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About CEHTP

QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us.

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About CEHTP

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  1. QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us The California Environmental Health Tracking Program: Improving Public Health With Better Information The California Environmental Health Tracking Program (CEHTP) is working to improve public health by delivering science-based information on the trends and distributions of diseases, environmental threats, and the often complex relationship between them. About CEHTP Learn about our mission, history, past and current activities, advisory group, and more Environmental Hazards Find data and information about hazards such as air pollution, pesticides, water, and more Environmental Exposures Find data and information about exposures such as carbon monoxide poisoning, lead, and more Health  Find data and information about health effects such as birth outcomes, asthma, cancer, and more Other Data Learn where to find data and information on demographics, schools, and more Tools and Services Use web tools developed by CEHTP. Find descriptions, tutorials, and more Concepts in Tracking Learn key concepts in Tracking, environmental health, statistics, and epidemiology. View glossary. Publications & Resources Find CEHTP publications and links to other publications and websites of interest

  2. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Health Data and Information Health and the environment Environmentally related diseases take a fiscal and human toll on Californians. For example, the costs associated with only nine chronic diseases, including childhood asthma, cancer, and lead poisoning, are estimated to be $10 billion per year, or $288 per person. Exposure to environmental hazards accounts for a significant proportion of many chronic diseases, including an estimated 30% of childhood asthma exacerbations and 10% of neurodevelopmental disorders in children.1 What does CEHTP do with health data? Establishing a cost-effective environmental health surveillance systems can play a key role in reducing environmentally related disease. The ability to link health and environmental data can be crucial for researchers to understand relationships between specific hazards and health outcomes. At the same time, health data on its own is a vital resource, helping Californians to understand issues of community vulnerability, asset allocation, and prevention for many conditions about which environmental links are already known. In this spirit, CEHTP seeks to promote the utility and dissemination of population health information. Heart Attacks (myocardial infarctions) Find data and information about heart attacks, also known as myocardial infarctions. Metadata Find details about the datasets and data sources used by CEHTP Asthma Find data and information about asthma. Maternal and Infant Health  Find data and information about maternal and infant health including prematurity, growth retardation, and infant mortality. Cancer Find data and information about different types of cancer. 1California Policy Resource Center. Strategies for Establishing an Environmental Health Surveillance System in California. Berkeley: Regents of the University of California (2004). ◄Home

  3. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Asthma in California Asthma is a disease that affects the lungs and makes it difficult to breath. It is a serious health concern affecting many adults and children in California. Research has shown that asthma is exacerbated by elements in the environment (e.g. air pollution). To help further understand the relationship between asthma and the environment, CEHTP is providing data and information to help track asthma in California. Create your own asthma tables, charts, and maps What do we know about asthma?Learn about asthma, the burden in California, disparities, and relationship with the environment. Measuring asthma in CaliforniaFind out about how asthma is measured, the asthma surveillance systems in California, and what data are available Asthma data for California Create your own asthma table, chart, and map using data compiled by CEHTP Asthma data for the U.S.  Learn where to find data and information on asthma nationwide Innovative approaches to asthma surveillanceCEHTP has piloted tracking methods to improve what we know about asthma Other asthma resources Find asthma resources on related topics Frequently asked questions about asthma Get answers to other questions about asthma HEALTH DATA ► Asthma ► Birth Outcomes Cancer Heart Attacks Metadata ◄Health

  4. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us What do we know about asthma? Asthma is a chronic disease that impacts over 5 million Californians. Not much is known about what causes people to develop asthma. We know much more about what causes asthma attacks and how to prevent them from occurring. We also know that asthma impacts different segments of the population differently, though it is not clear why. Our understanding of the impacts of the environment on asthma is also growing. Create your own asthma tables, charts, and maps What is asthma?  Learn about what causes asthma and asthma attacks, how it’s diagnosed, treated, and prevented. What is the asthma burden in California?  Find out how asthma impacts California residents. What are asthma disparities?  Find out what communities in California are most impacted by asthma. How is asthma related to the environment?  Learn more about the relationship between asthma and the environment. HEALTH DATA ► Asthma ► Birth Outcomes Cancer Heart Attacks Metadata ◄Asthma in California

