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State of Alaska

Health Indicator Report of Asthma - Current Asthma - Adults (18+)

In 2018, 9.5% of adults (18 years of age and older) in the United States had current asthma and 14.7% had asthma sometime during their life.^1^ In 2017, 3,564 Americans died from asthma (9.9 per 100,000,000).^2^ Asthma's impact on health, quality of life, and the economy is substantial. Including cost for missed work, medical costs, and early mortality, asthma cost the U.S. $81.9 billion between 2008 and 2013. ^3^ [[br]] [[br]] ---- {{class .SmallerFont 1. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. BRFSS Prevalence & Trends Data Online. [https://www.cdc.gov/brfss/brfssprevalence/]. Accessed September 18, 2019. 2. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2017 on CDC WONDER Online Database, released December, 2018. Data are from the Multiple Cause of Death Files, 1999-2017, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at [http://wonder.cdc.gov/ucd-icd10.html] on Aug 29, 2019. 3. Nurmagambetov T, Kuwahara R, Garbe P. The Economic Burden of Asthma in the United Stated, 2008-2013. Ann Am Thorac Soc 2018; 15:348-356. }}

Notes

Alaska: Alaska Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services; US: Behavioral Risk Factor Surveillance System, Centers for Disease Control and Prevention. Alaska data were obtained from the Standard AK BRFSS survey from 2000 to 2003, 2007, and 2010, and from the Standard and Supplemental AK BRFSS surveys combined in 2004 through 2006, 2008, and 2009. The Supplemental AK BRFSS survey is conducted using identical methodology as the Standard AK BRFSS and allows a doubling of the BRFSS sample size for those measures included on both surveys.   Geographic descriptions of boroughs and census areas can be found at: [http://dhss.alaska.gov/dph/InfoCenter/Pages/ia/brfss/geo_bca.aspx]. Alaska Native people refers to any mention of American Indian or Alaska Native heritage when enumerating racial and ethnic background. Individuals of multiple races incorporating American Indian/Alaska Native are moved into the Alaska Native group. When race and ethnicity are consider concurrently, Hispanic individuals with American Indian/Alaska Native heritage are combined into the Alaska Native (any mention) group and removed from the Hispanic class. The definition of the Alaska Native group is intended to conform to the eligibility requirements for access to Alaska Native Tribal Health Consortium.

Data Sources

  • Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion
  • U.S. Data: National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS)

Data Interpretation Issues

Questions on lifetime asthma and current asthma have been asked on the Standard AK BRFSS survey continuously since 2000. Asthma questions have also appeared on the Supplemental AK BRFSS survey in 2004-2006 and 2008-2009, thereby doubling the responses for those years. Post-stratification weights were used for Alaska prior to 2006; raking weights were used from 2007 onward. For more on this methodological change see: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/method.aspx].

Definition

Percentage of adults 18 years of age and older who responded "Yes" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the questions: "Have you ever been told by a doctor, nurse, or other health professional that you had asthma?" and, if so, "Do you still have asthma?"

Numerator

Weighted number of adults (18+) who responded "Yes" on the BRFSS to the questions: "Have you ever been told by a doctor, nurse, or other health professional that you had asthma?" and, if so, "Do you still have asthma?"

Denominator

Weighted number of adults (18+) with complete and valid responses on the BRFSS to the two asthma questions, excluding those with missing, "Don't know/Not sure," or "Refused" responses.

Healthy People Objective: Reduce activity limitations among persons with current asthma

U.S. Target: 10.2 percent

How Are We Doing?

This indicator has been measured by the BRFSS since 2000. The percentage of Alaska adults who currently have asthma has increased slightly over that period, from 6.9% in 2000 to 9.8% in 2018. The occurrence of asthma at anytime during the lifetime has increased from 11.2% in 2000 to 15.3% in 2018. One-third (33.9%) of adults with current asthma said that they were limited in activities due to physical, mental, or emotional problems for the period of 2013-2017. Since 2000, women have consistently reported higher prevalence of current asthma than men. In 2018, 13.2% of women reported currently having asthma compared to 6.5% of men. Those unable to work (22.8) experienced significantly higher levels of current asthma than those who were employed (8.6) and those not in the workforce (9.0%). Rates of asthma from the BRFSS are initially presented for all Alaskans and Alaska Native people. Subsequent analyses are reported by demographic subpopulations of sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, and Medicaid eligibility. Crosstabulations were also conducted for three-year averages by body mass index, current smoking, sexual orientation, and number of Adverse Childhood Experiences. Significant differences occurred within each comparison. Rates of asthma by regions of Alaska are presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 7 Alaska Public Health Regions, 2) single-year for the 11 behavioral health assessment regions based upon aggregations of 20,000 population, and 3) five-year averages for the 12 tribal health organization regions. These time intervals match those for the InstantAtlas health profiles for each of the geographic regionalizations of Alaska for those desiring longer time series.

