) 3.5 (0.2) 3.6 (0.2)

Female ................... 5.0 (0.2) 5.0 (0.2) 4.5 (0.2) 4.4 (0.2) 5.0 (0.2) 5.0 (0.2) 4.9 (0.2) 4.8 (0.2) 5.0 (0.2) 5.4 (0.2)

Race2

White. . . . . . . . . . . . . . . . . . . . . 4.2 (0.1) 4.1 (0.1) 3.7 (0.1) 3.9 (0.1) 4.1 (0.1) 4.2 (0.2) 4.0 (0.2) 4.0 (0.2) 4.1 (0.2) 4.3 (0.1)

Black ..................... 5.2 (0.3) 5.4 (0.3) 4.7 (0.3) 5.2 (0.3) 4.6 (0.3) 4.6 (0.3) 5.1 (0.4) 5.4 (0.4) 5.3 (0.4) 5.8 (0.4)

Other races ................. 4.2 (0.3) 4.1 (0.4) 4.0 (0.5) 3.3 (0.3) 4.5 (0.5) 4.5 (0.5) 3.8 (0.4) 4.9 (0.6) 4.4 (0.5) 5.0 (0.5)

Ethnicity3

Hispanic or Latino ............. 3.4 (0.3) 2.9 (0.2) 3.3 (0.2) 3.1 (0.2) 3.5 (0.2) 3.6 (0.3) 4.1 (0.3) 3.2 (0.3) 3.5 (0.3) 4.0 (0.3)

Not Hispanic or Latino .......... 4.5 (0.1) 4.5 (0.1) 4.0 (0.1) 4.3 (0.1) 4.3 (0.1) 4.4 (0.2) 4.2 (0.2) 4.5 (0.2) 4.5 (0.2) 4.7 (0.2)

Age

Children (0–17) .............. 5.7 (0.2) 5.8 (0.3) 5.5 (0.2) 5.5 (0.3) 5.2 (0.2) 5.6 (0.3) 5.2 (0.3) 5.6 (0.3) 5.5 (0.3) 5.7 (0.3)

Adults (18 or over) ............ 3.8 (0.1) 3.8 (0.1) 3.3 (0.1) 3.6 (0.1) 3.9 (0.1) 3.8 (0.1) 3.8 (0.2) 3.8 (0.2) 3.9 (0.1) 4.2 (0.1)

Age group

0–4 years .................. 4.7 (0.4) 4.8 (0.4) 4.2 (0.4) 3.9 (0.4) 4.4 (0.5) 4.5 (0.5) 4.1 (0.5) 4.1 (0.5) 4.5 (0.5) 4.6 (0.6)

5–14 years ................. 6.5 (0.4) 6.3 (0.4) 6.0 (0.4) 5.9 (0.3) 5.9 (0.3) 6.5 (0.5) 5.3 (0.4) 6.7 (0.5) 6.1 (0.4) 6.4 (0.4)

15–34 years ................ 4.5 (0.2) 4.3 (0.2) 3.9 (0.2) 3.9 (0.2) 4.1 (0.2) 3.7 (0.2) 4.3 (0.3) 4.1 (0.3) 3.8 (0.2) 4.1 (0.2)

35–64 years ................ 3.8 (0.2) 3.8 (0.2) 3.5 (0.2) 3.8 (0.2) 4.0 (0.2) 4.2 (0.2) 3.9 (0.2) 4.0 (0.2) 4.3 (0.2) 4.6 (0.2)

65 years or over .............. 2.6 (0.2) 2.9 (0.3) 2.3 (0.2) 3.2 (0.3) 3.0 (0.3) 2.8 (0.3) 3.4 (0.3) 2.9 (0.3) 2.9 (0.3) 3.5 (0.3)

Region

Northeast .................. 4.7 (0.3) 4.7 (0.3) 4.3 (0.3) 4.4 (0.3) 4.9 (0.3) 4.5 (0.3) 4.5 (0.4) 4.1 (0.3) 4.7 (0.3) 4.2 (0.3)

Midwest ................... 4.6 (0.2) 4.4 (0.2) 4.2 (0.3) 4.1 (0.2) 3.9 (0.2) 4.5 (0.3) 3.7 (0.3) 4.6 (0.3) 4.3 (0.3) 4.6 (0.3)

South .................... 4.2 (0.2) 3.9 (0.2) 3.5 (0.2) 3.8 (0.2) 4.0 (0.2) 4.1 (0.2) 4.2 (0.3) 3.8 (0.2) 4.2 (0.3) 4.5 (0.2)

West ..................... 3.8 (0.2) 4.3 (0.3) 3.7 (0.2) 4.1 (0.2) 4.5 (0.3) 4.2 (0.3) 4.5 (0.3) 4.8 (0.3) 4.2 (0.3) 4.9 (0.3)

Federal poverty threshold4

Below 100% ................ 6.0 (0.4) 6.1 (0.4) 5.7 (0.3) 5.9 (0.4) 6.4 (0.4) 6.9 (0.4) 5.8 (0.4) 6.6 (0.5) 6.3 (0.4) 6.6 (0.4)

100% to less than 250% ......... 4.5 (0.2) 4.4 (0.2) 4.1 (0.2) 4.4 (0.2) 4.4 (0.2) 4.5 (0.3) 4.7 (0.3) 4.4 (0.3) 4.7 (0.3) 4.7 (0.3)

250% to less than 450% ......... 4.2 (0.2) 3.9 (0.2) 3.7 (0.2) 3.6 (0.2) 4.1 (0.2) 3.8 (0.3) 3.6 (0.3) 3.9 (0.3) 3.6 (0.3) 4.1 (0.3)

450% or above............... 3.8 (0.2) 3.8 (0.2) 3.2 (0.2) 3.5 (0.2) 3.5 (0.2) 3.2 (0.2) 3.6 (0.3) 3.7 (0.3) 4.0 (0.3) 3.9 (0.3)

1

Percentage is for the civilian noninstitutionalized population; except for age-specific estimates, percentages are age adjusted to the 2000 U.S. standard population.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Hawaiian and Other Pacific Islander, those
 

with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

4

The federal poverty threshold includes persons with reported and missing family income based on imputed income values using multiple imputation.
 

SOURCE: CDC/NCHS, National Health Interview Survey.
 
Series 3, No. 35 [ Page 33

Table 4. Percentage with one or more asthma attacks in the past 12 months, by detailed age group and selected characteristics:

United States, average annual 2008–2010

0–17 18 years 0–4 5–14 15–34 15–19 20–24 25–34 35–64 65 years

Characteristic Total years or over years years years years years years years or over

Percent (standard error)1

Total ................ 4.4 (0.1) 5.6 (0.2) 4.0 (0.1) 4.4 (0.3) 6.4 (0.2) 4.0 (0.2) 4.3 (0.3) 4.3 (0.4) 3.7 (0.2) 4.3 (0.1) 3.1 (0.2)

Sex

Male ................ 3.6 (0.1) 6.5 (0.3) 2.6 (0.1) 5.6 (0.5) 7.5 (0.4) 3.0 (0.2) 3.8 (0.4) 2.9 (0.5) 2.6 (0.3) 2.7 (0.2) 2.4 (0.2)

Female. . . . . . . . . . . . . . . 5.1 (0.1) 4.6 (0.2) 5.2 (0.1) 3.1 (0.4) 5.2 (0.3) 5.1 (0.2) 4.7 (0.4) 5.7 (0.6) 4.9 (0.3) 5.9 (0.2) 3.7 (0.2)

Race2

White ................ 4.1 (0.1) 4.9 (0.2) 3.9 (0.1) 3.6 (0.3) 5.6 (0.3) 3.9 (0.2) 4.0 (0.3) 4.2 (0.4) 3.8 (0.2) 4.2 (0.1) 3.1 (0.2)

Male ............... 3.4 (0.1) 5.9 (0.3) 2.6 (0.1) 5.0 (0.5) 6.8 (0.4) 2.8 (0.2) 3.5 (0.5) 2.7 (0.5) 2.6 (0.3) 2.6 (0.2) 2.4 (0.3)

Female ............. 4.8 (0.1) 3.8 (0.2) 5.1 (0.2) 2.2 (0.3) 4.2 (0.3) 5.1 (0.3) 4.5 (0.5) 5.8 (0.7) 5.0 (0.3) 5.7 (0.2) 3.7 (0.2)

Black ................ 5.6 (0.2) 8.7 (0.4) 4.4 (0.2) 6.8 (0.9) 10.5 (0.7) 4.4 (0.4) 5.0 (0.6) 4.9 (0.9) 3.8 (0.4) 4.9 (0.4) 3.2 (0.4)

Male ............... 4.9 (0.3) 9.6 (0.7) 2.8 (0.3) 7.7 (1.2) 11.8 (1.0) 3.5 (0.5) 4.7 (1.0) *4.6 (1.6) 2.2 (0.6) 2.8 (0.4) 2.2 (0.5)

Female ............. 6.2 (0.3) 7.7 (0.6) 5.7 (0.4) 5.9 (1.3) 9.2 (1.0) 5.2 (0.5) 5.4 (1.0) 5.2 (1.0) 5.1 (0.6) 6.6 (0.6) 3.8 (0.6)

Other races ............ 4.9 (0.3) 6.5 (0.6) 4.2 (0.3) 6.6 (1.3) 6.7 (0.8) 4.2 (0.5) 5.3 (1.1) *4.2 (1.4) 3.6 (0.6) 4.8 (0.5) 2.8 (0.8)

Male ............... 4.1 (0.4) 6.9 (0.9) 2.8 (0.3) 7.5 (2.0) 6.6 (1.0) 3.3 (0.6) 5.3 (1.5) * 3.0 (0.7) 3.0 (0.5) *2.0 (0.7)

Female ............. 5.7 (0.5) 6.1 (0.9) 5.5 (0.6) 5.7 (1.4) 6.7 (1.3) 5.0 (0.8) 5.4 (1.6) *6.4 (2.5) 4.1 (0.9) 6.4 (0.8) *3.5 (1.2)

Ethnicity3

Hispanic or Latino ........ 3.6 (0.2) 4.4 (0.3) 3.2 (0.2) 4.0 (0.5) 5.3 (0.4) 2.5 (0.2) 1.8 (0.3) 3.2 (0.5) 2.6 (0.3) 3.6 (0.2) 3.6 (0.6)

Male ............... 3.1 (0.2) 5.2 (0.4) 2.0 (0.2) 5.1 (0.8) 5.9 (0.6) 1.9 (0.3) 1.9 (0.4) *2.0 (0.6) 1.9 (0.5) 2.1 (0.3) *2.9 (1.0)

Female ............. 4.1 (0.2) 3.6 (0.4) 4.4 (0.3) 2.9 (0.6) 4.6 (0.6) 3.2 (0.3) 1.8 (0.4) 4.5 (0.9) 3.4 (0.4) 5.2 (0.4) 4.2 (0.7)

Puerto Rican ........... 9.2 (0.9) 11.7 (1.6) 7.8 (0.9) 10.0 (2.5) 14.7 (2.2) 5.6 (0.8) 5.2 (1.5) *7.7 (2.6) 4.7 (1.1) 9.9 (1.5) *5.1 (1.7)

Male ............... 8.9 (1.3) 15.9 (2.6) 5.1 (1.3) 12.9 (3.5) 20.4 (3.9) *4.6 (1.5) *8.2 (3.4) * * *5.7 (2.2) *

Female ............. 9.4 (0.9) 7.4 (1.5) 10.3 (1.2) *6.8 (2.7) 8.7 (2.1) 6.5 (1.1) * *7.4 (3.0) 8.4 (2.0) 13.6 (2.0) *6.4 (2.2)

Mexican .............. 2.9 (0.2) 3.4 (0.3) 2.6 (0.2) 3.3 (0.6) 4.0 (0.4) 2.1 (0.2) 1.0 (0.2) 2.8 (0.6) 2.3 (0.4) 2.9 (0.3) 3.7 (0.9)

Male ............... 2.3 (0.2) 3.6 (0.4) 1.5 (0.3) 3.8 (0.9) 4.0 (0.5) 1.4 (0.3) *1.1 (0.4) *2.0 (0.8) *1.3 (0.4) 1.5 (0.4) *3.4 (1.6)

Female ............. 3.6 (0.3) 3.2 (0.4) 3.8 (0.3) 2.8 (0.7) 3.9 (0.7) 2.9 (0.4) 1.0 (0.3) 3.6 (1.1) 3.5 (0.6) 4.4 (0.5) 3.9 (1.0)

Not Hispanic or Latino ..... 4.5 (0.1) 5.9 (0.2) 4.1 (0.1) 4.5 (0.4) 6.7 (0.3) 4.4 (0.2) 4.8 (0.4) 4.6 (0.4) 4.0 (0.2) 4.4 (0.1) 3.1 (0.2)

Male ............... 3.7 (0.1) 6.9 (0.3) 2.7 (0.1) 5.8 (0.6) 8.0 (0.4) 3.2 (0.2) 4.3 (0.5) 3.1 (0.5) 2.8 (0.3) 2.8 (0.2) 2.3 (0.2)

Female ............. 5.2 (0.1) 4.9 (0.3) 5.3 (0.2) 3.2 (0.4) 5.4 (0.4) 5.5 (0.3) 5.4 (0.5) 6.0 (0.6) 5.3 (0.3) 5.9 (0.2) 3.7 (0.2)

Region

Northeast ............. 4.3 (0.2) 5.4 (0.4) 4.0 (0.2) 3.7 (0.6) 6.3 (0.6) 3.9 (0.4) 3.8 (0.6) 4.4 (1.0) 3.8 (0.5) 4.4 (0.3) 3.4 (0.4)

Midwest .............. 4.5 (0.2) 6.2 (0.4) 3.9 (0.2) 5.1 (0.8) 6.8 (0.5) 4.9 (0.3) 5.3 (0.7) 5.0 (0.9) 4.6 (0.5) 4.0 (0.3) 2.4 (0.3)

South. . . . . . . . . . . . . . . . 4.1 (0.1) 6.0 (0.3) 3.5 (0.2) 5.0 (0.6) 7.0 (0.4) 3.2 (0.2) 3.9 (0.5) 3.4 (0.4) 2.8 (0.3) 4.0 (0.2) 3.2 (0.3)

West ................ 4.6 (0.2) 4.6 (0.3) 4.6 (0.2) 3.3 (0.5) 5.4 (0.5) 4.4 (0.3) 4.0 (0.5) 5.0 (0.8) 4.3 (0.4) 5.0 (0.3) 3.6 (0.3)

Federal poverty threshold4

Below 100% ........... 6.4 (0.2) 7.4 (0.4) 5.9 (0.3) 6.1 (0.8) 8.3 (0.7) 4.9 (0.4) 4.7 (0.6) 4.8 (0.6) 5.1 (0.6) 7.6 (0.5) 4.8 (0.6)

100% to less than 250% .... 4.5 (0.2) 5.5 (0.3) 4.2 (0.2) 4.0 (0.5) 6.4 (0.4) 4.2 (0.3) 4.2 (0.6) 4.0 (0.5) 4.3 (0.4) 4.7 (0.3) 3.5 (0.3)

250& to less than 450% .... 3.9 (0.2) 4.8 (0.3) 3.6 (0.2) 3.8 (0.6) 5.6 (0.5) 3.4 (0.3) 3.9 (0.6) 3.5 (0.7) 3.2 (0.4) 4.0 (0.3) 2.8 (0.3)

450% or above .......... 3.6 (0.1) 5.0 (0.3) 3.3 (0.2) 3.7 (0.6) 5.7 (0.5) 3.8 (0.3) 4.3 (0.6) 5.3 (1.1) 3.1 (0.4) 3.4 (0.2) 2.4 (0.3)

* Figure does not meet standards of reliability or precision. Estimates with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over 50%.
 

1

Percent is for the civilian noninstitutionalized population; crude percents are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

4

The federal poverty threshold includes persons with reported and missing family income based on imputed income values using multiple imputation.
 