  5. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us What is asthma? Asthma is a disease that affects the lungs. It is the most common chronic disease among children in the U.S.  Asthma is characterized by ongoing inflammation of the lining of the lung passages.  Frequently, this inflammation does not cause symptoms.  Other times, the lung passages undergo spasms resulting in symptoms such as coughing, chest tightness, and wheezing.  The severity of those symptoms can range from mild to life-threatening. Create your own asthma tables, charts, and maps • What causes asthma? • The complete causes of asthma are still unknown, but both genetic and environmental factors influence asthma development. Once a person has asthma, there are a number of things that trigger symptoms such as colds, allergens, and air pollution. Though a person can get asthma at any age, it is more likely to be diagnosed in childhood than in adulthood. • Once a person has asthma, it doesn’t go away, although it may get better at times. There is no cure for asthma. With proper management, most people can control their condition so that symptoms occur infrequently and have a minimal impact on their daily life. • What is an asthma attack? • Asthma symptoms may be mild and go unnoticed for long periods of time.  When asthma symptoms become worse, it is called an “asthma attack”. During asthma attacks, symptoms may interfere with school, work, or play.  For some, asthma attacks may be serious enough to warrant visits to the emergency department or hospitalization.  In the worst situation, an asthma attack can cause death. • Common asthma symptoms include: • Wheezing • Chest tightness • Coughing ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► (1 of 3)

  6. What causes an asthma attack? There is a difference between what causes someone to have asthma and what triggers asthma attacks and symptoms. We know much more about elements that trigger asthma attacks. The most common asthma triggers include viruses, allergens, irritants, and exercise. What are asthma triggers? Asthma triggers bring on asthma attacks and symptoms. The most common asthma triggers include viruses, allergens, irritants, and exercise. • Allergens, or substances that can cause an allergic reaction, include: • Mold • Dust mites • Cockroaches • Pet dander • Pollen from trees, bushes, weeds, grasses, and other plants • Irritants, or particles in the air that irritate the nose and breathing passages, include: • Air pollution • Chemicals used in the household and workplace • Cold air or changes in weather • Strong odors • Tobacco smoke (both from smoking and secondhand smoke) • Medications • Respiratory infections • Each person with asthma may be susceptible to different asthma triggers. To prevent asthma attacks, it is important to minimize exposure to these asthma triggers. (2 of 3)

  7. How can asthma be diagnosed? There is no single way to diagnose asthma.Asthma can be diagnosed by physicians through interviews with patients, physical examinations, trials of medications, and lung function testing.  Some individuals with asthma may not be diagnosed, especially if they are not receiving adequate medical care. How can asthma be controlled? Although there is no known cure for asthma, severe attacks are generally considered preventable.  Once asthma is developed, it is important to manage the disease and prevent asthma attacks. Asthma can be controlled with regular preventative healthcare, a clear asthma action plan, medication, and by avoiding known asthma triggers. How can asthma be prevented? No one knows for certain how to prevent asthma from developing. However, individuals can lower the chance of having an asthma attack. Right now many researchers are trying to understand what causes the development of asthma so that it can be prevented. Until we know more about what causes asthma, the best way to prevent attacks is to avoid the triggers, like secondhand smoke, that make asthma worse. Other preventative actions include proper using medications, preventing colds and flus, and getting regular check-ups from a healthcare provider. To improve asthma at a societal level, the California Department of Public Health has coordinated the development of the Strategic Plan for Asthma in California 2008-2012 (PDF). This plan outlines strategies and recommendations for different stakeholders throughout the state to work collaboratively to reduce the asthma burden for California. Where can I learn more about asthma? See our compiled list of asthma resources. (3 of 3) ◄What do we know about asthma?

