Changing Trends in Asthma Prevalence Among Children

Abstract

Background: Childhood asthma prevalence doubled from 1980 to 1995 and then increased more slowly from 2001 to 2010. During this second period, racial disparities increased. More recent trends remain to be described.

Methods: We analyzed current asthma prevalence using 2001-2013 National Health Interview Survey data for children ages 0 to 17 years. Logistic regression with quadratic terms was used to test for nonlinear patterns in trends. Differences between demographic subgroups were further assessed with multivariate models controlling for gender, age, poverty status, race/ethnicity, urbanicity, and geographic region.

Results: Overall, childhood asthma prevalence increased from 2001 to 2009 followed by a plateau then a decline in 2013. From 2001 to 2013, multivariate logistic regression showed no change in prevalence among non-Hispanic white and Puerto Rican children and those in the Northeast and West; increasing prevalence among 10- to 17-year-olds, poor children, and those living in the South; increasing then plateauing prevalence among 5- to 9-year-olds, near-poor children, and non-Hispanic black children; and increasing then decreasing prevalence among 0- to 4-year-olds, nonpoor, and Mexican children and those in the Midwest. Non-Hispanic black-white disparities stopped increasing, and Puerto Rican children remained with the highest prevalence.

Conclusions: Current asthma prevalence ceased to increase among children in recent years and the non-Hispanic black-white disparity stopped increasing due mainly to plateauing prevalence among non-Hispanic black children.

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Copyright © 2016 by the American Academy of Pediatrics.

Figures

FIGURE 1

Current asthma prevalence and modeled trend, children aged 0 to 17 years: United States, 2001–2013. The dotted line shows logistic regression with linear and quadratic terms for time with peak modeled prevalence at 2008. Source: CDC/NCHS, NHIS.

FIGURE 2

Trend in asthma prevalence by race: United States, 1982–2013. White and black races were analyzed without regard to Hispanic ethnicity to allow greater comparability of estimates across the entire time period. Asthma period prevalence estimates (1982–1996) are not directly comparable to current asthma prevalence estimates (2001–2013) due to different survey questions and methodology. Source: CDC/NCHS, NHIS.

FIGURE 3

Adjusted predicted margins of current asthma prevalence among 0- to 17-year-olds by age group (A), poverty status (B), race/ethnicity (C), and geographic region (D): United States, 2001–2013. Predicted margins are adjusted for gender, age group, poverty status, race/ethnicity, family structure, urbanicity, geographic region of residence, and 4 interactions (between time [linear and quadratic time in years] and each of 4 groups: age group, poverty status, race/ethnicity, and geographic region). *Significant linear trend by orthogonal polynomial contrast F test, P < .05. **Significant quadratic trend by orthogonal polynomial contrast F test, P < .05. Source: CDC/NCHS, NHIS. NH, non-Hispanic.