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Respiratory Diseases Data Details

RD-1 Reduce asthma deaths

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 1,000,000 
Baseline (Year)
3.4 (2007)
Target-Setting Method
This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
Numerator
Number of asthma deaths (ICD-10 codes J45-J46) among persons under age 35 years
Denominator
Number of persons under age 35 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Deaths due to asthma (ICD-10 codes J45-J46).

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Trend Issues
Mortality data by marital status were not available for 60% of Georgia’s records in 2008 and 94% of Georgia’s records in 2009. Therefore, 2008 and 2009 data by marital status should be interpreted with caution.
Changes Between HP2010 and HP2020
This objective combines the age groups tracked by three Healthy People 2010 asthma deaths objectives: persons under age 5 years (objective 24-1a), 5–14 years (objective 24-1b), and 15–34 year (objective 24-1c) into one age group for persons under age 35 years.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. However, the baseline estimate for the total population did not change so the target remained the same. Some baseline estimates for population subgroups were revised.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 1,000,000 
Baseline (Year)
11.0 (2007)
Target
4.9
Target-Setting Method
Projection/trend analysis
Numerator
Number of asthma deaths (ICD-10 codes J45-J46) among persons aged 35 to 64 years
Denominator
Number of persons aged 35 to 64 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Deaths due to asthma (ICD-10 codes J45-J46).

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Trend Issues
Mortality data by marital status were not available for 60% of Georgia’s records in 2008 and 94% of Georgia’s records in 2009. Therefore, 2008 and 2009 data by marital status should be interpreted with caution.
Target Calculation Methods
Linear regression was used to estimate the Healthy People 2020 target based on 1999-2007 trend data from the NVSS-M. The Healthy People 2020 baseline year is 2007 and the target was derived by calculating the expected rate a decade later.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. The target was adjusted from 6.0 to 4.9 deaths per million adults aged 35 to 64 years using the original target-setting method. Although the baseline estimate for the total population did not change, some baseline estimates for population subgroups were revised.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 1,000,000 
Baseline (Year)
43.4 (2007)
Target
21.5
Target-Setting Method
Projection/trend analysis
Numerator
Number of asthma deaths (ICD-10 codes J45-J46) among persons aged 65 years and over
Denominator
Number of persons aged 65 years and over
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Deaths due to asthma (ICD-10 codes J45-J46).

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Trend Issues
Mortality data by marital status were not available for 60% of Georgia’s records in 2008 and 94% of Georgia’s records in 2009. Therefore, 2008 and 2009 data by marital status should be interpreted with caution.
Target Calculation Methods
The average annual percent change for the period from 1999 to 2007 was 4.7 percent of the baseline rate (43.3 per million population aged 65 years and over). Applying a 4.7 percent decrease to each successive year from 2008 to 2017 resulted in a target value of 22.9 deaths per million population for this age group.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. Thus, the original baseline was revised from 43.3 to 43.4 deaths per million adults aged 65 years and over. The target was adjusted from 22.9 to 21.5 deaths per million to reflect the revised baseline using the original target-setting method.

RD-2 Reduce hospitalizations for asthma

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Discharge Survey (NHDS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 10,000 
Baseline (Year)
41.4 (2007)
Target
18.2
Target-Setting Method
Minimal statistical significance
Numerator
Number of discharges with a principal diagnosis of asthma (ICD-9-CM code 493) among children under age 5 years
Denominator
Number of children under age 5 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Principal diagnosis is the diagnosis chiefly responsible for admission of the person to the hospital.

FOR SINGLE DATA YEARS: Hospital discharge rates are calculated using the July 1 estimates of the civilian population from the Vintage matching the data year for the postcensal period based on the 2000 census. For example, July 1, 2007 civilian population for rates of data year 2007, the 2007 estimates from Vintage 2007 are used as the denominator for 2007 rates. Rates for 2010 are also calculated using the July 1 estimates based on the 2000 census.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the target was revised from 18.1 to 18.2 hospitalizations for asthma per 10,000 children under age 5 years due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Discharge Survey (NHDS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 10,000 (age adjusted—see Comments)
Baseline (Year)
11.1 (2007)
Target
8.7
Target-Setting Method
Minimal statistical significance
Numerator
Number of discharges with a principal diagnosis of asthma (ICD-9-CM code 493) among persons aged 5 to 64 years
Denominator
Number of persons aged 5 to 64 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Principal diagnosis is the diagnosis chiefly responsible for admission of the person to the hospital.

