Mannino David M, Homa David M, Akinbami Lara J, Moorman Jeanne E, Gwynn Charon, Redd Stephen C
Division of Environmental Hazards and Health Effects, National Center for Environmental Health, USA.
MMWR Surveill Summ. 2002 Mar 29;51(1):1-13.
PROBLEM/CONDITION: Asthma, a chronic disease occurring among both children and adults, has been the focus of clinical and public health interventions during recent years. In addition, CDC has outlined a strategy to improve the timeliness and geographic specificity of asthma surveillance as part of a comprehensive public health approach to asthma surveillance.
This report presents national data regarding self-reported asthma prevalence, school and work days lost because of asthma, and asthma-associated activity limitations (1980-1996); asthma-associated outpatient visits, asthma-associated hospitalizations, and asthma-associated deaths (1980-1999); asthma-associated emergency department visits (1992-1999); and self-reported asthma episodes or attacks (1997-1999).
CDC's National Center for Health Statistics (NCHS) conducts the National Health Interview Survey annually, which includes questions regarding asthma and asthma-related activity limitations. NCHS collects physician office-visit data in the National Ambulatory Medical Care Survey, emergency department and hospital outpatient data in the National Hospital Ambulatory Medical Care Survey, hospitalization data in the National Hospital Discharge Survey, and death data in the Mortality Component of the National Vital Statistics System.
During 1980-1996, asthma prevalence increased. Annual rates of persons reporting asthma episodes or attacks, measured during 1997-1999, were lower than the previously reported asthma prevalence rates, whereas the rates of lifetime asthma, also measured during 1997-1999, were higher than the previously reported rates. Since 1980, the proportion of children and adults with asthma who report activity limitation has remained stable. Since 1995, the rate of outpatient visits and emergency department visits for asthma increased, whereas the rates of hospitalization and death decreased. Blacks continue to have higher rates of asthma emergency department visits, hospitalizations, and deaths than do whites.
Since the previous report in 1998 (CDC. Surveillance for Asthma--United States, 1960-1995. MMWR 1998;47[No. SS-1]:1-28), changes in asthma-associated morbidity and death have been limited. Asthma remains a critical clinical and public health problem. Although data in this report indicate certain early indications of success in current asthma intervention programs (e.g., limited decreases in asthma hospitalization and death rates), the continued presence of substantial racial disparities in these asthma endpoints highlights the need for continued surveillance and targeted interventions.
问题/状况：哮喘是一种在儿童和成人中均会出现的慢性疾病，近年来一直是临床和公共卫生干预的重点。此外，美国疾病控制与预防中心（CDC）已制定一项战略，以提高哮喘监测的及时性和地理特异性，作为哮喘监测综合公共卫生方法的一部分。
本报告呈现了关于自我报告的哮喘患病率、因哮喘而损失的上学和工作日以及与哮喘相关的活动受限情况的全国数据（1980 - 1996年）；与哮喘相关的门诊就诊、住院治疗以及哮喘相关死亡情况（1980 - 1999年）；与哮喘相关的急诊科就诊情况（1992 - 1999年）；以及自我报告的哮喘发作情况（1997 - 1999年）。
美国疾病控制与预防中心的国家卫生统计中心（NCHS）每年开展全国健康访谈调查，其中包括有关哮喘及与哮喘相关的活动受限情况的问题。国家卫生统计中心在全国门诊医疗调查中收集医生门诊就诊数据，在全国医院门诊医疗调查中收集急诊科和医院门诊数据，在全国医院出院调查中收集住院数据，并在国家生命统计系统的死亡率部分收集死亡数据。
在1980 - 1996年期间，哮喘患病率有所上升。1997 - 1999年期间所测量的报告哮喘发作的年发生率低于先前报告的哮喘患病率，而同样在1997 - 1999年期间所测量的终生哮喘发生率则高于先前报告的发生率。自1980年以来，报告有活动受限的哮喘儿童和成人比例一直保持稳定。自1995年以来，哮喘门诊就诊率和急诊科就诊率上升，而住院率和死亡率下降。黑人因哮喘到急诊科就诊、住院治疗和死亡的比率继续高于白人。
自1998年的上一份报告（美国疾病控制与预防中心。美国哮喘监测，1960 - 1995年。《发病率与死亡率周报》1998；47[第SS - 1号]：1 - 28）以来，与哮喘相关的发病率和死亡率变化有限。哮喘仍然是一个关键的临床和公共卫生问题。尽管本报告中的数据表明当前哮喘干预项目有某些初步成功迹象（例如，哮喘住院率和死亡率有限下降），但这些哮喘相关指标中持续存在的显著种族差异凸显了持续监测和针对性干预的必要性。
