Epidemiology of asthma

As of 2011, circa 235 million people worldwide were affected by asthma,[2] and approximately 250,000 people die per year from the disease.[3] Low and middle income countries make up more than 80% of the mortality.[4] Rates vary between countries with prevalences between 1 and 18%.[3] It is more common in developed than developing countries.[3] One thus sees lower rates in Asia, Eastern Europe and Africa.[5] Within developed countries it is more common among those who are economically disadvantaged while in contrast in developing countries it is more common amongst the affluent.[3][6] The reason for these differences is not well known.[3]

Rates of asthma rates in 2017[1]

While asthma is twice as common in boys as girls,[3] severe asthma occurs at equal rates.[7] Among adults, however, asthma is twice as common in women as men.[7][8]

Increasing frequency
The prevalence of childhood asthma in the United States has increased since 1980, especially in younger children.

Rates of asthma have increased significantly between the 1960s and 2008 [9][10] with it being recognized as a major public health problem since the 1970s.[5] Some 9% of US children had asthma in 2001, compared with just 3.6% in 1980. The World Health Organization (WHO) reports that some 10% of the Swiss population have asthma as of 2007, compared with 2% some 25–30 years ago.[11] In the United States the age-adjusted prevalence of asthma increased from 7.3 to 8.2 percent during the years 2001 through 2009.[12]

Region specific data

United States

Asthma affects approximately 7% of the population of the United States and causes approximately 4,210 deaths per year.[13][14][15] In 2005, asthma affected more than 22 million people, including 6 million children, and accounted for nearly 500,000 hospitalizations that same year.[16] In 2010, asthma accounted for more than one-quarter of admitted emergency department visits in the U.S. among children aged 1–9 years, and it was a frequent diagnosis among children aged 10–17 years.[17] From 2000 through 2010, the rate of pediatric hospital stays for asthma declined from 165 to 130 per 100,000 population, respectively, whereas the rate for adults remained about 119 per 100,000 population.[18]

Asthma prevalence in the U.S. is higher than in most other countries in the world, but varies drastically between ethnic populations.[19] Asthma prevalence is highest in Puerto Ricans, African Americans, Filipinos, Irish Americans, and Native Hawaiians, and lowest in Mexicans and Koreans.[20][21][22] Rates of asthma-related hospital admissions in 2010 were more than three times higher among African American children and two times higher for African American adults compared with White and Asian and Pacific Islander people.[18] Also, children who are born in low-income families have higher risk of asthma.[23]

Asthma prevalence also differs between populations of the same ethnicity who are born and live in different places.[24] U.S.-born Mexican populations, for example, have higher asthma rates than non-U.S. born Mexican populations that are living in the U.S.[25]

United Kingdom

Asthma affects approximately 5% of the United Kingdom’s population.[26] In England, an estimated 261,400 people were newly diagnosed with asthma in 2005; 5.7 million people had an asthma diagnosis and were prescribed 32.6 million asthma-related prescriptions.[27]

Canada

Data depicts an increasing trend in asthma prevalence among Canada’s population. In 2000-2001 asthma prevalence was monitored at 6.5%; by 2010-2011 a 4.3% increase was shown, with asthma prevalence totaling 10.8% of Canada's population.[28]

Furthermore, asthma prevalence varies among the provinces of Canada; the highest prevalence is Ontario at 12.1%, and the lowest is Nunavut at 3.8%.[28] Though there is an overall decrease in the incidence of new asthma cases in Canada, prevalence is rising. This can be attributed to a decrease in case-specific mortality due to improved management and control of asthma and its symptoms.

Latin and Central America

It is approximated that 40 million Latin Americans live with asthma.[29]

In some reports, urban residency within Latin America has been found to be associated with an increased prevalence of asthma.[29] Childhood asthma prevalence was found to be higher than 15 percent in a majority of Latin American countries.[30] Similarly, a study published relating to asthma prevalence in Havana, Cuba estimated that approximately 9 percent of children under the age of 15 are undiagnosed for asthma, possible due to lack of resources in the region.[29]

Japan

The prevalence of asthma in adults in Japan is rapidly increasing, however there is a significant difference for the children in Japan. The mean prevalence of asthma in Japan has increased from about 1% to 10% or higher in children and to about 6–10% in adults since the 1960s.[31] There has been a 1.5 fold increase in the prevalence of asthma per decade in Japan from the 1960s.[31] Three surveys done from 1985, 1999 and 2006 show adult asthma is increasing, while the same surveys indicate that the prevalence of asthma in children is decreasing.[32] To compare this to another Asia-Pacific country the estimated prevalence of asthma in male and female children in Mongolia in a 2009 ISSAC study was 20.9% and 21.0%[33]

Asia

Data regarding the epidemiology of asthma in the continent of Asia as whole is scarce, particularly regarding adult populations. However, similarly to much of the rest of the globe, prevalence of childhood asthma appears to be rising. Systematic childhood studies, such as the International Study of Asthma and Allergies in Childhood (ISAAC), provide data regarding the epidemiology of asthma among Asia's youth population. Asthma prevalence among Asia’s adult population is less clear in comparison due to the comparatively higher monitoring of younger populations. However, the data available points to a positive correlation between age and asthma prevalence. Findings indicate that the prevalence of asthma among the Asian adult population is less than 5%; while findings pertaining to elderly populations illustrate a rate somewhere between 1.3-15.3%.[34]

International migration

In a review of studies on the prevalence of asthma among migrant populations, those born in high-income countries were found to have higher rates of asthma than migrants. Second-generation migrants had a higher risk of asthma than first-generation migrants, and the prevalence of asthma increases with longer time of residence in the host country.[35] This confirms the role of the environment in the development of asthma.