FOR SINGLE DATA YEARS: Hospital discharge rates are calculated using the July 1 estimates of the civilian population from the Vintage matching the data year for the postcensal period based on the 2000 census. For example, July 1, 2007 civilian population for rates of data year 2007, the 2007 estimates from Vintage 2007 are used as the denominator for 2007 rates. Rates for 2010 are also calculated using the July 1 estimates based on the 2000 census.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 5-17, 18-44, 45-64
  • Sex: 5-17, 18-44, 45-64
  • Race/Ethnicity: 5-17, 18-44, 45-64
  • Geographic Region: 5-17, 18-44, 45-64
  • Health Insurance Status: 5-17, 18-44, 45-64
  • Marital Status: 15-17, 18-44, 45-64

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the target was revised from 8.6 to 8.7 hospitalizations for asthma per 10,000 children and adults aged 5 to 64 years due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Discharge Survey (NHDS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 10,000 (age adjusted—see Comments)
Baseline (Year)
25.3 (2007)
Target
20.1
Target-Setting Method
Minimal statistical significance
Numerator
Number of discharges with a principal diagnosis of asthma (ICD-9-CM code 493) among persons aged 65 years and over
Denominator
Number of persons aged 65 years and over
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Principal diagnosis is the diagnosis chiefly responsible for admission of the person to the hospital.

FOR SINGLE DATA YEARS: Hospital discharge rates are calculated using the July 1 estimates of the civilian population from the Vintage matching the data year for the postcensal period based on the 2000 census. For example, July 1, 2007 civilian population for rates of data year 2007, the 2007 estimates from Vintage 2007 are used as the denominator for 2007 rates. Rates for 2010 are also calculated using the July 1 estimates based on the 2000 census.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 65-74, 75+
  • Sex: 65-74, 75+
  • Race/Ethnicity: 65-74, 75+
  • Geographic Region: 65-74, 75+
  • Marital Status: 65-74, 75+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the target was revised from 20.3 to 20.1 hosptializations per 10,000 adults aged 65 years and over due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

RD-3 Reduce emergency department (ED) visits for asthma

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Ambulatory Medical Care Survey (NHAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 10,000 
Baseline (Year)
132.8 (2005-2007)
Target
95.7
Target-Setting Method
Minimal statistical significance
Numerator
Number of visits to an emergency department with a first-listed diagnosis of asthma (ICD-9-CM code 493) among children under age 5 years
Denominator
Number of children under age 5 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

FOR MULTIPLE DATA YEARS: Emergency department visit rates are calculated based on sum of July 1 estimates of the civilian noninstitutionalized populations for each of the data years involved (e.g., the denominator of a rate for 2005-2007 combined is the sum of the population estimates for 2005, 2006, and 2007). The population estimates are from the Vintage matching the data year for the postcensal period based on the 2000 census (e.g., July 1, 2005 civilian noninstitutionalized population estimates from Vintage 2005). July 1, 2010 population estimates based on the 2000 census are used for 2010.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2011, the original baseline was revised from 132.7 to 132.8 asthma ED visits per 10,000 children under age 5 years due to a revised programming error. The target was adjusted from 95.5 to 95.6 asthma ED visits per 10,000 to reflect the revised baseline using the original target-setting method. In 2013, the target was revised a second time from 95.6 to 95.7 asthma ED visits per 10,000 due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Ambulatory Medical Care Survey (NHAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 10,000 
Baseline (Year)
57.0 (2005-2007)
Target
49.6
Target-Setting Method
Minimal statistical significance
Numerator
Number of visits to an emergency department with a first-listed diagnosis of asthma (ICD-9-CM code 493) among persons aged 5 to 64 years
Denominator
Number of persons aged 5 to 64 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

