Post on 03-Jul-2020
1
ASTHMA
BURDEN REPORT, GEORGIA,
2015
2
Acknowledgements
Georgia Department of Public Health Brenda Fitzgerald, MD
Commissioner, State Health Officer
Health Protection J. Patrick O’Neal, MD
Director
Epidemiology Program Cherie L. Drenzek, DVM, MS
State Epidemiologist
Chronic Disease, Healthy Behaviors and Injury Rana Bayakly, MPH
Epidemiology Section Chief Epidemiologist
Behavioral Surveillance Madhavi Vajani, MPH
Team Lead
Health Promotion and Disease Prevention Section Jean O’Connor, JD, DrPH
Director
Georgia Asthma Control Program Francesca Lopez, MSPH, AE-C
Program Manager
For more information on asthma surveillance in Georgia, please contact:
Asthma Epidemiologist
Chronic Disease, Healthy Behaviors, and Injury Epidemiology Section
Georgia Department of Public Health
2 Peachtree Street, 14th Floor
Atlanta, GA 30303-3142
(404) 463-4628
http://dph.georgia.gov/asthma-surveillance
This publication is supported by the Cooperative Agreement numbers U59EH000520 and
5U580000021-03 from the Centers for Disease Control and Prevention (CDC). Its contents are
solely the responsibility of the authors and do not necessarily represent the official view of the
CDC.
Suggested citation: Annor F., Bayakly A., Vajani M., Drenzek, C., Lopez F., O’Connor J.
Georgia Asthma Burden Report. Georgia Department of Public Health, Health Protection,
Epidemiology, Chronic Disease, Healthy Behaviors and Injury Epidemiology Section, May
2015.
3
Table of Contents
Acknowledgements ....................................................................................................................................... 2
Georgia Counties and Public Health Districts .............................................................................................. 4
PART A – ASTHMA IN CHILDREN ......................................................................................................... 5
Key Findings: ............................................................................................................................................ 5
A1. Emergency Room Visits .................................................................................................................... 6
A1.1. Overall trends of asthma ER visits between 2010 and 2012, Georgia ........................................ 6
A1.2. Disparities in Asthma ER Visits among Georgia Children aged 0-17 Years .............................. 8
A1.3. Multiple Asthma ER Visits among Georgia Children aged 0-17 Years ................................... 13
A2. Hospitalizations ................................................................................................................................ 15
A2.1 Overall asthma hospitalizations among Georgia children .......................................................... 15
A2.2. Disparities in asthma hospitalizations among children ............................................................. 16
A2.3. Repeat Asthma Hospitalizations among Georgia Children aged 0-17 years ............................ 19
PART B – ASTHMA IN ADULTS ............................................................................................................ 20
Key Findings: .......................................................................................................................................... 20
B1. Asthma ER Visits ............................................................................................................................. 21
B1.1 Overall asthma ER visit trends among Georgia Adults 18 years and older ............................... 21
B1.2. Disparities in Adult Asthma ER visits ...................................................................................... 23
B1.3. Repeat Asthma ER Visits among Adults................................................................................... 24
B2. Asthma Hospitalizations among Adults ........................................................................................... 28
B2.1. Overall trend of asthma hospitalizations among Georgia adults ............................................... 28
............................................................................................................................................................ 30
