As of 2011, approximately 235 million people worldwide were affected by asthma,[2] and roughly 250,000 people die per year from asthma-related causes.[3] Low and middle income countries make up more than 80% of the mortality.[4] Rates vary between countries with prevalences between 1 and 18%.[3] It is more common in developed than developing countries.[3] Rates are lower in Asia, Eastern Europe, and Africa.[5] Within developed countries it is more common among those who are economically disadvantaged while in contrast in developing countries it is more common amongst the affluent.[3][6] The reason for these differences is not well known.[3]
While asthma is twice as common in boys as girls,[3] severe asthma occurs at equal rates.[7] Among adults, however, asthma is twice as common in women as men.[7][8]
Increasing frequency
Rates of asthma have increased significantly between the 1960s and 2008 [9][10] with it being recognized as a major public health problem since the 1970s.[5] Some 9% of US children had asthma in 2001, compared with just 3.6% in 1980. The World Health Organization (WHO) reports that some 10% of the Swiss population have asthma as of 2007, compared with 2% some 25–30 years ago.[11] In the United States the age-adjusted prevalence of asthma increased from 7.3 to 8.2 percent during the years 2001 through 2009.[12]
Region specific data
United States
Asthma affects approximately 7% of the population of the United States and causes approximately 4,210 deaths per year.[13][14][15] In 2005, asthma affected more than 22 million people, including 6 million children, and accounted for nearly 500,000 hospitalizations that same year.[16] In 2010, asthma accounted for more than one-quarter of admitted emergency department visits in the U.S. among children aged 1–9 years, and it was a frequent diagnosis among children aged 10–17 years.[17] From 2000 through 2010, the rate of pediatric hospital stays for asthma declined from 165 to 130 per 100,000 population, respectively, whereas the rate for adults remained about 119 per 100,000 population.[18]
Asthma prevalence in the U.S. is higher than in most other countries in the world, but varies drastically between ethnic populations.[19] Asthma prevalence is highest in Puerto Ricans, Latino, African Americans, Filipinos, Irish Americans, and Native Hawaiians, and lowest in Mexicans and Koreans.[20][21][22][23] Rates of asthma-related hospital admissions in 2010 were more than three times higher among African American children and two times higher for African American and Latino adults compared with White and Asian and Pacific Islander people.[18][23] Also, children who are born in low-income families have higher risk of asthma.[24]
Asthma prevalence also differs between populations of the same ethnicity who are born and live in different places.[25] U.S.-born Mexican populations, for example, have higher asthma rates than non-U.S. born Mexican populations that are living in the U.S.[26]
United Kingdom
Asthma affects approximately 5% of the United Kingdom's population.[27] In England, an estimated 261,400 people were newly diagnosed with asthma in 2005; 5.7 million people had an asthma diagnosis and were prescribed 32.6 million asthma-related prescriptions.[28]
Canada
Data depicts an increasing trend in asthma prevalence among Canada's population. In 2000-2001 asthma prevalence was monitored at 6.5%; by 2010-2011 a 4.3% increase was shown, with asthma prevalence totaling 10.8% of Canada's population.[29]
Furthermore, asthma prevalence varies among the provinces of Canada; the highest prevalence is Ontario at 12.1%, and the lowest is Nunavut at 3.8%.[29] Though there is an overall decrease in the incidence of new asthma cases in Canada, prevalence is rising. This can be attributed to a decrease in case-specific mortality due to improved management and control of asthma and its symptoms.