FOR MULTIPLE DATA YEARS: Emergency department visit rates are calculated based on sum of July 1 estimates of the civilian noninstitutionalized populations for each of the data years involved (e.g., the denominator of a rate for 2005-2007 combined is the sum of the population estimates for 2005, 2006, and 2007). The population estimates are from the Vintage matching the data year for the postcensal period based on the 2000 census (e.g., July 1, 2005 civilian noninstitutionalized population estimates from Vintage 2005). July 1, 2010 population estimates based on the 2000 census are used for 2010.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2011, the original baseline was revised from 56.4 to 57.0 asthma ED visits per 10,000 children and adults aged 5 to 64 years due to a revised programming error. The target was adjusted from 49.1 to 49.7 asthma ED visits per 10,000 to reflect the revised baseline using the original target-setting method. In 2013, the target was revised a second time from 49.7 to 49.6 asthma ED visits per 10,000 due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Ambulatory Medical Care Survey (NHAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 10,000 
Baseline (Year)
21.9 (2005-2007)
Target
13.7
Target-Setting Method
Minimal statistical significance
Numerator
Number of visits to an emergency department with a first-listed diagnosis of asthma (ICD-9-CM code 493) among persons aged 65 years and over
Denominator
Number of persons aged 65 years and over
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

FOR MULTIPLE DATA YEARS: Emergency department visit rates are calculated based on sum of July 1 estimates of the civilian noninstitutionalized populations for each of the data years involved (e.g., the denominator of a rate for 2005-2007 combined is the sum of the population estimates for 2005, 2006, and 2007). The population estimates are from the Vintage matching the data year for the postcensal period based on the 2000 census (e.g., July 1, 2005 civilian noninstitutionalized population estimates from Vintage 2005). July 1, 2010 population estimates based on the 2000 census are used for 2010.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2011, the original baseline was revised from 21.0 to 21.9 athma visits per 10,000 adults aged 65 years and over due to a revised programming error. The target was adjusted from 13.2 to 13.8 asthma visits per 10,000 to reflect the revised baseline using the original target-setting method. In 2013, the target was revised a second time from 13.8 to 13.7 asthma visits per 10,000 due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent (age adjusted—see Comments)
Baseline (Year)
12.7 (2008)
Target
10.3
Target-Setting Method
Minimal statistical significance
Numerator
Number of persons who report having ‘current’ asthma and activity limitation due to a respiratory problem
Denominator
Number of persons who report having ‘current’ asthma
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey:

[NUMERATOR:]

For persons under age 18 years:

What conditions or health problems cause [PERSON] limitations?

  • Positive response: Asthma/breathing problem.

For persons aged 18 years and over:

What condition or health problem causes you to to have difficulty with these activities?

  • Positive response: Lung/breathing problem (e.g. asthma, emphysema).

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Persons are classified as having an activity limitation if they responded that lung/breathing problems caused limitations.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the target was revised from 10.2 to 10.3 percent due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

RD-5 Reduce the proportion of persons with asthma who miss school or work days

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
58.7 (2008)
Target
48.8
Target-Setting Method
Minimal statistical significance
Numerator
Number of children aged 5 to 17 who missed school days among those who report an episode of asthma or an asthma attack in the past year
Denominator
Number of children aged 5 to 17 years who report having an asthma attack in the past year
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

DURING THE PAST 12 MONTHS, that is since {12 month ref. date}, HOW MANY DAYS of {daycare or preschool/school/school or work} did [CHILD] miss because of {his/her} asthma?

  1. ______ Days
  2. Child was home schooled
  3. Child did not go to day care, preschool, school, or work
  4. Refused
  5. Don’t know

[NUMERATOR AND DENOMINATOR:]

DURING THE PAST 12 MONTHS, has [CHILD] had an episode of asthma or an asthma attack?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Persons are classified as having missed school if they responded “1-365” to the question about number of days missed.

Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 24-05 in that objective 24-05 was divided into separate objectives for children (RD-5.1) and adults (RD-5.2). The definition was modified from the average number of school or work days lost due to asthma to the percentage of persons who miss school days (RD-5.1) or work days (RD-5.2) due to asthma.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the target was revised from 48.7 to 48.8 percent due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
33.2 (2008)
Target
26.7
Target-Setting Method
Minimal statistical significance
Numerator
Number of adults aged 18 to 64 years who missed work among those who report an episode of asthma or an asthma attack in the past year
Denominator
Number of adults aged 18 to 64 years who report having an asthma attack in the past year
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

DURING THE PAST 12 MONTHS, HOW MANY DAYS were you UNABLE to work because of your asthma?

  1. ______ Days
  2. Unable to do this activity
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

During the PAST 12 MONTHS, have you had an episode of asthma or an asthma attack?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Persons are classified as having missed work if they responded “1-365” to the question about number of days missed.

Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 24-05 in that objective 24-05 was divided into separate objectives for children (RD-5.1) and adults (RD-5.2). The definition was modified from the average number of school or work days lost due to asthma to the percentage of persons who miss school days (RD-5.1) or work days (RD-5.2) due to asthma.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the target was revised from 26.8 to 26.7 percent due to asthma due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent (age adjusted—see Comments)
Baseline (Year)
12.1 (2008)
Target
14.5
Target-Setting Method
Minimal statistical significance
Numerator
Number of persons who report having current asthma and have ever taken a course or class on how to manage their asthma
Denominator
Number of persons who report having current asthma
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

For persons under age 18 years:

Has [PERSON] EVER taken a course or class on how to manage [his/her] asthma?
*Include adult(s) who took a course for the child's asthma.

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you ever taken a course or class on how to manage asthma yourself?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Persons are classified as having received formal education on asthma if they reported taking a course or class on self- management. This includes adults who took a course for a child.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Disability Status: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the target was revised from 14.4 to 14.5 percent due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

RD-7 Increase the proportion of persons with current asthma who receive appropriate asthma care according to National Asthma Education and Prevention Program (NAEPP) guidelines

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
33.4 (2008)
Target
36.8
Target-Setting Method
Minimal statistical significance
Numerator
Number of persons who report having current asthma and who received asthma management plans from their health care provider
Denominator
Number of persons who report having current asthma
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER given [PERSON] an asthma management plan?

  1. Yes
  2. No
  3. Don't know
  4. Refused

For persons aged 18 years and over:

Has a doctor or other health professional EVER given you an asthma management plan?

  1. Yes
  2. No
  3. Don't know
  4. Refused

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Don't know
  4. Refused

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Don't know
  4. Refused

For persons aged 18 years and over:

Have you EVER been told by a doctor or other health professional that you have asthma?

  1. Yes
  2. No
  3. Don't know
  4. Refused

Do you still have asthma?

  1. Yes
  2. No
  3. Don't know
  4. Refused
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Persons are classified as having received a written asthma management plan if they responded “yes” to the question on receiving a management plan listed under Numerator.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Disability Status: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
95.9 (2008)
Target
Not applicable
Target-Setting Method
This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
Numerator
Number of persons with current asthma who report receiving instruction on how to use the inhaler properly
Denominator
Number of persons with current asthma who report ever having used a prescription inhaler
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

For persons under age 18 years:

Has a health professional shown [PERSON] how to use [his/her] inhaler? (This includes showing parents for their young children.)

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Has a health professional shown you how to use your inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has [PERSON] EVER used a PRESCRIPTION inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you ever used a PRESCRIPTION inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Persons are classified as having received proper-use instructions with prescribed inhalers if they responded “yes” to the question on inhaler instruction by a medical professional as listed under Numerator.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Disability Status: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
64.8 (2008)
Target
68.5
Target-Setting Method
Minimal statistical significance
Numerator
Number of persons who report having received education on how to respond to an asthma episode, and either how to recognize early signs and symptoms or how to monitor peak flow
Denominator
Number of persons who report having current asthma
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER taught [PERSON] or his/her parent or guardian:

How to recognize early signs or symptoms of an asthma episode?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

How to respond to episodes of asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

How to monitor peak flow for daily therapy?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Has a doctor or other health professional ever taught you:

How to recognize early signs or symptoms of an asthma episode?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

How to respond to episodes of asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

How to monitor peak flow for daily therapy?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Persons are classified as having education on early signs, symptoms and response to asthma episodes if they responded “yes” to being taught how to respond to an episode of asthma and either how to recognize early signs and symptoms of an asthma episode or how to monitor peak flow.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Disability Status: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
87.9 (2008)
Target
90.2
Target-Setting Method
Minimal statistical significance
Numerator
Number of persons with current asthma who do not use quick relief inhalers or who used less than three canisters in the past three months
Denominator
Number of persons who report having current asthma
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

For persons under age 18 years:

Has [PERSON] EVER used a PRESCRIPTION inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

DURING THE PAST 3 MONTHS, has [PERSON] used the kind of PRESCRIPTION inhaler THAT YOU BREATHE IN THROUGH YOUR MOUTH, that gives QUICK relief from asthma symptoms?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

DURING THE PAST 3 MONTHS did [PERSON] use more than three canisters of this type of inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you ever used a PRESCRIPTION inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

DURING THE PAST 3 MONTHS, have you used the kind of PRESCRIPTION inhaler THAT YOU BREATHE IN THROUGH YOUR MOUTH, that gives QUICK relief from asthma symptoms?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