  8. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us What is the asthma burden in California? Create your own asthma tables, charts, and maps Asthma impacts a population in many ways Since many people are able to manage their symptoms or no longer experience symptoms, the number of people who have been diagnosed with asthma is different from the number of people who currently experience severe symptoms. To understand the complete asthma burden in California, it’s important to look at how many people have actually been diagnosed with asthma (lifetime asthma prevalence), how many are currently experiencing asthma attacks (current asthma prevalence), how people are using the healthcare system to manage their asthma, and the economic costs associated with asthma. Asthma is on the rise Nationwide, the prevalence of asthma has been on the rise 1. In California, the lifetime prevalence for asthma is higher than the national prevalence and has increased over the past decade (1995-2005) 2. Over 5 million Californians, or 13 %, have been diagnosed with asthma at some point in their lives. Among California adults, 2.1 million (7.6%) currently have asthma. Among California children, 827,000 (8.6%) currently have asthma. About a third of children with asthma have had an asthma attack in the past year 2. Need for better asthma management When asthma is not properly controlled,symptoms may be exacerbated and can result in an emergency department (ED) visit, hospitalization, or death. In 2006, there were approximately, 98,995 asthma-related visits to the ED in California and 21,818 asthma-related hospitalizations. In 2004, there were 450 deaths due to asthma (13 deaths per every 1 million California residents) 2. ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► (1 of 2)

  9. Asthma is costly In addition to the impact on the health of Californians, there are enormous direct and indirect economic costs associated with asthma. In 2005, asthma hospitalizations in California cost $763 million. Between 1995 and 2005, the average charge per asthma hospitalization more than doubled from $9,277 to $23,953 2. ________________________________________________________________________________ 1. Moorman JE, Rudd RA, et al. National Surveillance for Asthma --- United States, 1980-2004. MMWR. Oct. 19, 2007; 56 (S S08); 1-14; 18-54. 2. Milet M, Tran S, Eatherton M, Flattery J, Kreutzer R. “The Burden of Asthma in California: A Surveillance Report.” Richmond, CA: California Department of Health Services, Environmental Health Investigations Branch, June 2007. Available at: http://www.californiabreathing.org/images/stories/publications/asthmaburdenreport.pdf (2 of 2) ◄What do we know about asthma?

  10. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us What are the asthma disparities in California? Asthma is not distributed equally Different segments of the population bear a disproportionate burden of asthma. These disparities are significant by race and ethnicity, income, gender, age, and geographic location. For example, in 2005, rates of lifetime asthma prevalence varied significantly by race and ethnicity: Lifetime Asthma Prevalence in California, 2005 Data Source: California Health Interview Survey 2005 Racial and ethnic disparities in asthma In California, American Indian/Alaskan Natives have an asthma prevalence two times greater than Hispanics and Asian/Pacific Islanders. Since little is known about what causes people to develop asthma, the reason for this disparity is not well understood. It has been well-established that Blacks bear a disproportionate share of the asthma burden. In addition to having a higher prevalence, Blacks have much higher rates of asthma ED visits, hospitalizations, and mortality than Whites . Create your own asthma tables, charts, and maps What’s a confidence interval? ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► (1 of 3)

  11. Asthma disparities also exist within subgroups of these broader race/ethnicity categories. Among Hispanic school-aged children in California, asthma prevalence ranged from 13.2% for Mexican American students to 22.8% for Puerto Rican students. Among Asian/Pacific Islander school-aged children, asthma prevalence ranged from 10.9% for Korean American students to 23.8% for Filipino American students. The reasons for disparities within the race/ethnic groups are not fully understood. They may be influenced by characteristics related to country of birth, residential history, generational status, and/or degree of acculturation. Income disparities in asthma Although the prevalence of asthma does not vary by income in California, people with lower incomes tend to have more severe symptoms, higher rates of asthma hospitalizations, and are more likely to have repeat visits to the hospital. Geographic disparities in asthma Asthma also varies widely by geographic area. Causes for this might include differences in population demographics, insurance coverage, access to and quality of healthcare, and/or air pollution. Communities that are exposed to more pollution often have higher rates of asthma ED visits, hospitalizations, and mortality. Why do disparities in asthma exist? It is not fully understood why low-income communities and communities of color experience such vast asthma disparities. However, awareness about these asthma disparities has increased in California in recent years, as more attention has been focused on issues such as environmental justice, the goods movement, and climate change. These issues highlight the disproportionate impact on the environment and health of these same communities. Disparities in the quality of and access to health care experienced by these communities also account for some of the disparities in asthma outcomes. (2 of 3)

