The Burden of Asthma in California: A Surveillance Report

Using all of the most recent available surveillance data, this report presents a comprehensive summary of the burden of asthma in California.

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Over five million Californians have been diagnosed with asthma at some point in their lives, and almost three million currently have asthma. The majority of adults with asthma have mild symptoms, but about one in four have symptoms that are moderate or severe. About a third of children with asthma had an attack in the past year.

Surveillance data show that there is much room for improvement in routine health care for people with asthma. Half of adults with asthma have not had a routine checkup for asthma in the past year and only about one-third of adults and children with asthma have received an asthma management plan.

More encouraging is that the data indicate a decline in rates of the most severe outcomes—hospitalizations and deaths. Still, there are almost 500 deaths, 36,000 hospital discharges, and 145,000 emergency department (ED) visits (that did not result in hospitalization) per year due to asthma.

In addition, the costs of asthma hospitalizations are enormous—$763 million in 2005. This figure does not include the cost of ED visits, which are a precursor of asthma hospital admissions. Proper prevention efforts could reduce many of these poor outcomes and costs. For example, 19 percent of people who were hospitalized for asthma from 2003 to 2005 had at least one repeat visit during that time period. Intervening to prevent those repeat asthma hospitalizations would have saved $565 million over three years.

In almost all measures of asthma burden, there are large disparities by race/ethnicity, income, age, gender, and geographic location. Blacks have especially disproportionate rates of ED visits, hospitalizations, and mortality. Although people of all incomes have a similar prevalence of asthma, people with lower incomes have more severe symptoms, higher rates of hospitalizations, and are more likely to have repeat hospitalizations. 

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