DURING THE PAST 3 MONTHS did you use more than three canisters of this type of inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Persons are classified as having received medication regimens that prevent the need for more than one canister of short-acting inhaled beta agonists per month for relief of asthma if they responded ’no’ to using any inhaled quick relief medication or ‘no’ to using more than three canisters of quick relief inhalers in the past three months.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Disability Status: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent (age adjusted—see Comments)
Baseline (Year)
50.8 (2008)
Target
54.6
Target-Setting Method
Minimal statistical significance
Numerator
Number of persons who report current asthma who report having been advised to change things at home, school, or work to improve their asthma
Denominator
Number of persons who report current asthma
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER advised you to change things in [PERSON's] home, school, or work to improve [his/her] asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Has a doctor or other health professional EVER advised you to change things in your home, school, or work to improve your asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Persons are classified as having received assistance with assessing and reducing exposure to environmental risk factors in their home, school, and work environments if they responded “yes” to the questions listed under Numerator.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Disability Status: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the target was revised from 54.5 to 54.6 percent due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Numerator
Number of persons who report current asthma who report having at least one routine medical follow-up visit in the past 12 months
Denominator
Number of persons who report current asthma
Questions Used to Obtain the National Baseline Data

From the 2013 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

For persons under age 18 years:

During the past 12 months, how many times did [PERSON] see a doctor or other health professional for a routine checkup for [PERSON’s] asthma? Please do not include emergency room visits, visits to urgent care centers, or other visits for acute care for an asthma episode or attack.

  1. 0 times
  2. 1-365 times
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

During the past 12 months, how many times did you see a doctor or other health professional for a routine checkup for your asthma? Please do not include emergency room visits, visits to urgent care centers, or other visits for acute care for an asthma episode or attack.

  1. 0 times
  2. 1-365 times
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Persons are classified as having at least one routine medical follow-up visit in the past 12 months if they responded “1-365 times” to the question listed under Numerator.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Disability Status: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Numerator
Number of persons whose doctor assessed their asthma control in the past 12 months
Denominator
Number of persons who report current asthma
Questions Used to Obtain the National Baseline Data

From the 2013 National Health Interview Survey Asthma Supplement:

[NUMERATOR:]

For persons under age 18 years:

The next three questions are about the last time [PERSON] saw a doctor or other health care professional for routine care or for any reason.

At his/her last visit, did [PERSON]'s doctor or other health professional ask how often….[PERSON] had asthma symptoms?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

At his/her last visit, did [PERSON]’s doctor or other health professional ask how often….[PERSON] used a quick relief inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

At his/her last visit, did [PERSON]’s doctor or other health professional ask how often….asthma symptoms limited [PERSON] daily activities?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

The next three questions are about the last time you saw a doctor or other health care professional for routine care or for any reason.

At your last visit, did your doctor or other health professional ask how often….you had asthma symptoms?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

At your last visit, did your doctor or other health professional ask how often….you used a quick relief inhaler?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

At your last visit, did your doctor or other health professional ask how often….asthma symptoms limited your daily activities?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

For persons under age 18 years:

Has a doctor or other health professional EVER told you that [PERSON] had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Does [PERSON] still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

For persons aged 18 years and over:

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Persons are classified as having had their doctor assess their asthma control in the past 12 months if they responded “yes” to all three questions listed under Numerator.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Sex: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Race/Ethnicity: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Educational Attainment: 25-44, 45-54, 55-64, 65-74, 75+
  • Family Income: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Family Type: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Country of Birth: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Disability Status: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Geographic Location: <18, 18-44, 45-54, 55-64, 65-74, 75+
  • Health Insurance Status: <18, 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55-64, 65-74, 75+

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent (age adjusted—see Comments)
Baseline (Year)
14.4 (2010)
Target
17.9
Target-Setting Method
Minimal statistical significance
Numerator
Number of persons age 18 and over with current asthma who are currently employed or who were employed at some time in the past 12 months and who have discussed with a doctor or other health professional whether their asthma was work-related
Denominator
Number of persons age 18 and over with current asthma who are currently employed or employed at some time in the past 12 months
Questions Used to Obtain the National Baseline Data

From the 2010 National Health Interview Survey Occupational Health Supplement:

[NUMERATOR:]

Have you been told by a doctor or other health professional that your asthma [fill: was probably caused by your work/was probably made worse by your work/was ever made worse by any job you have ever had]?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Did YOU ever discuss with a doctor or other health professional whether your asthma [fill: was probably caused by your work/was probably made worse by your work/was ever made worse by any job you have ever had]?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

[NUMERATOR AND DENOMINATOR:]

Although you did not work last week, did you have a job or business at any time in the PAST 12 MONTHS?

