Health Impacts
Asthma
Asthma is a serious problem in New England. Adult and childhood asthma rates are among the highest in the country, and New England has the highest number of hospital visits due to asthma per capita—81 percent higher than the national average. (1) While asthma rates may be leveling off in other parts of the country, they appear to be still increasing in this region.(2)
The causes of asthma are unclear, however scientific research has shown that smog and soot from air pollution can worsen and even trigger asthma attacks. There is also evidence that ozone and diesel exhaust particles my cause asthma. Other air pollutants such as nitrogen oxides are also suspected of contributing to asthma attacks. And, nearly two-thirds of those suffering from asthma live in an area where at least one federal air-quality standard is not being met. (3)
Asthma is the fastest growing chronic disease--the number of Americans with asthma has more than doubled in the past 15 years.(4) Asthma has reached epidemic proportions—nearly one in 13 school-aged children have asthma,(5) and the percentage of children with asthma is rising more rapidly in preschool-aged children than in any other age group. (6)
In Massachusetts, one-third of all missed school days are attributed to asthma, and asthma is the number one cause of doctor’s office visits, emergency room visits, and hospital admissions for children. (7)
This trend of increasing incidence of asthma can be seen in the three target communities. Figure 2 shows increased asthma-related hospitalizations between 1990 and 2003 for all three communities:
Figure 2: Graph created from MassCHIP (MA DPH) download of asthma-related hospitalizations; turned into rate using population statistics from the MA Institute of Social and Economic Research (MISER)
The Importance of Asthma as an Indicator in the Three Target Communities:
When comparing the respiratory trends between asthma hospitalizations in the three target communities and hospitalizations for all respiratory illnesses, asthma appears to cause the majority of hospitalizations. In Beverly, asthma accounted for 10 out of every 11 people per 1000 hospitalized for respiratory illness, or 90 percent of the hospitalizations. In Salem, 9 out of every 11 hospitalizations per 1000, or 80 percent, were asthma related, and in Marblehead, 4.5 out of every 7 hospitalizations per 1000 were due to asthma, or 65 percent.
Salem: There is more readily available data for Salem than for the other two communities in the study .Asthma-related hospitalizations increased 47 percent between 1990 and 2003 and are 18 percent higher as compared with the rest of the state. Hospitalization rates for children were exceedingly high – 73 percent higher than the state rate for children ages 5-9, and 67 percent higher for children ages birth to 4 years.
The same trend can be seen for asthma related emergency room visits. For all ages there were 28 percent more asthma-related emergency room visits as compared with the state adjusted average. The differences for young children were much more dramatic. The rate of preschool children (ages 0 – 4) having asthma-related visits to the emergency room was 81 percent higher than the state age-adjusted rate, and was 49 percent higher for children aged 5 to 9 years.
Beverly: Asthma-related hospitalizations increased 130 percent between 1990 and 2003; rising from under 4 asthma-related hospitalizations per 1000 residents to 10. When Beverly’s rates are compared to the rest of the state by age, hospitalizations were only elevated for residents ages 65 and over. However, hospitalizations for asthma for the other age groups were higher than the goal for the community that was set by the State.
Marblehead: Asthma-related hospitalizations increased 60 percent between 1990 and 2003. However, Marblehead’s rate still compares favorably with the rest of MA, falling below the State’s age-adjusted rate for hospital discharges.
Figure 3 : Hospital Discharges - Asthma
| |
Area Count |
Area Age-adjusted Rate |
State Age-adjusted Rate |
| Salem |
71 |
179.5 |
155.4 |
| Beverly |
72 |
183 |
155.4 |
| Marblehead |
20 |
96.9 |
155.4 |
Source: MassCHIP (MA DPH) Instant Topics, Health Status Indicators. Rates are expressed per 100,000 people based on 2003 hospital discharges (UHDDS). Yellow highlights represent those categories which are elevated above the existing State Age-Specific Rate.
Asthma Related Deaths:
The actual number of asthma-related deaths in these communities is very small; however Salem’s rates are substantially higher than age-adjusted rates for the state. The data shows: (see charts in appendix ?)
Salem: Total asthma-related deaths are 92 percent higher than the state age-adjusted rate; and for people aged 20 and older, the rate is 88 percent higher.
Beverly: Asthma-related deaths were elevated only for the group aged 35 to 64 when compared with the rest of the state.
Marblehead: Data was not available, possibly because the numbers were too small.
(1) http://www.mass.gov/dep/air/community/airhealt.htm accessed 12/5/05
(2) "The Burden of Asthma in New England", the Asthma Regional Council, March 2006
(3) Environmental Defense, from:
http://www.environmentaldefense.org/ cleanairforlife.cfm?subnav=da_asthma
accessed 12/07/05
(4) Ibid; Environmental defense
(5) US EPA from:
http://www.epa.gov/iaq/schools/asthma/asthma_epidemic.htm
accessed 3/25/06
(6) Ibid; US EPA
(7) http://www.mass.gov/dep/air/community/airhealt.htm
accessed 12/5/05 |
