2018 GEORGIA DATA SUMMARY | ASTHMA IN CHILDREN Asthma is a chronic inflammatory disorder of the airways characterized by episodes of reversible breathing problems due to airways narrowing and obstruction. These episodes can range in severity from mild to life threatening1. ASTHMA PREVALENCEa: In 2017, the overall asthma prevalence among children in Georgia aged 0-17 years was 9.1%. Overall, 13.5% of children in Georgia had been told at some point in their lives that they had asthma. Differences in asthma prevalence existed by demographic characteristics. Boys had a higher prevalence (10.4%) of asthma than girls (7.8%), but the difference is not significant Non-Hispanic Blacks had a significantly higher prevalence (14.5%) of asthma compared to nonHispanic Whites (3.4%) Children of non-Hispanic origin had a significant higher prevalence (10.0%) of asthma compared to those of Hispanic origin (4.1%) Asthma prevalence was significantly higher among children whose family annual household income was less than $25,000 than among children from families whose family income is more than $75,000 (12.8% vs 5.9%) (Figure 1). Prevalence (%) Figure 1. Prevalence of Asthma Among Children by Family Annual Income, Georgia, 2017 15 12.8 9.6 10 5.9 5 4.0 0 Less than $25k $25k-$49k $50k-$74k Family Annual Income $75k or more The annual asthma hospitalization rate was higher among boys (127/100,000) than girls (80/100,000) The overall asthma hospitalization rate was higher for black children (162/100,000) than for white children (71/100,000). This trend was consistent across age groups (Figure 2) Rate per 100,000 Figure 2. Asthma Hospitalization Agespecific Rate Among Children 0-17 years by Race, Georgia, 2017 White Black 500 400 300 270 200 135 100 0 0-4 yrs 216 80 88 35 5-9 yrs 10-14 yrs Age Groups 23 34 15-17 yrs ASTHMA EMERGENCY DEPARTMENT (ED) VISITSc: In 2017, there were 24,271 asthma-related ED visits among children 0-17 years of age in Georgia. This represents an overall annual asthma-related ED visit rate of 968 per 100,000 The total charges for asthma-related ED visits among children amounted to more than $55.7 million ASTHMA HOSPITALIZATIONS: In 2017, there were 2,614 asthma-related hospitalizations among children 0-17 years of age in Georgia. These hospitalizations represented an overall asthma-related hospitalization rate of 104 per 100,000 per year The total charges for asthma-related hospitalizations among Georgia children amounted to $37.4 million The asthma-related hospitalization rate among children decreased as age increased (Figure 2). Children aged 0-4 years had the highest hospitalization rate (183 per 100,000 population) Rate per 100,000 Figure 3. Asthma-related ED Visits AgeSpecific Rate Among Children 0-17 years by Race, Georgia, 2017 White Black 5000 4000 3000 2000 1000 0 1,983 638 0-4 yrs 2,487 560 1,453 337 5-9 yrs 10-14 yrs Age Groups 903 273 15-17 yrs Children 5-9 years of age had the highest asthma ED visit rate of 1289 per 100,000 but dropped to 515 per 100,000 in children 15 to 17 years of age (Figure 3) The ED visit rate was higher among boys (1152/100,000) than among girls (776/100,000). The overall asthma ED visit rate was over three times higher for black children (1782/100,000) than for white children (465/100,000). This trend was consistent across each age group (Figure 3) REGIONAL DIFFERENCES IN ASTHMA PREVALENCE, HOSPITALIZATION RATES, AND ED VISIT RATES: In Georgia, child asthma prevalence, hospitalization rates and ER visit rates differed by region (Public Health District; PHD). Prevalence: In 2015-2017, four PHDs with the highest prevalence of children asthma were Clayton County (3-3), West Central (7), South (8-1), and Southwest (8-2), with rates of 12.3%, 19.4%, 12.4, and 18.6% respectively. (Map 1, Table 1) Map 1. Asthma Prevalence, Children 0-17 Years, by PHD, Georgia, 2015-2017 