Burden of Asthma in Kentucky

BACKGROUND:   Asthma is associated with significant morbidity in Kentucky. Kentucky has 120 counties that are divided into 15 Area Development Districts (ADD) for the purposes of planning and funding.  Using Behavioral Risk Factor Surveillance data, the Kentucky Asthma Program identified eight of the area development districts with higher prevalence rates of asthma in which to implement objectives and activities defined in the 2009 Kentucky State Plan for Addressing Asthma. This was made possible through a small amount of state funding and CDC funding initially received in 2009 and ongoing annually. The objective of this study is to measure the current burden of asthma and resulting impact of interventions implemented by the Kentucky Respiratory Disease Asthma Program and Kentucky Asthma Partnership.

METHODS:   Prevalence data was obtained from Kentucky Behavioral Risk Factor Surveillance Survey (BRFSS) 2004-2011.  Hospitalization and mortality data (2001- 2011) was obtained from Office of Health Policy and Office of Vital Statistics respectively. Men and women, age 18 and older were included in this analysis.  Child asthma was reported by the parent responding to the BRFSS survey. Prevalence estimates (weighted) of self-reported asthma were calculated for each Area Development District (ADD). Similarly, age-adjusted asthma hospitalizations and mortality rates were calculated for each year from 2001- 2011 for all ADDs.

RESULTS:   Current Asthma prevalence in Kentucky has continued to increase since 2004 (8.3%) to 2010(10.4%) as compared to the US rates of 8.1% in 2004 to 8.6% in 2010. Conversely, the child asthma age-adjusted hospitalizations rates have shown a steep decline in Kentucky since 2009 in targeted Area Development Districts. It was observed that there was a 35.5% decline in child asthma hospitalization rates in the targeted areas as compared to only 6.7% decline in the non-targeted areas. The decline in adult asthma hospitalization rates was gradual. One major limitation of this study is that these changes in the hospitalization rates cannot be solely attributed to program activities.

CONCLUSIONS:   A decrease in asthma hospitalizations rates especially in children has been observed since 2009. This decrease is particularly evident in targeted ADDs of Kentucky. But further studies are needed to understand the factors that have helped in a declining trend seen in child asthma hospitalization rates. Asthma in Kentucky needs to be further addressed to decrease the burden of morbidity and mortality associated with asthma.