Latin and Central America
It is approximated that 40 million Latin Americans live with asthma.[30]
In some reports, urban residency within Latin America has been found to be associated with an increased prevalence of asthma.[30] Childhood asthma prevalence was found to be higher than 15 percent in a majority of Latin American countries.[31] Similarly, a study published relating to asthma prevalence in Havana, Cuba estimated that approximately 9 percent of children under the age of 15 are undiagnosed for asthma, possible due to lack of resources in the region.[30]
Japan
The prevalence of asthma in adults in Japan is rapidly increasing, however there is a significant difference for the children in Japan. The mean prevalence of asthma in Japan has increased from about 1% to 10% or higher in children and to about 6–10% in adults since the 1960s.[32] There has been a 1.5 fold increase in the prevalence of asthma per decade in Japan from the 1960s.[32] Three surveys done from 1985, 1999 and 2006 show adult asthma is increasing, while the same surveys indicate that the prevalence of asthma in children is decreasing.[33] To compare this to another Asia-Pacific country the estimated prevalence of asthma in male and female children in Mongolia in a 2009 ISSAC study was 20.9% and 21.0%[34]
Asia
Data regarding the epidemiology of asthma in the continent of Asia as whole is scarce, particularly regarding adult populations. However, similarly to much of the rest of the globe, prevalence of childhood asthma appears to be rising. Systematic childhood studies, such as the International Study of Asthma and Allergies in Childhood (ISAAC), provide data regarding the epidemiology of asthma among Asia's youth population. Asthma prevalence among Asia's adult population is less clear in comparison due to the comparatively higher monitoring of younger populations. However, the data available points to a positive correlation between age and asthma prevalence. Findings indicate that the prevalence of asthma among the Asian adult population is less than 5%; while findings pertaining to elderly populations illustrate a rate somewhere between 1.3 and 15.3%.[35]
International migration
In a review of studies on the prevalence of asthma among migrant populations, those born in high-income countries were found to have higher rates of asthma than migrants. Second-generation migrants had a higher risk of asthma than first-generation migrants, and the prevalence of asthma increases with longer time of residence in the host country.[36] This confirms the role of the environment in the development of asthma.
Regional differences
A survey conducted by the ISSAC Steering Committee conducted a study from 1992 to 1993 in adults aged 22 to 44 comparing the prevalence of asthma in 10 developed countries. An important note to consider is the population differences between these countries. The United States population in 1992 was 256.9 million, 14.5 times that of Australia (17.5 mil), and 4.5 times of the United Kingdom (57.51 mil).[37][38][39] However, Australia and the UK have a higher prevalence than the US by 2.4 times on the lower end and 4.6 times on the higher end. In another study taken in 1992 for Japan the prevalence of asthma in Japan was 13%[40] with a population of 124.2 million.[41]
Japan | 05 | 20–44 | 8.1 |
Australia | 92–93 | 20–44 | 28.1 |
Australian Aboriginal person | 90–91 | 20–84 | 11.1 |
UK | 92–93 | 20–44
20–44 |
27.0
30.3 |
Germany | 92–93 | 20–44 | 17.0 |
Spain | 92–93 | 20–44 | 22.0 |
France | 92–93 | 20–44 | 14.4 |
USA | 92–93 | 20–44 | 25.7 |
Italy | 92–93 | 20–44 | 9.5 |
Iceland | 92–93 | 20–44 | 18.0 |
Greece | 92–93 | 20–44 | 16.0 |
Prevalence of asthma (4th column) in 11 different countries
(1st column) between the years 1992 and 1994 (2nd column)
in the ages 20–44 (3rd column) including Japan in 2005
Social determinants
Differences in socioeconomic status has shown disparities among the prevalence of asthma across populations.[42] In the United States, socioeconomic status is associated with race, due to population trends, Black and Hispanic populations are more likely to have asthma, due to higher concentrations in low-income areas. In other areas of the world, the same trend that lower socioeconomic status is related to higher severity of asthma symptoms. Airway reactivity and symptoms for children of low socioeconomic status in Canada tend to be higher than those of higher-income areas.[42] The contrast between residents of rural and suburban areas can be seen in a study of Kenya[43] and Ethiopia,[44] where prevalence of asthma is lower in rural areas, and higher in urban areas. A similar trend can be seen in the United States, where an urban-rural gradient shows the increase in the prevalence of asthma closer to the inner city.[45]
A study published by BMC Pulmonary Medicine shows the relation between those who live in large urban, small urban, and rural areas. Large urban can be classified as the inner-city, and small urban is related to suburban areas. The inner city and rural communities have several commonalities that are important when determining socioeconomic status. They are both more likely to have higher poverty rates, and higher mortality rates, thus having a lower health status than suburban residents.[46] It was found that asthma prevalence in large urban areas was 20.9%, small urban was 21.5%, and rural was 15.1%. However, it is important to acknowledge that rural residents experienced more asthma-like symptoms (wheezing, whistling, and coughing) than those in urban areas, rural residents had 5% more asthma like symptoms.[45] Also, residents in large urban areas were less likely to use medical services for asthma symptoms.[45]
Multiple factors contribute to socioeconomic disparities, income and education, pollutant exposures and allergens are uncontrollable influences on an individual. Stressors related to neighborhood violence and safety, behavioral risk factors, and lack of access to adequate medications and healthcare also contribute to an increased prevalence of asthma. Low income alone accounts for a significant increase in poor asthma outcomes, including severity, lung function, and morbidity rates.[47]
Secondhand smoke is a common exposure for asthmatic children in low-income households. Children who live with at least one smoker are more likely to have asthma than those who don't.[48] People living below the poverty line and with less education have a higher second-hand smoke exposure than those who do not.[49] Also, those with blue-collar jobs are more likely to be exposed at work, as well as those with service jobs (servers and bartenders) are exposed to smoke at businesses that do not have smoking restrictions.