  12. Other factors associated with asthma Children make up a large part of the asthma burden, in terms of asthma prevalence as well as ED visit and hospitalization rates. Among children, boys have higher rates of asthma than girls. Among adults, women have higher rates than men. Smoking can exacerbate asthma and worsen asthma symptoms. Two thirds of people who smoke experience asthma symptoms monthly, while less than half of non-smokers experience asthma symptoms monthly. Obesity is associated with asthma among both children and adults. It is not certain whether one causes the other, or whether there is a separate factor causing both. Children who are overweight or obese have a higher risk of having asthma. This higher risk is evident among both males and females and across race and ethnicity groups. _________________________________________________________________________________________________________ 3. Stockman JK, Garcia K, Von Behren J, Bembom O, Shaikh N, Kreutzer R. “Asthma Disparities Among African Americans”. California Asthma Facts, Volume 2, Issue 1. March 2004. Environmental Health Investigations Branch, California Department of Health Services. 4. National Center for Health Statistics: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/ashtma03-05/asthma03-05.htm#fig5 5. Davis A, Kreutzer R, Lipsett M, King G, Shaikh N. Asthma Prevalence in Hispanic and Asian American Ethnic Subgroups: Results from the California Healthy Kids Survey. Pediatrics. 2006;118(2):e363-e378. 6. Chinn, S. Obesity and asthma: Evidence for and against a causal relation. Journal of Asthma. 2003: 40(1):1-16. 7. Eatherton M, King G, Rossi D, Shrem D, Bolcoa J, Kreutzer R, Cowan B. “Asthma and Obesity: Results from the California Healthy Kids Survey, 2001-2003.” California Asthma Facts. May 2006: 3(1). Environmental Health Investigations Branch, California Department of Health Services. 8. Hastert TA, Babey SH, Brown ER and Meng YY. Pets and Smoking in the Home Associated with Asthma Symptoms and Asthma-Like Breathing Problems. Los Angeles: UCLA Center for Health Policy Research, 2007. (3 of 3) ◄What do we know about asthma?

  13. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us What environmental factors are related to asthma? There is increasing evidence and awareness about the relationship between asthma and the environment. There is some evidence that environmental factors can cause asthma. However, we know much more about what indoor and outdoor environmental factors can exacerbate asthma symptoms or trigger asthma attacks. How much does our environment affect asthma? Since there are many non-environmental factors that contribute to asthma, there have been efforts to estimate what proportion of the asthma burden is related to the environment. This estimate is also known as the environmental attributable fraction or EAF. In a study conducted by the World Health Organization, it is estimated that 44% of the asthma burden worldwide is due to the environment. In the U.S., an expert panel estimated that 30% of asthma exacerbations among children were related to the environment. This was associated with an annual cost of $2.0 billion. Indoor air quality Indoor air quality in the home and workplace is a concern for people with asthma. In the home, some indoor air pollutants, also known as asthma triggers, are associated with both the development and exacerbation of asthma. These include house dust mites, environmental tobacco smoke, cockroaches, and dander from cats. Other indoor air pollutants are known to trigger asthma attacks, such as mold, chemicals, and strong odors. Asthma and the workplace Work-related asthma is asthma that can be caused or triggered by conditions or substances in the workplace. Currently, there are approximately 350 substances known to cause new onset asthma in the work place. This list of substances is continually updated by the Association of Occupational and Environmental Clinics. In California, estimates indicate that 137,000 to 315,000 adults have asthma related to their work environment. Create your own asthma tables, charts, and maps ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► (1 of 2)

  14. Environmental tobacco smoke Exposure to environmental tobacco smoke (ETS), also called second hand smoke, can cause symptoms and asthma attacks in both children and adults. Exposure to ETS may also cause the development of asthma in children and adults . In 2005, the California Air Resources Board estimated that exposure to ETS contributes to 202,300 excess childhood asthma episodes per year. Improving indoor air quality in California At the state-level, efforts to improve indoor air environments are focused on schools, childcare centers, healthy homes, institutional settings, and workplaces. These efforts involve reducing exposures to environmental triggers. To learn more about what the State is doing to address indoor environments and asthma, see Goal 4 in the Strategic Plan for Asthma in California 2008-2012 (PDF). Outdoor air quality Exposure to outdoor air pollutants are known to be associated with asthma severity, hospitalizations, emergency department (ED) visits, and asthma deaths. Outdoor air pollutants may even by related to the risk of developing asthma. Ozone, particulate matter (PM) 2.5, and PM 10, have been shown to contribute to an increase in asthma-related ED visits and hospitalization among both children and adults. Other pollutants related to increased asthma ED visits include carbon monoxide (CO), nitrogen dioxide (NO2), and pollution from coal and petrochemical sources . The California Air Resources Board (ARB) estimates that exposures to high levels of PM 2.5 and ozone are associated with 81,000 to 320,000 cases of asthma and other respiratory symptoms annually. The economic cost of these cases is estimated to be between $1.6 and $6.2 million dollars annually. Climate Change Climate change adversely impacts ambient temperature, levels of air pollution, and the amount of pollen in the air. These are associated with asthma exacerbation. It is important to continue to track the impact of climate changein California, as this phenomenon will continue to have an impact on asthma and other health outcomes. __________________________________________________________________________________________________ References (2 of 2) ◄What do we know about asthma?