PART C – ASTHMA MORTALITY ......................................................................................................... 32
C1.1. Overall age-adjusted asthma mortality rate in Georgia between 2001 and 2011 ...................... 33
C1.2. Age-adjusted asthma mortality rates by race ............................................................................. 34
Data Sources: .............................................................................................................................................. 37
Methods and Technical Notes ..................................................................................................................... 38
4
Georgia Counties and Public Health Districts
1-1: Northwest
Bartow
Catoosa
Chattooga
Dade
Floyd
Gordon
Haralson
Paulding
Polk
Walker
1-2: North
Georgia Cherokee
Fannin
Gilmer
Murray
Pickens
Whitefield
2-0: North
Banks
Dowson
Forsyth
Franklin
Habersham
Hall
Hart
Lumpkin
Rabun
Stephens
Towns
Union
White
3-1: Cobb/Douglas
Cobb
Douglas
3-2: Fulton
Fulton 3-3: Clayton
County
Clayton
3-4: East Metro
Gwinnett
Newton
Rockdale
3-5: DeKalb
DeKalb 4-0: LaGrange
Butts
Carroll
Coweta
Fayette
Henry
Lamar
Meriwether
Pike
Spalding
Troup
Upson
7-0: West Central
Chattahoochee
Clay
Crisp
Dooly
Harris
Macon
Marion
Muscogee
Quitman
Randolph
Schley
Stewart
Sumter
Talbot
Taylor
Webster
8-1: South
Ben Hill
Berrien
Brooks
Cook
Echols
Irwin
Lanier
Lowndes
Tift
Turner
9-2: Coastal
Bryan
Camden
Chatham
Effingham
Glynn
Liberty
Long
McIntosh
8-2: Southwest Baker
Calhoun
Colquitt
Decatur
Dougherty
Early
Grady
Lee
Miller
Mitchell
Seminole
Terrell
Thomas
Worth
9-1: Southeast
Appling
Atkinson
Bacon
Brantley
Bulloch
Candler
Charlton
Clinch
Coffee
Evans
Jeff Davis
Pierce
Tattnall
Toombs
Ware
Wayne
5-2: North
Central
Baldwin
Bibb
Crawford
Hancock
Houston
Jasper
Jones
Monroe
Peach
Putnam
Twiggs
Washington
Wilkinson
5-1: South
Central
Bleckley
Dodge
Johnson
Laurens
Montgomery
Pulaski
Telfair
Treutlen
Wheeler
Wilcox
10-0:
Northeast
Barrow
Clarke
Elbert
Greene
Jackson
Madison
Morgan
Oconee
Oglethorpe
Walton
6-0: East Central
Burke
Columbia
Emanuel
Glascock
Jefferson
Jenkins
Lincoln
McDuffie
Richmond
Screven
Taliaferro
Warren
Wilkes
5
PART A – ASTHMA IN CHILDREN
Asthma Emergency Room Visits and Hospitalizations among Georgia Children 0-17 years
Key Findings: An average of 27,000 asthma emergency room (ER) visits occurred annually among Georgia
children aged 0-17 years during 2010-2012, an average rate of 1083/100,000 population.
Three notable seasonal peaks were observed in the number of asthma emergency room visits
among Georgia children - during spring, early fall and late fall seasons.
The rate of asthma ER visits among Georgia children was highest among 0-4 year olds, blacks
and boys.
The rate of asthma ER visits among Georgia children was highest in the metro Atlanta and
Augusta areas.
The total charges for asthma ER visits among Georgia children increased from $33.6 million in
2010 to $44.2 million in 2012.
Among Georgia children who had an asthma ER visit in 2012, 16% had repeat visits during the
calendar year.
On average, 3,000 asthma hospitalizations occurred annually among Georgia children during
2010-2012.
Among Georgia children, the highest rate of asthma hospitalizations occurred among 0-4 year
olds, blacks and boys.
About 7% of children who were hospitalized for asthma during 2012 had repeat asthma
hospitalizations during the calendar year.
6
A1. Emergency Room Visits
A1.1. Overall trends of asthma ER visits between 2010 and 2012, Georgia
Between 2010 and 2012, there was an average of 27,000 asthma Emergency Room (ER) visits
annually among Georgia children aged 0-17 years.
In Georgia during 2010-2012:
There were three notable periods in each calendar year when the number of asthma ER
visits was highest among children- during spring, early fall and late fall seasons (Fig
A1.1).
o The number of asthma ER visits among children increased in early February and
remained high until late May.
o Then the number of visits dropped in early June to reach the lowest level for the
year and remained low until early August.
o After the first week in August, the number of visits increased to reach the highest
peak in late August.
o In early September, the number of visits dropped from the August peak but
remained fairly high until the end of November compared to the number of visits
observed in June (Fig A1.1).