Gender
Globally, there are 136 million women with asthma, 57% of the 235 million people living with asthma. In addition to being more common among women, women experience more severe symptoms and are more likely to die from asthma.[50] The severity and frequency of asthma complications is related to both gender and age. Although asthma is more prevalent and more severe in boys among children, many women experience a significant worsening of symptoms around and after puberty.[51] The timing of the change in prevalence and severity around puberty suggest that asthma pathogenesis is related to sex hormones or hormone levels.
Between 2014-15 and 2019-20 more than 5,100 women in the United Kingdom died from an asthma attack compared with fewer than 2,300 men. Based on emergency hospital admissions in England, among all admissions 20 to 49 years old, women were 2.5 times more likely to be admitted to hospital for asthma treatment compared with men.
Notes
- ↑ "Asthma prevalence". Our World in Data. Retrieved 15 February 2020.
- ↑ "World Health Organization Fact Sheet Fact sheet No 307: Asthma". 2009. Archived from the original on June 29, 2011. Retrieved 2 September 2010.
- 1 2 3 4 5 6 GINA 2011, pp. 2–5
- ↑ World Health Organization. "WHO: Asthma". Archived from the original on 15 December 2007. Retrieved 2007-12-29.
- 1 2 Mason RJ, Broaddus VC, Martin T, King TE, Schraufnagel DE, Murray JF, Nadel JA (2010). Murray and Nadel's textbook of respiratory medicine (5th ed.). Philadelphia, PA: Saunders/Elsevier. pp. Chapter 38. ISBN 978-1416047100.
- ↑ Uphoff, E (2015). "A systematic review of socioeconomic position in relation to asthma and allergic diseases". European Respiratory Journal. 46 (2): 364–374. doi:10.1183/09031936.00114514. PMID 25537562.
- 1 2 Bush A, Menzies-Gow A; Menzies-Gow (December 2009). "Phenotypic differences between pediatric and adult asthma". Proc Am Thorac Soc. 6 (8): 712–9. doi:10.1513/pats.200906-046DP. PMID 20008882.
- ↑ "Testosterone explains why women more prone to asthma". ScienceDaily. May 8, 2017.
- ↑ Grant EN, Wagner R, Weiss KB (August 1999). "Observations on emerging patterns of asthma in our society". J. Allergy Clin. Immunol. 104 (2 Pt 2): S1–9. doi:10.1016/S0091-6749(99)70268-X. PMID 10452783.
- ↑ Anandan C, Nurmatov U, van Schayck OC, Sheikh A (February 2010). "Is the prevalence of asthma declining? Systematic review of epidemiological studies". Allergy. 65 (2): 152–67. doi:10.1111/j.1398-9995.2009.02244.x. PMID 19912154. S2CID 19525219.
- ↑ World Health Organization (2007). Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach (PDF). World Health Organization. pp. 15–20, 49. ISBN 978-92-4-156346-8. Archived from the original on 18 May 2010. Retrieved 2010-05-14.
