Professional Documents
Culture Documents
A Growing Epidemic
Andrew Catherine
9-8487-8026
Fall 2010
BBH 440
Asthma is a chronic lung disease characterized by episodic asthma
breath, coughing, and chest tightness (Asthma: What is It?). The severity and
triggers of the attacks vary from person to person. Some individuals may
experience minor symptoms and discomfort, but others may also have
severe airway constriction that if untreated could cause death (The Global
Initiative for Asthma). Currently there is no cure for asthma ,it is a chronic
(CDC Asthma).
suggests that environmental and genetic factors are causal factors (Miller
triggers the acute asthma attacks. These triggers are different for each
person, but often include: tobacco smoke, high levels of air pollution, mold,
(CDC Asthma). Some link between obesity and asthma (Grant, Wagner and
2
I am interested in investigating asthma due to its significant impact in
the healthcare system in the future. With the growing incidence and
segments of the population are more likely to have asthma) behind asthma
community member.
and genetic) and their interactions are not well understood. The large
Importance of Asthma
placing higher demands on the healthcare system. The disease also seems
to favor middle and lower income classes, making the monetary burden high
for those who can afford it less. In the US in 2006, people visited their doctor
for asthma over 13 million times and had 444,000 admission to the hospital
for asthma (CDC Asthma). With such large demand placed on healthcare
3
WHO information indicates that over 300 million people today are
living with asthma and that last year alone, more than a quarter of a million
people died because of the disease (WHO Asthma). Any disease that impacts
society. There are several global initiatives (though with less support and
fame then global HIV/AIDS and infectious disease initiatives) to try and better
understand what causes asthma and how to reduce its incidence (WHO
Asthma also has the distinction of being the most common chronic
disease in children (Akinbami). In the past century much progress has been
made combating childhood diseases making them all but a thing of the past
it adds additional cost and burden to families. In the developing world where
medical care is less accessible, asthma can become a death sentence for
environmental factors that can increase risk for asthma should be addressed
(Miller and Ho). As part of the overall global warming and air pollution
air quality that is hard to dispute. As the climate changes in the future,
4
asthma may become even more of a conscious public health issue that may
This graph (above) from CDC National Health Interview Surveys shows
that since 1980, the prevalence of asthma in children has grown (CDC
Asthma). The data shows trend in both children and lifetime diagnosis of
asthma. This supports the information on the CDC’s website about the
growing numbers of asthma cases. There has been much debate and
5
thought over what is causing the rise in asthma cases. Increases in obesity
also the idea that reduced exposure to diseases when a baby is leading to
higher asthma rates (the good hygiene hypothesis). Changes in air pollution
The 2008 BRFSS survey (above) shows that the prevalence of asthma
Even areas with lower prevalence of asthma are not all that low compared to
numbers 30 years ago. Some localized variation on the city and town level
6
do exist depending on which ethnic groups and income level segments of the
population live in one small particular area. The majority of US states now
have greater than 8.3% of the adult population living with asthma.
health care. In China, South Africa, Mexico, and Russia the mortality rates for
asthma are higher since in these countries access to medical care is more
expensive and/or less prevalent. This map highlights the inequality that
exists with regard to health care, but is very important in chronic diseases
7
There exists very different incidence and prevalence rates for different
ethnic groups. Many more African Americas, Irish Americans, Puerto Ricans,
and Native Hawaiians have asthma in comparison with the rest of the US
population (Davis, Kreutzer and Lipsett) (Lara, Akinbami and Flores). This
seems to stem from the genetic link that increases the risk of having asthma
income groups at higher rates than middle and high income groups. Some
and other household pests (Asthma Triggers: Cockroaches and Pests). This
population segments that cannot afford the treatments for asthma (CDC
Asthma).
8
Source: National Health Interview Survey; CDC National Center for Health Statistics
past) condition that usually presents in childhood. This explains why a larger
percentage of children have asthma than adults today but this trend will be
Source: National Health Interview Survey; CDC National Center for Health Statistics
is needed.
Source: asthmablog.org
Asthma). Exactly why each of these trigger a response and not others is not
Not all of these agents causes asthma in every person. Someone with
hand some else with asthma may be triggered by all of these and more
suggests that environmental and genetic factors are causal factors. Some
10
link is thought to exists between obesity and asthma. Asthma is also thought
at higher risk, yet studies have shown that reducing this exposure has
crack down on air pollution by demanding more regulation to try and stop
Prevention
lung function tests although these may always determine every case. For
(or a steroid inhaler) for daily use to prevent (or reduce the risk) of
Often a patient can determine what triggers these attacks and then try to
for acute events. These short acting inhalers used intermittently with asthma
Treatment
Asthma has no cure at this point and time. Treatments currently exist
for asthma attacks. Here a person may be given a fast acting inhaler to use
inhalers quickly dilate the airway passages in the lungs to increase air
inhaler that they should take usually daily to help prevent constriction and
identifying these, a person may try and avoid exposure to them. This is a
very effective method but may not always be practical. If a person's triggers
are poor air quality and they lack the mean of moving to a place with less
found \that lungs have sporadic taste receptors (Melnick). These taste
receptors act differently from those in the tongue and react only to bitter
tastes. When “tasting” or sensing a bitter taste they dilate the lung airway
12
passages. This interesting fact could be used as a possible treatment for
bronchoconstriction.
the past decade and have found that the risk for US children is not the same
as the risks for children from developing countries (Tufts University Scientists
lower social economic status and are more exposed to household pests they
are at greater risk for asthma. This indicates that the country or area that
asthma or not.
Asthma is a growing US and global health issue that has large impacts
asthma stands to affect a larger and larger segment of the next generation.
access across the world; closing the access gaps will help with the managing
of not only asthma, but other chronic diseases sparing many of pain,
leading to higher costs. The strain placed on doctors, hospitals, and families
13
to provide care is stressed more by trying to find ways to pay for treatment
and management.
higher than other similar groups (gender, age, race) (CDC Asthma). There
are also statistics that show that asthma is more common in the lower
would be ideal) need to be found that will improve asthma management and
What I Learned
topics (AIDS, TB, and Asthma) beyond what I knew before both in terms of
the disease and the epidemiology. This series of projects was a great
groups much more radically than I thought. The projects also let me explore
a topic that I wanted to know more about and analyze that disease. I had
known that Asthma was more prevalent today then in the past, but I did not
know the extent to which this condition is growing and the costs and issues it
14
I also found that these projects made me more familiar with online
research resources available through the library. This proficiency will serve
Bibliography
Akinbami, Lara J. "The State of Childhood Asthma, United States, 1980-2005."
Advanced Data. National Center for Health Statistics, 2006.
Miller, RL and SM Ho. "Environmental epigenetics and asthma: current concepts and
call for studies." American Journal of Respiratory and Critical Care Medicine 177.6
(2008): 567-573.
Ramsey, CD and JC Celedon. "The hygiene hypothesis and asthma." Current Opinion
in Pulmonary Medicine 11.1 (2005): 14-20.
West Virginia Asthma Education and Prevention Program. 2010. 4 December 2010
<http://www.wvasthma.org>.
16