  1. Had job last week
  2. Yes
  3. No
  4. Refused
  5. Don’t know

Have you EVER been told by a doctor or other health professional that you had asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

Do you still have asthma?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Persons are classified as having discussed with a doctor or other health professional whether their asthma was work-related if they responded “yes” to either question listed under Numerator. The doctor may have discussed work-related asthma with the respondent but ruled it out, or the doctor may have told the respondent that their asthma was probably work-related. Both situations indicate that the topic was addressed.

Assessing whether a person's asthma might be work-related is only appropriate if the person is currently employed or was recently employed. Persons are classified as currently employed or employed at some time in the past 12 months if they reported having a job in the previous week or if they responded “yes” to the employment question listed under Numerator and Denominator.

To maintain consistency with the Council of State and Territorial Epidemiologists (CSTE), the case definition for asthma is based on ‘current’ asthma (yes to ‘ever asthma’ and yes to ‘still asthma’).

Updated clinical treatment guidelines for asthma were released in 2007. The NHLBI guidelines retain this recommendation: “The expert panel recommends that clinicians query patients who are employed and have asthma about possible occupational exposures, particularly those who have new-onset disease.”

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 18-44, 45-54, 55+
  • Sex: 18-44, 45-54, 55+
  • Race/Ethnicity: 18-44, 45-54, 55+
  • Educational Attainment: 25-44, 45-54, 55+
  • Family Income: 18-44, 45-54, 55+
  • Family Type: 18-44, 45-54, 55+
  • Country of Birth: 18-44, 45-54, 55+
  • Disability Status: 18-44, 45-54, 55+
  • Geographic Location: 18-44, 45-54, 55+
  • Health Insurance Status: 18-44, 45-54, 55-64
  • Marital Status: 18-44, 45-54, 55+
Target Calculation Methods
The target is the smallest improvement that results in a statistically significant difference (at the 0.05 level of significance) when tested against the baseline value, assuming the same standard error for the target as the baseline.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, this objective became measureable.

References

Additional resources about the objective.

  1. Balmes J, Becklake M, Blanc P, Henneberger P, Kreiss K, Mapp C, Milton D, Schwartz D, Toren K, Viegi G. American Thoracic Society Statement: Occupational contribution to the burden of airway disease. Am J Respir Crit Care Med. 2003;167(5):787-97.
  2. Breton CV, Zhang Z, Hunt PR, Pechter E, Davis L. Characteristics of work related asthma: results from a population based survey. Occup Environ Med. 2006;63(6):411-5.
  3. Henneberger PK, Derk SJ, Sama SR, Boylstein RJ, Hoffman CD, Preusse PA, Rosiello RA, Milton DK. The frequency of workplace exacerbation among health maintenance organization members with asthma. Occup Environ Med. 2006;63(8):551-7.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Asthma Control Program; Centers for Disease Control and Prevention, National Center for Environmental Health (CDC/NCEH)
Changed Since the Healthy People 2020 Launch
No
Measure
number 
Baseline (Year)
43 (2009)
Target
47
Target-Setting Method
10 percent improvement
Numerator
Number of states (including the District of Columbia) and territories that have a system for tracking asthma cases, illness, and disability
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

A system for tracking asthma cases, illness, and disability is defined as: (1) a funding award from the National Asthma Control Program; (2) a funding award from the Environmental Public Health Tracking Program; or (3) implementation of the Asthma call back survey. The ACB is a comprehensive asthma specific survey conducted among respondents with a history of doctor diagnosed asthma who are identified during the Behavioral Risk Factor Survey.

Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 24-08 in that the count of geographic areas with asthma surveillance systems was expanded to include US territories in addition to states, and the definition was modified to include recipients of either of two funding sources that require asthma surveillance in addition to states and territories participating in a detailed asthma survey.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
No
Measure
percent (age adjusted—see Comments)
Baseline (Year)
23.2 (2008)
Target
18.7
Target-Setting Method
Minimal statistical significance
Numerator
Number of persons 45 years and over who report having emphysema or chronic bronchitis and currently experience an activity limitation due to a respiratory problem
Denominator
Number of persons 45 years and over who report having emphysema or chronic bronchitis
Questions Used to Obtain the National Baseline Data

From the 2008 National Health Interview Survey:

[NUMERATOR:]

What condition or health problem causes you to have difficulty with these activities?