- ↑ Centers for Disease Control and Prevention (CDC) (May 2011). "Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001--2009". MMWR Morb. Mortal. Wkly. Rep. 60 (17): 547–52. PMID 21544044.
- ↑ Fanta CH (March 2009). "Asthma". New England Journal of Medicine. 360 (10): 1002–14. doi:10.1056/NEJMra0804579. PMID 19264689.
- ↑ Lazarus SC (August 2010). "Clinical practice. Emergency treatment of asthma". N. Engl. J. Med. 363 (8): 755–64. doi:10.1056/NEJMcp1003469. PMID 20818877.
- ↑ Getahun D, Demissie K, Rhoads GG (June 2005). "Recent trends in asthma hospitalization and mortality in the United States". J Asthma. 42 (5): 373–8. doi:10.1081/JAS-62995. PMID 16036412. S2CID 25298857.
- ↑ NHLBI Guideline 2007, p. 1
- ↑ Wier LM, Hao Y, Owens P, Washington R. Overview of Children in the Emergency Department, 2010. HCUP Statistical Brief #157. Agency for Healthcare Research and Quality, Rockville, MD. May 2013. Archived 2013-12-03 at the Wayback Machine
- 1 2 Barrett ML, Wier LM, Washington R (January 2014). "Trends in Pediatric and Adult Hospital Stays for Asthma, 2000-2010". HCUP Statistical Brief #169. Rockville, MD: Agency for Healthcare Research and Quality. PMID 24624462. Archived from the original on 2014-03-28. Retrieved 2014-03-28.
- ↑ Gold DR, Wright R (2005). "Population disparities in asthma". Annu Rev Public Health. 26: 89–113. doi:10.1146/annurev.publhealth.26.021304.144528. PMID 15760282.
- ↑ Lara M, Akinbami L, Flores G, Morgenstern H (January 2006). "Heterogeneity of childhood asthma among Hispanic children: Puerto Rican children bear a disproportionate burden". Pediatrics. 117 (1): 43–53. doi:10.1542/peds.2004-1714. PMID 16396859. S2CID 38317718.
- ↑ Davis AM, Kreutzer R, Lipsett M, King G, Shaikh N (August 2006). "Asthma prevalence in Hispanic and Asian American ethnic subgroups: results from the California Healthy Kids Survey". Pediatrics. 118 (2): e363–70. doi:10.1542/peds.2005-2687. PMID 16882779. S2CID 21651814.
- ↑ Johnson DB, Oyama N, LeMarchand L, Wilkens L (September 2004). "Native Hawaiians mortality, morbidity, and lifestyle: comparing data from 1982, 1990, and 2000". Pac Health Dialog. 11 (2): 120–30. PMID 16281689.
- 1 2 Israel, Elliot; Cardet, Juan-Carlos; Carroll, Jennifer K.; Fuhlbrigge, Anne L.; She, Lilin; Rockhold, Frank W.; Maher, Nancy E.; Fagan, Maureen; Forth, Victoria E.; Yawn, Barbara P.; Hernandez, Paulina Arias (2022-02-26). "Reliever-Triggered Inhaled Glucocorticoid in Black and Latinx Adults with Asthma". New England Journal of Medicine. 386 (16): 1505–1518. doi:10.1056/NEJMoa2118813. PMC 10367430. PMID 35213105. S2CID 247106044.
- ↑ "C-FERST Issue Profile: Childhood Asthma". EPA. 2016-03-30. Retrieved 15 February 2017.
- ↑ Gold DR, Acevedo-Garcia D (July 2005). "Immigration to the United States and acculturation as risk factors for asthma and allergy". J. Allergy Clin. Immunol. 116 (1): 38–41. doi:10.1016/j.jaci.2005.04.033. PMID 15990770.
- ↑ Eldeirawi KM, Persky VW (May 2006). "Associations of acculturation and country of birth with asthma and wheezing in Mexican American youths". J Asthma. 43 (4): 279–86. doi:10.1080/0277090060022869. PMID 16809241. S2CID 29050101.
- ↑ Anderson HR, Gupta R, Strachan DP, Limb ES (January 2007). "50 years of asthma: UK trends from 1955 to 2004". Thorax. 62 (1): 85–90. doi:10.1136/thx.2006.066407. PMC 2111282. PMID 17189533.
