2020 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 2018, the overall asthma prevalence among children in Georgia aged 0-17 years was 7.6%. Overall, 12.3% 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 (9.8%) of asthma than girls (5.3%) Children of non-Hispanic origin had a higher prevalence (8.3%) of asthma compared to those of Hispanic origin (3.3%) Non-Hispanic Blacks had a higher prevalence (10.4%) of asthma compared to Hispanics (3.3%) Asthma prevalence was significantly higher among children whose family annual household income was $49,999 and less than among children from families whose family income is more than $50,000 (Figure 1). Prevalence (%) Figure 1. Prevalence of Asthma Among Children 0-17 years by Family Annual Income, Georgia, 2018 12 10 9.3 8 6 4 2 0 Less than $25k 10.6 $25k-$49k 5.3 $50k-$75k Family Annual Income 5.9 $75k+ ASTHMA HOSPITALIZATIONS: In 2018, there were 2,309 asthma-related hospitalizations among children 0-17 years of age in Georgia. These hospitalizations represented an overall asthmarelated hospitalization crude rate of 92 per 100,000 per year The annual asthma hospitalization rate was higher among boys (109/100,000) than girls (74/100,000) The total charges for asthma-related hospitalizations among Georgia children amounted to $41.6 million The asthma-related hospitalization rate among children decreased as age increased. Children aged 0-4 years had the highest hospitalization rate (156 per 100,000 population) Within each age group, asthma age-specific hospitalization rate was highest among Non-Hispanic Blacks (Figure 2) Rate per 100,000 Figure 2. Age-Specific Asthma Hospitalization Rate Among Children 0-17 years by Race/Ethnicity, Georgia, 2018 White Non-Hispanics Black Non-Hispanics Hispanics 250 223 200 150 116 100 50 24 0 0-4 yrs 178 68 14 94 30 6 5-9 yrs 10-14 yrs Age Groups 41 18 2 15-17 yrs ASTHMA EMERGENCY DEPARTMENT (ED) VISITSc: In 2018, there were 24,624 asthma-related ED visits among children 0-17 years of age in Georgia. This represents an overall annual asthma-related ED visits rates of 983 per 100,000 The total charges for asthma-related ED visits among children amounted to more than $67.5 million Rate per 100,000 Figure 3. Age-Specific Asthma-Related ED Visits Rate Among Children 0-17 years by Race/Ethnicity, Georgia, 2018 White Non-Hispanics Black Non-Hispanics Hispanics 3000 2500 2000 1500 1000 500 0 2046 603 375 0-4 yrs 2401 1522 556 441 321 313 5-9 yrs 10-14 yrs Age Groups 937 255 220 15-17 yrs The ED visits rate was higher among boys (1,167/100,000) than among girls (797/100,000). Non-Hispanic Black children 5-9 years of age had the highest asthma ED visits rate of 2,401 per 100,000; while Hispanic children 15-17 years of age had the lowest age-specific rate 220 per 100,000 (Figure 3) Non-Hispanic Black children (1,800/100,000) were three times more likely to report ED visits than Non-Hispanic white children (445/100,000) and four times more likely to report ED visits than Hispanics (353/100,000) REGIONAL DIFFERENCES IN ASTHMA PREVALENCE, HOSPITALIZATION RATES AND ED VISITS RATES: In Georgia, child asthma prevalence, hospitalization rates and ED visits rates differed by region (Public Health District; PHD). Prevalence: In 2016-2018, the four PHDs with the highest prevalence of children asthma were West Central (7), Fulton (3-2), East Central (6) and Clayton County (3-3), with rates of 13.9%, 12.3%, 11.8% and 11.2% respectively. (Map 1, Table 1) Map 1. Asthma Prevalence, Children 0-17 Years of Age, by PHD, Georgia, 2016-2018 Table 1. Asthma Prevalence among children by Public Health Districts from 2016 to 2018 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 Prevalence 7.2% 6.4% 5.7% 6.4% 12.3% 11.2% 7.7% 8.2% 7.8% 10.8% 6.8% 11.8% 13.9% 10.5% 10.4% 7% 10.6% 6% Hospitalizations: In 2016-2018, four PHDs with the highest age-adjusted asthma hospitalization rates were South Central (5-1), Dekalb (3-5), Fulton (5-2) and Clayton County (3-3) with rates of 283, 182, 165 and 149 per 100,000 respectively. (Map 2, Table 2) Map 2. Age-Adjusted Asthma Hospitalization Among Children 0-17 Years of Age, by PHD, Georgia, 20162018 Table 2. Age-Adjusted Asthma Hospitalization Rate among children 0-17 years by Public Health Districts, Georgia District Name County Hospitalization Rate (per 100,000) 2016-2018 2018 Annual Numbers 1-1 Northwest (Rome) Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, Walker 65 87 1-2 North Georgia (Dalton) Cherokee, Fannin, Gilmer, Murray, Pickens, Whitefield 62 50 2 North (Gainesville) Banks, Dowson, Forsyth, Franklin, Habersham, Hall, Hart, Lumpkin, Rabun, Stephens, Towns, Union, White 60 80 