The number of asthma ER visits among children was highest during the weekend period-
Saturdays to Mondays (Fig A1.2).
The total charges for asthma ER visits among Georgia children aged 0-17 years increased
from about $33.6 million in 2010 to $44.2 million in 2012 (Fig A1.3). The median charge
per asthma ER visit also shifted upward from $984 in 2010 to $1,175 in 2012.
7
17.3
15.8
14.5 13.7
12.1 12.1
14.6
17.4
16.0
14.5
12.9 12.8 12.3
14.3
17.6
16.3
14.3 13.4
12.4 12.5 13.5
0
5
10
15
20
Sun Mon Tue Wed Thu Fri Sat
Pe
rce
nt
Ast
hm
a ER
Vis
its
Day of the Week
Fig A1.2. Asthma ER Visits among Georgia Children 0-17 Years, by Day of the Week, 2010-2012
2010 2011 2012
33.6
38.1
44.2
20
30
40
50
2010 2011 2012
Tota
l Ch
arge
s in
Mill
ion
s, U
S D
olla
rs
Year
Fig A1.3. Total Charges for Asthma ER Visits among Georgia Children, by Year, 2010-2012
8
1,426
1,240
785
491
1,434
1,268
785
470
1,514 1,466
886
555
0
500
1000
1500
2000
0-4yrs 5-9yrs 10-14yr 15-17yrs
Rat
e p
er
10
0,0
00
Age Categories
Fig A1.4. Age-Specific Rate (per 100,000) of Asthma ER Visits among Children 0-17 years in Georgia, 2010-2012
2010 2011 2012
A1.2. Disparities in Asthma ER Visits among Georgia Children aged 0-17 Years
The rate of asthma ER visits among Georgia children was not randomly distributed. Children
with specific demographic characteristics and in specified geographic locations had higher
asthma ER visit rates than others. The overall asthma ER visit rate was highest among younger
children (under 5 years), boys, blacks, and children living in urban areas.
In Georgia during 2010-2012:
The average age-specific asthma ER visits rates per 100,000 were: 1,434 for children
aged 0-4 year olds; 1,325 for 5-9 year olds; 818 for 10-14 year olds; and 505 for 15-17
year olds (Fig A1.4).
Boys (1,316/100,000) had higher asthma ER visits rate than girls (839/100,000) (Fig
A1.5).
The rate of asthma ER visits was four times higher for black children (2,050/100,000)
than for white children (502/100,000), and eight times higher for black children than for
Asian children (272/100,000) (Fig A1.6).
Children living in non-rural counties (1,122/100,000) had higher asthma ER visit rates
than those living in rural counties (887/100,000) (Fig A1.7).
The rate of asthma ER visits was higher among children residing in the following
Georgia Public Health Districts (PHD); DeKalb, Fulton, East Central, and Clayton (Map
A1.1).
9
1260 1266 1421
809 814 894
0
500
1000
1500
2000
2010 2011 2012
Rat
e p
er
10
0,0
00
Year
Fig A1.5. Rate of Asthma ER Visits among Children 0-17 years, by Gender, 2010-2012
Male Female
1984 2020 2144
483 476 547 236 255 324 143 134 414
0
500
1000
1500
2000
2500
2010 2011 2012
Rat
e p
er
10
0,0
00
Year
Fig A1.6. Rate of Asthma ER Visits among Children 0-17 years in Georgia, by Race, 2010-2012
Black White Asian AA, PI
Note: AA= American Indians or Alaska Natives, PI= Pacific Islanders Asian is a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent
including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
10
869 847 947
1074 1084 1207
0
500
1000
1500
2000
2010 2011 2012
Rat
e p
er
10
0,0
00
Year
Fig A1.7. Rate of Asthma ER Visits among Children 0-17 years in Georgia, by Rural/non-Rural Status, 2010-2012
Rural Non-Rural
Non-Rural County: Any county with 35,000 or more total population per the 2000 Census.