SOURCE: CDC/NCHS, National Health Interview Survey.
Page 34 [ Series 3, No. 35

Table 5. Percentage with one or more asthma attacks in the past 12 months among those with current asthma, by year and selected

characteristics: United States, 2001–2010

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Percent (standard error)1

Total ..................... 55.8 (1.0) 56.5 (1.0) 53.2 (1.1) 54.2 (1.1) 53.5 (1.0) 52.1 (1.2) 52.3 (1.4) 52.9 (1.3) 49.9 (1.2) 51.9 (1.1)

Sex

Male ..................... 51.2 (1.6) 52.2 (1.7) 48.5 (1.8) 53.0 (1.7) 50.5 (1.7) 45.7 (2.0) 49.0 (2.2) 49.1 (2.0) 47.5 (1.9) 48.6 (1.8)

Female ................... 58.5 (1.3) 58.6 (1.3) 55.0 (1.4) 54.6 (1.4) 54.8 (1.3) 56.4 (1.5) 54.6 (1.7) 55.3 (1.7) 51.6 (1.6) 53.1 (1.5)

Race2

White. . . . . . . . . . . . . . . . . . . . . 55.4 (1.2) 56.5 (1.2) 53.1 (1.3) 54.3 (1.3) 54.4 (1.2) 52.7 (1.4) 52.8 (1.7) 52.7 (1.5) 50.4 (1.4) 52.7 (1.3)

Black ..................... 59.2 (2.3) 57.0 (2.4) 50.4 (2.4) 55.4 (2.6) 46.8 (2.3) 47.3 (2.6) 51.1 (2.6) 51.9 (2.6) 47.2 (2.6) 47.3 (2.3)

Other races ................. 56.4 (3.6) 61.1 (3.7) 57.2 (4.4) 47.8 (3.8) 60.7 (4.3) 52.0 (4.2) 50.3 (4.1) 58.0 (4.2) 56.1 (3.8) 57.4 (3.4)

Ethnicity3

Hispanic or Latino ............. 56.0 (2.9) 54.8 (2.9) 57.4 (2.8) 55.2 (2.9) 56.2 (2.7) 57.2 (3.0) 57.8 (2.6) 53.9 (3.3) 51.2 (2.8) 52.2 (2.8)

Not Hispanic or Latino .......... 56.2 (1.1) 56.7 (1.1) 53.1 (1.2) 54.4 (1.2) 53.3 (1.1) 52.0 (1.3) 51.4 (1.6) 52.8 (1.3) 49.8 (1.4) 52.2 (1.2)

Age

Children (0–17) .............. 61.7 (1.8) 64.9 (1.8) 62.7 (1.7) 61.2 (1.7) 56.7 (1.8) 56.1 (2.2) 54.8 (2.3) 57.2 (2.2) 53.9 (2.2) 58.3 (1.9)

Adults (18 or over) ............ 53.8 (1.2) 53.0 (1.2) 49.8 (1.3) 51.3 (1.3) 51.8 (1.2) 50.3 (1.5) 50.4 (1.7) 50.7 (1.5) 47.7 (1.4) 49.1 (1.3)

Age group

0–4 years .................. 70.7 (3.5) 77.3 (3.2) 69.7 (3.7) 65.1 (3.7) 60.8 (3.6) 69.9 (4.7) 59.0 (4.7) 64.4 (4.9) 66.2 (4.8) 68.3 (4.4)

5–14 years ................. 63.4 (2.2) 63.6 (2.3) 62.7 (2.2) 61.5 (2.3) 58.5 (2.3) 56.0 (2.7) 53.9 (3.0) 59.4 (2.8) 51.7 (2.8) 58.2 (2.5)

15–34 years ................ 54.0 (1.9) 53.4 (2.0) 51.4 (2.1) 51.8 (2.2) 52.2 (2.2) 45.6 (2.3) 49.1 (2.8) 48.5 (2.6) 46.6 (2.2) 45.4 (2.3)

35–64 years ................ 55.5 (1.7) 54.0 (1.7) 52.5 (1.7) 54.7 (1.7) 55.3 (1.7) 56.4 (2.0) 54.1 (2.1) 54.3 (2.1) 51.9 (2.0) 54.1 (1.7)

65 years or over .............. 43.2 (3.1) 49.9 (3.1) 38.8 (3.1) 42.5 (2.7) 37.7 (2.4) 37.5 (3.2) 44.3 (3.3) 40.5 (3.0) 36.9 (3.1) 41.6 (2.7)

Region

Northeast .................. 53.9 (2.2) 53.9 (2.2) 53.4 (2.2) 54.4 (2.5) 54.0 (2.2) 50.0 (2.7) 49.8 (2.9) 48.3 (2.8) 49.0 (2.5) 45.3 (2.8)

Midwest ................... 58.4 (2.0) 58.2 (1.9) 51.9 (2.3) 53.7 (2.1) 48.2 (2.2) 52.4 (2.5) 43.3 (3.1) 52.3 (2.5) 47.6 (2.3) 50.6 (2.3)

South .................... 56.1 (1.7) 55.6 (1.8) 53.5 (2.0) 54.9 (1.8) 54.1 (1.7) 51.8 (2.1) 56.8 (2.2) 52.2 (2.1) 52.0 (2.1) 52.4 (1.8)

West ..................... 54.1 (2.5) 59.0 (2.3) 55.0 (2.1) 53.1 (2.5) 58.3 (2.1) 54.9 (2.3) 57.1 (2.5) 56.6 (2.3) 50.5 (2.6) 56.5 (2.2)

Federal poverty threshold4

Below 100% ................ 58.7 (2.3) 56.9 (2.5) 57.2 (2.2) 60.8 (2.3) 59.4 (2.2) 55.3 (2.4) 54.2 (2.5) 59.2 (2.8) 51.4 (2.5) 55.9 (2.1)

100% to less than 250% ......... 55.9 (2.0) 56.9 (2.2) 53.2 (2.0) 56.0 (2.0) 52.4 (2.1) 54.7 (2.3) 53.7 (2.5) 51.7 (2.7) 53.0 (2.4) 53.1 (2.1)

250% to less than 450% ......... 57.9 (2.2) 58.0 (2.3) 55.6 (2.3) 50.9 (2.5) 54.9 (2.3) 51.0 (2.5) 49.9 (2.8) 51.2 (2.5) 45.9 (2.5) 48.2 (2.3)

450% or above............... 54.2 (2.2) 54.4 (2.2) 49.8 (2.4) 52.0 (2.3) 50.9 (2.1) 47.6 (2.7) 54.0 (2.4) 52.3 (2.6) 51.0 (2.4) 52.4 (2.5)

1

Percent is for the civilian noninstitutionalized population with current asthma; except for age-specific estimates, percentages are age adjusted to the 2000 U.S. standard population. Estimates for
 

2001–2004 may not match those in the 2007 Surveillance Summary for this indicator (Table 10 in that publication) due to minor programming differences.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

4

The federal poverty threshold includes persons with reported and missing family income based on imputed income values using multiple imputation.
 

SOURCE: CDC/NCHS, National Health Interview Survey.
 
Series 3, No. 35 [ Page 35

Table 6. Percentage with one or more asthma attack in the past 12 months among those with current asthma, by detailed age group and

selected characteristics: United States, average annual 2008–2010

0–17 18 years 0–4 5–14 15–34 15–19 20–24 25–34 35–64 65 years

Characteristic Total years or over years years years years years years years or over

Percent (standard error)1

Total ................ 51.2 (0.7) 56.5 (1.1) 49.1 (0.9) 66.3 (2.8) 56.4 (1.5) 46.8 (1.4) 42.1 (2.6) 45.0 (2.8) 51.4 (1.9) 53.5 (1.1) 39.7 (1.7)

Sex

Male ................ 49.2 (1.1) 56.3 (1.7) 44.4 (1.5) 67.5 (3.5) 56.3 (2.0) 41.1 (2.2) 39.6 (3.9) 35.7 (4.6) 46.5 (3.5) 49.4 (2.0) 37.2 (3.1)

Female. . . . . . . . . . . . . . . 52.7 (0.9) 56.7 (1.8) 51.7 (1.1) 64.2 (4.2) 56.5 (2.3) 51.0 (1.8) 44.4 (3.2) 51.7 (3.7) 54.4 (2.4) 55.5 (1.4) 41.0 (2.1)

Race2

White ................ 51.0 (0.8) 56.9 (1.5) 49.1 (1.0) 69.5 (3.3) 57.2 (1.9) 46.9 (1.6) 41.0 (3.1) 45.9 (3.2) 51.7 (2.2) 53.4 (1.3) 39.7 (1.8)

Male ............... 49.4 (1.3) 57.7 (2.0) 44.7 (1.7) 74.0 (4.0) 58.4 (2.5) 41.0 (2.7) 37.9 (4.7) 35.4 (5.3) 47.5 (4.1) 49.3 (2.3) 37.7 (3.4)

Female ............. 52.2 (1.1) 55.5 (2.3) 51.6 (1.2) 60.6 (6.0) 55.4 (2.8) 51.2 (2.1) 43.7 (4.0) 53.5 (4.5) 54.3 (2.8) 55.5 (1.6) 40.9 (2.3)

Black ................ 49.2 (1.3) 52.9 (1.9) 46.6 (1.9) 54.2 (4.9) 54.5 (2.8) 44.4 (2.8) 41.5 (3.9) 40.9 (6.7) 50.0 (4.6) 49.8 (2.7) 38.0 (4.1)

Male ............... 46.4 (2.1) 51.4 (3.0) 40.0 (3.2) 49.4 (6.0) 53.5 (3.7) 39.7 (4.6) 40.8 (6.7) 39.3 (10.3) 38.5 (8.9) 43.7 (4.5) 33.5 (6.6)

Female ............. 51.4 (1.7) 54.9 (3.1) 49.8 (2.3) 62.3 (7.8) 55.8 (4.5) 47.8 (3.3) 42.3 (5.3) 42.2 (7.0) 55.7 (4.8) 52.4 (3.1) 39.8 (5.3)

Other races ............ 58.1 (2.4) 63.5 (3.7) 55.0 (3.0) 80.8 (7.8) 55.8 (4.8) 51.2 (4.6) 55.5 (8.5) 46.8 (11.2) 51.7 (5.9) 62.5 (3.9) 42.5 (8.5)

Male ............... 54.2 (3.8) 60.0 (5.8) 48.8 (4.4) 79.6 (11.2) 48.7 (6.3) 45.4 (6.8) 51.4 (11.7) *27.6 (13.3) 49.1 (9.2) 63.3 (6.1) *33.7 (11.0)

Female ............. 61.0 (2.8) 68.3 (5.1) 58.3 (3.7) 82.9 (7.2) 64.3 (7.1) 55.8 (6.1) 61.5 (11.7) 55.7 (13.4) 53.6 (8.2) 62.1 (4.7) 47.9 (11.1)

Ethnicity3

Hispanic or Latino ........ 52.2 (1.7) 54.8 (2.5) 50.4 (2.4) 66.9 (4.7) 52.8 (2.9) 41.3 (3.3) 26.1 (4.2) 51.2 (6.7) 45.2 (4.9) 58.5 (3.3) 48.6 (5.6)

Male ............... 50.0 (2.6) 55.2 (3.2) 44.7 (4.3) 69.9 (6.7) 51.8 (3.6) 36.6 (5.7) 26.3 (6.2) 42.5 (11.0) 41.0 (9.1) 53.3 (5.6) 50.8 (11.4)

Female ............. 54.0 (2.1) 54.2 (3.7) 54.0 (2.5) 61.6 (6.7) 54.1 (4.7) 45.3 (3.9) 25.9 (5.6) 56.6 (8.3) 48.7 (5.1) 61.1 (3.9) 47.5 (6.9)

Puerto Rican ........... 54.1 (4.0) 67.0 (5.0) 47.1 (5.2) 70.9 (9.9) 68.2 (6.4) 35.2 (5.8) *29.7 (10.8) 56.7 (11.8) 28.5 (7.2) 57.8 (7.0) 38.0 (10.8)

Male ............... 52.8 (6.0) 69.3 (6.9) 36.6 (9.1) 73.6 (13.8) 69.6 (8.5) *24.0 (9.3) * *52.7 (20.3) * 56.5 (13.8) *

Female ............. 55.3 (4.5) 62.5 (7.7) 53.1 (5.5) 66.1 (16.4) 65.4 (9.4) 45.1 (5.9) * 59.6 (14.9) 44.8 (7.6) 58.3 (8.0) 44.1 (12.2)

Mexican .............. 51.0 (2.2) 50.6 (3.3) 51.3 (3.0) 66.2 (6.4) 47.2 (3.7) 44.7 (4.4) 20.5 (4.8) 52.7 (9.2) 54.3 (6.3) 55.5 (4.8) 52.7 (8.2)

Male ............... 47.6 (3.4) 48.9 (4.3) 46.0 (5.3) 65.1 (9.2) 44.7 (4.3) 41.1 (6.5) *21.0 (7.0) 57.2 (13.1) 50.3 (10.8) 45.6 (8.3) 59.7 (13.8)

Female ............. 53.7 (2.7) 52.8 (4.8) 54.2 (3.4) 68.0 (7.4) 50.3 (6.0) 47.1 (5.7) 20.0 (5.9) 50.4 (11.2) 56.5 (7.8) 60.7 (5.3) 48.2 (11.2)

Not Hispanic or Latino ..... 51.1 (0.8) 56.8 (1.3) 49.0 (0.9) 66.2 (3.3) 57.2 (1.7) 47.6 (1.5) 44.3 (2.9) 44.3 (3.0) 52.6 (2.1) 52.9 (1.2) 39.1 (1.7)

Male ............... 49.1 (1.2) 56.6 (1.9) 44.3 (1.5) 66.8 (4.1) 57.3 (2.3) 41.9 (2.4) 41.6 (4.4) 34.9 (4.9) 47.8 (3.7) 49.0 (2.2) 36.3 (3.1)

Female ............. 52.6 (1.0) 57.2 (2.0) 51.5 (1.1) 64.9 (5.1) 57.0 (2.6) 51.8 (1.9) 46.7 (3.5) 51.0 (3.9) 55.4 (2.6) 54.9 (1.5) 40.6 (2.2)

Region

Northeast ............. 47.3 (1.7) 50.2 (2.8) 46.2 (2.1) 59.0 (7.5) 52.3 (3.8) 37.9 (3.5) 30.7 (5.6) 45.2 (7.8) 39.2 (4.6) 52.5 (2.5) 41.7 (3.7)

Midwest .............. 50.2 (1.3) 57.5 (2.2) 47.1 (1.7) 67.8 (5.0) 56.3 (2.9) 51.1 (2.7) 48.4 (5.8) 47.2 (5.9) 56.0 (3.8) 47.9 (2.2) 34.5 (3.5)

South. . . . . . . . . . . . . . . . 52.2 (1.2) 57.6 (1.8) 49.7 (1.5) 65.0 (4.0) 58.1 (2.4) 44.9 (2.4) 43.2 (3.9) 39.6 (4.2) 50.4 (3.8) 54.9 (2.1) 42.6 (3.0)

West ................ 54.1 (1.6) 58.6 (2.6) 52.7 (1.8) 73.1 (7.3) 56.8 (3.3) 51.4 (2.9) 43.0 (4.8) 49.7 (5.6) 57.5 (3.2) 58.0 (2.4) 38.5 (3.1)

Federal poverty threshold4

Below 100% ........... 55.1 (1.4) 56.9 (2.4) 54.0 (1.7) 58.9 (5.3) 55.7 (3.2) 51.8 (2.5) 47.2 (4.9) 48.5 (4.6) 58.4 (4.1) 58.1 (2.4) 47.5 (4.6)

100% to less than 250% .... 51.4 (1.3) 56.3 (2.1) 49.2 (1.5) 67.0 (4.2) 56.0 (2.7) 48.0 (2.5) 41.1 (4.9) 41.4 (4.9) 58.7 (3.8) 54.7 (2.4) 40.2 (2.6)

250% to less than 450% .... 47.9 (1.5) 55.1 (2.5) 45.5 (1.8) 73.0 (5.3) 55.7 (3.0) 42.4 (3.1) 39.0 (5.0) 43.4 (5.9) 44.3 (4.1) 49.6 (2.4) 37.2 (3.3)

450% or above .......... 51.3 (1.5) 57.8 (2.8) 49.5 (1.7) 75.6 (6.2) 58.9 (3.6) 45.6 (3.2) 42.7 (5.4) 48.6 (7.5) 46.0 (4.1) 53.4 (2.0) 37.7 (4.3)

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over
 

50%.
 

1

Percentage is for the civilian noninstitutionalized population with current asthma; crude percents are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

4

The federal poverty threshold includes persons with reported and missing family income based on imputed income values using multiple imputation.
 

SOURCE: CDC/NCHS, National Health Interview Survey.
Page 36 [ Series 3, No. 35

Table 7. Rate of physician office visits with asthma as the first-listed diagnosis per 10,000 population, by year and selected patient

characteristics: United States, 2001–2009

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate (standard error)1

Total ................ 409.7 (44.0) 457.4 (40.2) 448.5 (40.6) 470.2 (50.9) 440.3 (45.2) 361.3 (39.8) 475.3 (45.5) 298.6 (30.3) 351.2 (32.9)
 

Sex

Male ................ 405.5 (64.2) 344.9 (43.5) 409.9 (52.7) 418.9 (58.3) 449.6 (58.4) 282.2 (41.5) 487.8 (57.5) 262.1 (38.3) 309.4 (36.8)
 

Female. . . . . . . . . . . . . . . 405.9 (54.4) 549.3 (57.9) 484.1 (54.8) 514.7 (68.0) 423.2 (53.9) 429.4 (57.9) 452.9 (59.4) 325.8 (43.2) 386.2 (48.7)
 

Race2

White ................ 434.2 (49.3) 473.2 (45.1) 468.8 (45.0) 476.6 (57.7) 445.7 (47.8) 358.7 (40.6) 481.5 (51.1) 285.9 (31.5) 354.1 (34.5)
 

Black ................ *299.5 (98.2) 368.7 (72.4) 349.2 (89.8) 477.1 (109.5) 411.5 (102.0) 314.5 (92.3) 594.9 (119.5) 342.4 (73.4) 410.7 (111.9)
 

Other races ............ *294.1 (93.4) *576.7 (386.6) *469.6 (171.7) *420.8 (146.9) *463.0 (166.9) *383.7 (119.7) *227.6 (87.4) *370.0 (162.2) 123.7 (60.2)
 

Ethnicity3

Hispanic or Latino ........ . . . . . . 460.4 (130.9) 422.9 (99.4) 530.2 (169.7) 287.8 (93.2) 457.9 (93.1) 446.4 (84.8) 426.8 (81.0)

Not Hispanic or Latino ..... . . . . . . 456.9 (43.5) 472.3 (53.6) 414.0 (38.8) 371.8 (40.0) 475.6 (52.2) 271.2 (31.5) 343.2 (35.0)

Age

Children (0–17).......... 605.7 (129.8) 597.7 (91.7) 738.9 (133.0) 895.1 (208.9) 743.7 (176.4) 465.9 (102.1) 902.3 (178,6) 481.8 (95.5) 884.2 (97.3)
 

Adults (18 or over)........ 337.5 (65.6) 404.8 (76.4) 350.3 (60.0) 328.4 (57.0) 338.3 (54.6) 325.4 (75.6) 323.5 (56.8) 237.5 (37.0) 310.8 (48.9)
 

Age group

0–4 years ............. 1,064.9 (303.7) 735.0 (161.6) 1,092.5 (296.0) 1,095.2 (293.4) 938.7 (236.3) 308.6 (102.8) 1,167.4 (249.7) 646.3 (169.9) 444.1 (129.2)
 

5–14 years ............ 468.5 (105.1) 631.8 (116.5) 667.2 (130.4) 817.8 (222.4) 677.7 (192.9) 606.4 (148.7) 965.5 (196.3) 445.6 (104.2) 516.2 (108.9)
 

15–34 years............ 251.2 (59.8) 250.4 (50.7) 218.4 (49.6) 332.0 (76.5) 286.5 (71.1) 186.7 (40.8) *290.7 (92.0) 146.4 (34.7) 221.2 (41.9)
 

35–64 years............ 292.8 (69.2) 355.3 (76.0) 389.6 (77.5) 361.5 (73.8) 392.5 (62.8) 341.8 (75.9) 315.7 (60.4) 261.2 (47.6) 329.7 (56.5)
 

65 years or over ......... 675.9 (192.5) 870.4 (222.3) 545.6 (148.9) 389.7 (108.1) 387.7 (112.1) *566.2 (261.1) 408.9 (115.1) 393.3 (134.8) 468.0 (164.5)
 

Region

Northeast ............. 431.1 (96.7) 625.4 (114.2) 377.9 (83.3) 689.7 (170.4) 320.5 (67.6) 600.7 (136.5) 604.9 (153.7) 509.2 (108.2) 454.0 (81.6)
 

Midwest .............. 353.0 (101.5) 277.5 (56.9) 453.6 (78.0) 455.3 (71.3) 451.3 (81.2) 271.5 (54.3) 341.6 (64.6) 210.0 (39.0) 360.4 (62.2)
 

South. . . . . . . . . . . . . . . . 392.1 (68.2) 455.1 (71.2) 428.0 (70.5) 455.5 (81.7) 528.5 (99.5) 385.3 (71.9) 610.1 (84.1) 245.2 (39.2) 370.4 (64.0)
 

West ................ 483.6 (98.1) 524.7 (83.8) 551.9 (96.9) 324.4 (96.6) 390.0 (74.8) 218.7 (45.1) 302.6 (64.9) 306.7 (68.7) 224.7 (4.5)
 

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over
 

50%.
 