Regional differences

A survey conducted by the ISSAC Steering Committee conducted a study from 1992 to 1993 in adults aged 22 to 44 comparing the prevalence of asthma in 10 developed countries. An important note to consider is the population differences between these countries. The United States population in 1992 was 256.9 million, 14.5 times that of Australia (17.5 mil), and 4.5 times of the United Kingdom (57.51 mil).[36][37][38] However, Australia and the UK have a higher prevalence than the US by 2.4 times on the lower end and 4.6 times on the higher end. In another study taken in 1992 for Japan the prevalence of asthma in Japan was 13%[39] with a population of 124.2 million.[40]

Japan 05 20–44 8.1
Australia 92–93 20–44 28.1
Australia Aborigine 90–91 20–84 11.1
UK 92–93 20–44

20–44

 27.0

30.3

Germany 92–93 20–44 17.0
Spain 92–93 20–44 22.0
France 92–93 20–44 14.4
USA 92–93 20–44 25.7
Italy 92–93 20–44 9.5
Iceland 92–93 20–44 18.0
Greece 92–93 20–44 16.0

Prevalence of asthma (4th column) in 11 different countries

(1st column) between the years 1992 and 1994 (2nd column)

in the ages 20–44 (3rd column) including Japan in 2005

Notes
  1. "Asthma prevalence". Our World in Data. Retrieved 15 February 2020.
  2. "World Health Organization Fact Sheet Fact sheet No 307: Asthma". 2009. Archived from the original on June 29, 2011. Retrieved 2 September 2010.
  3. GINA 2011, pp. 2–5
  4. World Health Organization. "WHO: Asthma". Archived from the original on 15 December 2007. Retrieved 2007-12-29.
  5. Mason RJ, Broaddus VC, Martin T, King TE, Schraufnagel DE, Murray JF, Nadel JA (2010). Murray and Nadel's textbook of respiratory medicine (5th ed.). Philadelphia, PA: Saunders/Elsevier. pp. Chapter 38. ISBN 978-1416047100.
  6. Uphoff, E (2015). "A systematic review of socioeconomic position in relation to asthma and allergic diseases". European Respiratory Journal. 46 (2): 364–374. doi:10.1183/09031936.00114514. PMID 25537562.
  7. Bush A, Menzies-Gow A; Menzies-Gow (December 2009). "Phenotypic differences between pediatric and adult asthma". Proc Am Thorac Soc. 6 (8): 712–9. doi:10.1513/pats.200906-046DP. PMID 20008882.
  8. "Testosterone explains why women more prone to asthma". ScienceDaily. May 8, 2017.
  9. Grant EN, Wagner R, Weiss KB (August 1999). "Observations on emerging patterns of asthma in our society". J. Allergy Clin. Immunol. 104 (2 Pt 2): S1–9. doi:10.1016/S0091-6749(99)70268-X. PMID 10452783.
  10. Anandan C, Nurmatov U, van Schayck OC, Sheikh A (February 2010). "Is the prevalence of asthma declining? Systematic review of epidemiological studies". Allergy. 65 (2): 152–67. doi:10.1111/j.1398-9995.2009.02244.x. PMID 19912154. S2CID 19525219.
  11. World Health Organization (2007). Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach (PDF). pp. 15–20, 49. ISBN 978-92-4-156346-8. Archived from the original on 18 May 2010. Retrieved 2010-05-14.
  12. Centers for Disease Control and Prevention (CDC) (May 2011). "Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001--2009". MMWR Morb. Mortal. Wkly. Rep. 60 (17): 547–52. PMID 21544044.
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  16. NHLBI Guideline 2007, p. 1
  17. Wier LM, Hao Y, Owens P, Washington R. Overview of Children in the Emergency Department, 2010. HCUP Statistical Brief #157. Agency for Healthcare Research and Quality, Rockville, MD. May 2013.
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  20. Lara M, Akinbami L, Flores G, Morgenstern H (January 2006). "Heterogeneity of childhood asthma among Hispanic children: Puerto Rican children bear a disproportionate burden". Pediatrics. 117 (1): 43–53. doi:10.1542/peds.2004-1714. PMID 16396859. S2CID 38317718.
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  22. Johnson DB, Oyama N, LeMarchand L, Wilkens L (September 2004). "Native Hawaiians mortality, morbidity, and lifestyle: comparing data from 1982, 1990, and 2000". Pac Health Dialog. 11 (2): 120–30. PMID 16281689.