Rural County: Any county with less than 35,000 total populations per the 2000 Census.
11
Map A1.1 – Rate of Asthma ER Visits among Georgia Children Aged 0-17 years, by Public
Health Districts, 2010-2012
12
Map A1.2 – Rate of Asthma ER Visits among Georgia Children Aged 0-17 years, by
County of Residence, 2010-2012
13
16.9 15.4 14.3
18.8
14.4
0.0
10.0
20.0
30.0
40.0
Males Females 0-4 yrs 5-11 yrs 12-17 yrs
Pe
rce
nt
Sex
Fig A1.8. Percent of Children 0-17 years who had more than one Asthma ER Visits, by Sex and Age, Georgia 2012
Age
A1.3. Multiple Asthma ER Visits among Georgia Children aged 0-17 Years
Having more than one (or repeat) asthma ER visit within a calendar year may be an indication of
uncontrolled asthma.
In Georgia during 2012:
About 23,620 children aged 0-17 years had a total of 29,035 asthma ER visits.
Of the children who had asthma ER visits, 3,854, representing about 16%, had a repeat
asthma ER visits during the 2012 calendar year.
Of those who had repeat asthma ER visits, 40% had 2 visits, 14% had three visits, 6%
had four visits, and the remaining 39% had five or more visits during 2012.
Among children 0-17 years, repeat asthma ER visits was more common in male, black,
aged 5-11 years, and Medicaid, Medicare or Peachcare health insurers.
o While 17% of boys had repeat asthma ER visits, 15% of girls did.
o While 18% of African-American children had repeat asthma ER visits, 13.0% of
white children did.
o Whereas 18% of children aged 5-11 years had repeat asthma ER visits in 2012, 14%
of children aged 0-4 years and 12-17 years each did.
o Whereas 18% of Medicare, Medicaid, and Peachcare-insured children had repeat
asthma ER visits, the number of repeat visits was lower among children covered by
other payor types during 2012.
14
13.2
18.0
14.3
17.9 17.8
11.9
15.6 17.5
0.0
10.0
20.0
30.0
40.0
Whites Black Others Medicaid Medicare Private Self-Pay Peachcare
Pe
rce
nt
Race
Fig A1.9. Percent of Children 0-17 who had more than one Asthma ER Visits, by Race and Payor Type, Georgia, 2012
Insurance Type
15
$5,000
$5,500
$6,000
$6,500
$7,000
$7,500
$8,000
2010 2011 2012
Me
dia
n T
ota
l Ch
arge
s
Year
Fig A2.1. Median Charges for Asthma Hospitalizations among Georgia Children, by Year, 2010-2012
A2. Hospitalizations
A2.1 Overall asthma hospitalizations among Georgia children
Between 2010 and 2012, there were total of 8,987 hospitalizations among Georgia
children aged 0-17 years, representing an overall hospitalization rate of 120 per 100,000.
Specifically, there were: 2,965 (119/100,000) hospitalizations in 2010; 2,947
(118/100,000) hospitalizations in 2011; and 3,075 (123/100,000) hospitalizations in 2012.
Two-thousand, seven hundred and fifty (2,750) children were hospitalized for asthma in
Georgia during 2010, while 2,695 children and 2,881children were hospitalized for
asthma during 2011 and 2012 respectively.
Children hospitalized for asthma in Georgia during 2012 spent an average of 2.2 days in
the hospital.
The total charges for asthma hospitalizations among children 0-17 years were
approximately $26.7 million, $27.4 million and $40 million for 2010, 2011 and 2012
respectively.
The median total charges for asthma hospital admissions among children 0-17 years
shifted upward from $6,678 in 2010 to $7,757 in 2012 (Fig A2.1).