. . . Category not applicable.
 

1

Except for age-specific estimates, rates are age adjusted to the 2000 U.S. standard population.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race. Ethnicity was not imputed in 2001 or 2002. It is not shown for those years due to a high rate of missing data.
 

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey.
2009

Series 3, No. 35 [ Page 37

Table 8. Rate of physician office visits with asthma as the first-listed diagnosis per 100 persons with current asthma, by year and selected

patient characteristics: United States, 2001–2009

2001 2002 2003 2004 2005 2006 2007 2008

Rate (standard error)1

Total ................ 55.6 (9.7) 63.4 (9.6) 64.8 (10.2) 66.2 (11.3) 57.7 (10.1) 46.3 (8.3) 60.6 (10.3) 38.2 (5.0) 43.0 (5.9)

Sex

Male ................ 63.9 (14.3) 56.1 (8.7) 69.2 (11.1) 67.0 (11.3) 71.9 (16.7) 39.8 (6.8) 74.6 (12.7) 36.9 (7.0) 43.9 (6.9)

Female. . . . . . . . . . . . . . . 49.6 (9.3) 68.7 (12.0) 61.7 (11.1) 65.7 (13.1) 47.8 (7.5) 51.4 (11.7) 50.7 (11.0) 39.2 (6.2) 42.4 (7.1)

Race2

White ................ 60.9 (10.9) 69.1 (11.2) 71.0 (12.0) 69.3 (12.5) 60.0 (10.5) 48.3 (9.4) 63.9 (12.2) 39.4 (5.7) 46.5 (6.9)

Black ................ *32.9 (11.4) 42.4 (11.4) 37.1 (9.7) 53.3 (12.8) *45.8 (17.4) *39.6 (15.1) 61.5 (14.4) 34.5 (9.1) 39.7 (11.1)

Other races ............ *45.7 (16.0) *51.3 (22.4) *58.8 (23.2) *59.8 (21.3) *58.6 (25.4) *38.6 (12.8) *22.2 (8.3) * *14.0 (6.9)

Ethnicity3

Hispanic or Latino ........ . . . . . . *74.8 (24.5) 93.8 (24.8) * *44.7 (15.8) 75.9 (18.2) 77.6 (17.5) 64.8 (15.0)

Not Hispanic or Latino ..... . . . . . . 63.6 (10.6) 63.0 (11.6) 52.5 (6.6) 46.5 (8.8) 58.2 (11.5) 33.0 (4.8) 40.0 (5.9)

Age

Children (0–17).......... 69.6 (15.1) 71.9 (11.4) 86.8 (16.0) 105.7 (25.0) 83.6 (20.1) 50.2 (11.2) 99.3 (20.2) 51.2 (10.4) 51.9 (10.4)

Adults (18 or over)........ 49.3 (9.7) 59.7 (11.4) 54.8 (9.5) 49.2 (8.6) 46.9 (7.7) 44.6 (10.5) 44.6 (8.0) 32.7 (5.2) 39.4 (6.5)

Age group

0–4 years ............. 186.4 (55.1) 123.4 (29.2) 184.2 (52.1) 195.5 (54.7) 139.0 (36.7) *53.4 (18.6) 171.8 (40.1) 105.9 (30.0) *71.0 (21.8)

5–14 years ............ 47.5 (10.9) 69.1 (13.2) 70.7 (14.3) 90.0 (24.8) 69.2 (20.0) 55.9 (14.1) 103.0 (21.9) 40.8 (9.8) 46.0 (10.0)

15–34 years............ 31.6 (7.6) 33.2 (6.9) 30.4 (7.0) 47.0 (11.0) 38.1 (9.6) 23.8 (5.4) *34.8 (11.2) 18.2 (4.4) 28.5 (5.6)

35–64 years............ 44.0 (10.5) 52.1 (11.3) 61.1 (12.4) 53.4 (11.0) 55.1 (9.0) 46.9 (10.6) 45.6 (9.0) 36.9 (6.9) 41.8 (7.4)

65 years or over ......... 113.5 (33.1) 148.8 (39.1) 94.8 (26.5) 55.5 (15.7) 50.9 (15.0) *80.9 (37.8) 54.7 (15.8) *54.8 (19.1) *61.0 (21.9)

Region

Northeast ............. 51.9 (14.6) 74.9 (20.0) *47.5 (14.4) *93.1 (43.0) *37.3 (11.4) *67.8 (21.8) * 63.7 (17.1) *5.0 (16.1)

Midwest .............. *45.9 (21.5) 37.6 (9.7) 58.3 (15.6) 61.3 (13.7) 59.3 (14.7) 31.4 (7.7) *38.8 (12.0) 23.2 (5.9) 39.8 (8.8)

South. . . . . . . . . . . . . . . . *54.2 (16.6) *67.3 (20.9) *69.6 (21.3) 68.0 (17.1) *71.4 (25.6) *52.5 (18.6) 82.7 (17.4) 36.5 (7.6) 49.5 (12.5)

West ................ *75.6 (25.0) 76.0 (21.1) *84.4 (26.9) *46.1 (18.1) 53.5 (12.9) 31.2 (8.1) 42.2 (11.8) *38.0 (12.0) 29.3 (8.2)

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE greater
 

than 50%.
 

. . . Category not applicable.
 

1

Crude rates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race. Ethnicity was not imputed in 2001 or 2002. It is not shown for those years due to a high rate of missing data.

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey.
Page 38 [ Series 3, No. 35

Table 9. Rate of hospital outpatient department visits with asthma as the first-listed diagnosis per 10,000 population, by year and selected

patient characteristics: United States, 2001–2009

2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate (standard error)1

Total ................ 46.4 (5.2) 43.5 (4.8) 52.9 (6.2) 36.6 (3.6) 44.6 (4.1) 37.5 (3.5) 48.0 (7.6) 55.8 (6.5) 39.6 (5.8)

Sex

Male ................ 34.9 (4.9) 41.4 (5.9) 43.4 (7.3) 32.2 (5.1) 36.6 (5.3) 32.3 (4.1) 44.5 (7.9) 48.0 (7.2) 41.5 (7.4)

Female. . . . . . . . . . . . . . . 56.3 (8.4) 45.2 (5.9) 61.6 (7.2) 39.8 (4.5) 51.9 (6.3) 41.9 (5.3) 51.4 (9.0) 62.9 (8.4) 37.1 (5.7)

Race2

White ................ 43.9 (5.8) 32.9 (4.4) 36.7 (5.2) 24.2 (2.9) 35.8 (3.8) 32.3 (3.8) 35.6 (6.2) 45.8 (6.5) 33.6 (4.5)

Black ................ 76.1 (10.4) 115.7 (16.7) 152.1 (24.0) 116.4 (19.3) 111.3 (19.8) 65.0 (10.6) 128.4 (27.4) 105.2 (18.9) *69.1 (20.8)

Other races ............ *15.4 (4.7) *20.0 (7.4) 52.6 (15.7) *46.1 (20.0) *31.2 (10.2) *42.2 (13.6) *14.7 (4.8) 52.5 (13.6) *43.9 (14.4)

Ethnicity3

Hispanic or Latino ........ . . . . . . 117.7 (29.8) 59.5 (14.5) 70.6 (14.0) 41.4 (8.6) 85.0 (20.0) 73.7 (17.9) 26.6 (6.1)

Not Hispanic or Latino ..... . . . . . . 47.8 (6.6) 35.2 (3.9) 40.5 (4.2) 36.2 (3.8) 41.5 (6.4) 55.4 (7.2) 44.5 (7.3)

Age

Children (0–17).......... 78.5 (18.6) 87.0 (17.3) 102.8 (27.6) 63.2 (10.7) 85.6 (14.5) 64.7 (9.7) *114.2 (39.5) 113.8 (27.9) 103.9 (27.9)

Adults (18 or over)........ 35.1 (8.4) 28.7 (4.9) 35.8 (9.5) 27.6 (5.1) 31.0 (5.4) 28.0 (5.0) 25.4 (6.0) *36.5 (7.7) 17.8 (2.6)

Age group

0–4 years ............. 128.8 (33.9) 110.9 (25.2) 127.7 (38.3) 105.1 (25.9) 121.7 (29.0) 67.4 (14.8) *154.4 (53.2) 140.2 (48.1) 123.1 (33.9)

5–14 years ............ 71.5 (18.2) 95.1 (23.0) 106.6 (28.9) 48.4 (9.8) 77.3 (13.5) 73.1 (12.3) *110.0 (42.3) 117.6 (27.0) *105.2 (33.4)

15–34 years............ 31.8 (8.6) 35.4 (8.1) 37.7 (7.6) 28.3 (5.9) 31.6 (5.6) 26.5 (5.6) 33.5 (8.1) *46.7 (12.2) 32.3 (6.2)

35–64 years............ 34.9 (9.4) 24.7 (4.9) *35.6 (11.6) 28.1 (6.0) 36.1 (8.3) 30.8 (6.4) 25.3 (6.8) 30.5 (6.2) 16.1 (3.7)

65 years or over ......... *38.1 (15.7) *23.4 (9.1) *36.9 (14.0) *29.9 (11.0) *21.6 (8.0) *24.4 (9.9) *21.0 (10.1) *40.9 (17.6) *

Region

Northeast ............. 54.1 (9.4) 62.0 (9.0) 105.3 (17.4) 60.8 (9.1) 85.3 (12.8) 52.5 (9.2) 74.7 (13.6) 76.8 (13.6) 76.8 (14.1)

Midwest .............. 67.0 (12.8) 45.2 (10.3) 32.3 (7.2) 42.2 (8.0) 53.4 (9.3) 57.0 (9.5) 31.3 (6.0) 82.3 (16.3) 50.3 (10.0)

South. . . . . . . . . . . . . . . . 44.8 (10.3) 44.8 (9.8) 54.2 (12.6) 24.3 (5.1) 26.7 (5.8) 26.5 (5.2) *53.6 (16.7) 54.3 (12.9) *32.3 (12.9)

West ................ 19.2 (5.0) 23.4 (5.5) 25.5 (7.3) 31.1 (7.7) 30.0 (6.4) 24.2 (5.1) *36.0 (15.4) 17.8 (4.7) *14.7 (4.9)

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE greater
 

than 50%.
 

. . . Category not applicable.
 

1

Except for age-specific estimates, rates are age adjusted to the 2000 U.S. standard population.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race. Ethnicity was not imputed in 2001 or 2002. It is not shown for those years due to a high rate of missing data.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
Series 3, No. 35 [ Page 39

Table 10. Rate of hospital outpatient department visits with asthma as the first-listed diagnosis per 100 persons with current asthma, by

year and selected patient characteristics: United States, 2001–2009

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate (standard error)1

Total ..................... 6.3 (1.1) 6.1 (0.9) 7.6 (1.5) 5.1 (0.7) 5.9 (0.8) 4.8 (0.7) 6.2 (1.5) 7.1 (1.2) 4.8 (0.9)

Sex

Male ..................... 5.7 (1.0) 7.0 (1.3) 7.5 (1.8) 5.2 (1.0) 5.9 (1.1) 4.7 (0.7) 6.8 (1.8) 6.8 (1.3) 5.9 (1.3)

Female ................... 6.8 (1.5) 5.5 (0.9) 7.7 (1.6) 5.0 (0.9) 5.9 (0.9) 4.8 (0.8) 5.7 (1.4) 7.4 (1.3) 3.9 (0.7)

Race2

White. . . . . . . . . . . . . . . . . . . . . 6.1 (1.4) 4.8 (1.0) 5.5 (1.2) 3.5 (0.6) 4.8 (0.8) 4.2 (0.7) 4.7 (1.3) 6.2 (1.2) 4.3 (0.7)

Black ..................... 10.0 (1.8) 14.0 (2.5) 18.1 (4.5) 12.9 (2.6) 11.8 (2.9) 8.0 (1.7) *14.5 (4.6) 12.1 (3.2) *7.1 (2.6)

Other races ................. *2.0 (0.7) *2.9 (1.3) *6.8 (2.6) *6.4 (2.8) *4.3 (1.5) *4.2 (1.5) *1.7 (0.7) *5.2 (1.9) *4.7 (1.7)

Ethnicity3

Hispanic or Latino ............. . . . . . . *16.8 (8.0) 9.7 (2.8) 12.0 (3.3) 7.6 (1.9) *13.6 (5.1) 11.9 (3.0) 4.4 (1.2)

Not Hispanic or Latino .......... . . . . . . 6.5 (1.3) 4.6 (0.7) 5.0 (0.7) 4.4 (0.7) 5.0 (1.1) 6.5 (1.2) 4.8 (1.0)

Age

Children (0–17) .............. 9.0 (2.2) 10.5 (2.1) 12.1 (3.3) 7.5 (1.3) 9.6 (1.7) 7.0 (1.1) *12.5 (4.4) 12.1 (3.0) 10.8 (2.9)

Adults (18 or over) ............ 5.1 (1.2) 4.2 (0.7) 5.6 (1.5) 4.1 (0.8) 4.3 (0.8) 3.8 (0.7) 3.5 (0.8) 5.0 (1.1) 2.3 (0.4)

Age group

0–4 years .................. 22.5 (6.2) 18.6 (4.5) *21.5 (6.7) 18.8 (4.9) 18.0 (4.5) 11.7 (2.8) *22.7 (8.1) *23.0 (8.3) 19.6 (5.7)

5–14 years ................. 7.2 (1.9) 10.4 (2.6) 11.3 (3.1) 5.3 (1.1) 7.9 (1.4) 6.7 (1.2) *11.7 (4.6) 10.8 (2.6) *9.4 (3.0)

15–34 years ................ 4.0 (1.1) 4.7 (1.1) 5.2 (1.1) 4.0 (0.9) 4.2 (0.8) 3.4 (0.7) 4.0 (1.0) 5.8 (1.5) 4.2 (0.8)

35–64 years ................ 5.2 (1.4) 3.6 (0.7) *5.6 (1.8) 4.1 (0.9) 5.1 (1.2) 4.2 (0.9) 3.7 (1.0) 4.3 (0.9) 2.0 (0.5)

65 years or over .............. *6.4 (2.7) *4.0 (1.6) *6.4 (2.5) *4.3 (1.6) *2.8 (1.0) *3.5 (1.4) *2.8 (1.4) *5.7 (2.5) *

Region

Northeast .................. *6.6 (2.0) 7.5 (1.4) *13.6 (5.0) 8.3 (2.2) 10.1 (2.6) 5.9 (1.4) *9.0 (3.3) 9.2 (1.8) 7.8 (1.8)

Midwest ................... *8.8 (3.1) 6.2 (1.5) 4.1 (1.0) 5.6 (1.5) 6.9 (1.6) 6.6 (1.8) 3.7 (0.9) *9.3 (2.8) 5.5 (1.4)

South .................... *6.1 (2.0) *6.6 (2.2) *8.7 (3.2) 3.5 (0.9) 3.6 (1.0) 3.5 (0.9) *7.1 (3.2) *7.8 (2.7) *

West ..................... *3.2 (1.1) *3.5 (1.1) *4.0 (1.6) *4.4 (1.8) *4.2 (1.5) *3.5 (1.2) * *2.3 (0.8) *1.9 (0.7)

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over

50%.
 

. . . Category not applicable.
 