- ↑ Simpson CR, Sheikh A (March 2010). "Trends in the epidemiology of asthma in England: a national study of 333,294 patients". J R Soc Med. 103 (3): 98–106. doi:10.1258/jrsm.2009.090348. PMC 3072257. PMID 20200181.
- 1 2 Canada, Public Health Agency of (2018-05-01). "Asthma and Chronic Obstructive Pulmonary Disease (COPD) in Canada, 2018". aem. Retrieved 2018-11-26.
- 1 2 3 Forno E, Gogna M, Cepeda A, Yañez A, Solé D, Cooper P, Avila L, Soto-Quiros M, Castro-Rodriguez JA, Celedón JC (September 2015). "Asthma in Latin America". Thorax. 70 (9): 898–905. doi:10.1136/thoraxjnl-2015-207199. PMC 4593416. PMID 26103996.
- ↑ Mallol J, Solé D, Baeza-Bacab M, Aguirre-Camposano V, Soto-Quiros M, Baena-Cagnani C (August 2010). "Regional variation in asthma symptom prevalence in Latin American children". The Journal of Asthma. 47 (6): 644–50. doi:10.3109/02770901003686480. PMID 20642377. S2CID 23993282.
- 1 2 Ichinose, Masakazu; Sugiura, Hisatoshi; Nagase, Hiroyuki; Yamaguchi, Masao; Inoue, Hiromasa; Sagara, Hironori; Tamaoki, Jun; Tohda, Yuji; Munakata, Mitsuru; Yamauchi, Kohei; Ohta, Ken; Japanese Society of Allergology (2017-04-01). "Japanese guidelines for adult asthma 2017". Allergology International. 66 (2): 163–189. doi:10.1016/j.alit.2016.12.005. ISSN 1323-8930. PMID 28196638.
- ↑ Iwanaga, Takashi; Tohda, Yuji (October 2016). "Epidemiology of asthma in Japan". Nihon Rinsho. Japanese Journal of Clinical Medicine. 74 (10): 1603–1608. ISSN 0047-1852. PMID 30551268.
- ↑ Yoshihara, Shigemi; Munkhbayarlakh, Sonomjants; Makino, Sohei; Ito, Clyde; Logii, Narantsetseg; Dashdemberel, Sarangerel; Sagara, Hironori; Fukuda, Takeshi; Arisaka, Osamu (2016-01-01). "Prevalence of childhood asthma in Ulaanbaatar, Mongolia in 2009". Allergology International. 65 (1): 62–67. doi:10.1016/j.alit.2015.07.009. ISSN 1323-8930. PMID 26666488.
- ↑ Song WJ, Kang MG, Chang YS, Cho SH (April 2014). "Epidemiology of adult asthma in Asia: toward a better understanding". Asia Pacific Allergy. 4 (2): 75–85. doi:10.5415/apallergy.2014.4.2.75. PMC 4005350. PMID 24809012.
- ↑ Cabieses, B (2014). "A Systematic Review on the Development of Asthma and Allergic Diseases in Relation to International Immigration: The Leading Role of the Environment Confirmed". PLOS ONE. 9 (8): e105347. Bibcode:2014PLoSO...9j5347C. doi:10.1371/journal.pone.0105347. PMC 4139367. PMID 25141011.
- ↑ Bureau, US Census. "Statistical Abstract of the United States: 1992". The United States Census Bureau. Retrieved 2020-12-03.
- ↑ "Population, total - Australia | Data". data.worldbank.org. Retrieved 2020-12-03.
- ↑ "Population, total - United Kingdom | Data". data.worldbank.org. Retrieved 2020-12-03.
- ↑ Ichinose, Masakazu; Sugiura, Hisatoshi; Nagase, Hiroyuki; Yamaguchi, Masao; Inoue, Hiromasa; Sagara, Hironori; Tamaoki, Jun; Tohda, Yuji; Munakata, Mitsuru; Yamauchi, Kohei; Ohta, Ken; Japanese Society of Allergology (2017-04-01). "Japanese guidelines for adult asthma 2017". Allergology International. 66 (2): 163–189. doi:10.1016/j.alit.2016.12.005. ISSN 1323-8930. PMID 28196638.