16
146.0
91.0
78.0
191.0
208.0
143.0
64.0
23.0
144.0
91.0
72.0
191.0 205.0
145.0
61.0
26.0
152.0
94.0 83.0
182.0
200.0
166.0
64.0
27.0
0
50
100
150
200
250
Boys Girls White Black 0-4yrs 5-9yrs 10-14yrs 15-17yrs
Rat
e p
er
10
0,0
00
Race
Fig A2.2. Rate of Asthma Hospitalizations among Children 0-17 years, by Sex, Race, and Age, Georgia 2010-2012
2010 2011 2012
Sex Age
A2.2. Disparities in asthma hospitalizations among children
In Georgia during 2010-2012:
The rate of asthma hospitalizations was higher among boys (average rate of 147/100,000)
than girls (mean rate of 92/100,000) (Fig A2.2).
The rate of asthma hospitalizations was higher among blacks and children 0-4 years of
age (Fig A2.2).
The South Central and DeKalb PHDs had the highest rates of asthma ER visits during
2010-2012 (Maps A2.1).
17
Map A2.1. Rate of Asthma Hospitalizations among Georgia Children Aged 0-17 years, by
Public Health District, 2010-2012
18
Map A2.2. Rate of Asthma Hospitalizations among Georgia Children Aged 0-17 years, by
County of Residence, 2010-2012
19
5.5 6.2
5.3
6.5
3.9
0.0
2.0
4.0
6.0
8.0
10.0
12.0
Males Females Whites Black Others
Pe
rce
nt
Race
Fig A2.3. Percent Repeat Asthma Hospitalizations among Children 0-17 years, by Sex and Race, Georgia 2012
5.3
6.5
4.6
6.6
4.7
2.9
0.0
2.0
4.0
6.0
8.0
10.0
12.0
0-4 yrs 5-11 yrs 12-17 yrs Medicaid Private Self-Pay
Pe
rce
nt
Insurance Type
Fig A2.4. Distribution of Repeat Asthma Hospitalizations among Children 0-17 years, by Age and Insurance type, Georgia 2012
Age
A2.3. Repeat Asthma Hospitalizations among Georgia Children aged 0-17 years
In Georgia during 2012, 2,881 children aged 0-17 years were hospitalized 3,075 times for asthma
during the calendar year.
About 7% (194) of the children hospitalized for asthma in 2012 were hospitalized two or
more times for asthma during the calendar year (repeat).
A repeat asthma hospitalization was higher among girls, black children, Medicaid-insured
and children 5-11 years of age (Figs A2.3 and A2.4).
Sex
20
PART B – ASTHMA IN ADULTS
Asthma Emergency Room Visits and Hospitalizations among Georgia Adults 18 years and
older
Key Findings:
Between 2010 and 2012, a total of 86,167 asthma-related ER visits occurred among
Georgia adults, an average of 28,700 visits per year and at an average rate of 392/100,000
population.
Total charges from adult asthma ER visits increased during 2010-2012, from $49.5
million in 2010 to $60.0 million in 2011 and to $68.1 million in 2012.
Among Georgia adults, the number of asthma-related ER visits was highest among blacks
and females.
Among adults who visited the ER for asthma in 2012, approximately 18% had two or
more ER visits within the year.
Between 2010 and 2012, there were total of 21,946 asthma-related hospitalizations
among adults 18 years and older with asthma listed as the principal diagnosis: 7,436 in
2010; 7,344 in 2011; and 7,166 in 2012.
The rate of asthma hospitalizations among adults was highest among blacks, women, and
those aged 65 years and older.
Of Georgia adults hospitalized for asthma in 2012, about 13% were hospitalized two or
more times during the calendar year.
21
0
40
80
120
160
Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12
Nu
mb
er
of
Dai
ly E
R v
isit
s
Date
Fig B1.1. Daily Asthma ER Visits among Georgia Adults Aged 18 + Years, 2010-2012
2012 2011 2010
B1. Asthma ER Visits
B1.1 Overall asthma ER visit trends among Georgia Adults 18 years and older
In Georgia during 2010-2012, there were three notable periods in each year when the
number of asthma ER visits was high among adults- during April to early May, in mid-
September, and during November through to December (Fig B1.1).
The daily ER visit trend in adults seems to mimic that of children but the peaks were
lower than those observed in children.