How Do We Compare With the U.S.?

The prevalence of current asthma in Alaska is similar to that seen in the U.S. (9.8% and 9.5% in 2018, respectively).

Evidence-based Practices

The National Asthma Control Initiative (NACI), a program of the [https://www.nhlbi.nih.gov/about/org/naepp National Asthma Education and Prevention Program (NAEPP)], coordinated by the [https://www.nhlbi.nih.gov/ National Heart, Lung, and Blood Institute (NHLBI)], is a multi-component, mobilizing, and action-oriented initiative to engage diverse stakeholders who are concerned about or involved in improving asthma control. Its ultimate aim is to bring the asthma care that patients receive in line with evidence-based recommendations from two reports published by the NAEPP: the [https://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines Expert Panel Report 3-Guidelines for the Diagnosis and Management of Asthma (EPR-3)] and its companion [https://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines/implementation-panel-report-3 Guidelines Implementation Panel (GIP) Report-Partners Putting Guidelines Into Action]. The NACI is bringing together organizations from local, state, regional, and national levels so that they can share best practices, pool and direct resources, and identify new directions and learning opportunities. The NACI focuses on three major efforts: [https://www.nhlbi.nih.gov/health-pro/resources/lung/naci/naci-in-action/demonstration-projects.htm NACI Demonstration Projects], the [https://www.nhlbi.nih.gov/health-pro/resources/lung/naci/naci-in-action/partners.htm NACI Strategic Partnership Program], and the [https://www.nhlbi.nih.gov/health-pro/resources/lung/naci/naci-in-action/champions.htm NACI Champions Program]. In communities across the country, these efforts are engaging health care professionals, patients and families, schools and childcare settings, professional associations, and many others to implement innovative, strategic interventions to overcome barriers to implementing clinical guidelines and reducing asthma disparities. Through such efforts, the NACI hopes to speed the adoption of these recommendations by clinicians and adherence to them by patients and their families and caregivers. The NACI seeks to produce high-impact solutions and meaningful change in asthma control by: [[br]]* Convening and energizing national, regional, state, and local leaders. [[br]]* Developing a communication infrastructure for information sharing and accessing resources. [[br]]* Mobilizing champion networks to implement and integrate clinical and community-based interventions with emphasis on sustainability. [[br]]* Demonstrating evidence-based and best practice approaches for specific audiences in various settings with emphasis on closing the asthma disparity gap. [[br]]* Monitoring and assessing NACI progress toward its goals by measuring outcomes and sharing lessons learned. At the core of the NACI are six priority messages selected from the EPR-3 and detailed in the GIP Report. If practiced routinely and implemented widely, these action-oriented messages have the power to improve asthma control and transform the lives of people with asthma: [[br]]* '''Use inhaled corticosteroids''' to control asthma. [[br]]* '''Use written asthma action plans''' to guide patient self-management. [[br]]* '''Assess asthma severity''' at the initial visit to determine initial treatment. [[br]]* '''Assess and monitor asthma control''' and adjust treatment if needed. [[br]]* '''Schedule follow-up visits''' at periodic intervals. [[br]]* '''Control environmental exposures''' that worsen the patient's asthma. Failure to control asthma diminishes physical, psychological, and social wellbeing and quality of life; increases health disparities, particularly among African American, Puerto Rican, and socioeconomically disadvantaged populations; and places added burden on families, schools, workplaces, and health care systems.
Page Content Updated On 08/29/2019, Published on 09/20/2019
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Wed, 16 October 2019 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Mon, 30 Sep 2019 08:25:45 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Wed, 16 October 2019 21:58:07 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Mon, 30 Sep 2019 08:25:45 AKDT