1

Crude rates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race. Ethnicity was not imputed in 2001 or 2002. It is not shown for those years due to a high rate of missing data.
 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
Page 40 [ Series 3, No. 35

Table 11. Rate of physician office visits with asthma as the first-listed diagnosis per 100 persons with current asthma, by detailed age

group and selected patient characteristics: United States, average annual 2007–2009

0–17 18 years 0–4 5–14 15–34 35–64 65 years

Characteristic Total years or over years years years years or over

Rate (standard error)1

Total ..................... 47.1 (4.8) 66.9 (8.5) 38.9 (4.4) 117.2 (18.5) 61.2 (8.5) 27.2 (4.7) 41.4 (4.9) 57.0 (12.2)

Sex

Male ..................... 51.1 (5.4) 74.9 (9.5) 35.0 (4.6) 118.6 (19.7) 72.5 (10.6) 24.3 (4.8) 42.5 (7.1) 39.6 (10.8)

Female ................... 44.1 (5.6) 55.5 (11.0) 41.1 (5.5) 114.5 (35.7) 44.5 (9.5) 29.4 (6.1) 40.9 (5.7) 66.5 (16.6)

Race2

White. . . . . . . . . . . . . . . . . . . . . 49.9 (5.7) 80.5 (11.3) 39.7 (4.9) 156.9 (28.9) 72.0 (10.8) 30.6 (6.1) 42.0 (5.3) 54.7 (13.4)

Male.................... 55.4 (6.3) 90.2 (12.4) 36.6 (5.0) 158.1 (30.0) 85.2 (13.4) 27.5 (5.9) 42.3 (7.1) 44.3 (12.3)

Female .................. 45.8 (6.7) 66.0 (15.1) 41.6 (6.3) *154.8 (56.9) 51.2 (12.8) 32.8 (7.9) 41.8 (6.3) *60.5 (18.5)

Black ..................... 44.9 (7.0) 52.3 (10.7) 38.9 (8.5) 89.5 (26.4) 47.6 (13.6) *19.0 (5.8) 43.4 (12.8) *73.4 (36.6)

Male.................... 48.0 (10.4) 55.3 (12.8) *37.3 (17.0) *90.0 (29.4) *51.2 (15.5) *21.2 (10.0) * *

Female .................. 42.6 (7.9) 48.3 (14.0) 39.6 (9.0) *88.8 (44.0) *42.9 (16.1) *17.6 (6.2) 39.7 (11.1) *

Other races ................. *23.5 (7.5) *16.4 (6.1) *27.9 (11.6) * *25.4 (10.0) * * 68.7 (34.0)

Male.................... *16.3 (6.1) *22.6 (10.1) * * *37.8 (17.2) * * *

Female .................. *29.3 (12.6) * 38.0 (17.8) * * * * *

Ethnicity3

Hispanic or Latino ............. 72.6 (9.9) 95.6 (17.8) 55.5 (10.7) 183.1 (45.2) 67.3 (15.4) *35.4 (11.1) 72.0 (15.7) *71.4 (29.3)

Male.................... 76.7 (14.7) 101.2 (23.7) 47.4 (14.1) 191.0 (56.1) 73.6 (21.3) *33.9 (15.2) *67.3 (25.1) *

Female .................. 69.1 (11.5) 87.5 (19.1) 60.1 (14.4) 169.1 (57.5) 59.0 (18.7) *36.6 (15.9) 74.3 (19.6) *99.3 (45.9)

Not Hispanic or Latino .......... 43.5 (5.1) 60.6 (9.3) 37.0 (4.7) 97.6 (18.4) 59.8 (9.7) 26.1 (5.2) 38.1 (5.0) 55.9 (12.5)

Male.................... 47.2 (5.5) 69.2 (9.7) 33.6 (4.9) 97.2 (18.6) 72.3 (11.9) 23.0 (5.1) 39.9 (7.3) 40.6 (11.6)

Female .................. 40.8 (6.1) 48.3 (12.5) 39.0 (5.7) 98.2 (40.3) 40.8 (10.8) 28.4 (6.6) 37.2 (5.7) 64.2 (17.0)

Region

Northeast .................. 61.4 (16.5) *76.3 (27.9) 55.2 (13.9) *132.9 (45.6) *70.0 (25.3) * 49.5 (13.3) *112.2 (40.7)

Midwest ................... 33.9 (6.0) 38.5 (8.0) 32.0 (6.8) *50.3 (23.1) 38.0 (8.3) 19.9 (4.8) 41.3 (10.4) *35.5 (13.3)

South .................... 56.6 (8.5) 86.3 (15.5) 42.2 (8.1) 156.2 (35.0) 72.4 (16.0) 35.9 (7.1) 39.7 (7.2) *63.6 (26.2)

West ..................... 36.3 (7.6) 58.8 (15.3) 29.1 (7.5) *98.4 (34.0) 62.5 (18.3) *14.1 (5.3) 37.2 (9.8) *30.1 (12.8)

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over
 

50%.
 

1

Crude estimates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey.
Series 3, No. 35 [ Page 41

Table 12. Rate of hospital outpatient department visits with asthma as the first-listed diagnosis per 100 persons with current asthma, by

detailed age group and selected patient characteristics: United States, average annual 2007–2009

0–17 18 years 0–4 5–14 15–34 35–64 65 years

Characteristic Total years or over years years years years or over

Rate (standard error)1

Total ..................... 6.0 (0.8) 11.8 (2.4) 3.6 (0.5) 21.8 (4.8) 10.6 (2.2) 4.7 (0.7) 3.3 (0.5) *3.1 (0.9)

Sex

Male ..................... 6.5 (1.0) 11.7 (2.3) 2.9 (0.5) 21.0 (5.2) 10.1 (2.1) 4.2 (0.8) 2.5 (0.6) *2.9 (1.2)

Female ................... 5.6 (0.8) 11.9 (2.7) 4.0 (0.5) 23.0 (5.7) 11.2 (2.8) 5.0 (0.9) 3.7 (0.5) *3.3 (1.3)

Race2

White. . . . . . . . . . . . . . . . . . . . . 5.1 (0.8) 10.4 (2.3) 3.3 (0.5) 23.1 (6.4) 8.8 (1.8) 4.0 (0.8) 3.2 (0.5) *2.7 (1.0)

Male.................... 5.3 (0.9) 10.2 (2.3) 2.7 (0.6) *23.1 (7.1) 8.1 (1.8) 3.7 (0.8) 2.3 (0.7) *2.5 (1.1)

Female .................. 4.8 (0.7) 10.8 (2.6) 3.6 (0.6) *23.2 (7.7) 9.9 (2.3) 4.3 (1.0) 3.6 (0.6) *2.9 (1.4)

Black ..................... 11.1 (2.4) 17.6 (4.6) 5.7 (1.3) *23.9 (7.3) 17.4 (5.2) 7.8 (2.1) *4.8 (1.5) *

Male.................... 12.4 (2.9) 18.4 (4.7) *3.7 (1.6) *21.8 (7.9) 18.3 (5.0) *6.7 (2.6) *3.6 (1.8) *

Female .................. 10.1 (2.3) *16.6 (5.2) 6.6 (1.6) *27.1 (9.5) *16.3 (6.6) 8.6 (2.4) *5.3 (1.8) *

Other races ................. 4.0 (1.0) *5.1 (1.6) *3.2 (1.1) *10.0 (4.9) *4.1 (1.4) *4.2 (2.0) *1.6 (0.7) *

Male.................... *4.2 (1.3) *4.5 (1.9) *3.9 (1.7) * *3.3 (1.1) * *1.6 (0.8) *

Female .................. *3.7 (1.2) *5.9 (2.6) *2.8 (1.2) * *5.2 (2.4) * * *

Ethnicity3

Hispanic or Latino ............. 9.9 (2.2) 13.4 (3.7) 7.4 (2.0) *18.9 (5.8) *12.3 (3.8) *7.5 (2.3) *5.8 (2.1) *13.9 (6.9)

Male.................... 8.3 (2.2) 13.0 (3.8) * *19.0 (7.3) *11.5 (3.5) * * *

Female .................. 11.3 (2.6) 13.9 (4.1) 10.1 (2.7) *18.7 (6.6) *13.3 (5.2) *10.9 (3.9) *6.9 (2.6) *

Not Hispanic or Latino .......... 5.4 (0.8) 11.5 (2.5) 3.2 (0.4) 22.6 (5.5) 10.2 (2.3) 4.3 (0.7) 3.0 (0.4) *2.3 (0.8)

Male.................... 6.2 (1.0) 11.5 (2.5) 2.9 (0.5) 21.7 (5.9) 9.8 (2.3) 4.4 (0.8) 2.4 (0.6) *2.9 (1.2)

Female .................. 4.9 (0.7) 11.4 (2.8) 3.3 (0.5) 24.3 (6.8) 10.7 (2.8) 4.2 (0.8) 3.4 (0.5) *

Region

Northeast .................. 8.6 (1.8) *14.0 (4.4) 6.4 (1.4) *29.2 (11.9) 13.7 (3.7) 7.6 (1.8) 5.2 (1.5) *5.3 (2.5)

Midwest ................... 6.2 (1.1) 10.3 (2.3) 4.5 (1.1) *20.9 (6.5) 8.9 (2.2) *4.8 (1.6) 4.8 (1.1) *

South .................... *6.3 (2.0) *13.3 (5.4) 3.0 (0.8) *18.9 (8.4) *12.6 (5.2) 4.7 (1.3) 2.4 (0.7) *

West ..................... *3.0 (1.2) * 1.2 (0.3) * * *1.8 (0.7) 1.3 (0.4) *

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over

50%.

1

Crude estimates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race. Ethnicity was not imputed in 2001 or 2002. It is not shown for those years due to a high rate of missing data.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
Page 42 [ Series 3, No. 35

Table 13. Rate of emergency department visits with asthma as the first-listed diagnosis per 10,000 population, by year and selected patient

characteristics: United States, 2001–2009

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate (standard error)1

Total ..................... 59.7 (3.4) 67.9 (3.8) 61.6 (3.5) 64.0 (4.0) 61.7 (3.8) 55.3 (3.4) 59.6 (3.9) 64.5 (4.3) 69.7 (4.6) 
 

Sex

Male ..................... 46.7 (4.0) 65.5 (5.3) 55.0 (4.9) 62.0 (5.4) 54.7 (4.9) 47.8 (4.5) 50.5 (4.8) 60.7 (6.0) 69.5 (6.7) 
 

Female ................... 71.7 (5.1) 69.6 (5.1) 67.9 (4.8) 65.3 (5.0) 68.3 (5.5) 62.2 (4.7) 67.7 (5.4) 67.0 (5.3) 69.2 (5.9) 
 

Race2

White. . . . . . . . . . . . . . . . . . . . . 48.2 (3.5) 46.9 (3.7) 48.9 (3.6) 43.6 (3.5) 44.4 (3.6) 39.1 (3.4) 43.7 (3.7) 44.0 (3.7) 51.0 (4.4) 
 

Black. . . . . . . . . . . . . . . . . . . . . 153.6 (14.7) 218.8 (18.2) 151.9 (13.1) 195.0 (18.7) 175.6 (17.7) 157.5 (14.6) 167.0 (16.5) 180.4 (17.7) 182.1 (19.3)
 

Other races ................. *22.2 (6.8) 23.8 (5.9) 26.6 (7.3) 39.1 (9.2) 42.1 (11.5) 45.4 (11.2) 26.2 (7.2) 55.0 (13.6) 70.5 (17.0) 
 

Ethnicity3

Hispanic or Latino ............. . . . . . . 89.1 (11.8) 57.5 (7.8) 73.1 (10.8) 64.8 (9.7) 58.1 (10.2) 59.7 (9.7) 72.3 (10.2) 
 

Not Hispanic or Latino .......... . . . . . . 58.4 (3.6) 65.2 (4.4) 59.0 (4.1) 55.0 (3.8) 61.2 (4.3) 66.7 (4.6) 68.7 (5.0) 
 

Age

Children (0–17) .............. 91.6 (11.2) 99.7 (13.7) 95.6 (10.3) 103.2 (14.4) 102.4 (11.3) 80.7 (9.5) 87.2 (12.9) 103.1 (13.8) 111.5 (15.3)
 

Adults (18 or over) ............ 49.0 (3.5) 56.9 (4.2) 49.6 (4.3) 50.4 (5.0) 46.8 (4.1) 45.3 (4.0) 49.8 (4.6) 50.7 (5.0) 54.8 (5.4) 
 

Age group

0–4 years .................. 136.6 (24.1) 159.7 (31.0) 159.1 (26.3) 168.3 (28.2) 162.7 (23.4) 115.1 (17.5) 122.1 (25.1) 145.1 (32.6) 131.5 (25.9)
 

5–14 years ................. 85.4 (11.7) 79.2 (11.1) 67.0 (8.0) 82.1 (12.9) 86.3 (12.9) 64.5 (9.1) 75.8 (13.9) 101.4 (12.8) 123.0 (19.1)
 

15–34 years ................ 62.8 (6.2) 74.9 (7.6) 70.3 (7.0) 73.6 (8.8) 63.1 (7.1) 57.8 (7.0) 62.2 (7.2) 63.6 (9.5) 64.9 (8.5) 
 

35–64 years ................ 43.6 (4.2) 53.3 (4.9) 44.8 (4.7) 42.8 (5.5) 43.8 (5.2) 48.6 (5.6) 50.7 (6.1) 43.7 (5.1) 56.5 (6.8) 
 

65 years or over .............. 31.2 (6.5) 32.1 (7.8) 30.8 (7.3) 27.8 (6.1) 23.1 (5.3) 17.8 (4.3) 25.0 (5.5) 40.9 (8.5) 22.8 (5.2) 
 

Region

Northeast .................. 86.6 (8.2) 78.2 (6.7) 94.6 (8.5) 93.7 (9.5) 81.5 (8.3) 73.4 (8.3) 73.1 (8.3) 89.0 (12.9) 102.1 (12.2)
 

Midwest ................... 66.9 (7.8) 67.2 (8.3) 47.2 (7.1) 73.8 (9.5) 64.7 (9.0) 62.7 (8.7) 58.4 (8.2) 75.0 (10.6) 85.1 (11.4) 
 

South .................... 54.9 (5.7) 76.9 (7.4) 62.5 (5.9) 61.5 (7.0) 56.9 (6.3) 48.3 (5.1) 65.1 (7.2) 62.1 (6.3) 63.5 (7.6) 
 

West ..................... 37.4 (6.2) 44.8 (6.7) 47.2 (6.8) 33.7 (5.4) 50.6 (7.3) 44.4 (7.5) 42.2 (7.2) 40.2 (6.1) 40.1 (6.7) 
 

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over
 

50%.
 

. . . Category not applicable.
 

1

Except for age-specific estimates, rates are age adjusted to the 2000 U.S. standard population.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race. Ethnicity was not imputed in 2001 or 2002. It is not shown for those years due to a high rate of missing data.
 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
Series 3, No. 35 [ Page 43

Table 14. Rate of emergency department visits with asthma as the first-listed diagnosis per 100 persons with current asthma, by year and

selected patient characteristics: United States, 2001–2009

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate (standard error)1

Total ..................... 8.2 (0.6) 9.5 (0.8) 8.8 (0.7) 8.9 (0.8) 8.0 (0.6) 7.0 (0.6) 7.7 (0.7) 8.2 (0.8) 8.4 (0.8)

Sex

Male ..................... 7.6 (0.8) 10.8 (1.1) 9.4 (1.1) 10.0 (1.2) 8.6 (0.9) 6.9 (0.8) 7.7 (0.9) 8.5 (1.0) 9.9 (1.2)

Female ................... 8.6 (0.7) 8.5 (0.7) 8.4 (0.7) 8.1 (0.9) 7.5 (0.7) 7.0 (0.7) 7.6 (0.9) 7.8 (0.8) 7.4 (0.8)

Race2

White. . . . . . . . . . . . . . . . . . . . . 6.7 (0.6) 6.7 (0.7) 7.3 (0.7) 6.3 (0.7) 5.9 (0.5) 5.0 (0.5) 5.8 (0.7) 5.9 (0.6) 6.4 (0.7)

Black ..................... 19.4 (2.5) 25.0 (3.0) 18.2 (2.3) 23.5 (3.3) 19.3 (2.6) 18.4 (2.3) 18.1 (2.6) 19.5 (2.7) 17.6 (2.7)

Other races ................. *3.1 (1.2) 3.7 (1.0) *3.6 (1.3) 5.0 (1.4) *5.5 (1.7) *4.1 (1.4) *3.0 (0.9) *5.5 (2.0) *7.6 (3.0)

Ethnicity3

Hispanic or Latino ............. . . . . . . 16.1 (2.6) 12.7 (2.3) 13.7 (2.5) 10.1 (1.8) 8.6 (1.7) 10.6 (2.0) 13.3 (2.4)

Not Hispanic or Latino .......... . . . . . . 7.9 (0.7) 8.5 (0.8) 7.2 (0.6) 6.5 (0.6) 7.5 (0.7) 7.8 (0.7) 7.7 (0.8)

Age

Children (0–17) .............. 10.5 (1.3) 12.0 (1.7) 11.2 (1.3) 12.2 (1.8) 11.5 (1.3) 8.7 (1.1) 9.6 (1.5) 11.0 (1.6) 11.6 (1.7)

Adults (18 or over) ............ 7.2 (0.5) 8.4 (0.7) 7.8 (0.7) 7.5 (0.8) 6.5 (0.6) 6.2 (0.6) 6.9 (0.7) 7.0 (0.7) 7.1 (0.7)

Age group

0–4 years .................. 23.9 (4.6) 26.8 (5.7) 26.8 (4.9) 30.0 (5.6) 24.1 (4.0) 19.9 (3.6) 18.0 (4.1) 23.8 (5.9) 20.9 (4.6)

5–4 years .................. 8.6 (1.2) 8.7 (1.3) 7.1 (0.9) 9.0 (1.50 8.8 (1.4) 5.9 (0.9) 8.1 (1.6) 9.3 (1.3) 11.0 (1.8)

15–34 years ................ 7.9 (0.8) 9.9 (1.1) 9.8 (1.1) 10.4 (1.3) 8.4 (1.0) 7.4 (1.0) 7.4 (1.0) 7.9 (1.3) 8.4 (1.2)

35–64 years ................ 6.5 (0.7) 7.8 (0.8) 7.0 (0.8) 6.3 (0.8) 6.2 (0.8) 6.7 (0.8) 7.3 (0.9) 6.2 (0.8) 7.2 (0.9)

65 years or over .............. 5.2 (1.1) 5.5 (1.4) 5.4 (1.3) 4.0 (0.9) 3.0 (0.7) 2.5 (0.6) 3.3 (0.8) 5.7 (1.2) 3.0 (0.7)

Region

Northeast .................. 10.3 (1.3) 9.3 (1.1) 11.8 (1.6) 12.4 (2.0) 9.2 (1.2) 8.1 (1.4) 8.8 (1.5) 10.7 (2.1) 11.0 (2.0)

Midwest ................... 8.8 (1.6) 9.4 (1.7) 6.1 (1.2) 9.8 (2.1) 8.1 (1.5) 7.2 (1.4) 6.7 (1.5) 8.3 (1.7) 9.0 (1.9)

South .................... 7.7 (1.0) 11.3 (1.6) 10.0 (1.4) 9.1 (1.5) 7.7 (1.1) 6.5 (1.1) 8.7 (1.2) 8.9 (1.2) 8.6 (1.5)

West ..................... 5.9 (0.8) 6.7 (1.2) 7.4 (1.4) 4.7 (1.0) 6.9 (1.3) 6.2 (1.3) 6.2 (1.8) 5.1 (1.1) 5.2 (1.2)

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE greater
 

than 50%.
 

