Colorado asthma resources
CDPHE:Colorado Asthma Program
American Lung Association in Colorado: Asthma
National asthma resources
National Environmental Public Health Tracking: Asthma
CDC: Asthma
CDC: Breathing Easier Brochure
EPA: Asthma
EPA: AirNow Enviroflash! Air Quality Notifications

National Public Health Tracking Program
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Age-adjusted rate (direct adjustment)
A measure of the frequency of an event per population unit that has been statistically adjusted to minimize the effect of different age distributions in different populations. People of different ages are more or less susceptible to certain illnesses, and more or less likely to engage in behaviors that might protect their health or put it at risk. Age-adjusted rates show if there are differences among groups independent of the age distributions within the groups. They also show differences in a group over time independent of the changing age structure of the group.
 
 
Age-specific rate
A rate in which the number of events and population at risk are restricted to an age group (e.g., the birth rate for women age 15 to 19; death rate for people age 45 to 64).
 


Dataset details

Interpreting the data
 

What these data tell us:
  • These data can be used to identify trends and patterns in the occurrence of asthma hospitalizations among Colorado residents over time and across counties.
  • These data present state and county incidence of asthma hospitalizations. That is the number of hospitalizations due to asthma that occurred during a specified time among those of a specified age and residents of a specified geography.
What these data do not tell us:
  • These data do not describe the prevalence of asthma. That means they do not tell us the number of people currently suffering from asthma.
  • Because these data are based on inpatient hospitalizations they may reflect more severe cases of asthma since people who are hospitalized often have more severe illness than those who are not hospitalized.
  • Comparisons of these asthma hospitalization data to environmental measures are done at the aggregate level, and just because events occur in the same geographic area does not mean that one must cause the other for each individual person. Elevated rates of asthma hospitalizations in geographic areas with higher than average environmental exposures do not necessarily indicate that the environmental exposure is causing the asthma hospitalizations. There may be other factors contributing to the disease for different individuals.
 
Numerator/Denominator Information
 

Event/numerator data:
Asthma hospital discharges, Hospital Discharge Dataset, Colorado Hospital Association.

Population/denominator data:
2009-based midyear resident population estimates, State Demography Office, Colorado Department of Local Affairs.

 

Limitations of the data
 
It does not include all asthma cases.
Hospitalization data does not include asthma among individuals who are not hospitalized for at least one night. Those who do not receive medical care, receive medical treated in outpatient settings, or die without being admitted to a hospital are not included in this data.

Differences in rates by year or county may reflect differences or changes in diagnostic techniques, changes in coding of asthma for hospital admissions, or changes in access to medical care. Multiple admissions are not identified so the true number of people hospitalized for asthma may be overestimated.
Although duplicate records are excluded, the measures are based upon events, not individuals. So if a person is admitted to the hospital for asthma, then admitted to the hospital for asthma again later, that would be counted as two separate events even though it was the same person.

It does not take into account many factors affecting hospitalization rates.
Rates may differ due to sociodemographic characteristics and associated behaviors. Factors such as access to medical care can affect the likelihood of a person being hospitalized for asthma.

Reporting rates at the state and county level is a broad measure.
These data will not show the true asthma burden at a more local level, such as the neighborhood level. And these data are not geographically specific enough to be linked with many types of environmental exposure which may vary across the county.
 


Data not included
 
  • These data do not include hospital discharges from Federal facilities in Colorado, namely the Denver and Grand Junction Veterans Affairs Medical Centers.
 

Calculation methods
 
  • Asthma hospitalizations identified by ICD-9 Code: 493.XX
  • Age-specific hospitalization rates are computed per 10,000 population in respective age group and geographic population.
  • Age-adjusted rates are computed per 100,000 population and are adjusted by direct method using the Year 2000 U.S. Standard Population.
 

Metadata
 

 
What is asthma?
 

Asthma is a disease that causes the airways of the lungs to become swollen, fill with fluid and tighten.

Asthma is also one of the most common long-term diseases in children, but many adults have asthma, too.

Asthma causes repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs (triggers).

Asthma can be controlled by taking medicine and avoiding the triggers that can cause an attack. You must remove the triggers in your environment that can make your asthma worse or cause an attack.
 

Why is asthma a concern?
 

Every day in the United States:
  • 30,000 people have an asthma attack
  • 5,000 people visit the emergency room due to asthma
  • 1,000 people are admitted to the hospital due to asthma
  • 11 people die due to asthma
Asthma often causes lower quality of life for children who have it and the people who care for them. Asthma is associated with undesirable health outcomes that could be prevented, such as obesity.

There are also large direct and indirect economic costs, including hospitalization, medications and time off from school or work.

 

What is known about asthma and the environment?
 

If a person has asthma, the airways in the lungs are irritated and swollen so they are more likely to react strongly to:
  • Irritants, such as tobacco smoke and air pollution
  • Allergens, such as pollen, mold or mildew
  • Infections, such as a cold or the flu
A number of studies have reported associations between air pollution exposures and asthma. Specifically, researchers have found an association between increased hospital admissions for asthma and particulate matter, an outdoor air pollutant.

Scientific studies have also linked ground-level ozone with increased asthma attacks and hospitalizations due to asthma.
 

Who is at risk?
 
  • Asthma affects all races, ages, and genders
  • Asthma often starts in childhood and is more common in children than in adults
  • If someone in your family has asthma, you are also more likely to have it
 

How can risk be reduced?
 

Asthma has no cure, but it can be controlled.

The majority of problems associated with asthma, including hospitalization and death, are preventable if asthma is managed according to established guidelines.

An asthma action plan (also called a management plan) is a written plan that you develop with your doctor to help control your asthma. The asthma action plan shows your daily treatment, such as what kind of medicines to take and when to take them. Your plan describes how to control asthma long term and how to handle worsening asthma, or attacks. The plan explains when to call the doctor or go to the emergency room. If you are the parent of a child with asthma, give a copy of the asthma action plan to your child’s school, especially the school nurse. Effective management includes controlling exposure to factors that trigger attacks.

Important triggers include:
  • Second hand smoke
  • Dust
  • Mold or mildew
  • Pet dander
  • Cockroaches and other pests
  • Outdoor air pollution
  • Strong smells or odors, including perfumes
Two key air pollutants can affect asthma:

Ground-level ozone, which is found in smog.
Ground-level ozone is often worst on hot summer days, especially in the afternoons and early evenings. Particle pollution can be bad any time of year, even in winter. It can be especially bad when the weather is calm, allowing air pollution to build up.

Particle pollution, which is in haze, smoke and dust.
Particle levels can also be high near busy roads or highways, during rush hour, around factories and when smoke is in the air from wood stoves, fireplaces or burning vegetation.

People can take steps to help protect their health from air pollution. They should:
  • Know how sensitive they are to air pollution
  • Know when and where air pollution may be bad
  • Plan activities when and where pollution levels are lower, using the Air Quality Index to guide planning
  • Change their activity level
  • Listen to their bodies
  • Keep quick-relief medicine on hand when they're active outdoors
  • Follow an asthma action plan with the help of their health care provider.

 

How is asthma tracked?
 

The Tracking Network uses data on hospitalizations due to asthma.

Because the Tracking Network uses hospital data to calculate asthma measures, it reflects more severe cases of asthma. If people have to be hospitalized for asthma, they usually have more severe cases than people with asthma symptoms who are not hospitalized.
 
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