  • Positive response: Lung/breathing problem (e.g. asthma, emphysema).

[NUMERATOR AND DENOMINATOR:]

Have you EVER been told by a doctor or other health professional that you had emphysema?

  1. Yes
  2. No
  3. Refused
  4. Don’t know

DURING THE PAST 12 MONTHS, have you been told by a doctor or other health professional that you had Chronic bronchitis?

  1. Yes
  2. No
  3. Refused
  4. Don’t know
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Persons are classified as having an activity limitation if they responded that lung/breathing problems caused limitations.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 45-49, 50-64, 65+
  • Sex: 45-49, 50-64, 65+
  • Race/Ethnicity: 45-49, 50-64, 65+
  • Educational Attainment: 45-49, 50-64, 65+
  • Family Income: 45-49, 50-64, 65+
  • Family Type: 45-49, 50-64, 65+
  • Country of Birth: 45-49, 50-64, 65+
  • Geographic Location: 45-49, 50-64, 65+
  • Health Insurance Status: 45-49, 50-64
  • Marital Status: 45-49, 50-64, 65+
Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 24-09 in that the denominator was modified from adults aged 45 years and over who report current activity limitations to adults aged 45 years and over report ever having emphysema or chronic bronchitis.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 (age adjusted—see Comments)
Baseline (Year)
113.9 (2007)
Target
102.6
Target-Setting Method
Projection/trend analysis
Numerator
Number of COPD deaths (ICD-10 codes J40-J44, and excludes asthma) among persons aged 45 years and over
Denominator
Number of persons aged 45 years and over
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Deaths due to COPD (ICD 10 codes J40-J44, and excludes asthma).

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 45-54, 55-64, 65-74, 75-84, 85+
  • Sex: 45-54, 55-64, 65-74, 75-84, 85+
  • Race/Ethnicity: 45-54, 55-64, 65-74, 75-84, 85+
  • Country of Birth: 45-54, 55-64, 65-74, 75+
  • Geographic Location: 45-54, 55-64, 65-74, 75-84, 85+
  • Marital Status: 45-54, 55-64, 65-74, 75+
Trend Issues
Mortality data by marital status were not available for 60% of Georgia’s records in 2008 and 94% of Georgia’s records in 2009. Therefore, 2008 and 2009 data by marital status should be interpreted with caution.
Target Calculation Methods
Linear regression was used to estimate the Healthy People 2020 target based on 1999-2007 trend data from the NVSS-M. The Healthy People 2020 baseline year is 2007 and the target was derived by calculating the expected rate a decade later.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. Thus, the original baseline was revised from 112.4 to 113.9 deaths per 100,000 adults aged 45 years and over. The target was adjusted from 98.5 to 102.6 deaths per 100,000 to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Discharge Survey (NHDS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
No
Measure
per 10,000 (age adjusted—see Comments)
Baseline (Year)
56.0 (2007)
Target
50.1
Target-Setting Method
Minimal statistical significance
Numerator
Number of hospital discharges with a principal diagnosis of COPD (ICD-9-CM codes 490-492, 496) among adults aged 45 years and over
Denominator
Number of adults aged 45 years and over
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Principal diagnosis is the diagnosis chiefly responsible for admission of the person to the hospital.

FOR SINGLE DATA YEARS: Hospital discharge rates are calculated using the July 1 estimates of the civilian population from the Vintage matching the data year for the postcensal period based on the 2000 census. For example, July 1, 2007 civilian population for rates of data year 2007, the 2007 estimates from Vintage 2007 are used as the denominator for 2007 rates. Rates for 2010 are also calculated using the July 1 estimates based on the 2000 census.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 45-64, 65-74, 75+
  • Sex: 45-64, 65-74, 75+
  • Race/Ethnicity: 45-64, 65-74, 75+
  • Geographic Region: 45-64, 65-74, 75+
  • Marital Status: 45-64, 65-74, 75+