  15. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us How is asthma measured? There are many ways to measure asthma Asthma is a complex disease that has a range of severity and symptoms. Because there is no single way to diagnose asthma and people experience asthma differently, measuring asthma in the population is difficult. It is important to know how many people have asthma (known as prevalence), as well as understand the symptoms and the severity of their asthma. The effort to keep track of asthma in the population is called asthma surveillance. Create your own asthma tables, charts, and maps The Asthma Surveillance Pyramid The Asthma Surveillance Pyramid is a model developed by the Centers for Disease Control and Prevention (CDC) to describe the spectrum of asthma indicators, or ways to measure the asthma burden. To get a complete picture of asthma in California, we must look at all the asthma indicators depicted on the pyramid. This is a challenge because data are not readily available for all the indicators. HEALTH DATA ► Asthma ► Birth Outcomes Cancer Heart Attacks Metadata • The pyramid sits on a base (1) that represents asthma • prevalence, or all people with asthma. Within this • group, the severity and symptoms of asthma can be • very different. Some individuals may not even know • they have asthma. • Each level of the pyramid represents an indicator of • asthma (2-6). The lower levels of the pyramid indicate • less severe asthma, which affects a greater proportion • of people with asthma. Each successively higher level • in the pyramid represents increasingly severe asthma, • affecting a smaller proportion of people with asthma. • Outside the pyramid are quality of life, cost, pharmacy, • and triggers (7-10). These are four factors that impact • or are impacted by asthma. The components of the • pyramid are described in more detail below. (1 of 3)

  16. Indicators of asthma • For more information on how each asthma indicator is measured and where the data is from, click on the indicator name below. • Asthma Prevalencerefers to all the people with asthma in a population during a period of time. Severity refers to the range of symptoms that people with asthma can experience. • Scheduled Office Visitsrepresent people who have access to a physician, indicating their asthma may be controlled. • Unscheduled Office Visitsrepresent people who have access to a physician, but who may be experiencing severe symptoms. • Emergency Department /Urgent Carevisits represent people with asthma who end up at the emergency department (ED) or utilize urgent care services for treatment of asthma symptoms. This may be because they have been unable to manage their asthma properly or they lack access to a primary health care provider. • Hospitalizations represent people with severe asthma who end up being hospitalized for their asthma. Like ED visits, asthma hospitalizations suggest that the individual may not have been able to manage his or her asthma properly. Asthma hospitalizations are often preventable and are very serious and costly. • Mortality represents people who die from their asthma. Like asthma hospitalizations and ED visits, most asthma deaths can be prevented with proper management and quality health care. • Factors that may impact or be impacted by asthma • Quality of Life When a person’s asthma is not properly managed or treated, their quality of life can be greatly • impacted. This may include activity limitations, school/work absenteeism, and general health status. (2 of 3)

  17. Cost There are many direct and indirect costs associated with asthma. These may include health care utilization costs, such as hospitalizations or ED visits (direct), and missed days at work costs (indirect) . • Pharmacy Asthma can be managed and treated by having access to and properly using medication. • TriggersAn asthma trigger is an element that makes existing asthma worse or brings about an asthma attack. Each person with asthma may be susceptible to different types of triggers. Barriers to measuring asthma The data for the indicators on the asthma surveillance pyramid are not always available or simple to obtain. They often come from different data sources and are collected for different reasons. For example, health care providers are not required to report asthma-related office visits to the State. Hospital data are collected for the purposes of tracking health care quality, rather than for public health surveillance. Where data from hospitals or health care providers do not exist, telephone-administered surveys are often used to gather information. However, telephone surveys are limited by what the respondent can or can’t recall. Learn more about how indicators are measured and who collects the data- Asthma indicators: measurement and data collection in California. (3 of 3) ◄Asthma in California