. . . Category not applicable.
 

1

Crude rates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race. Ethnicity was not imputed in 2001 or 2002. It is not shown for those years due to a high rate of missing data.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
Page 44 [ Series 3, No. 35

Table 15. Rate of emergency department visits with asthma as the first-listed diagnosis per 100 persons with current asthma, by detailed

age group and selected patient characteristics: United States, average annual 2007–2009

0–17 18 years 0–4 5–14 15–34 15–19 20–24 25–34 35–64 65 years

Characteristic Total years or over years years years years years years years or over

Rate (standard error)1

Total ................ 8.1 (0.5) 10.7 (1.0) 7.0 (0.5) 20.8 (3.0) 9.5 (1.0) 7.9 (0.7) 6.5 (1.0) 9.1 (1.3) 8.2 (1.0) 6.9 (0.6) 4.0 (0.6)

Sex

Male ................ 8.7 (0.7) 11.8 (1.3) 6.7 (0.6) 22.6 (3.6) 10.4 (1.3) 6.9 (1.0) 5.7 (1.3) 7.5 (1.9) 7.7 (1.4) 7.0 (0.8) 2.6 (0.6)

Female. . . . . . . . . . . . . . . 7.6 (0.6) 9.3 (1.1) 7.2 (0.6) 17.6 (3.3) 8.2 (1.2) 8.6 (0.9) 7.2 (1.3) 10.2 (1.7) 8.5 (1.2) 6.9 (0.6) 4.7 (0.8)

Race2

White ................ 6.1 (0.5) 9.4 (1.0) 5.0 (0.4) 19.7 (3.5) 8.7 (1.1) 5.9 (0.6) 5.0 (1.0) 6.5 (1.1) 6.1 (0.9) 4.6 (0.5) 3.2 (0.5)

Male ............... 6.6 (0.6) 10.7 (1.4) 4.4 (0.5) 22.3 (4.6) 10.0 (1.6) 4.7 (0.9) *3.9 (1.4) 4.5 (1.3) 5.5 (1.4) 4.2 (0.7) 2.4 (0.6)

Female ............. 5.7 (0.5) 7.4 (1.2) 5.3 (0.5) 14.6 (3.9) 6.7 (1.3) 6.8 (0.9) 6.0 (1.4) 8.2 (1.8) 6.4 (1.0) 4.9 (0.6) 3.7 (0.7)

Black ................ 18.3 (1.9) 15.2 (2.1) 20.9 (2.4) 24.2 (4.6) 13.1 (2.1) 19.6 (3.3) 13.9 (3.2) 23.9 (5.9) 22.8 (5.1) 21.6 (3.0) *10.2 (3.3)

Male ............... 19.7 (2.4) 16.3 (2.5) 24.7 (3.9) 24.2 (5.3) 14.5 (2.6) 21.0 (4.8) 14.3 (4.3) 28.2 (13.0) *27.7 (9.8) 26.1 (5.2) *

Female ............. 17.3 (1.9) 13.8 (2.6) 19.1 (2.5) 24.2 (6.3) 11.4 (2.9) 18.7 (3.5) 13.6 (4.3) 21.6 (5.9) 20.7 (5.2) 19.6 (2.9) *11.2 (4.2)

Other races ............ 5.4 (1.4) 7.6 (2.0) 4.0 (1.6) *17.2 (6.4) *5.2 (1.7) *3.9 (1.7) * 4.1 (2.0) * *3.1 (1.3) *

Male ............... 5.0 (1.5) *7.1 (2.3) * *20.1 (8.5) *2.9 (1.2) * * * * * *

Female ............. *5.7 (1.8) *8.4 (2.6) *4.6 (1.9) * *8.3 (3.3) *5.2 (2.6) * * * *3.1 (1.3) *

Ethnicity3

Hispanic or Latino ........ 10.8 (1.3) 12.5 (2.1) 9.6 (1.3) 19.5 (4.9) 11.1 (2.4) 11.1 (2.0) *7.2 (3.0) *16.7 (5.6) 10.5 (2.6) 7.9 (1.4) *7.8 (2.9)

Male ............... 12.5 (2.0) 15.4 (2.9) 9.2 (2.1) 23.2 (6.1) 14.7 (3.9) *9.6 (2.9) * * *8.7 (3.8) *7.5 (2.8) *

Female ............. 9.3 (1.5) 8.4 (2.2) 9.8 (1.7) *12.9 (5.5) 6.4 (1.8) 12.2 (2.8) * *17.0 (6.7) *11.7 (3.6) 8.1 (1.7) *10.2 (4.5)

Not Hispanic or Latino ..... 7.7 (0.5) 10.3 (1.1) 6.7 (0.5) 21.2 (3.6) 9.2 (1.0) 7.5 (0.7) 6.4 (1.0) 8.2 (1.2) 7.9 (1.0) 6.8 (0.6) 3.7 (0.5)

Male ............... 8.1 (0.7) 11.0 (1.4) 6.4 (0.6) 22.4 (4.2) 9.5 (1.3) 6.5 (0.9) 5.6 (1.4) 6.5 (1.6) 7.5 (1.6) 6.9 (0.8) 2.5 (0.6)

Female ............. 7.4 (0.6) 9.5 (1.2) 6.9 (0.6) 19.0 (4.0) 8.6 (1.4) 8.1 (0.9) 7.1 (1.4) 9.4 (1.7) 8.1 (1.2) 6.7 (0.6) 4.3 (0.7)

Region

Northeast ............. 10.2 (1.3) 12.5 (2.2) 9.2 (1.2) *20.6 (6.3) 12.8 (2.4) 11.3 (2.2) 11.7 (2.7) *15.1 (4.9) 9.0 (2.1) 8.1 (1.2) *5.6 (1.7)

Midwest .............. 8.0 (1.3) 10.9 (2.6) 6.8 (1.0) *22.7 (8.7) 9.6 (2.1) 6.4 (1.4) *3.7 (1.3) 5.4 (1.6) 9.4 (2.5) 7.8 (1.2) 3.2 (0.9)

South. . . . . . . . . . . . . . . . 8.7 (0.9) 11.5 (1.6) 7.4 (0.8) 20.9 (3.9) 9.5 (1.7) 8.9 (1.3) 7.5 (2.1) 11.2 (2.5) 8.3 (1.6) 7.2 (1.0) 4.1 (1.0)

West ................ 5.5 (0.9) 7.3 (1.6) 4.9 (0.9) 17.7 (4.7) 6.4 (1.5) 5.4 (1.1) *3.0 (1.5) 6.7 (2.0) 5.9 (1.6) 4.7 (1.0) *3.3 (1.0)

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over

50%.

1

Crude estimates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
Series 3, No. 35 [ Page 45

Table 16. Rate of hospital discharges with asthma as the first-listed diagnosis per 10,000 population, by year and selected patient

characteristics: United States, 2001–2009

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate (standard error)1

Total ..................... 16.1 (1.0) 17.0 (1.0) 19.8 (1.1) 17.0 (1.0) 16.5 (0.9) 14.7 (0.9) 15.1 (1.1) 14.4 (1.0) 15.4 (1.1)

Sex

Male ..................... 13.3 (1.1) 13.9 (1.1) 16.3 (1.3) 14.4 (1.2) 13.3 (1.0) 12.1 (1.1) 12.5 (1.1) 11.6 (1.1) 12.7 (1.2)

Female ................... 18.4 (1.1) 19.4 (1.2) 22.7 (1.3) 18.9 (1.1) 19.0 (1.1) 16.8 (1.0) 17.4 (1.2) 17.4 (1.3) 17.7 (1.1)

Race2

White. . . . . . . . . . . . . . . . . . . . . 10.0 (0.7) 10.5 (0.8) 12.1 (0.8) 10.0 (0.7) 11.0 (0.7) 9.4 (0.7) 8.9 (0.8) 8.5 (0.8) 9.5 (0.8)

Black ..................... 30.5 (2.9) 35.8 (3.2) 39.5 (3.4) 33.5 (3.2) 27.0 (2.3) 29.3 (2.7) 29.1 (3.0) 30.7 (3.3) 28.5 (3.0)

Other races ................. 13.3 (2.0) 10.0 (1.5) 17.5 (2.8) 18.8 (3.0) 13.6 (2.6) 7.0 (1.1) 10.5 (2.0) 13.2 (2.5) 16.3 (2.8)

Age

Children (0–17) .............. 26.2 (4.7) 26.9 (4.8) 31.2 (5.3) 27.0 (4.8) 22.4 (3.4) 21.0 (4.3) 21.3 (5.2) 18.1 (4.1) 19.1 (4.8)

Adults (18 or over) ............ 12.5 (1.5) 13.4 (1.7) 16.0 (2.0) 13.6 (1.8) 14.6 (1.8) 12.9 (1.6) 13.2 (1.9) 13.9 (2.4) 14.6 (1.8)

Age group

0–4 years .................. 56.2 (10.9) 59.0 (11.0) 62.7 (11.5) 59.9 (11.1) 49.3 (8.0) 43.3 (9.7) 41.4 (9.7) 35.4 (7.9) 40.6 (11.6)

5–14 years ................. 17.8 (3.2) 17.3 (3.1) 21.6 (3.5) 17.0 (3.1) 14.6 (2.4) 14.1 (3.0) 16.3 (4.5) 12.7 (3.3) 12.1 (2.9)

15–34 years ................ 6.5 (0.9) 7.0 (1.2) 8.4 (1.3) 6.2 (1.0) 6.1 (1.0) 5.5 (0.8) 5.3 (0.9) 6.4 (1.2) 5.1 (0.9)

35–64 years ................ 13.3 (1.7) 14.5 (1.8) 16.4 (1.9) 13.4 (1.7) 14.4 (1.9) 14.0 (1.8) 13.8 (2.1) 14.5 (2.6) 15.4 (1.9)

65 years or over .............. 21.4 (2.6) 22.5 (3.2) 30.5 (4.5) 28.7 (4.5) 30.5 (4.8) 23.7 (3.4) 25.4 (4.0) 25.2 (5.0) 29.0 (4.3)

Region

Northeast .................. 19.3 (3.2) 20.5 (3.4) 31.0 (4.5) 23.5 (3.5) 22.0 (2.6) 22.1 (2.9) 24.7 (3.9) 18.9 (3.0) 21.0 (2.1)

Midwest ................... 16.7 (2.1) 15.8 (2.1) 19.8 (2.4) 16.9 (2.2) 17.3 (2.2) 13.8 (1.7) 11.5 (1.4) 11.8 (1.6) 13.4 (1.6)

South .................... 15.8 (1.3) 17.7 (1.4) 17.4 (1.3) 15.8 (1.3) 15.9 (1.3) 13.4 (1.1) 14.2 (1.2) 16.2 (1.7) 15.3 (1.7)

West ..................... 12.7 (2.2) 13.7 (2.1) 14.7 (2.2) 13.9 (2.4) 11.6 (2.1) 11.6 (2.6) 12.1 (2.7) 11.0 (2.1) 12.8 (2.6)

1

Except for age-specific estimates, rates are age adjusted to the 2000 U.S. standard population.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned. Those with ‘‘unknown’’ race were excluded.
 

SOURCE: CDC/NCHS, National Hospital Discharge Survey.
 
Page 46 [ Series 3, No. 35

Table 17. Rate of hospital discharges

patient characteristics: United States,

with asthma

2001–2009

as the first-listed diagnosis per 100 persons with current asthma, by year and selected

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009

Total .....................

Sex

Male .....................

Female ...................

Race2

White. . . . . . . . . . . . . . . . . . . . .

Black .....................

Other races .................

Age

Children (0–17) ..............

Adults (18 or over) ............

Age group

0–4 years ..................

5–14 years .................

15–34 years ................

35–64 years ................

65 years or over ..............

Region

Northeast ..................

Midwest ...................

South ....................

West .....................

2.2

2.2

2.3

1.5

3.9

1.3

3.0

1.9

9.7

1.8

0.8

2.0

3.9

*2.3

2.2

2.2

*2.2

(0.3)

(0.3)

(0.3)

(0.2)

(0.8)

(0.3)

(0.6)

(0.2)

(2.0)

(0.3)

(0.1)

(0.3)

(0.5)

(0.9)

(0.6)

(0.4)

(0.8)

2.4

2.3

2.5

1.6

4.0

1.2

3.2

2.1

9.8

1.9

1.0

2.2

4.1

*2.5

2.1

2.6

*2.3

(0.3)

(0.4)

(0.3)

(0.2)

(0.8)

(0.3)

(0.6)

(0.3)

(2.0)

(0.4)

(0.2)

(0.3)

(0.6)

(1.1)

(0.6)

(0.5)

(0.7)

2.9

2.8

2.9

1.8

4.5

*3.0

3.7

2.5

10.5

2.3

1.2

2.6

5.5

*4.0

2.4

2.7

*2.6

(0.4)

(0.4)

(0.4)

(0.2)

(0.8)

(1.0)

(0.6)

(0.3)

(2.1)

(0.4)

(0.2)

(0.3)

(0.9)

(1.5)

(0.6)

(0.5)

(0.9)

2.4

2.3

2.5

1.5

3.8

3.1

3.2

2.1

10.7

1.9

0.9

2.0

4.3

*3.3

2.1

2.4

*2.0

Rate

(0.3)

(0.4)

(0.3)

(0.2)

(0.8)

(0.9)

(0.6)

(0.3)

(2.2)

(0.4)

(0.2)

(0.3)

(0.7)

(1.2)

(0.6)

(0.5)

(0.7)

(standard error)1

2.2 (0.3) 1.9

2.1 (0.3) 1.8

2.3 (0.3) 2.1

1.5 (0.2) 1.3

2.9 (0.5) 3.2

1.9 (0.5) 0.8

2.5 (0.4) 2.3

2.1 (0.3) 1.8

7.3 (1.3) 7.5

1.5 (0.3) 1.3

0.8 (0.1) 0.7

2.0 (0.3) 1.9

4.2 (0.7) 3.5

*2.7 (0.9) *2.6

2.1 (0.5) 1.7

2.3 (0.4) 1.8

*1.7 (0.6) *1.8

(0.3)

(0.3)

(0.3)

(0.2)

(0.6)

(0.2)

(0.5)

(0.2)

(1.8)

(0.3)

(0.1)

(0.3)

(0.6)

(0.9)

(0.5)

(0.3)

(0.7)

2.0

1.9

2.0

1.3

2.9

*1.3

2.3

1.8

6.1

1.7

0.6

2.0

3.6

*3.2

1.3

2.0

*1.7

(0.3)

(0.4)

(0.3)

(0.2)

(0.6)

(0.5)

(0.6)

(0.3)

(1.5)

(0.5)

(0.1)

(0.3)

(0.6)

(1.3)

(0.4)

(0.4)

(0.7)

1.9

1.7

2.2

1.2

2.9

1.5

1.9

1.9

5.8

1.2

0.8

2.1

3.7

*2.6

*1.3

2.5

*1.4

(0.3)

(0.3)

(0.4)

(0.2)

(0.7)

(0.4)

(0.4)

(0.3)

(1.4)

(0.3)

(0.2)

(0.4)

(0.8)

(1.1)

(0.5)

(0.6)

(0.6)

2.0

1.9

2.0

1.3

2.5

1.9

2.0

1.9

*6.5

1.1

0.7

2.0

3.9

2.5

1.4

2.2

(0.3)

(0.3)

(0.3)

(0.2)

(0.6)

(0.5)

(0.5)

(0.2)

(2.0)

(0.3)

(0.1)

(0.3)

(0.6)

(0.5)

(0.4)

(0.5)

*

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown

50%.
 

1

Crude rates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and

those with more than one race, and those with a race other than the groups mentioned. Those with ‘‘unknown’’ race were excluded.
 