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Ambulatory Medical Care Survey (NHAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 10,000 (age adjusted—see Comments)
Baseline (Year)
81.7 (2007)
Target
56.8
Target-Setting Method
Minimal statistical significance
Numerator
Number of hospital emergency department visits with a first listed diagnosis of COPD (ICD-9-CM codes 490-492, 496) among adults aged 45 years and over
Denominator
Number of adults aged 45 years and over
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

FOR SINGLE DATA YEARS: Emergency department visit rates are calculated using the July 1 estimates of the civilian noninstitutionalized population from the Vintage matching the data year for the postcensal period based on the 2000 census. For example, July 1, 2007 civilian noninstitutionalized population estimates from Vintage 2007 are used as the denominator for 2007 rates. Rates for 2010 are also calculated using the July 1 estimates based on the 2000 census.

Age Adjustment

This Indicator uses Age-Adjustment Groups:

  • Total: 45-64, 65-74, 75+
  • Sex: 45-64, 65-74, 75+
  • Race/Ethnicity: 45-64, 65-74, 75+
  • Geographic Location: 45-64, 65-74, 75+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2011, the original baseline was revised from 79.6 to 81.7 COPD ED visits per 10,000 adults aged 45 years and over due to a revised programming error. The target was adjusted from 55.2 to 57.3 COPD ED visits per 10,000 to reflect the revised baseline using the original target-setting method. In 2013, the target was revised a second time from 57.3 to 56.8 COPD ED visits per 10,000 persons aged 45 years and over due to a change in the rounding rules for target calculations of Minimal Statistical Significance.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
*** Missing *** 
Numerator
Number of adults 45 to 79 years of age with lung function below the lower limit of normal who have ever been diagnosed with emphysema or are still diagnosed with chronic bronchitis
Denominator
Number of adults 45 to 79 years of age with lung function below the lower limit of normal
Questions Used to Obtain the National Baseline Data

From the 2007-2008 National Health and Nutrition Examination Survey:

[NUMERATOR:]

Has a doctor or other health professional ever told {you/[PERSON]} that [you/s/he]

  • had emphysema
  • had chronic bronchitis?

{Do you/Does [PERSON]} still have chronic bronchitis?

Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Abnormal lung function is based on a (FEV/FVC) percent less than or equal to 70 in spirometric testing. Participants perform the spirometry test using a spirometer, a device that measures the amount of air a subject exhales and the rate at which he or she exhales the air. The basic standard spirometric test requires the subject to exhale as forcefully as possible after taking in a full, deep breath. Forced Vital Capacity (FVC) is the maximum volume of air exhaled forcefully after a maximal inspiration. Forced Expiratory Volume in One Second (FEV1) is the volume of air exhaled during the first second of a forced expiratory maneuver. Normally, a healthy person can be expected to exhale from 70 to 80 percent of the FVC in the first second of a forced expiration maneuver. In the current NHANES spirometry study, the primary measurement used to assess obstructive lung disorders will be the ratio of forced expiratory volume in 1 second to forced vital capacity expressed as a percentage, or FEV1/FVC%.

Adults who report being diagnosed with asthma but not emphysema or chronic bronchitis are excluded from this measure based on the definitions of COPD from the American Thoracic Society COPD Guidelines. These guidelines state that asthma differs from COPD in its pathogenic and therapeutic response and should therefore be considered a different clinical entity. However, these guidelines also recognize that COPD and asthma may co-exist in many individuals and that FEV1 does not return to normal after use of bronchodilators in these individuals and frequently worsens over time. By excluding asthma from the definition, it is possible that the proportion of adults with abnormal lung function with an obstructive lung disease diagnosis will be overestimated. Although the prevalence of individuals with asthma and coexisting but undiagnosed obstructive lung disease is believed to be small, it cannot be estimated with available surveillance data. The ATS COPD Guidelines recommend additional research to better discern the prevalence, clinical course and therapeutic response in these individuals.

References

Additional resources about the objective.

  1. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease
    http://ajrccm.atsjournals.org/cgi/reprint/163/5/1256
  2. HHS, NCHS. National Health and Nutrition Examination Survey, 2007-2008, Examination Data Files. Respiratory Health - Spirometry Procedural Manual. Hyattsville, MD: CDC, 2008.
  3. Johannessen A, Lehmann S, Omenaas ER, Elder GE, Bakke PS, Gulsvik A. Post-bronchodilator spirometry reference values in adults and implications for disease management. Am J Respir Crit Care Med 2006;173: 1316–1325.