  18. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Asthma indicators: measurement and data collection in California Prevalence How is asthma prevalence measured? Prevalence is estimated through telephone surveys of a random sample of the population. Adult survey respondents are asked if they have ever been diagnosed with asthma by a health care provider, while parents or guardians are asked if their children have been diagnosed with asthma. This is a measure of lifetime asthma prevalence. Respondents are also asked if they or their children still experience asthma symptoms, a measure of current asthma prevalence. Where do the data come from? Prevalence data in California come from two surveys. The Behavioral Risk Factor Surveillance System (BRFSS) is a survey that is nationally coordinated by the Centers for Disease Control and Prevention and conducted in California by the Survey Research Group of the CDPH.The California Health Interview Survey (CHIS) is a statewide survey conducted by University of California at Los Angeles in collaboration with the California Department of Public Health, the Department of Health Care Services, and the Public Health Institute. To see the prevalence estimates in California, see California Breathing’s Asthma Burden Report (PDF) Severity How is asthma severity measured? There is no routine system for collecting clinical asthma severity information in California. BRFSS and CHIS do not include questions about asthma severity as diagnosed or assessed by a health care provider. However, the surveys include questions on asthma symptoms and healthcare. This information is used to assess how asthma affects the people who have it. Survey topics include: the number of school or work days missed due to asthma, days of activity limitation due to asthma, frequency of symptoms and asthma attacks, and how well asthma is managed. Where do the data come from? Asthma severity is estimated from two surveys, BRFSS and CHIS.BRFSS has been conducted in California since 1984. Some years have included very detailed information about asthma severity. However, the sample size of BRFSS is too small to get reliable estimates for population subgroups such as race/ethnicity groups. CHIS has only been conducted bi-annually since 2001, but it has a much larger sample size and can provide reliable estimates by race/ethnicity and county.    ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► (1 of 3)

  19. Scheduled and Unscheduled Office Visits How are office visits measured? Scheduled or unscheduled office visits could ideally be measured by identifying asthma-related visits in medical records, though health care providers are not required to report this information to the State. Another way to gather information on office visits is through telephone administered surveys. Where do the data come from? Currently, there is no system that gathers medical record data to track asthma-related office visits in California. The Behavioral Risk Factor Surveillance System (BRFSS) asks people with asthma how many office visits they have had in the past year. However, self-reported information may be inaccurate. This question also does not provide details about the full extent of health care usage for asthma, nor the type and quality of care that is given. Emergency Department/Urgent Care Visits How are asthma emergency department visits measured? An asthma-related emergency department (ED) visit is measured by examining hospital records on ED visits and identifying the visits that had an asthma diagnosis. Some ED visits may result in a hospitalization. Where do the data come from? Hospitals are required to report all ED visits to the California Office of Statewide Health Planning and Development (OSHPD). OSHPD began collecting and maintaining ED data in California in 2005. The OSHPD Emergency Department/Ambulatory Surgery (ED/AS) databases include information such as age, gender, race/ethnicity, and diagnosis. Create your own table, chart, and map with asthma ED data (2 of 3)

  20. Create your own table, chart, and map with asthma hospitalization data Hospitalizations How are asthma hospitalizations measured? An asthma-related hospital admission is identified by looking at hospitalization data and selecting the admissions that had an asthma diagnosis. Where do the data come from? Hospitals are required to report all hospitalizations to the California Office of Statewide Health Planning and Development (OSHPD). OSHPD maintains data on asthma hospitalizations in its Patient Discharge Databases (PDD). These datasets include information such as age, gender, race/ethnicity, diagnosis, and charges. Mortality How is asthma mortality measured? An asthma death is identified by looking at death records data and selecting cases that had asthma listed as the primary cause of death. Where does the data come from? Data on asthma deaths come from death certificate data compiled by the California Department of Public Health, Center for Health Statistics (CHS). These data have been routinely collected since ####. These data sets have a record for each death in California. Records include information such as age, gender, race/ethnicity, and cause of death. (3 of 3) ◄ How is asthma measured?

