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Focus Area 24Respiratory 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 yearsChildren 5-14 years Adolescents and adults 15-34 yearsAdults 35-64 yearsAdults 65 years and over
24-1 Deaths from Asthma
Children under 5 yearsChildren 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 plansPersons with prescribed inhalers who …….receive instructionEducation about recognizing early signsMedication regimensFollowup medical careAssistance with assessing….…environmental risks
24-8 Surveillance SystemsChildren under 5 yearsChildren and adults 5-64 yearsAdults 65 years and over
24-3 Hospital Emergency Department Visits for Asthma
Asthma
Cannot assess (limited data)Getting worseImproving Little or no change
Respiratory Diseases Objectives
24-9 Activity Limitations due to Chronic Lung and Breathing Problems
24-10 Deaths from COPD
Seek medical evaluationReceive follow-up care
24-11 Medical Evaluation and Followup
Chronic Obstructive Pulmonary Disease (COPD)
Obstructive Sleep Apnea (OSA)
24-12 Vehicular Crashes Related to Excessive Sleepiness
Cannot assess (limited data)Getting worseImproving Little or no change
Respiratory Diseases Objectives
COPD24-9. Activity limitations 24-10. Deaths
Asthma
24-1. Deaths
24-2. Hospitalizations
24-4. Activity limitations
24-5. School or work days lost
24-6. Patient education
Highlighted Objectives
Asthma Facts
• Chronic condition occurring among both children and adults
• 74% increase in self-reported asthma from 1980 to 1996
• 85% increase in physician visits from 1980 to 1999 • 18 days of school or work lost due to asthma per
person with asthma
• 75 emergency department visits and 18 hospitalizations for asthma per 10,000 population
• Evidence of some declines in recent years (except young children)
0 20 40 60 80 Deaths per Million
Under 5 years
5-14 years
15-34 years
35-64 years
65 years and over
1999
20012010Target
Obj. 24-1a-e Source: National Vital Health Statistics System, NCHS, CDC.
Asthma Deaths
0
5
10
15
20
25
1980 1985 1990 1995 2000
Age-adjusted death rate per million
Deaths per MillionNote: 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
IslanderBlack
White
Hispanic
Female
Male0 10 20 30 40 50
2010 Target
Obj. 24-1d
Asthma DeathsAges 35 – 64 Years
1999
2001
Hospitalizations per 10,000
Asthma Hospitalizations
Note: Data for ages 5-64 and 65 and over are age-adjusted to the 2000 standard population.Source: National Hospital Discharge Survey, NCHS, CDC.
Under 5 years
5-64 years
65 years and over
0 20 40 60 80
1998
2001
2010Target
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 1998. In 2001, persons reported one or more races. Data by race are shown for persons who reported one racial group.Source: National Hospital Discharge Survey, NCHS, CDC.
Black
White
Female
Male
0 10 20 30 40
Obj. 24-2c
2010 Target
Asthma Hospitalizations
1998
2001
PercentNote: Data are age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. In 1997, persons reported one or more races and identified one race as best representing their race. Data by single race category are for persons who reported only one racial group.Source: National Health Interview Survey, NCHS, CDC.
Total
Asian or Pacific Islander
Black
White
Hispanic
0 5 10 15 20
Activity Limitations Among Persons with Asthma
1997
2002
Obj. 24-4
2010 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
income0 10 20 30
Activity Limitations Among Persons with Asthma
1997
2002
Obj. 24-4
2010 Target
School or Work Days Lost Among Persons with Asthma, 2002
Number of Days Lost
Total
Black
White
Hispanic
Female
Male
0 10 20 30 40
Note: Data are age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races. Data by single race category are for persons who reported only one racial group.Source: National Health Interview Survey, NCHS, CDC. Obj. 24-5
Patient Education Among Adults with Asthma
Percent
Total
Black
White
Hispanic
Female
Male
0 10 20 30
2010 Target
Note: Data are for ages 18 and over and age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races. Data by single race category are for persons who reported only one racial group.Source: National Health Interview Survey, NCHS, CDC. Obj. 24-6
1998
1999
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 COPD1988 - 94
Note: NHIS and NHANES data are based on self-reports. Mild and moderate COPD is defined by spirometric ratio of FEV1 (forced expiratory volume in 1 second) to FVC (forced vital capacity) less than 70%. Source: Mannino, et al. MMWR 2002 / 51(SS06);1-16.
Per 100,000
Percent50
40
30
20
10
0
NHIS self-report NHANES self-report Mild/moderate COPD
25-44 45-54 55-64 65-74 75+ Age group
1980 2000
Note: COPD is defined as ICD-9 codes 490-492 and 496 for 1980 data and ICD-10 codes J40-J44 for 2000 data, and excludes asthma. Data are age adjusted to 2000 standard population Source: Mannino, et al. MMWR 2002 / 51(SS06);1-16.
Per 100,000
Female Male
Deaths per 100,000100
80
60
40
20
0
COPD DeathsAges 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.
2010 Target
Deaths per 100,0000 50 100 150 200
Obj. 24-10
1999
2001
PercentNote: Data are for ages 45 years and over and age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons reported one or more races. Data by single race category are for persons who reported only one racial group.Source: National Health Interview Survey, NCHS, CDC.
Total
Black
White
Hispanic
0 1 2 3 4 5
2010 Target
1997
2002
Obj. 24-9
Activity Limitations Due toChronic 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
income0 1 2 3 4 5 6 7
2010 Target
1997
2002
Obj. 24-9
Activity Limitations Due toChronic Lung and Breathing
Problems
Progress review data and slidescan be found on the web at:
http://www.cdc.gov/nchs/hphome.htmhttp://www.cdc.gov/nchs/hphome.htm