Focus Area 24 Respiratory Diseases Progress Review June 29, 2004

Burden of Respiratory Diseases Prevalence (self or proxy-reported) 3.6 million children 22 million adults Annual Burden (estimated) 20 million physician and outpatient visits 3.5 million hospital emergency visits 1.2 million hospitalizations 124,000 deaths

Children under 5 years Children 5-14 years Adolescents and adults years Adults years Adults 65 years and over 24-1 Deaths from Asthma Children under 5 years Children and adults 5-64 years Adults 65 years and over 24-2 Hospitalizations for Asthma 24-4 Activity Limitations 24-5 School or Work Days Lost 24-6 Patient Education 24-7 Appropriate Asthma Care Written asthma management plans Persons with prescribed inhalers who …….receive instruction Education about recognizing early signs Medication regimens Followup medical care Assistance with assessing ….…environmental risks 24-8 Surveillance Systems Children under 5 years Children and adults 5-64 years Adults 65 years and over 24-3 Hospital Emergency Department Visits for Asthma Asthma Cannot assess (limited data) Getting worse Improving Little or no change Respiratory Diseases Objectives

24-9 Activity Limitations due to Chronic Lung and Breathing Problems Deaths from COPD Seek medical evaluation Receive follow-up care Medical Evaluation and Followup Chronic Obstructive Pulmonary Disease (COPD) Obstructive Sleep Apnea (OSA) Vehicular Crashes Related to Excessive Sleepiness Cannot assess (limited data) Getting worse Improving Little or no change Respiratory Diseases Objectives

COPD 24-9.Activity limitations Deaths Asthma 24-1.Deaths 24-2.Hospitalizations 24-4.Activity limitations 24-5.School or work days lost 24-6.Patient education Highlighted Objectives

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

Deaths per Million Under 5 years 5-14 years years years 65 years and over Target Obj. 24-1a-e Source: National Vital Health Statistics System, NCHS, CDC. Asthma Deaths Age-adjusted death rate per million

Deaths per Million Note: Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race; selection of more than one race was not an option. Source: National Vital Health Statistics System, NCHS, CDC. Asian or Pacific Islander Black White Hispanic Female Male Target Obj. 24-1d Asthma Deaths Ages 35 – 64 Years

Hospitalizations per 10,000 Asthma Hospitalizations Note: Data for ages 5-64 and 65 and over are age-adjusted to the 2000 standard population. Source: National Hospital Discharge Survey, NCHS, CDC. Under 5 years 5-64 years 65 years and over Target Obj. 24-2a-c

Hospitalizations per 10,000 Ages 65 Years and Over Note: Data are age adjusted to the 2000 standard population. Black and white include persons of Hispanic or non-Hispanic origin. Persons were asked to select only one race category; selection of more than one race category was not an option in In 2001, persons reported one or more races. Data by race are shown for persons who reported one racial group. Source: National Hospital Discharge Survey, NCHS, CDC. Black White Female Male Obj. 24-2c 2010 Target Asthma Hospitalizations

Percent Note: Data are age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. In 1997, persons reported one or more races and identified one race as best representing their race. Data by single race category are for persons who reported only one racial group. Source: National Health Interview Survey, NCHS, CDC. Total Asian or Pacific Islander Black White Hispanic Activity Limitations Among Persons with Asthma Obj Target

Percent Note: Data are age adjusted to the 2000 standard population. Source: National Health Interview Survey, NCHS, CDC.. Female Male Poor Near poor Middle/high income Activity Limitations Among Persons with Asthma Obj Target

School or Work Days Lost Among Persons with Asthma, 2002 Number of Days Lost Total Black White Hispanic Female Male Note: Data are age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races. Data by single race category are for persons who reported only one racial group. Source: National Health Interview Survey, NCHS, CDC. Obj. 24-5

Patient Education Among Adults with Asthma Percent Total Black White Hispanic Female Male Target Note: Data are for ages 18 and over and age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races. Data by single race category are for persons who reported only one racial group. Source: National Health Interview Survey, NCHS, CDC. Obj

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

Estimated Prevalence of COPD Note: NHIS and NHANES data are based on self-reports. Mild and moderate COPD is defined by spirometric ratio of FEV 1 (forced expiratory volume in 1 second) to FVC (forced vital capacity) less than 70%. Source: Mannino, et al. MMWR 2002 / 51(SS06);1-16. Per 100,000 Percent Age group

Note: COPD is defined as ICD-9 codes and 496 for 1980 data and ICD-10 codes J40-J44 for 2000 data, and excludes asthma. Data are age adjusted to 2000 standard population Source: Mannino, et al. MMWR 2002 / 51(SS06);1-16. Per 100,000 Female Male Deaths per 100, COPD Deaths Ages 25 Years and Over

COPD Deaths American Indian Asian or Pacific Islander Black White Hispanic Note: COPD is defined as ICD-10 J40-J44, and excludes asthma. Data are for ages 45 years and over and age adjusted to 2000 standard population. American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race; selection of more than one race was not an option. Source: National Vital Statistics System, NCHS, CDC Target Deaths per 100, Obj

Percent Note: Data are for ages 45 years and over and age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races. Data by single race category are for persons who reported only one racial group. Source: National Health Interview Survey, NCHS, CDC. Total Black White Hispanic Target Obj Activity Limitations Due to Chronic Lung and Breathing Problems

Percent Note: Data are for ages 45 years and over and age adjusted to the 2000 standard population. Source: National Health Interview Survey, NCHS, CDC. Female Male Poor Near poor Middle/high income Target Obj Activity Limitations Due to Chronic Lung and Breathing Problems

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