Epidemiology

Asthma affects approximately 4 to 5 percent of the population in the United States. 2 It is the most common chronic disease of childhood, with a prevalence of 5 to 10 percent.3 On the other end of the spectrum, asthma affects 7 to 10 percent of the elderly, accounting for 68,000 admissions to hospitals in 1991. 4 About one-half of cases of asthma develop before the age of 10 and another one-third before the age of 40. The 2:1 male to female preponderance of asthma in childhood equalizes by age 30. Self-reported prevalence rates for asthma in the United States increased by 75 percent from 1980 to 1994, with the most substantial increase occurring among children aged 0 to 14 years.2 Similar prevalence rates are reported in developed nations throughout the world. 5 During the same period, the estimated annual number of office visits for asthma in the United States more than doubled from 4.6 million to 10.4 million, hospitalization rates increased from 386,000 to 466,000, and mortality rates associated with asthma, which had been decreasing from 1960 through 1962 and again from 1975 through 1977, increased in all race, gender, and age strata.2 Death rates were consistently higher among blacks and among the elderly. The economic implications of asthma are substantial despite advances in treatment. In the United States alone, the estimated direct and indirect cost of asthma in all age groups was 6.2 billion dollars in 1990. 6

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