- ↑ "Population, total - United Kingdom, Japan | Data". data.worldbank.org. Retrieved 2020-12-03.
- 1 2 Litonjua, Augusto A.; Carey, Vincent J.; Weiss, Scott T.; Gold, Diane R. (1999). "Race, socioeconomic factors, and area of residence are associated with asthma prevalence". Pediatric Pulmonology. 28 (6): 394–401. doi:10.1002/(SICI)1099-0496(199912)28:6<394::AID-PPUL2>3.0.CO;2-6. ISSN 1099-0496. PMID 10587412. S2CID 43744145.
- ↑ Odhiambo, J.A.; Ng'ang'a, L.W.; Mungai, M.W.; Gicheha, C.M.; Nyamwaya, J.K.; Karimi, F.; MacKlem, P.T.; Becklake, M.R. (1998-11-01). "Urban–rural differences in questionnaire-derived markers of asthma in Kenyan school children". European Respiratory Journal. 12 (5): 1105–1112. doi:10.1183/09031936.98.12051105. ISSN 0000-0000. PMID 9864005.
- ↑ Yemaneberhan, Haile; Bekele, Zegaye; Venn, Andrea; Lewis, Sarah; Parry, Eldryd; Britton, John (July 1997). "Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia". The Lancet. 350 (9071): 85–90. doi:10.1016/s0140-6736(97)01151-3. ISSN 0140-6736. PMID 9228959. S2CID 36933263.
- 1 2 3 Lawson, Joshua A.; Rennie, Donna C.; Cockcroft, Don W.; Dyck, Roland; Afanasieva, Anna; Oluwole, Oluwafemi; Afsana, Jinnat (2017-01-05). "Childhood asthma, asthma severity indicators, and related conditions along an urban-rural gradient: a cross-sectional study". BMC Pulmonary Medicine. 17 (1): 4. doi:10.1186/s12890-016-0355-5. ISSN 1471-2466. PMC 5216545. PMID 28056923.
- ↑ Blumenthal, Susan J.; Kagen, Jessica (2002-01-02). "The Effects of Socioeconomic Status on Health in Rural and Urban America". JAMA. 287 (1): 109. doi:10.1001/jama.287.1.109-JMS0102-3-1. ISSN 0098-7484.
- ↑ Cardet, Juan Carlos; Louisias, Margee; King, Tonya S.; Castro, Mario; Codispoti, Christopher D.; Dunn, Ryan; Engle, Linda; Giles, B. Louise; Holguin, Fernando; Lima, John J.; Long, Dayna (February 2018). "Income is an independent risk factor for worse asthma outcomes". Journal of Allergy and Clinical Immunology. 141 (2): 754–760.e3. doi:10.1016/j.jaci.2017.04.036. PMC 5696111. PMID 28535964.
- ↑ Ciaccio, Christina E.; DiDonna, Anita; Kennedy, Kevin; Barnes, Charles S.; Portnoy, Jay M.; Rosenwasser, Lanny J. (2014-11-01). "Secondhand tobacco smoke exposure in low-income children and its association with asthma". Allergy and Asthma Proceedings. 35 (6): 462–466. doi:10.2500/aap.2014.35.3788. ISSN 1088-5412. PMC 4210654. PMID 25584913.
- ↑ CDCTobaccoFree (2021-04-23). "Cigarette and Tobacco Use Among People of Low Socioeconomic Status". Centers for Disease Control and Prevention. Retrieved 2021-12-02.
- ↑ "Asthma and Lung UK report - Asthma is worse for women (27 April 2022)". Patient Safety Learning - the hub. 27 April 2022. Retrieved 2022-05-12.
- ↑ Shah, Ruchi; Newcomb, Dawn C. (2018). "Sex Bias in Asthma Prevalence and Pathogenesis". Frontiers in Immunology. 9: 2997. doi:10.3389/fimmu.2018.02997. ISSN 1664-3224. PMC 6305471. PMID 30619350.
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