  21. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Asthma data for California • Tracking asthma in California • A number of programs contribute to the effort to understand asthma in California by collecting, analyzing, and disseminating data and information. The California Environmental Health Tracking Program (CEHTP) aims to provide and improve information about the burden of asthma due to the environment. From previous research, we know that asthma-related hospitalizations and emergency department (ED) visits are associated with air pollution and other environmental factors. By tracking these asthma indicators, CEHTP hopes to provide data and information to support efforts to reduce asthma related to the environment. • What data are available here? • Our data query system allows you to create your own table, charts, and maps using data on these asthma hospitalization and ED visit measures. These measures were developed in a joint effort by CEHTP, the CDC Tracking Program and grantees, the State Environmental Health Indicators Collaborative, California Breathing, and other stakeholders. • Other asthma data for California • California Breathing (CB), the state asthma surveillance program, analyzes and disseminates asthma data and information for purposes of reducing the overall burden of asthma. A few of CB’s more recent publications with asthma data include: • California Breathing: County Asthma Profiles • California Breathing: Asthma Burden Report (PDF) • To learn more about CB’s asthma surveillance efforts, see the California Breathing Asthma Surveillance Overview . HEALTH DATA ► Asthma ► Birth Outcomes Cancer Heart Attacks Metadata Create your own asthma tables, charts, and maps ◄ Asthma in California

  22. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Asthma data query To create a table, chart, or map, select from the following list of options: ►Submit your selection x x x x ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► ◄ Asthma data for California

  23. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table ► Chart Map Information Data Sources & Limitations Modify your query Age-adjusted Asthma Hospitalization Rates Among Total California Residents by County, 2005 • What does this data tell us? How can I use this data? •  To see county-specific data, click on the county name. • See these data calculated in other ways (explanation of methods here ): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. ◄ Asthma data query

  24. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table Chart ► Map Information Data Sources & Limitations Modify your query Age-adjusted Asthma Hospitalization Rates Among Total California Residents by County, 2005 • What does this data tell us? How can I use this data? •  To see county-specific data, click on the county name. • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Rate per 10,000 residents Footnotes: data source, suppression info, etc. ◄ Asthma data query

  25. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table Chart Map Information Data Sources & Limitations Modify your query • ► What does this data tell us? How can I use this data? •  To see county-specific data, click on the county name. • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse ◄ •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. ◄ Asthma data query

  26. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us ►Modify your query ►Table Chart Map Information Data Sources & Limitations • What are asthma hospitalizations? • This asthma indicator represent people with severe asthma who end up being hospitalized for their asthma. Asthma hospitalizations are very serious, often preventable, and very costly. • What does this data tell us? How can this data be used? • This data can be used to compare the total number and rates of asthma hospitalizations by county. • This data identifies which counties have the highest or lowest asthma hospitalization rates. • This data identifies which counties have hospitalization rates higher than the State. • This data can be used to identify which segments within the county population (e.g. Latino, children) • are at highest risk for asthma hospitalizations. • This information can inform public health practitioners and health care service providers in program • planning and in targeting interventions. • What can’t this data tell us? • This data can not tell us what neighborhoods within the county are at highest risk for asthma • hospitalizations • This data can not tell us what causes asthma hospitalizations. • This data alone can not tell us the total burden of asthma in a county. •  To see county-specific data, click on the county name. • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► ◄ Asthma data query

  27. Modify your query • 1. Select another indicator: • 2. Select another year: • 3. Select another population: • 4. Select another way to calculate the data: • Asthma ED visits • 2001 (scroll down to see options) • Total population • Age group: • 0-17 years old • 18-64 years old • 65 and older • Race/ethnicity group: • Asian • Black • Latino • White • Other • Gender: • Male • Female • Age-adjusted rates • Crude-rates • Modeled rates QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us ►Table Chart Map Information Data Sources & Limitations Modify your query • What are asthma hospitalizations? • This asthma indicator represent people with severe asthma who end up being hospitalized for their asthma. Asthma hospitalizations are very serious, often preventable, and very costly. • What does this data tell us? How can this data be used? • This data can be used to compare the total number and rates of asthma hospitalizations by county. • This data identifies which counties have the highest or lowest asthma hospitalization rates. • This data identifies which counties have hospitalization rates higher than the State. • This data can be used to identify which segments within the county population (e.g. Latino, children) • are at highest risk for asthma hospitalizations. • This information can inform public health practitioners and health care service providers in program • planning and in targeting interventions. • What can’t this data tell us? • This data can not tell us what neighborhoods within the county are at highest risk for asthma • hospitalizations • This data can not tell us what causes asthma hospitalizations. •  To see county-specific data, click on the county name. • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► ►Submit ◄ Asthma data query