The number of daily asthma ER visits among Georgia adults was higher during Sundays
and Mondays (Fig B1.2).
In Georgia during 2010 to 2012, the estimated total charges for asthma ER visits among
adults 18 years and older was $173.6 million; $49.5 for 2010, $60.0 million for 2011, and
$68.1 million for 2012.
The median total charges per adult asthma ER visit shifted upward between 2010 and
2012; from $1,344 in 2010 to $1,491 in 2012 (Fig B1.3).
22
15.3 15.3 14.4 14.5
13.8 13.5 13.3
15.4 15.3 14.8 14.2 13.6 13.1 13.7
15.18 15.5 14.61 14.21 13.63 13.48 13.4
0
5
10
15
20
Sun Mon Tue Wed Thu Fri Sat
Day of the Week
Fig B1.2. Percent Asthma ER Visits among Georgia Adults, 18+ Years, by Day of the Week, 2010-2012
2012 2011 2010
1000
1100
1200
1300
1400
1500
2010 2011 2012
Tota
l Ch
arge
s in
US
Do
llars
Year
Fig B1.3. Median Total Charges Per Visit, Adult Asthma ER Visits, Georgia 2010-2012
.
23
423 320
532
223
882
0
200
400
600
800
1000
Total Males Females White Black
Rat
e p
er
10
0,0
00
Race
Fig B1.4. Rate of Asthma ER Visits among Adults, by Sex and Race, Georgia 2012
573 564 479
438
300
204
0
200
400
600
800
1000
18-24yrs 25-34yrs 35-44yrs 45-54yrs 55-64yrs 65+ yrs
Rat
e p
er
10
0,0
00
Age
Fig B1.5. Rate of Asthma ER Visits among Adults, by Age, Georgia 2012
B1.2. Disparities in Adult Asthma ER visits
The total asthma ER visit rate among adults 18 years and older during 2012 was
430/100,000.
The rate was higher among females (532/100,000) than males (320/100,000), which is in
contrast to the results from children when comparing boys to girls (Fig B1.4).
The rate was almost four times higher among blacks (882/100,000) than whites
(223/100,000). (Fig B1.4).
The rate of asthma ER visits decreased with increasing age among adults (Fig B1.5).
Sex
24
B1.3. Repeat Asthma ER Visits among Adults
In Georgia during 2012:
Approximately 23,300 adults had 31,929 asthma ER visits.
Of adults who visited the ER for asthma, 19,212 (82.5%) had one visit in the calendar
year while the remaining 4,079 (17.5%) had two or more asthma ER visits.
Of those who had repeat asthma ER visits, 39.2% had two visits, 20.5% had three visits,
and 13.1% had four visits, while the remaining 27.6% had five or more visits during the
calendar year (Fig B1.6).
Having repeat asthma ER visits was more common among males, blacks and those 25-34
years of age (Fig B1.8).
Having repeat asthma ER visits was higher among the Medicaid population and those
who indicated as self-paying (Fig B1.9).
One Visit, 82.5%
Repeat, 17.5%
2 Visits, 39.2%
3 Visits, 20.5%
4 Visits, 13.1%
5 or More Visits, 27.6%
Fig B1.6. Percent of Adults with Repeat Asthma ER Visits and the Number of Times
they visited the ER, Georgia, 2012
25
16.3
19.9 18.9 18.5
15.6
10.4
20.4
14.7 13.6
20.1
0.0
5.0
10.0
15.0
20.0
25.0
18-24 25-34 35-44 45-54 55-64 65+ Medicaid Medicare Private Self-Pay
Pe
rce
nt
Insurance Type
Fig B1.8. Percent Repeat Asthma ER Visits among Adults, by Age and Insurance Source, Georgia, 2012
Sex
Age
26
Map B1.1 – Rate of Asthma ER Visits among Georgia Adults 18+ years, by Public Health
District, 2010-2012
27
Map B1.2 – Rate of Asthma ER Visits among Georgia Adults 18+ years, by County of
residence, 2010-2012
28
97
51
139
73
152
66
0
50
100
150
200
250
Total Males Females Whites Black Other
Rat
e p
er
10
0,0
00
Race
Fig B2.1. Rate of Asthma Hospitalizations among Adults, by Sex and Race, Georgia, 2012
B2. Asthma Hospitalizations among Adults
B2.1. Overall trend of asthma hospitalizations among Georgia adults
Between 2010 and 2012, there were a total of 21,946 hospitalizations among adults aged
18 years and older with asthma listed as the principal diagnosis: 7,436 in 2010; 7,344 in
2011; and 7,166 in 2012.