SOURCE: CDC/NCHS, National Hospital Discharge Survey.

have an RSE

Other Pacific

over
 

Islander,
 
Series 3, No. 35 [ Page 47

Table 18. Rate of hospital discharges with asthma as the first-listed diagnosis per 100 persons with current asthma, by detailed age group

and selected patient characteristics: United States, average annual 2007–2009

0–17 18 years 0–4 5–14 15–34 15–19 20–24 25–34 35–64 65 years

Characteristic Total years or over years years years years years years years or over

Rate (standard error)1

Total ................ 2.0 (0.2) 2.1 (0.4) 1.9 (0.2) 5.2 (1.0) 1.6 (0.4) 0.7 (0.1) 0.6 (0.1) 0.6 (0.1) 0.9 (0.1) 2.0 (0.2) 3.7 (0.4)

Sex

Male ................ 1.8 (0.2) 2.2 (0.5) 1.5 (0.2) 5.3 (1.1) 1.6 (0.4) 0.6 (0.1) 0.5 (0.1) 0.5 (0.1) 0.8 (0.2) 1.8 (0.2) 2.8 (0.4)

Female. . . . . . . . . . . . . . . 2.1 (0.2) 1.9 (0.4) 2.1 (0.2) 5.0 (1.1) 1.6 (0.3) 0.8 (0.1) 0.6 (0.1) 0.7 (0.1) 1.0 (0.1) 2.1 (0.2) 4.2 (0.5)

Race2

White ................ 1.3 (0.2) 1.4 (0.3) 1.2 (0.1) 4.2 (0.9) 1.1 (0.3) 0.4 (0.1) 0.3 (0.1) 0.4 (0.1) 0.5 (0.1) 1.3 (0.2) 2.3 (0.3)

Male ............... 1.1 (0.2) 1.4 (0.4) 0.9 (0.1) 4.0 (0.9) *1.1 (0.4) 0.3 (0.1) *0.2 (0.1) *0.2 (0.1) 0.4 (0.1) 1.1 (0.2) 1.7 (0.3)

Female ............. 1.4 (0.2) * 1.4 (0.2) 4.6 (1.3) 1.1 (0.2) 0.5 (0.1) *0.4 (0.1) 0.6 (0.1) 0.6 (0.1) 1.4 (0.2) 2.6 (0.4)

Black ................ 2.8 (0.3) 2.2 (0.4) 3.3 (0.4) 3.8 (0.8) 1.9 (0.4) 1.3 (0.2) 1.0 (0.3) 0.8 (0.2) 2.1 (0.5) 3.7 (0.5) 6.2 (1.2)

Male ............... 2.6 (0.4) 2.2 (0.5) 3.1 (0.5) 3.8 (0.9) 1.9 (0.5) 1.4 (0.3) *0.7 (0.3) *1.2 (0.5) *3.0 (1.2) 3.5 (0.6) 5.8 (1.7)

Female ............. 2.9 (0.4) 2.1 (0.4) 3.4 (0.4) 3.9 (1.0) 1.7 (0.5) 1.3 (0.2) *1.4 (0.4) *0.7 (0.2) 1.7 (0.4) 3.9 (0.5) 6.3 (1.3)

Other races ............ 1.6 (0.3) 1.3 (0.3) 1.7 (0.3) 2.4 (0.7) *1.1 (0.3) *0.4 (0.2) *0.2 (0.1) * *0.8 (0.4) 1.7 (0.4) 5.7 (1.5)

Male ............... 1.5 (0.3) 1.4 (0.4) 1.5 (0.4) *2.2 (0.7) *1.4 (0.5) *0.4 (0.2) * * * 1.7 (0.5) *4.6 (2.3)

Female ............. 1.6 (0.3) *1.1 (0.3) 1.9 (0.4) *2.8 (1.2) *0.8 (0.4) * * * * 1.8 (0.5) *6.6 (2.2)

Region

Northeast ............. 2.7 (0.3) 2.4 (0.5) 2.9 (0.4) 6.4 (1.6) 2.0 (0.4) 1.0 (0.2) 0.9 (0.2) *1.0 (0.3) 1.1 (0.3) 2.9 (0.4) 6.1 (0.8)

Midwest .............. 1.4 (0.2) 1.0 (0.2) 1.5 (0.2) 3.0 (0.7) 0.7 (0.2) 0.5 (0.1) 0.3 (0.1) 0.7 (0.2) 0.6 (0.1) 1.7 (0.3) 3.0 (0.6)

South. . . . . . . . . . . . . . . . 2.2 (0.4) *2.1 (0.6) 2.3 (0.4) 4.3 (1.3) *1.7 (0.5) 0.8 (0.2) 0.7 (0.2) 0.5 (0.1) 1.2 (0.2) 2.4 (0.4) 4.2 (0.9)

West ................ *1.6 (0.7) * 1.1 (0.3) * * *0.5 (0.2) *0.4 (0.2) *0.4 (0.2) *0.7 (0.2) 1.2 (0.3) *2.1 (0.7)

* Figure does not meet standards of reliability or precision. Estimates presented with an asterisk have a relative standard error (RSE) of 30%–50%. Estimates that are not shown have an RSE over
 

50%.
 

1

Crude estimates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned. Those with ‘‘unknown’’ race were excluded.
 

SOURCE: CDC/NCHS, National Hospital Discharge Survey.
Page 48 [ Series 3, No. 35

Table 19. Rate of deaths with asthma as the underlying cause per million population, by year and selected characteristics: United States,

2001–2009

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate (standard error)1

Total ..................... 15.0 (0.2) 14.8 (0.2) 14.0 (0.2) 12.8 (0.2) 12.8 (0.2) 11.7 (0.2) 11.0 (0.2) 10.6 (0.2) 10.5 (0.2)

Sex

Male ..................... 11.8 (0.3) 12.3 (0.3) 11.4 (0.3) 10.4 (0.3) 9.7 (0.3) 9.4 (0.3) 9.0 (0.3) 8.3 (0.3) 8.4 (0.2)

Female ................... 17.5 (0.3) 16.6 (0.3) 15.9 (0.3) 14.5 (0.3) 15.0 (0.3) 13.4 (0.3) 12.3 (0.3) 12.4 (0.3) 12.1 (0.3)

Race2

White. . . . . . . . . . . . . . . . . . . . . 12.2 (0.2) 12.1 (0.2) 11.4 (0.2) 10.4 (0.2) 10.4 (0.2) 9.4 (0.2) 8.8 (0.2) 8.5 (0.2) 8.4 (0.2)

Black ..................... 35.9 (1.1) 34.1 (1.1) 31.7 (1.1) 30.6 (1.0) 30.4 (1.0) 27.4 (1.0) 25.5 (0.9) 24.7 (0.9) 24.9 (0.8)

Other races ................. 17.4 (0.9) 14.9 (0.8) 16.1 (0.8) 13.2 (0.7) 12.9 (0.7) 12.4 (0.7) 12.5 (0.7) 10.9 (0.6) 11.2 (0.9)

Ethnicity3

Hispanic or Latino ............. 13.9 (0.7) 13.2 (0.6) 13.0 (0.6) 11.4 (0.6) 10.1 (0.5) 9.9 (0.5) 8.3 (0.4) 9.4 (0.5) 6.0 (0.4)

Not Hispanic or Latino .......... 15.2 (0.2) 15.0 (0.2) 14.1 (0.2) 13.0 (0.2) 13.1 (0.2) 12.0 (0.2) 11.4 (0.2) 10.9 (0.2) 10.7 (0.2)

Age

Children (0–17) .............. 2.6 (0.2) 3.0 (0.2) 2.7 (0.2) 2.5 (0.2) 2.3 (0.2) 2.3 (0.2) 2.5 (0.2) 2.6 (0.2) 2.8 (0.2)

Adults (18 or over) ............ 19.2 (0.3) 18.8 (0.3) 18.0 (0.3) 16.5 (0.3) 16.7 (0.3) 15.3 (0.3) 14.4 (0.3) 14.0 (0.3) 14.0 (0.3)

Age group

0–4 years .................. 2.1 (0.3) 2.4 (0.4) 2.2 (0.3) 1.8 (0.3) 2.0 (0.3) 1.6 (0.3) 2.2 (0.3) 2.0 (0.3) 2.0 (0.3)

5–14 years ................. 2.4 (0.2) 3.0 (0.3) 2.7 (0.3) 2.6 (0.3) 2.4 (0.2) 2.5 (0.2) 2.7 (0.3) 2.8 (0.3) 2.8 (0.3)

15–34 years ................ 4.7 (0.2) 5.0 (0.3) 4.8 (0.2) 4.4 (0.2) 4.1 (0.2) 4.0 (0.2) 4.0 (0.2) 3.9 (0.2) 4.5 (0.2)

35–64 years ................ 14.7 (0.4) 14.5 (0.4) 14.2 (0.4) 12.7 (0.3) 12.7 (0.3) 12.1 (0.3) 11.0 (0.3) 10.6 (0.3) 10.9 (0.3)

65 years or over .............. 60.7 (1.3) 58.2 (1.3) 54.4 (1.2) 51.3 (1.2) 52.4 (1.2) 46.3 (1.1) 43.4 (1.1) 42.4 (1.0) 38.8 (1.0)

Region

Northeast .................. 14.4 (0.5) 13.8 (0.5) 13.8 (0.5) 12.3 (0.5) 12.2 (0.5) 10.5 (0.5) 9.8 (0.4) 10.4 (0.5) 9.9 (0.4)

Midwest ................... 15.1 (0.5) 15.7 (0.5) 13.5 (0.5) 12.9 (0.5) 13.1 (0.4) 11.5 (0.4) 11.5 (0.4) 11.1 (0.4) 11.2 (0.4)

South .................... 14.9 (0.4) 14.2 (0.4) 13.8 (0.4) 12.6 (0.4) 12.9 (0.3) 11.4 (0.3) 10.9 (0.3) 10.3 (0.3) 10.2 (0.3)

West ..................... 16.2 (0.5) 15.9 (0.5) 15.1 (0.4) 13.8 (0.4) 13.0 (0.4) 13.5 (0.4) 11.6 (0.4) 11.1 (0.4) 11.1 (0.4)

1

Except for age-specific estimates, rates are age adjusted to the 2000 U.S. standard population.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

SOURCE: CDC/NCHS, National Vital Statistics System.
 
Series 3, No. 35 [ Page 49

Table 20. Rate of deaths with asthma as the underlying cause per 10,000 persons with current asthma, by year and selected characteristics:

United States, 2001–2009

Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate (standard error)1

Total ..................... 2.1 (0.06) 2.1 (0.06) 2.1 (0.06) 1.9 (0.05) 1.7 (0.05) 1.6 (0.05) 1.5 (0.05) 1.5 (0.05) 1.4 (0.04)

Sex

Male ..................... 1.7 (0.07) 1.9 (0.08) 1.8 (0.08) 1.6 (0.07) 1.4 (0.06) 1.3 (0.07) 1.3 (0.07) 1.1 (0.06) 1.2 (0.06)

Female ................... 2.4 (0.08) 2.3 (0.08) 2.2 (0.08) 2.1 (0.07) 2.0 (0.07) 1.8 (0.07) 1.6 (0.07) 1.7 (0.07) 1.5 (0.06)

Race2

White. . . . . . . . . . . . . . . . . . . . . 1.9 (0.06) 2.0 (0.07) 1.9 (0.06) 1.6 (0.05) 1.6 (0.05) 1.5 (0.06) 1.4 (0.06) 1.4 (0.05) 1.2 (0.05)

Black ..................... 3.8 (0.25) 3.4 (0.21) 3.2 (0.20) 3.1 (0.20) 2.9 (0.18) 2.7 (0.18) 2.3 (0.16) 2.3 (0.16) 2.2 (0.15)

Other races ................. 1.0 (0.11) 1.0 (0.11) 1.7 (0.22) 1.3 (0.16) 1.2 (0.15) 0.7 (0.12) 0.8 (0.13) 0.7 (0.11) 0.9 (0.12)

Ethnicity3

Hispanic or Latino ............. 1.4 (0.11) 1.7 (0.15) 1.4 (0.11) 1.3 (0.11) 0.9 (0.08) 0.9 (0.09) 0.8 (0.07) 1.0 (0.09) 1.0 (0.09)

Not Hispanic or Latino .......... 2.2 (0.06) 2.2 (0.06) 2.1 (0.07) 1.9 (0.06) 1.8 (0.05) 1.7 (0.06) 1.6 (0.06) 1.5 (0.06) 1.4 (0.05)

Age

Children (0–17) .............. 0.3 (0.02) 0.4 (0.03) 0.3 (0.03) 0.3 (0.02) 0.3 (0.02) 0.2 (0.02) 0.3 (0.02) 0.3 (0.02) 0.3 (0.02)

Adults (18 or over) ............ 2.9 (0.09) 2.9 (0.09) 2.9 (0.09) 2.5 (0.08) 2.4 (0.07) 2.1 (0.08) 2.0 (0.08) 2.0 (0.07) 1.8 (0.06)

Age group

0–4 years .................. 0.4 (0.06) 0.4 (0.07) 0.4 (0.06) 0.3 (0.06) 0.3 (0.05) 0.3 (0.06) 0.3 (0.06) 0.3 (0.06) 0.3 (0.06)

5–14 years ................. 0.2 (0.03) 0.3 (0.03) 0.3 (0.03) 0.3 (0.03) 0.2 (0.03) 0.2 (0.03) 0.3 (0.03) 0.3 (0.03) 0.3 (0.03)

15–34 years ................ 0.6 (0.04) 0.7 (0.05) 0.7 (0.05) 0.6 (0.04) 0.6 (0.04) 0.5 (0.04) 0.5 (0.04) 0.5 (0.04) 0.6 (0.04)

35–64 years ................ 2.3 (0.10) 2.2 (0.09) 2.2 (0.10) 1.9 (0.08) 1.8 (0.08) 1.7 (0.08) 1.6 (0.08) 1.5 (0.08) 1.4 (0.07)

65 years or over .............. 11.0 (0.71) 10.7 (0.70) 9.9 (0.66) 7.7 (0.48) 7.2 (0.42) 6.9 (0.53) 6.1 (0.42) 6.2 (0.44) 5.3 (0.39)

Region

Northeast .................. 1.9 (0.12) 1.8 (0.11) 1.9 (0.12) 1.9 (0.12) 1.6 (0.10) 1.3 (0.11) 1.4 (0.11) 1.5 (0.12) 1.2 (0.09)

Midwest ................... 2.0 (0.11) 2.1 (0.13) 1.7 (0.11) 1.7 (0.09) 1.6 (0.09) 1.4 (0.11) 1.4 (0.11) 1.3 (0.09) 1.2 (0.08)

South .................... 2.1 (0.10) 2.1 (0.11) 2.2 (0.11) 1.9 (0.09) 1.9 (0.09) 1.6 (0.08) 1.6 (0.08) 1.6 (0.09) 1.5 (0.08)

West ..................... 2.5 (0.15) 2.4 (0.14) 2.5 (0.15) 1.9 (0.11) 1.9 (0.11) 2.0 (0.14) 1.6 (0.12) 1.4 (0.11) 1.5 (0.10)

1

Crude rates are shown.
 2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

SOURCE: CDC/NCHS, National Vital Statistics System.
Page 50 [ Series 3, No. 35

Table 21. Rate of deaths with asthma as the underlying cause per 10,000 persons with current asthma, by detailed age group and selected

characteristics: United States, average annual 2007–2009

0–17 18 years 0–14 5–14 15–34 15–19 20–24 25–34 35–64 65 years

Characteristic Total years or over years years years years years years years or over

Rate (standard error)1

Total ................ 1.4 (0.03) 0.3 (0.01) 1.9 (0.05) 0.3 (0.03) 0.3 (0.02) 0.5 (0.02) 0.3 (0.03) 0.5 (0.04) 0.7 (0.05) 1.5 (0.05) 5.8 (0.24)

Sex

Male ................ 1.2 (0.04) 0.3 (0.02) 1.9 (0.07) 0.3 (0.04) 0.3 (0.02) 0.7 (0.05) 0.4 (0.04) 0.7 (0.09) 1.1 (0.11) 1.7 (0.09) 4.4 (0.32)

Female. . . . . . . . . . . . . . . 1.6 (0.04) 0.3 (0.02) 2.0 (0.05) 0.4 (0.07) 0.2 (0.03) 0.4 (0.02) 0.3 (0.04) 0.3 (0.04) 0.5 (0.04) 1.4 (0.05) 6.6 (0.33)

Race2

White ................ 1.3 (0.03) 0.2 (0.01) 1.7 (0.04) 0.2 (0.04) 0.1 (0.01) 0.3 (0.02) 0.2 (0.03) 0.3 (0.03) 0.5 (0.04) 1.1 (0.04) 5.5 (0.25)

Male ............... 1.0 (0.04) 0.2 (0.02) 1.5 (0.06) 0.2 (0.04) 0.1 (0.02) 0.4 (0.04) 0.2 (0.04) 0.4 (0.06) 0.7 (0.08) 1.2 (0.07) 4.0 (0.32)

Female ............. 1.5 (0.04) 0.2 (0.02) 1.8 (0.05) 0.3 (0.07) 0.1 (0.02) 0.3 (0.02) 0.2 (0.03) 0.2 (0.03) 0.4 (0.04) 1.1 (0.05) 6.4 (0.35)

Black ................ 2.3 (0.10) 0.6 (0.05) 3.6 (0.18) 0.6 (0.09) 0.6 (0.06) 1.5 (0.12) 0.8 (0.11) 1.5 (0.23) 2.4 (0.28) 3.8 (0.27) 8.0 (0.81)

Male ............... 2.3 (0.14) 0.7 (0.06) 4.7 (0.41) 0.5 (0.10) 0.7 (0.09) 2.3 (0.27) 0.8 (0.16) 2.8 (0.72) 4.6 (1.08) 5.0 (0.60) 8.8 (1.73)

Female ............. 2.3 (0.11) 0.6 (0.07) 3.1 (0.18) 0.7 (0.17) 0.5 (0.07) 1.0 (0.11) 0.7 (0.15) 0.8 (0.16) 1.4 (0.20) 3.3 (0.25) 7.7 (0.91)

Other races ............ 0.9 (0.08) 0.1 (0.03) 1.4 (0.13) * * 0.3 (0.05) * * 0.4 (0.09) 0.9 (0.12) 7.6 (1.39)

Male ............... 0.8 (0.10) * 1.6 (0.21) * * 0.3 (0.09) * * * 1.4 (0.29) 5.9 (1.56)

Female ............. 1.0 (0.11) * 1.4 (0.15) * * * * * * 0.7 (0.11) 8.8 (2.11)

Ethnicity3

Hispanic or Latino ........ 0.9 (0.05) 0.2 (0.03) 1.5 (0.09) * 0.2 (0.03) 0.6 (0.07) 0.4 (0.08) 0.5 (0.13) 0.7 (0.11) 1.2 (0.10) 5.2 (0.69)

Male ............... 0.9 (0.07) 0.2 (0.03) 1.7 (0.18) * 0.2 (0.04) 0.8 (0.13) * * 1.1 (0.28) 1.7 (0.26) 4.0 (0.97)

Female ............. 1.0 (0.06) 0.2 (0.04) 1.3 (0.10) * * 0.4 (0.07) * * 0.5 (0.10) 0.9 (0.10) 6.0 (0.91)

Not Hispanic or Latino ..... 1.5 (0.03) 0.3 (0.02) 2.0 (0.05) 0.4 (0.04) 0.3 (0.02) 0.5 (0.03) 0.3 (0.03) 0.4 (0.04) 0.7 (0.05) 1.5 (0.05) 5.9 (0.26)

Male ............... 1.3 (0.04) 0.3 (0.02) 1.9 (0.07) 0.3 (0.05) 0.3 (0.03) 0.7 (0.05) 0.4 (0.05) 0.6 (0.09) 1.1 (0.12) 1.7 (0.09) 4.4 (0.34)

Female ............. 1.7 (0.04) 0.3 (0.01) 2.0 (0.05) 0.5 (0.05) 0.3 (0.02) 0.4 (0.02) 0.3 (0.02) 0.3 (0.02) 0.2 (0.01) 1.4 (0.04) 6.6 (0.33)

Region

Northeast ............. 1.4 (0.06) 0.2 (0.03) 1.9 (0.10) * 0.3 (0.04) 0.5 (0.05) 0.2 (0.05) 0.5 (0.12) 0.8 (0.11) 1.5 (0.10) 5.4 (0.46)

Midwest .............. 1.3 (0.06) 0.3 (0.03) 1.7 (0.08) 0.3 (0.07) 0.3 (0.04) 0.5 (0.05) 0.3 (0.05) 0.4 (0.07) 0.7 (0.10) 1.3 (0.08) 5.9 (0.51)

South. . . . . . . . . . . . . . . . 1.6 (0.06) 0.3 (0.02) 2.2 (0.08) 0.4 (0.06) 0.3 (0.03) 0.6 (0.04) 0.3 (0.05) 0.5 (0.08) 0.8 (0.08) 1.8 (0.09) 5.9 (0.43)

West ................ 1.5 (0.07) 0.3 (0.03) 1.9 (0.10) * 0.3 (0.04) 0.5 (0.05) 0.4 (0.08) 0.3 (0.06) 0.6 (0.08) 1.3 (0.08) 6.0 (0.53)

* Figure does not meet standards of reliability or precision. Estimates are not shown if there were fewer than 20 deaths.
 