  23. "C-FERST Issue Profile: Childhood Asthma". EPA. 2016-03-30. Retrieved 15 February 2017.
  24. Gold DR, Acevedo-Garcia D (July 2005). "Immigration to the United States and acculturation as risk factors for asthma and allergy". J. Allergy Clin. Immunol. 116 (1): 38–41. doi:10.1016/j.jaci.2005.04.033. PMID 15990770.
  25. Eldeirawi KM, Persky VW (May 2006). "Associations of acculturation and country of birth with asthma and wheezing in Mexican American youths". J Asthma. 43 (4): 279–86. doi:10.1080/0277090060022869. PMID 16809241. S2CID 29050101.
  26. Anderson HR, Gupta R, Strachan DP, Limb ES (January 2007). "50 years of asthma: UK trends from 1955 to 2004". Thorax. 62 (1): 85–90. doi:10.1136/thx.2006.066407. PMC 2111282. PMID 17189533.
  27. Simpson CR, Sheikh A (March 2010). "Trends in the epidemiology of asthma in England: a national study of 333,294 patients". J R Soc Med. 103 (3): 98–106. doi:10.1258/jrsm.2009.090348. PMC 3072257. PMID 20200181.
  28. Canada, Public Health Agency of (2018-05-01). "Asthma and Chronic Obstructive Pulmonary Disease (COPD) in Canada, 2018". aem. Retrieved 2018-11-26.
  29. Forno E, Gogna M, Cepeda A, Yañez A, Solé D, Cooper P, Avila L, Soto-Quiros M, Castro-Rodriguez JA, Celedón JC (September 2015). "Asthma in Latin America". Thorax. 70 (9): 898–905. doi:10.1136/thoraxjnl-2015-207199. PMC 4593416. PMID 26103996.
  30. Mallol J, Solé D, Baeza-Bacab M, Aguirre-Camposano V, Soto-Quiros M, Baena-Cagnani C (August 2010). "Regional variation in asthma symptom prevalence in Latin American children". The Journal of Asthma. 47 (6): 644–50. doi:10.3109/02770901003686480. PMID 20642377. S2CID 23993282.
  31. Ichinose, Masakazu; Sugiura, Hisatoshi; Nagase, Hiroyuki; Yamaguchi, Masao; Inoue, Hiromasa; Sagara, Hironori; Tamaoki, Jun; Tohda, Yuji; Munakata, Mitsuru; Yamauchi, Kohei; Ohta, Ken; Japanese Society of Allergology (2017-04-01). "Japanese guidelines for adult asthma 2017". Allergology International. 66 (2): 163–189. doi:10.1016/j.alit.2016.12.005. ISSN 1323-8930. PMID 28196638.
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  33. Yoshihara, Shigemi; Munkhbayarlakh, Sonomjants; Makino, Sohei; Ito, Clyde; Logii, Narantsetseg; Dashdemberel, Sarangerel; Sagara, Hironori; Fukuda, Takeshi; Arisaka, Osamu (2016-01-01). "Prevalence of childhood asthma in Ulaanbaatar, Mongolia in 2009". Allergology International. 65 (1): 62–67. doi:10.1016/j.alit.2015.07.009. ISSN 1323-8930. PMID 26666488.
  34. Song WJ, Kang MG, Chang YS, Cho SH (April 2014). "Epidemiology of adult asthma in Asia: toward a better understanding". Asia Pacific Allergy. 4 (2): 75–85. doi:10.5415/apallergy.2014.4.2.75. PMC 4005350. PMID 24809012.
  35. Cabieses, B (2014). "A Systematic Review on the Development of Asthma and Allergic Diseases in Relation to International Immigration: The Leading Role of the Environment Confirmed". PLOS ONE. 9 (8): e105347. Bibcode:2014PLoSO...9j5347C. doi:10.1371/journal.pone.0105347. PMC 4139367. PMID 25141011.
  36. Bureau, US Census. "Statistical Abstract of the United States: 1992". The United States Census Bureau. Retrieved 2020-12-03.
  37. "Population, total - Australia | Data". data.worldbank.org. Retrieved 2020-12-03.
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  39. Ichinose, Masakazu; Sugiura, Hisatoshi; Nagase, Hiroyuki; Yamaguchi, Masao; Inoue, Hiromasa; Sagara, Hironori; Tamaoki, Jun; Tohda, Yuji; Munakata, Mitsuru; Yamauchi, Kohei; Ohta, Ken; Japanese Society of Allergology (2017-04-01). "Japanese guidelines for adult asthma 2017". Allergology International. 66 (2): 163–189. doi:10.1016/j.alit.2016.12.005. ISSN 1323-8930. PMID 28196638.
  40. "Population, total - United Kingdom, Japan | Data". data.worldbank.org. Retrieved 2020-12-03.
References
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