The rate of asthma hospitalizations among adults during; 2010 was 103/100,000, in 2011,
it was 100/100,000, and in 2012, it was 97/100,000.
The asthma hospitalization rate was higher among males, blacks, adults aged 65 years
and older, and residents of rural counties (Fig B2.1 and B2.2).
The rate of asthma hospitalizations among adults was higher in the North Central,
Southwest and Southeast Public Health Districts (Map B2.1).
Sex
29
29
48
70
123 135
176
0
50
100
150
200
18-24 25-34 35-44 45-54 55-64 65+
Rat
e p
er
10
0,0
00
Age
Fig B2.2. Rate of Asthma Hospitalizations among Adults, by Age, Georgia, 2012
Non-Rural County: Any county with 35,000 or more total population per the 2000 Census.
Rural County: Any county with less than 35,000 total populations per the 2000 Census.
30
Map B2.1. Rate of Asthma Hospitalizations (per 100,000) among Georgia Adults Aged 18
years and older, by Public Health District, 2010-2012
31
Map B2.2. Rate of Asthma Hospitalizations (per 100,000) among Georgia Adults Aged 18+
years, by County of Residence, Georgia 2010-2012
32
PART C – ASTHMA MORTALITY
Key findings
Between 2001 and 2011, there were 1,145 asthma-related deaths in Georgia, representing
an age-adjusted asthma mortality rate of 13.0 per 1,000,000 deaths.
Overall, the age-adjusted asthma mortality rate significantly declined between 2001 and
2011 in Georgia.
The age-adjusted asthma mortality rate was significantly higher among blacks than
whites and among females than in males.
33
13 6
16 12
21
0
10
20
30
40
50
Total White Males Black Males WhiteFemales
BlackFemales
Rat
e p
er
1,0
00
,00
0
Sex and Race
Fig C1.1. Age-Adjusted Asthma Mortality Rate, by Race and Sex, 2001-2011
C1.1. Overall age-adjusted asthma mortality rate in Georgia between 2001 and 2011
Between 2001 and 2011, there were 1,145 asthma deaths (60 in children and 1,085 in
adults) in Georgia, representing an age-adjusted asthma mortality rate of 13 per
1,000,000 deaths.
Among children, the annual number of asthma deaths ranged between 1 (in 2004) and 9
(2002 and 2006).
Among adults, the annual number of asthma deaths in Georgia ranged between 79 (in
2009) and 121 (2001).
The age-adjusted asthma mortality rate was significantly higher among females
(14.0/1,000,000; 95% CI=13.0-15.0) than males (10.0/1,000,000; 95% 9.0-10.9).
The overall age-adjusted asthma mortality rate decreased from 18.0 per 1,000,000 in
2001 to 10.0 per 1,000,000 in 2011.
Between 2001 and 2011, the age-adjusted asthma mortality rate for females declined
from 23.0/1,000,000 (95% CI=18.3-27.7) to 10.0 per 1,000,000 (95% CI=7.2-12.8) in
2011. The rate decline was statistically significant.
Among males, the age-adjusted asthma mortality rate remained fairly stable during this
period.
34
0
10
20
30
40
50
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Age
-ad
just
ed
rat
e p
er
1,0
00
,00
0
Year
Fig C1.2. Age-Adjusted Asthma Mortality Rate, by Sex, Georgia 2001-2011
Total Males Females
C1.2. Age-adjusted asthma mortality rates by race
Between 2001 and 2011in Georgia, there were 570 deaths from asthma among whites and
555 asthma deaths among blacks, representing an age-adjusted rate of 9/1,000,000 (95%
CI= 8.3-9.7) and 23.0/1,000,000 (95% CI=21.1-24.9), respectively (Fig C1.3).