3-1 Cobb/Douglas Cobb, Douglas 144 283 3-2 Fulton Fulton 165 388 3-3 Clayton County (Jonesboro) Clayton 149 112 3-4 East Metro (Lawrenceville) Gwinnett, Newton, Rockdale 93 210 3-5 DeKalb DeKalb 182 259 4 LaGrange Butts, Carroll, Coweta, Fayette, Henry, Lamar, Meriwether, Pike, 87 131 Spalding, Troup, Upson 5-1 South Central (Dublin) Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler, Wilcox 283 70 5-2 North Central (Macon) Baldwin, Bibb, Crawford, Hancock, Houston, Jasper, Jones, Monroe, Peach, Putnam, Twiggs, Washington, Wilkinson 129 122 6 East Central (Augusta) Burke, Columbia, Emanuel, Glascock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren, Wilkes 111 68 7 West Central (Columbus) Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Marion, Muscogee, Quitman, Randolph, Schley, Stewart, Sumter, Talbot, Taylor, Webster 108 86 8-1 South (Valdosta) Ben Hill, Berrien, Brooks. Cook, Echols, Irwin, Lanier, Lowndes, Tift, 112 Turner 53 8-2 Southwest (Albany) Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas, Worth 91 58 9-1 Coastal (Savannah) Bryan, Camden, Chatham, Effingham, Glynn, Liberty, Long, McIntosh 118 147 Appling, Atkinson, Bacon, Brantley, Bulloch, Candler, Charlton, 9-2 Southeast (Waycross) Clinch, Coffee, Evans, Jeff Davis, Pierce, Tattnall, Toombs, Ware, 55 42 Wayne 10 Northeast Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe, Walton 72 63 ED Visits: In 2016-2018, four PHDs with the highest age-adjusted asthma ED visits rates were Dekalb (3-5), East Central (6), Cobb/Douglas (3-1) and Fulton (3-2) with rates of 1433, 1229, 1213, and 1210 per 100,000 respectively. (Map 3, Table 3) Map 3. Age-Adjusted Asthma ED Visits Among Children 0-17 Years of Age, by PHD, Georgia, 2016-2018 Table 3. Age-Adjusted Asthma ED visits rate among children 0-17 years by Public Health Districts, Georgia District Name County ED Visits Rate (per 100,000) 2016-2018 1-1 Northwest (Rome) Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, Walker 738 1-2 North Georgia (Dalton) Cherokee, Fannin, Gilmer, Murray, Pickens, Whitefield 367 2 North (Gainesville) Banks, Dowson, Forsyth, Franklin, Habersham, Hall, Hart, Lumpkin, Rabun, Stephens, Towns, Union, White 409 3-1 Cobb/Douglas Cobb, Douglas 1,213 3-2 Fulton Fulton 1,210 3-3 Clayton County (Jonesboro) Clayton 1,163 3-4 East Metro (Lawrenceville) Gwinnett, Newton, Rockdale 893 3-5 DeKalb DeKalb 1,433 4 LaGrange Butts, Carroll, Coweta, Fayette, Henry, Lamar, Meriwether, Pike, Spalding, 695 Troup, Upson 5-1 South Central (Dublin) 5-2 North Central (Macon) Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler, Wilcox Baldwin, Bibb, Crawford, Hancock, Houston, Jasper, Jones, Monroe, Peach, Putnam, Twiggs, Washington, Wilkinson 808 1,028 6 East Central (Augusta) 7 West Central (Columbus) 8-1 South (Valdosta) 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 1,229 953 620 8-2 Southwest (Albany) Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas, Worth 867 9-1 Coastal (Savannah) Bryan, Camden, Chatham, Effingham, Glynn, Liberty, Long, McIntosh 763 9-2 Southeast (Waycross) Appling, Atkinson, Bacon, Brantley, Bulloch, Candler, Charlton, Clinch, Coffee, Evans, Jeff Davis, Pierce, Tattnall, Toombs, Ware, Wayne 830 10 Northeast Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe, Walton 781 2018 Annual Numbers 1,245 420 678 2,716 3,582 1,111 2,666 2,656 1,508 288 1,258 1,475 1,002 439 791 1,272 767 750 2020 GEORGIA DATA SUMMARY | ASTHMA IN CHILDREN Data Sources a. 2016-2018 Georgia Behavioral Risk Factor Surveillance System (BRFSS) The BRFSS is a stratified random-digit dial telephone interview conducted among Georgia non-institutionalized residents 18 years and older to ascertain their health conditions, behaviors, and the use of preventive services. The survey is conducted in collaboration with the Centers for Disease Control and Prevention (CDC). b. 2016-2018 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. 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. 2016-2018 Georgia Emergency Department Visits Data Emergency department (ED) visits data are based on Georgia residents who were seen in the emergency department of nonfederal acute care hospitals in Georgia with asthma as the primary diagnosis. 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. Statistical Significance: Significance was determined when confidence intervals around prevalence were not overlapping References 1. Health Resources and Services Administration. Women's Health USA 2011. Rockville, Maryland: U.S. Department of Health and Human Services, 2011. Accessed on 8/20/2020. Available at https://mchb.hrsa.gov/whusa11/more/downloads/pdf/w11.pdf