1

Crude estimates are shown.
 

2

Race categories ‘‘White’’ and ‘‘Black’’ include only those with a single race. The category ‘‘Other races’’ includes Asian, American Indian and Alaska Native, Native Hawaiian and Other Pacific Islander,
 

those with more than one race, and those with a race other than the groups mentioned.
 

3

Persons of Hispanic and non-Hispanic origin may be of any race.
 

SOURCE: CDC/NCHS, National Vital Statistics System.
Series 3, No. 35 [ Page 51

Appendix I. Data Sources and Limitations

This report presents data on asthma

from ongoing data collection systems of

the Centers for Disease Control and

Prevention’s (CDC) National Center for

Health Statistics (NCHS). For an

overview of NCHS data systems, see

‘‘Surveys and Data Collection

Systems,’’ available from http://

www.cdc.gov/nchs/surveys.htm.

National Health Interview

Survey

Asthma prevalence data (1980–

1996, 2001–2009) and asthma attack

prevalence data (1997–2009) were

obtained from the National Health

Interview Survey (NHIS).

Sample design

NHIS is a cross-sectional household

interview survey of the U.S. civilian

noninstitutionalized population. Data are

collected continuously throughout the

year in all 50 states and the District of

Columbia. NHIS uses a multistage,

clustered sample design to produce

national estimates for a variety of health

indicators. Information on basic health

topics is collected for all household

members. Interviews are conducted in

the home by field staff from the U.S.

Census Bureau using a computerassisted personal interview, with

telephone interviewing permitted for

follow-up, if necessary. During

2001–2005, households with black and

Hispanic persons were oversampled;

starting in 2006, the NHIS sample

design also oversampled Asian persons.

From 2001 to 2009, the final response

rate for each survey component, which

takes household nonresponse into

account, ranged from 81.6%–88.1% for

the family questionnaire, 72.3%–81.3%

for the sample child, and 62.6%–74.3%

for the sample adult. More information

can be found at http://www.cdc.gov/

nchs/nhis.htm.

Item nonresponse

From 2001 through 2009, item

nonresponse for each of the

demographic indicators shown in this

report was generally less than 1%, with

the exception of poverty status, which is

based on detailed family income

ascertained from the family component

of the questionnaire. Because the

weighted percentages of persons with

unknown family income were relatively

high (24%–34% from 1997 through

2009), family income data were imputed

using multiple imputation, with five sets

of values created to allow the

assessment of variability due to

imputation. The ratio of family income

to the applicable federal poverty

thresholds were derived for families

with missing incomes based on imputed

income values (21). The denominators

for asthma prevalence exclude persons

with unknown information about asthma

status (less than 0.8% for all years

1997–2009).

National Ambulatory

Medical Care Survey

Physician office visit data

(2001–2009) were obtained from the

National Ambulatory Medical Care

Survey (NAMCS).

Sample design

NAMCS is an annual probability

survey of nonfederal, office-based

physicians who provide direct patient

care in the 50 states and the District of

Columbia, excluding radiologists,

anesthesiologists, and pathologists.

NAMCS collects data from a national

sample of over 2,000 physicians each

year who provide information on nearly

30,000 visits. Because persons with

multiple visits during the year may be

sampled more than once, NAMCS

estimates are for visits, not persons.

NAMCS uses a multistage sample

design procedure and sampling weights

applied to each record to provide

nationally representative estimates.

Visits to private, nonhospital-based

clinics, and health maintenance

organizations (HMOs) were within the

scope of the survey, but those that

occurred in federally operated facilities

and hospital-based outpatient

departments were excluded. A sample of

office-based physicians who reported

that they were in direct patient care was

taken from the master files of the

American Medical Association and the

American Osteopathic Association.

Between 2001 and 2009, the overall

unweighted physician response rate

ranged from 58.9% to 70.4%. More

information can be found at http://

www.cdc.gov/nchs/ahcd.htm.

Item nonresponse

Item nonresponse rates in NAMCS

were generally low (5% or less) with

some exceptions. Sex was imputed for

0.8%–4.5% of records with missing

values, and birth year was imputed for

1.9%–4.1% of records in survey years

2001–2008. During this period, race was

imputed for 16.9%–32.9% of records.

For 2003–2009, ethnicity was imputed

for 19.4%–35.0% of records, but was

not imputed in 2001–2002 when

between 20.5% and 25.8% of records

were missing ethnicity. In contrast to the

imputation method used for race and

ethnicity in 2005 and previous years

(random assignment of a value from a

patient record form with similar

characteristics based on physician

specialty, geographic region, and

three-digit ICD–9–CM code for primary

diagnosis), a hierarchical procedure was

used beginning in 2006. Records

missing race (or ethnicity) were initially

assigned the race from a donor record

after matching donor and recipient by

three-digit ICD–9–CM codes for

primary diagnosis and the ZIP code of

the patient making the sampled visit. If

no donor was found after several

matching rounds of increasing

geographic size (county, state,

geographic region), standard imputation

procedures used in 2005 and previous

years were applied. If both race and

ethnicity were missing, both were

imputed from the same donor. Standard

errors may be underestimated because

single imputation was used.
Page 52 [ Series 3, No. 35

National Hospital

Ambulatory Medical Care

Survey

Hospital outpatient visit data

(2001–2009) and hospital emergency

department (ED) visit data (2001–2009)

were obtained from the National

Hospital Ambulatory Medical Care

Survey (NHAMCS).

Sample design

NHAMCS is a national probability

sample survey of in-person visits made

in the United States to EDs and

outpatient departments (OPDs) of

nonfederal, short-stay hospitals

(hospitals with an average stay of fewer

than 30 days) and those whose specialty

is general (medical or surgical) or

children’s general. EDs that operate 24

hours a day are considered within the

scope of the ED component; EDs that

operate fewer than 24 hours are

included in the OPD component of

NHAMCS. The hospital sampling frame

for 2006 consisted of hospitals listed in

the 1991 Verispan Hospital Database

(formerly known as the SMG Hospital

Database), and updated using hospital

data from Verispan, L.L.C. About 500

hospitals are included in the sample

from which about 1,200 outpatient

clinics and 400 ED departments are

selected. Because persons with multiple

visits during the year may be sampled

more than once, estimates are for visits,

not persons. NHAMCS uses a

multistage probability sample and

sampling weights applied to each record

to produce nationally representative

estimates. Between 2001 and 2009, the

overall unweighted hospital response

rate ranged from 88.9% to 93.9%. More

information can be found at http://

www.cdc.gov/nchs/ahcd.htm.

Item nonresponse

Item nonresponse rates in

NHAMCS were generally low (5% or

less) with some exceptions. For survey

years 2001–2009, sex was missing and

imputed for 0.3%–3.1% of OPD records

and birth year was imputed for

0.7%–2.1% of OPD records; sex was

missing and imputed for 0.4%–1.6% of

ED records and birth year was imputed

for 0.8%–2.7% of ED records. During

this period, race was imputed for

9.4%–15.4% of OPD records and

imputed for 10.4%–15.3% of ED

records. Ethnicity was imputed for

11.8%–21.5% of OPD records and

imputed for 15.1%–23.8% of ED

records from 2003–2008. For

2001–2002, ethnicity was not imputed

and was missing for 13.3%–18.6% of

OPD records and for 17.0%–17.8% of

ED records. In contrast to imputation

methods used for race and ethnicity in

2005 and previous years (random

assignment of a value from a patient

record form with similar characteristics

based on physician specialty, geographic

region, and three-digit ICD–9–CM code

for primary diagnosis), in 2006, cases

missing race or ethnicity were initially

assigned a donor’s value after matching

the donor and recipient by three-digit

ICD–9–CM codes for primary diagnosis

and the ZIP code of the patient making

the sampled visit. If no donor was found

after several matching rounds,

imputation procedures based on

geographic region, OPD volume by

clinic type, and three-digit ICD–9–CM

codes for primary diagnosis were

applied. If both race and ethnicity were

missing, both were imputed from the

same donor. Beginning in 2007, a new

method was used to impute race and

ethnicity. Race and ethnicity

assignments were based, where possible,

on diagnosis and patient’s locality (ZIP

code, state, or county of residence). A

hot deck approach (i.e., filling in

missing values on incomplete records

using values from similar but complete

records of the same dataset) was

employed rather than the previously

used cold deck strategy (i.e., filling in

missing values on incomplete records

using values from similar but complete

records of the dataset from the previous

year), except in cases where a matching

record could not be obtained from the

current data. When race or ethnicity data

could not be assigned using patient

locality, the new method attempted to

impute within the same facility

wherever possible. Failing that,

imputation was based on diagnosis,

hospital, type of emergency service area,

immediacy, and, as a last resort, on a

randomly selected record.

National Hospital

Discharge Survey

Hospitalization data (1980–2009)

were obtained from the National

Hospital Discharge Survey (NHDS).

Sample design

NHDS collects data from a sample

of inpatient records acquired from a

national sample of hospitals. Because

persons with multiple discharges during

the year may be sampled more than

once, estimates are for discharges, not

persons. Only hospitals with an average

length of stay of fewer than 30 days for

all patients, general hospitals, and

children’s general hospitals are included

in the survey. Federal, military, and

Department of Veterans Affairs

hospitals, as well as hospital units of

institutions, such as prison hospitals, and

hospitals with fewer than six beds

staffed for patient use, are excluded.

NHDS collects data from a sample of

approximately 270,000 inpatient records

acquired from a national sample of

about 500 hospitals. Between 2001 and

2009, the overall unweighted hospital

response rate ranged from 86.0% to

93.9%. More information is available at

http://www.cdc.gov/nchs/about/major/

hdasd/nhds.htm.

Item nonresponse

Less than 1% of records were

missing the sex, age, or date of birth of

the patient. If the hospital record did not

state either the age or sex of patient, it

was imputed by assigning an age or sex

value that still maintained the known

distribution of these variables according

to the categories of the first-listed

diagnosis. In a very few cases (less than

1% of the records), the age or sex was

edited because it was inconsistent with

the diagnosis. For the period 2001–

2009, data for race were missing for

19% to 31% of all discharges, and no

attempt was made to impute for these

missing values. Among asthma

discharges, the percentage of records

missing data for race was lower than for
Series 3, No. 35

[ Page 53

all discharges, 19% to 21% for the

period 2001–2009.A study on NHDS

race data determined that hospitals that

did not report race were likely to havea

higher proportion of white discharges

than hospitals that did report race,

resulting in underestimation of hospital

discharges for white patients (22).

Consequently, the differences between

racial groups are likely to be smaller

than the estimates in this report indicate.

For example, using crude 2009

population-based rates, when records for

unknown race are excluded, black

persons hada hospitalization rate 2.8

times higher compared with white

persons. If all records with unknown

race are assumed to be for patients of

white race, the ratio of black-to-white

asthma hospitalization rates decreased to

2.0. Whereas 2.8 is likely to be an

overestimation of the black-white

disparity, 2.0 is likely to be an

underestimation given that not all

records with unknown race represent

white patients. Nonresponse for ethnicity

is generally higher than nonresponse for

race, and was not imputed, and is not

reported in this analysis.

Mortality Component of

the National Vital Statistics

System

Death data (1980–2009) were

obtained from the National Vital

Statistics System (NVSS) mortality files.

Data are based on information about

underlying cause of death from all death

certificates filed in the 50 states and the

District of Columbia, and are processed

by NCHS. Mortality statistics are based

on information coded by the states and

provided to NCHS through the Vital

Statistics Cooperative Program and from

copies of original certificates received

by NCHS from state registration offices.

More information is available at

http://www.cdc.gov/nchs/deaths.htm.

Item nonresponse

Age was not imputed for death

certificates with age not recorded or

unknown (between 0.01% and 0.02% of

the total deaths in 2001–2009). Records

with unknown age were not included in

estimates by age group, but were

included in overall estimates. All records

coded as ‘‘other races’’ (between 0.03%

and 0.40% of the total deaths in

2001–2009) or as unknown, not stated,

or not classifiable (between 0.07% and

0.22% of the total deaths in 2001–2009)

were assigned the racial designation of

the previous record. All records with

Hispanic origin not stated (between

0.15% and 0.33% of the total deaths in

2001–2009) were not included in

estimates by Hispanic origin, but were

included in the estimates by race and for

overall estimates.
Page 54 [ Series 3, No. 35

Appendix II. Technical Notes

In this report, data are presented for

both individual years and for the most

recent 3 years combined (2007–2009 or

2008–2010) for each data source. Three

years of data were aggregated to provide

average annual estimates for detailed

demographic subgroups. Combining 3

years of data provided more stable

estimates by increasing the sample size,

and consequently, reducing the standard

errors. Consequently, more information

about detailed demographic subgroups is

provided than could have been presented

if using only 1 year of data.

Counts of persons, visits, deaths,

and rates are provided in this report.

The counts give insight into the

magnitude of the disease burden on the

health care system and society. The rates

control for population size differences

among the demographic groups and give

additional insight into varying levels of

the disease, asthma severity,

management, and control. Rates were

calculated using two methods:

population-based estimates using the

estimated number of persons in the U.S.

population as denominators, and

risk-based estimates using the estimated

number of persons with current asthma

from the National Health Interview

Survey (NHIS) as denominators.

Population-based Rates

The type of U.S. census population

estimate for each health care use and

mortality data source reflects the U.S.

population potentially ‘‘exposed’’ to

each of these outcomes. Ambulatory

health care visit rates (Tables 7, 9, and

13) are based on the civilian

noninstitutionalized population;

hospitalization rates (Table 16) are based

on the civilian population; and mortality

rates (Table 19) are based on the

resident population. All populationbased rates are age adjusted using the

2000 U.S. population distribution in 11

age categories (see ‘‘Age Adjustment’’

below) when the sample size allowed

(23). Population-based rates are used to

measure the risk of disease in the U.S.

population overall and in demographic

groups.

Risk-based Rates

The average annual risk-based rate

tables (Tables 6, 11, 12, 15, 18, and 21)

are expressed relative to the estimate of

the number of people with current

asthma from NHIS for the appropriate

3-year period. The risk-based trend

tables (Tables 5, 8, 10, 14, 17, and 20)

are expressed relative to the estimate of

the number of people with current

asthma for the appropriate survey year

from NHIS. Risk-based rates account for

prevalence differences over time and

between subgroups. They provide

additional insight into understanding the

time trends for outcomes during a

period of increasing prevalence by

restricting the denominator of the rate to

the population at risk for the outcome.

Risk-based rates can be used to directly

compare the risk of an outcome (e.g.,

hospitalizations or deaths) among

subgroups due to factors other than a

difference in current asthma prevalence.

The population reference group for the

prevalence estimates (civilian

noninstitutionalized population) is

different than the reference groups for

hospital data (civilian population) and

for mortality data (residential

population). Therefore, the rates per 100

persons with asthma for these two

outcomes may be slight overestimates.

Standard errors for the asthma-specific

rates, which use the number with asthma

in the denominator, rather than a

population constant, were calculated

using formulae for ratios assuming that

covariance equals zero (24).

Age Adjustment

Except for estimates for specific age

groups, data shown in Figures 1, 3, 7, 8,

14, 18, 22, 26, 27, 29, and 30, and in

Tables 1, 3, 5, 7, 9, 13, 16, and 19 were

age adjusted using the 2000 U.S.

population provided by the U.S. Census

Bureau as the standard population (23).

Age adjustment was used to allow

comparison among various population

subgroups that have different age

structures. The following age groups

were used for age adjustment: under age

1, 1–4, 5–14, 15–24, 25–34, 35–44,

45–54, 55–64, 65–74, 75–84, and 85

years and over. Risk-based rates are not

age adjusted. Because these rates are

based on the population with asthma,

prevalence differences between

subgroups are already taken into

account. In addition, age adjusting is

used to eliminate changes in the age

distribution. There have been no

changes in the age distribution for those

with current asthma over the past 10

years.

Estimation of Counts

The estimated national counts of

persons with asthma (NHIS), number of

office visits for asthma to private

physicians’ offices (National Ambulatory

Medical Care Survey), hospital

outpatient departments and emergency

rooms (National Hospital Ambulatory

Medical Care Survey), and asthma

hospitalizations (National Hospital

Discharge Survey) are calculated by

weighting the number of respondents or

visits by the survey weights. Asthma

deaths are not based on estimates but

actual counts obtained from all death

certificates filed in the 50 states and the

District of Columbia.