The age-adjusted asthma mortality rate among blacks was significantly higher than
whites.
Between 2001 and 2011, the age-adjusted asthma mortality rate for both blacks and
whites significantly decreased. Among whites, the age-adjusted asthma mortality rate of
7/1,000,000 (95% CI=4.9-9.1) in 2011was significantly lower than the age-adjusted
asthma mortality rate of 15.0/1,000,000 (95% CI=11.6-18.3) in 2001. Among blacks, the
age-adjusted asthma mortality rate significantly declined between 2004 (33.0/1,000,000;
95% CI=24.9-41.1) and 2008 (15.0/1,000,000; 95% CI=10.2-19.8).
35
13 9
23
0
10
20
30
40
50
Total White Black
Rat
e p
er
1,0
00
,00
0
Race
Fig C1.3. Age-Adjusted Asthma Mortiality Rate, by Race, Georgia, 2001-2011
0
10
20
30
40
50
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Rat
e p
er
1,0
00
,00
0
Year
Fig C1.4. Age-Adjusted Asthma Mortality Rates, by Race, Georgia, 2001-2011
Total White Black
36
Asthma age-adjusted mortality rates by Health District, 2001-2011
The overall age-adjusted asthma mortality rates during the period from 2001 to 2011
was highest for residents in the Southwest Public District (8-2) at 21 deaths per
100,000, while the lowest overall age-adjusted rate was seen in the North Georgia
Health District (1-2) at a rate of 6 deaths per 1,000,000.
Map C1. Asthma Mortality Rate (per 1, 000,000 deaths), by Health Districts, Georgia 2001-2011
37
Data Sources:
Emergency Room (ER) Visit Data
Emergency room (ER) visit data in this report are based on ER visit data by Georgia residents
who were seen in the ER with asthma as the primary diagnosis. The ICD-9 codes (493.0-493.9)
used to select ER visits. Data included in this report were based on ER visits at non-federal acute
care hospitals in Georgia. Rates were age-adjusted to the 2000 US standard population via the
direct method. ER visit charges may differ from costs. Charges are based on the total charges
reported by the hospital. The amount a hospital is reimbursed is usually less than what is
charged.
Hospital Inpatient Discharge Data
Hospitalization data in this report are based on hospital discharge data for Georgia residents who
were hospitalized for asthma as the primary cause. The ICD-9 codes (493.0-493.9) used to select
hospitalizations due to asthma. We only included information reported by non-federal acute care
hospitals in Georgia. Rates were age-adjusted to the 2000 US standard population via the direct
method. Hospitalization charges may differ from costs. Charges are based on the total charges
reported by the hospital. The amount a hospital is reimbursed is usually less than what is
charged.
Georgia Vital Records Death Data
Mortality data are based on deaths of Georgia residents whose underlying cause of death was
asthma. Deaths from 2001-2011 with ICD-10 codes J45-J46 were selected. Death rates were age-
adjusted to the 2000 US standard population via the direct method.
38
Methods and Technical Notes
Age-Adjusted Rates
A weighted average of the age-specific rates (death, ER visits, or hospitalizations) where the
weights are the proportions of persons in the corresponding age groups of a standard population.
The calculation of an Age-Adjusted Rate uses the year 2000 U.S. standard million.
Using age-adjusted rates controls for differences in age structure between population at different
geographic locations or at a specified time so that observed differences in rates across areas over
time is not due solely to differences in the proportion of people in different age groups in
different areas.
Age-Specific Rates
[Number of death, hospitalizations, or ER visits in a specific age group / Population of same age
group] * 100,000.
Statistical significance
In this report, a result was considered statistically significant if there was no overlap in the 95%
confidence intervals (95% CI) of the percentages being compared.