Landmark survey reveals asthma in children remains significantly out of control in the United States


Asthma control in children falls far short of national treatment goals

New York, NY (December 8, 2004) – Findings from one of the nation's largest and most comprehensive surveys about children and asthma to date, Children and Asthma in America, reveal that more than half (54%) of all children with asthma had a severe asthma attack in the past year and more than one quarter (27%) had an asthma attack so bad they thought their life was in danger. The survey results released today underscore the severity of asthma in children in the U.S. and the significant impact the disease has on children and their families.

Presented on behalf of Asthma Action America, the survey findings suggest the U.S. is still falling far short of the national treatment goals established for asthma, and reveal the majority of children with asthma do not have it under control. This places children at potential risk for a variety of consequences including frequent symptoms, missed school, restrictions on activities, emotional distress, hospitalization and even life-threatening asthma attacks. Asthma is one of the most common chronic illnesses among children, with an estimated 5.8 million American children four to 18 years of age currently with the condition.

"These are disturbing findings, especially since asthma is a highly controllable disease," said William Sears M.D, nationally acclaimed author, pediatrician and associate clinical professor of pediatrics at the University of California Irvine School of Medicine. "We need to help parents recognize that proper asthma control means children are symptom-free all or most of the time. Parents should talk to their healthcare professional about prevention of asthma symptoms and long-term management so their child does not suffer needlessly."

Asthma Control in Children: Are We Missing The Mark?

In the survey, four out of five respondents reported that their or their child's asthma was well (43%) or completely controlled (35%), yet children missed the mark on nearly every treatment goal established by the National Heart, Lung, and Blood Institute (NHLBI) -- part of the National Institutes of Health. A point-by- point comparison shows asthma is not being as well-controlled as it should be:

NHLBI Goals of Therapy

  • Minimal or no chronic asthma symptoms (coughing, wheezing, shortness of breath, chest tightness) during the day or night

Children and Asthma in America Survey Findings

In the past four weeks;

  • 2/3 of children (67%) experienced asthma symptoms during the day, during the night or during exercise or exertion
  • Nearly one in five children (19%) experienced daytime symptoms three times a week to daily; almost a quarter (22%) experienced symptoms at least once a week at night

NHLBI Goals of Therapy

  • Minimal or no exacerbations (including hospitalization or emergency room visits)

Children and Asthma in America Survey Findings

  • 23% have visited the emergency room in the past year
  • 42% reported unscheduled acute care visits in the past year because of asthma

NHLBI Goals of Therapy

  • No limitations on activities; no school/parent's work missed

Children and Asthma in America Survey Findings

  • 54% missed school or daycare in the past year as a result of their asthma, with an average of nearly four days missed
  • 39% of parents of children with asthma missed work in the past year due to their child's condition
  • 62% of children said asthma caused them to limit activities a lot or some

NHLBI Goals of Therapy

  • Minimal use of short-acting beta-agonists (rescue inhaler)

Children and Asthma in America Survey Findings

  • Of those who used rescue medications in the past four weeks, nearly half (42%) used them three times a week to daily; nearly one in four (26%) used them daily

NHLBI Goals of Therapy

  • Having a written Asthma Action Plan

Children and Asthma in America Survey Findings

  • 54% of children with asthma said they did not have a written Asthma Action Plan

NHLBI Goals of Therapy

  • Visit your healthcare professional to monitor your asthma at least two times per year

Children and Asthma in America Survey Findings

  • 25% of children with asthma had not seen their healthcare professional about their condition in the past year
  • 54% have not had a lung function test in the past 12 months

Survey Shows Communication Gap Between Children and Parents

The Children and Asthma in America survey shows a concerning difference between how parents perceive their child's asthma and how children themselves perceive their disease. In fact, when comparing responses of parents and their children with asthma who were 10 to 15 years of age, the survey showed that the majority (71%) of parents and their children disagreed about the child's overall health status. Additionally, 32% of parents and their children disagreed that restrictions on activities was the worse thing about having asthma, 45% disagreed that the child experienced any daytime asthma symptoms in the past four weeks, and 38% disagreed that the child had no asthma symptoms in the same time period. Specifically, over the past four weeks, parents and their children disagreed that the child experienced coughing (46%), shortness of breath (44%), wheezing (40%) and breathing problems (37%).

"It is concerning to see so many parents thinking their child's asthma is under control when many children are experiencing symptoms on a daily basis," said Dr. Sears. "The lack of effective dialogue between parent and child about their asthma could be a major factor in why asthma still remains poorly controlled among America's children. It's important that parents regularly ask their child specific questions about symptoms so they can get an accurate picture of their child's level of asthma control."

More than Half of Those Surveyed Don't Understand Causes of Asthma Symptoms

Asthma is a highly controllable disease when proper prevention and long-term management of the underlying causes are followed. However, the survey reveals widespread misunderstanding about the causes of and treatments for asthma symptoms. The majority admitted they never heard of bronchoconstriction – tightening of the muscles surrounding the airways – (90%) or inflammation – airway-swelling and irritation – (93%) – the two underlying causes of asthma symptoms.

Only 53% of those classified as having severe asthma and 63% of those with moderate asthma reported they or their children took prescription medication for daily maintenance therapy during the past four weeks (like an inhaled corticosteroid). Additionally, 30% of respondents incorrectly named a short-acting beta-agonist (an inhaler used for treating sudden asthma symptoms) as a long-term asthma control medicine. National treatment guidelines recommend daily use of an inhaled corticosteroid as the preferred therapy for people with persistent asthma.

Facilitating Parent/Child Discussions: Helpful Resource Available

To help encourage the dialogue between parents and their child about asthma symptoms, Asthma Action America is offering a free asthma brochure featuring tips from Dr. Sears and the Asthma Control TestTM, five questions parents should ask their child to help assess their child's level of asthma control. The brochure and more information about asthma in children are available at or by calling 1-800-377-9575. Survey results can also be found at

About the Survey

Children and Asthma in America was conducted by Schulman, Ronca and Bucuvalas, Inc. (SRBI), a national research firm specializing in health issues. A national sample of 41,433 households was screened to generate households with a child four to 18 years of age with current asthma. The survey included 801 in-depth telephone interviews with parents or caregivers of the designated child with asthma in the household or the child with asthma exclusively if he or she was 16 to 18 years of age. In addition, the survey included interviews with nearly 300 pairs of parents and their children (10 to 15 years old) to provide comparison responses. All interviews were conducted from February to May 2004, and assessed knowledge, attitudes and behavior regarding children and asthma. The maximum expected sampling error associated with a sample of this size would be +/- 3.5 percentage points at the 95% confidence level. The survey was released on behalf of Asthma Action America®, a national asthma education campaign supported by leading organizations committed to improving asthma care in the U.S., and was funded by GlaxoSmithKline. GlaxoSmithKline is a research-based pharmaceutical company and a world leader in respiratory care.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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