Standard Error

With the exception of asthma

hospitalization rates for 1980–1987 and

all asthma death rates, standard errors

were calculated using SUDAAN to

account for each survey’s complex

sample design (9).

For asthma hospitalization rates for

1980–1987, the Division of Health Care

Statistics makes available tables for

generalized variances curves. The curves

are approximations of the relative

standard errors (RSEs) that are

applicable to estimates of discharges by

selected patient or hospital

characteristics. Because exact standard

errors are not provided for every size

estimate, linear arithmetic interpolation

was used to obtain RSE and standard
Series 3, No. 35 [ Page 55

errors for estimate sizes not included in

the hospitalization RSE tables (11).

For asthma deaths compiled from a

complete count of death certificate data

rather than from a sample, the random

variation associated with mortality

statistics is assumed to follow a Poisson

probability distribution (10). Therefore,

the standard error is associated with the

number of deaths (D):

√ √

where var(D) is the variance of D. The

standard error associated with crude and

age-specific death rates (R) assumes that

the population denominator (P) is a

constant and is:

For risk-based asthma death rates,

the standard error of the denominator

(the NHIS estimate of the number of

persons with current asthma) was

accounted for by using the formula for

ratios and assumed independent

observations (covariance equals zero)

(24).

Relative Standard Error

The RSE of an estimate is

calculated as:

RSE (percent) = (SEst/Est) c 100

where SEst is the standard error of

the estimate and Est is the estimate.

Estimates with an RSE less than or

equal to 30% are considered reliable.

RSEs between 30% and 50% were used

to indicate unreliable estimates in the

accompanying tables. Estimates with an

RSE more than 50% were not reported.

Tests of Significance

Standard errors were used in

significance tests. Statistical tests

performed to assess the significance of

differences in estimates were two-tailed

with no adjustments for multiple

comparisons. The test statistic used to

determine statistical significance of

differences between two percentages

was:

√

SE(D) = var(D) = D

SE(R) = √var(D/P) = R/

√D

|Xa – Xb

|

Z = Sa

2 + Sb2

where Xa and Xb are the two

percentages being compared, and Sa and

Sb are the standard errors of those

percentages. The critical value used for

two-sided tests at the 0.05 level of

significance was 1.96. Terms such as

‘‘higher than’’ and ‘‘less than’’ indicate

statistically significant differences.

Terms such as ‘‘similar’’ and ‘‘no

difference’’ indicate that the statistics

being compared were not significantly

different. Lack of comment regarding

the difference between any two statistics

does not necessarily suggest that the

difference was tested and found to be

not significant.

Test of significance of trends was

conducted using Joinpoint software to

test if an apparent change over time is

statistically significant, taking into

account the standard error for each data

point (12). The weighted least squares

regression models produce an annual

percentage rate change when the log of

the outcome is analyzed.

Stated Comparisons

All stated comparisons used a

nondirectional, two-tailed test and were

significant at the α ≤ 0.05 level. Only

selected comparisons among the shown

demographic groups were tested.

Analysis of Trends

Significance testing for trends over

time was performed with Joinpoint

software from the National Cancer

Institute (NCI) (12). The software fits

the simplest model to trend data while

allowing ‘‘joinpoints,’’ or points

marking a change in trend over the

period being analyzed. The program

starts with the minimum number of

joinpoints (i.e., zero, which is a straight

line) and tests whether more joinpoints

are statistically significant and should be

added to the model up to a maximum,

which was specified as two for all

models included in this report.

Significance tests use a Monte Carlo

Permutation method. More information

is available on the NCI Joinpoint

website at http://surveillance.cancer.gov/

joinpoint/.

Joinpoint calculates the average

annual percent change for each trend

segment using the underlying Joinpoint

regression model. Annual percent

change assumes a change at a constant

rate, and is calculated as the natural log

of the percent of the rate of the previous

year. More information can be found at

http://surveillance.cancer.gov/joinpoint/

aapc.html.

For some trends, the Joinpoint

software identified optimal models with

more than one joinpoint. A simpler

model with fewer joinpoints was chosen

for presentation if the difference

between the two models conveyed the

same overall message (i.e., the trend

segment with a statistically significant

annual percent change began and ended

with the same years, and the annual

percent change was within 5% of that

identified by the more complex model).
Page 56 [ Series 3, No. 35

Appendix III. Definition of Terms

Definition of General

Terms

Age—Age in years is recorded for each

person. Estimates are shown for age

groups under age 18, 18 or over, 0–4,

5–14, 15–34 (with subcategories 15–19,

20–24, 25–34 where sample size was

sufficient), 35–64, and 65 or over.

Race—The race and ethnicity categories

in this report follow the 1997 U.S.

Office of Management and Budget’s

Revisions to the Standards for the

Classification of Federal Data on Race

and Ethnicity to the extent possible,

given the multiple demographic

subcategories, respective sample sizes,

and consistency across the multiple data

sources used in this report. The 1997

standards specify five racial groups as

the minimum for data collection on race

in federal statistics: American Indian or

Alaska Native, Asian, Black or African

American, Native Hawaiian or Other

Pacific Islander, and White (25). The

standards also offer respondents the

opportunity to select more than one of

the five groups. Hispanic or Latino

origin includes persons of Mexican,

Puerto Rican, Cuban, Central and South

American, and other or unknown Latin

American or Spanish origin. Persons of

Hispanic origin may be of any race.

Race categories ‘‘white’’ and ‘‘black’’

are comprised of persons who indicated

only a single race group. ‘‘Other races’’

includes Asian, American Indian and

Alaskan Native, Native Hawaiian and

Other Pacific Islander, persons reporting

more than one race, and persons

reporting their race as something other

than those listed here or above. The

National Vital Statistics System (NVSS)

Mortality Component conformed to the

1997 standard in 21 states in 2005, and

increased to 27 states and the District of

Columbia in 2007. To provide

uniformity and comparability of NVSS

mortality data during the transition

period, before all or most of the data

become available in the new multiplerace format, the responses of those for

whom more than one race was reported

(multiple race) were bridged to a single

race (10).

Ethnicity: Hispanic or Latino—

Hispanic or Latino ethnicity includes

persons of Mexican, Puerto Rican,

Cuban, Central and South American, or

Spanish origins. Persons of Hispanic or

Latino origin may be of any race. In this

report, the ethnicity category includes

only ‘‘Hispanic or Latino’’ and ‘‘Not

Hispanic or Latino’’ because subgroups

of Hispanic ethnicity are not available

from most data sources. The National

Health Interview Survey (NHIS)

ethnicity reporting, however, includes

Mexican and Puerto Rican subgroups

for which estimates are included in this

report. The 1997 revision of Statistical

Policy Directive No. 15, Race and

Ethnic Standards for Federal Statistics

and Administrative Reporting, changed

the ethnicity category name from

‘‘Hispanic’’ to ‘‘Hispanic or Latino,’’ but

the definition of persons in that category

remained the same (25). Ethnicity

information is not available in

hospitalization data and detailed

Hispanic subgroup information is not

available in ambulatory health care use

or death data.

Geographic region—In the geographic

classification of the U.S. population,

states are grouped into the four regions

used by the U.S. Census Bureau: The

northeast region includes the states of

Connecticut, Maine, Massachusetts, New

Hampshire, New Jersey, New York,

Pennsylvania, Rhode Island, and

Vermont. The Midwest region includes

Illinois, Indiana, Iowa, Kansas,

Michigan, Minnesota, Missouri,

Nebraska, North Dakota, Ohio, South

Dakota, and Wisconsin. The southern

region includes Alabama, Arkansas,

Delaware, the District of Columbia,

Florida, Georgia, Kentucky, Louisiana,

Maryland, Mississippi, North Carolina,

Oklahoma, South Carolina, Tennessee,

Texas, Virginia, and West Virginia. The

western region includes Alaska, Arizona,

California, Colorado, Hawaii, Idaho,

Montana, Nevada, New Mexico,

Oregon, Utah, Washington, and

Wyoming.

Poverty status—The average annual

NHIS tables for 2008–2010 include

asthma prevalence estimates by poverty

status, which is not available from

National Center for Health Statistics

data sources on health care use or

mortality. Poverty status is based on

family income and family size, and is

calculated using the U.S. Census

Bureau’s poverty thresholds for the

previous calendar year. Because of the

different income questions used in the

2007 NHIS and beyond, poverty ratio

estimates may not be comparable with

those from earlier years. For more

information, see ‘‘Income and Assets

Section’’ on page 37 of the ‘‘2009

National Health Interview Survey

(NHIS) Public Use Data Release: NHIS

Survey Description,’’ available at

(ftp://ftp.cdc.gov/pub/Health_Statistics/

NCHS/Dataset_Documentation/NHIS/

2009/srvydesc.pdf).

Definition of Asthma

Terms

Prevalence and attacks—There are

four different prevalence measures that

can be estimated from NHIS, as shown

in the table below. Before 1997, data

from NHIS was used to estimate asthma

12-month period prevalence. As the

result of the 1997 survey redesign,

12-month asthma period prevalence has

not been measured since 1996.

Beginning in 1997, two new asthma

prevalence measures were introduced,

lifetime asthma prevalence and asthma

attack prevalence. In 2001, an additional

measure, current asthma prevalence, was

introduced to more completely capture

asthma prevalence. None of the three

asthma prevalence measures collected in

1997 and afterward are directly

comparable with the pre-1997 12-month

period prevalence measure.

Physician office visits—Physician

office visits for asthma collected from

the National Ambulatory Medical Care

Survey were defined as those with an

International Classification of Diseases,

Ninth Revision (ICD–9–CM) code 493

as the first-listed diagnosis.
Series 3, No. 35 [ Page 57

Hospital outpatient visits and

emergency department visits—An

outpatient or emergency department visit

for asthma based on National Hospital

Ambulatory Medical Care Survey data

was defined as an ICD–9–CM code 493

as a first-listed diagnosis.

Hospital discharges—A hospitalization

for asthma was estimated from the

National Hospital Discharge Survey and

defined as a discharge record with

ICD–9–CM code 493 as a first-listed

diagnosis.

Mortality—Asthma deaths are reported

using data from the Mortality

Component of the National Vital

Statistics System. Under ICD–9, which

was used from 1979 through 1998,

asthma deaths were defined as those

with an underlying cause code 493.

Under ICD–10, which has been used

since 1999, asthma deaths are defined as

those with underlying cause codes J45

and J46. Changes in ICD affected the

comparability of data coded according

to the different revisions. The asthma

comparability ratio for the entire

population was 0.89, which indicated

that 11% of the decline in asthma

mortality between 1998 and 1999 was a

consequence of the ICD revision (26).

List of Abbreviations

BRFSS: Behavioral Risk Factor

Surveillance System

ED: Emergency department

ICD: International Classification of

Diseases

NACP: National Asthma Control

Program

NAEPP: National Asthma Education and

Prevention Program

NAMCS: National Ambulatory Medical

Care Survey

Table. Summary of definitions for asthma items

Definitions for National Health Interview Survey (NHIS)

Estimate NHIS question Questionnaire

Asthma period prevalence During the past 12 months, did anyone in the Pre-1997 NHIS respiratory conditions questionnaire

family have asthma?

Lifetime asthma prevalence Has a doctor or other professional ever told you that 1997 forward NHIS sample child and sample adult

(you/your child) had asthma? core questionnaires

Current asthma prevalence Has a doctor or other professional ever told you that 2001 forward NHIS sample child and sample adult

(you/your child) had asthma? AND (Do you/does core questionnaires

your child) still have asthma?

Asthma attack prevalence Has a doctor or other professional ever told you that 1997 forward NHIS sample child and sample adult

(you/your child) had asthma? AND During the past core questionnaires

12 months, (have you/has your child) had an

episode of asthma or an asthma attack?

Definitions for National Ambulatory Medical Care Survey (NAMCS)

Estimate ICD–9–CM code Listed position

Asthma office visit 493 First-listed diagnosis

Definitions for National Hospital Ambulatory Medical Care Survey (NHAMCS)

Estimate ICD–9–CM code Listed position

Asthma

Asthma

outpatient visit

emergency department visit

493

493

First-listed

First-listed

diagnosis
 

diagnosis
 

Definitions for National Discharge Survey

Estimate ICD–9–CM code Listed position

Hospitalization for asthma 493 First-listed diagnosis

Definitions for Mortality Component of the National Vital Statistics System

Estimate ICD code Listed position

Asthma

Asthma

death

death

ICD–9 code 493

ICD–10 codes J45 and J46

1980–1998: underlying cause of death

1999 onward: underlying cause of death

NOTE: ICD is International Classification of Diseases.
Page 58 [ Series 3, No. 35

NCEH: National Center for

Environmental Health

NCHS: National Center for Health

Statistics

NHAMCS: National Hospital

Ambulatory Medical Care Survey

NHDS: National Hospital Discharge

Survey

NHIS: National Health Interview Survey

NVSS: National Vital Statistics System

OPD: Outpatient department

SLAITS: State and Local Area

Integrated Telephone Survey
Vital and Health Statistics

Series Descriptions

ACTIVE SERIES

Series 1.	 Programs and Collection Procedures—This type of report

describes the data collection programs of the National Center

for Health Statistics. Series 1 includes descriptions of the

methods used to collect and process the data, definitions, and

other material necessary for understanding the data.

Series 2.	 Data Evaluation and Methods Research—This type of

report concerns statistical methods and includes analytical

techniques, objective evaluations of reliability of collected

data, and contributions to statistical theory. Also included are

experimental tests of new survey methods, comparisons of

U.S. methodologies with those of other countries, and as of

2009, studies of cognition and survey measurement, and final

reports of major committees concerning vital and health

statistics measurement and methods.

Series 3.	 Analytical and Epidemiological Studies—This type of

report presents analytical or interpretive studies based on vital

and health statistics. As of 2009, Series 3 also includes

studies based on surveys that are not part of continuing data

systems of the National Center for Health Statistics and

international vital and health statistics reports.

Series 10.	 Data From the National Health Interview Survey—This

type of report contains statistics on illness; unintentional

injuries; disability; use of hospital, medical, and other health

services; and a wide range of special current health topics

covering many aspects of health behaviors, health status, and

health care utilization. Series 10 is based on data collected in

this continuing national household interview survey.

Series 11.	 Data From the National Health Examination Survey, the

National Health and Nutrition Examination Surveys, and

the Hispanic Health and Nutrition Examination Survey—

In this type of report, data from direct examination, testing,

and measurement on representative samples of the civilian

noninstitutionalized population provide the basis for (1)

medically defined total prevalence of specific diseases or

conditions in the United States and the distributions of the

population with respect to physical, physiological, and

psychological characteristics, and (2) analyses of trends and

relationships among various measurements and between

survey periods.

Series 13.	 Data From the National Health Care Survey—This type of

report contains statistics on health resources and the public’s

use of health care resources including ambulatory, hospital,

and long-term care services based on data collected directly

from health care providers and provider records.

Series 20.	 Data on Mortality—This type of report contains statistics on

mortality that are not included in regular, annual, or monthly

reports. Special analyses by cause of death, age, other

demographic variables, and geographic and trend analyses

are included.

Series 21.	 Data on Natality, Marriage, and Divorce—This type of

report contains statistics on natality, marriage, and divorce

that are not included in regular, annual, or monthly reports.

Special analyses by health and demographic variables and

geographic and trend analyses are included.

Series 23.	 Data From the National Survey of Family Growth—These

reports contain statistics on factors that affect birth rates,

including contraception and infertility; factors affecting the

formation and dissolution of families, including cohabitation,

marriage, divorce, and remarriage; and behavior related to

the risk of HIV and other sexually transmitted diseases.

These statistics are based on national surveys of women and

men of childbearing age.

DISCONTINUED SERIES

Series 4.	 Documents and Committee Reports—These are final

reports of major committees concerned with vital and health

statistics and documents. The last Series 4 report was

published in 2002. As of 2009, this type of report is included

in Series 2 or another appropriate series, depending on the

report topic.

Series 5.	 International Vital and Health Statistics Reports—This

type of report compares U.S. vital and health statistics with

those of other countries or presents other international data of

relevance to the health statistics system of the United States.

The last Series 5 report was published in 2003. As of 2009,

this type of report is included in Series 3 or another series,

depending on the report topic.

Series 6.	 Cognition and Survey Measurement—This type of report

uses methods of cognitive science to design, evaluate, and

test survey instruments. The last Series 6 report was

published in 1999. As of 2009, this type of report is included

in Series 2.

Series 12.	 Data From the Institutionalized Population Surveys—

The last Series 12 report was published in 1974. Reports

from these surveys are included in Series 13.

Series 14.	 Data on Health Resources: Manpower and Facilities—

The last Series 14 report was published in 1989. Reports on

health resources are included in Series 13.

Series 15.	 Data From Special Surveys—This type of report contains

statistics on health and health-related topics collected in

special surveys that are not part of the continuing data

systems of the National Center for Health Statistics. The last

Series 15 report was published in 2002. As of 2009, reports

based on these surveys are included in Series 3.

Series 16.	 Compilations of Advance Data From Vital and Health

Statistics—The last Series 16 report was published in 1996.

All reports are available online, and so compilations of

Advance Data reports are no longer needed.

Series 22.	 Data From the National Mortality and Natality Surveys—

The last Series 22 report was published in 1973. Reports

from these sample surveys, based on vital records, are

published in Series 20 or 21.

Series 24.	 Compilations of Data on Natality, Mortality, Marriage, and

Divorce—The last Series 24 report was published in 1996.

All reports are available online, and so compilations of reports

are no longer needed.

For answers to questions about this report or for a list of reports published

in these series, contact:

Information Dissemination Staff

National Center for Health Statistics

Centers for Disease Control and Prevention

3311 Toledo Road, Room 5412

Hyattsville, MD 20782

1–800–232–4636

E-mail: cdcinfo@cdc.gov

Internet: http://www.cdc.gov/nchs
U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, MD 20782

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DHHS Publication No. (PHS) 2013–1419, Series 3, No. 35