  28. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table Chart Map ►Information Data Sources & Limitations Modify your query Age-adjusted Asthma Hospitalization Rates Among Total California Residents by County, 2005 • What does this data tell us? How can I use this data? • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► ► Footnotes: data source, suppression info, etc. ◄ Asthma data query

  29. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table Chart Map ►Information Data Sources & Limitations Modify your query Age-adjusted Asthma Hospitalization Rates Among Total California Residents by County, 2005 • What does this data tell us? How can I use this data? • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP County-specific data 1. See a time series table and chart for this county. 2. See more detailed county-specific tables and charts. ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. ◄ Asthma data query

  30. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table ► Chart Map Information Data Sources & Limitations Modify your query Age-adjusted Asthma Hospitalization Rates Among Alameda County Residents, 2001-2006 • What does this data tell us? How can I use this data? • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. ◄ Asthma results

  31. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table Chart Map Information Data Sources & Limitations Modify your query Age-adjusted Asthma Hospitalization Rates Among Alameda County Residents, 2001-2006 • What does this data tell us? How can I use this data? • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP (fake data) ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Alameda California 0 2001 2002 2003 2004 2005 2006 Footnotes: data source, suppression info, etc. ►Asthma results

  32. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Modify your query • Asthma Hospitalization Rates Among Alameda County Residents, 2005, by • ► Race/ethnicity • Race/ethnicity by age • Race ethnicity by gender • Age • Age by race/ethnicity • Age by gender • Gender • Gender by race/ethnicity • Gender by age • What does this data tell us? How can I use this data? • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. ◄ Asthma results

  33. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table Chart Map Information Data Sources & Limitations Modify your query • What does this data tell us? How can I use this data? • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP Asthma Hospitalization Rates Among Alameda County Residents, 2005, by Race/ethnicity ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. • ► Race/ethnicity by age • ► Race ethnicity by gender ◄ Asthma results

  34. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us • ►Race/ethnicity Modify your query Table Chart Map Information Data Sources & Limitations • What does this data tell us? How can I use this data? • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse •  Request more asthma information from CEHTP Asthma Hospitalization Rates Among Alameda County Residents, 2005, by Race/ethnicity by age ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. • ► Race ethnicity by gender ◄ Asthma results

  35. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us • ► Race/ethnicity • ► Race ethnicity by age Modify your query Table Chart Map ►Information Data Sources & Limitations • What does this data tell us? How can I use this data? • See these data calculated in other ways (explanation of methods here): • Produce estimates for areas where data are sparse ◄ •  Request more asthma information from CEHTP Asthma Hospitalization Rates Among Alameda County Residents, 2005, by Race/ethnicity by gender ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. ◄ Asthma results

  36. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table Chart ► Map Information Data Sources & Limitations Modify your query Modeled Asthma Hospitalization Rates Among Total California Residents by County, 2005 • What does this data tell us? How can I use this data? • To see county-specific data, click on the county name. • See these data calculated in other ways (explanation of methods here): • Produce age-adjusted estimates •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. ◄ Asthma data query

  37. QUICK LINKS CEHTP Home ► About CEHTP Environmental Hazards Environmental Exposures Health ► Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us Table Chart Map Information Data Sources & Limitations Modify your query • What does this data tell us? How can I use this data? • To see county-specific data, click on the county name. • See these data calculated in other ways (explanation of methods here): • Produce age-adjusted estimates ◄ •  Request more asthma information from CEHTP ASTHMA What do we know about asthma? ► Measuring asthma in California ► Asthma data for CA ► Asthma data for the U.S.► Innovative approaches to asthma surveillance ► Asthma resources► Frequently asked questions about asthma► Create an asthma table, chart, or map ► Footnotes: data source, suppression info, etc. ◄ Asthma data query

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