Childhood asthma still high; individual plans seen as key

Children's visits to physicians' offices for asthma care doubled in the past decade, a new CDC report says.

By Susan J. Landers, AMNews staff. Jan. 22, 2007.

Washington -- A 10-year-old baseball-playing patient of Kurt Elward, MD, MPH, can round the bases a lot faster these days, and Dr. Elward, a Charlottesville, Va., family physician, attributes this circumstance to a closely followed asthma action plan.

The young player's dismal past seasons are no more, his mother told Dr. Elward, who first identified the child's asthma and then developed a treatment plan. Now the second baseman's disease is controlled, and he can hold his own on the field.

Newly developed medicines and close adherence to treatment are key to improved performance, said Dr. Elward. And the Charlottesville youngster is not alone. There are 6.5 million children younger than 18 who have asthma, according to a Dec. 12, 2006, report -- revised Dec. 29 -- from the Centers for Disease Control and Prevention's National Center for Health Statistics.

Those numbers seem resistant to change, according to "The State of Childhood Asthma in the United States: 1980-2005." But the good news is that deaths from asthma have declined since 1999, after a steady increase from 1980 to 1998. The disparity in asthma mortality between black and white children, however, has increased in recent years.

Another finding in the report focused on asthma-related visits to physicians' offices. These visits have increased sharply since the early 1990s, from 42 per 1,000 children younger than age 18 in 1990 to 89 per 1,000 in 2004.

"Greater numbers of ambulatory visits imply appropriate awareness of the need for regular follow-up and treatment," said Homer Boushey, MD, chief of the Asthma Clinical Research Center at the University of California, San Francisco, and a member of the board of the American Thoracic Society. "What is needed is a regular adherence to treatment, even when people are feeling pretty well, and a good understanding of action plans."