Table 1. Asthma Prevalence among children by Public Health Districts from 2015 to 2017 District County Prevalence 1-1 Northwest (Rome) 1-2 North Georgia (Dalton) 2 North (Gainesville) 3-1 Cobb/Douglas 3-2 Fulton 3-3 Clayton County (Jonesboro) 3-4 East Metro (Lawrenceville) 3-5 DeKalb 4 LaGrange 5-1 South Central (Dublin) 5-2 North Central (Macon) 6 East Central (Augusta) 7 West Central (Columbus) 8-1 South (Valdosta) 8-2 Southwest (Albany) 9-1 Coastal (Savannah) 9-2 Southeast (Waycross) 10 Northeast Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, Walker Cherokee, Fannin, Gilmer, Murray, Pickens, Whitefield Banks, Dowson, Forsyth, Franklin, Habersham, Hall, Hart, Lumpkin, Rabun, Stephens, Towns, Union, White Cobb, Douglas Fulton Clayton Gwinnett, Newton, Rockdale DeKalb Butts, Carroll, Coweta, Fayette, Henry, Lamar, Meriwether, Pike, Spalding, Troup, Upson Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler, Wilcox Baldwin, Bibb, Crawford, Hancock, Houston, Jasper, Jones, Monroe, Peach, Putnam, Twiggs, Washington, Wilkinson Burke, Columbia, Emanuel, Glascock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren, Wilkes Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Marion, Muscogee, Quitman, Randolph, Schley, Stewart, Sumter, Talbot, Taylor, Webster Ben Hill, Berrien, Brooks. Cook, Echols, Irwin, Lanier, Lowndes, Tift, Turner Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas, Worth Bryan, Camden, Chatham, Effingham, Glynn, Liberty, Long, McIntosh Appling, Atkinson, Bacon, Brantley, Bulloch, Candler, Charlton, Clinch, Coffee, Evans, Jeff Davis, Pierce, Tattnall, Toombs, Ware, Wayne Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe, Walton 6.2% 10.7% 8.3% 7.7% 10.4% 12.3% 5.5% 9.8% 6.5% 5.3% 8.6% 10.0% 19.4% 12.4% 18.6% 5.8% 10.0% 5.1% Hospitalizations: In 2017, six PHDs with the highest asthma hospitalization rates were South Central (5-1), Dekalb (3-5), Clayton County (3-3), Fulton (3-2), North Central (5-2), and Cobb/Douglas with rates of 236, 190, 177, 177, 127and 124 per 100,000 respectively. (Map 2, Table 2) Map 2. Asthma Hospitalization, Children 0-17 Years, by PHD, Georgia, 2017 Table 2. Asthma Hospitalization among children by Public Health Districts in 2017 District Name County 1-1 Northwest (Rome) 1-2 North Georgia (Dalton) 2 North (Gainesville) 3-1 Cobb/Douglas 3-2 Fulton 3-3 Clayton County (Jonesboro) 3-4 East Metro (Lawrenceville) 3-5 DeKalb 4 LaGrange 5-1 South Central (Dublin) 5-2 North Central (Macon) 6 East Central (Augusta) 7 West Central (Columbus) 8-1 South (Valdosta) 8-2 Southwest (Albany) 9-1 Coastal (Savannah) 9-2 Southeast (Waycross) 10 Northeast Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, Walker Cherokee, Fannin, Gilmer, Murray, Pickens, Whitefield Banks, Dowson, Forsyth, Franklin, Habersham, Hall, Hart, Lumpkin, Rabun, Stephens, Towns, Union, White Cobb, Douglas Fulton Clayton Gwinnett, Newton, Rockdale DeKalb Butts, Carroll, Coweta, Fayette, Henry, Lamar, Meriwether, Pike, Spalding, Troup, Upson Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler, Wilcox Baldwin, Bibb, Crawford, Hancock, Houston, Jasper, Jones, Monroe, Peach, Putnam, Twiggs, Washington, Wilkinson Burke, Columbia, Emanuel, Glascock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren, Wilkes Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Marion, Muscogee, Quitman, Randolph, Schley, Stewart, Sumter, Talbot, Taylor, Webster Ben Hill, Berrien, Brooks. Cook, Echols, Irwin, Lanier, Lowndes, Tift, Turner Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas, Worth Bryan, Camden, Chatham, Effingham, Glynn, Liberty, Long, McIntosh Appling, Atkinson, Bacon, Brantley, Bulloch, Candler, Charlton, Clinch, Coffee, Evans, Jeff Davis, Pierce, Tattnall, Toombs, Ware, Wayne Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe, Walton Hospitalization Rate (per 100,000) 47 47 39 124 177 177 90 190 81 236 127 111 102 117 98 86 44 52 Total Numbers 75 54 67 272 410 141 271 331 169 74 157 129 86 72 82 126 38 60 ED Visits: In 2017, six PHDs with the highest asthma ED visit rates were Dekalb (3-5), Fulton (3-2), East Central (6), Clayton County (3-3), West Central (7) and Cobb/Douglas (3-1) with rates of 1589, 1466, 1370, 1305, 1119, and 1116 per 100,000 respectively. (Map 3) Map 3. Asthma ED Visits, Children 0-17 Years, by PHD, Georgia, 2017 Table 3. Asthma ED visits rate among children by Public Health Districts in 2017 District Name County 1-1 Northwest (Rome) 1-2 North Georgia (Dalton) 2 North (Gainesville) 3-1 Cobb/Douglas 3-2 Fulton 3-3 Clayton County (Jonesboro) 3-4 East Metro (Lawrenceville) 3-5 DeKalb 4 LaGrange 5-1 South Central (Dublin) 5-2 North Central (Macon) 6 East Central (Augusta) 7 West Central (Columbus) 8-1 South (Valdosta) 8-2 Southwest (Albany) 9-1 Coastal (Savannah) 9-2 Southeast (Waycross) 10 Northeast Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, Walker Cherokee, Fannin, Gilmer, Murray, Pickens, Whitefield Banks, Dowson, Forsyth, Franklin, Habersham, Hall, Hart, Lumpkin, Rabun, Stephens, Towns, Union, White Cobb, Douglas Fulton Clayton Gwinnett, Newton, Rockdale DeKalb Butts, Carroll, Coweta, Fayette, Henry, Lamar, Meriwether, Pike, Spalding, Troup, Upson Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler, Wilcox Baldwin, Bibb, Crawford, Hancock, Houston, Jasper, Jones, Monroe, Peach, Putnam, Twiggs, Washington, Wilkinson Burke, Columbia, Emanuel, Glascock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren, Wilkes Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Marion, Muscogee, Quitman, Randolph, Schley, Stewart, Sumter, Talbot, Taylor, Webster Ben Hill, Berrien, Brooks. Cook, Echols, Irwin, Lanier, Lowndes, Tift, Turner Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas, Worth Bryan, Camden, Chatham, Effingham, Glynn, Liberty, Long, McIntosh Appling, Atkinson, Bacon, Brantley, Bulloch, Candler, Charlton, Clinch, Coffee, Evans, Jeff Davis, Pierce, Tattnall, Toombs, Ware, Wayne Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe, Walton ED Visit Rate (per 100,000) 683 384 403 1116 1466 1305 863 1589 711 850 1072 1370 1119 763 957 837 876 814 Total Numbers 1101 442 686 2441 3404 1038 2600 2771 1477 266 1322 1594 945 471 802 1222 759 930 2018 GEORGIA DATA SUMMARY | ASTHMA IN CHILDREN Data Sources a. 2015-2017 Georgia Behavioral Risk Factor Surveillance System (BRFSS) b. 2017 Georgia Hospital Inpatient Discharge Data Hospitalization data are based on hospital discharge data for Georgia residents who were hospitalized in non-federal acute care hospitals with asthma as the primary diagnosis. In October of 2015, medical coding for inpatient hospital discharges changed from ICD-9 CM to ICD-10 CM. The ICD- 10 code: J45 was used to select hospitalizations, based on the Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention (CDC) definition. c. 2017 Georgia Emergency Department Visit Data Emergency department (ED) visit data are based on Georgia residents who were seen in the emergency department of non-federal acute care hospitals in Georgia with asthma as the primary diagnosis. In October of 2015, medical coding for emergency room visits changed from ICD-9 CM to ICD-10 CM. The ICD- 10 code: J45 was used to select ED visits, based on the Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention (CDC) definition. Additional Definitions: Statistical Significance: In this report, estimates were considered statistically significantly different if the chi-square p-value was less than 0.05. References 1. U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Respiratory Diseases. Healthy People 2020. Washington, DC. Accessed on 2/9/2013. Available at http://www.health.state.ga.us/pdfs/epi/cdiee/2012%20Asthma%20Surveillance%20Report.pdf.