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We are fortunate to have available standards related to asthma care. These are the Clinical Practice Guidelines developed by the National Asthma Education and Prevention Program’s Expert Panel, under the National Heart, Lung and Blood Institute. Developed in 1991 and updated in 1997 and 2002, these guidelines offer specific advice in several key areas of asthma assessment and management. The guidelines provide a gold standard for asthma care and are recognized by federal public health agencies, health-care providers, universities, and nonprofit organizations. Historically, the prevalence of asthma has been measured from a question on the National Health Interview Survey. It is simply the percentage of respondents who answer “yes” to the question “In the past 12 months, has anyone in the family had asthma”? This slide demonstrates the increase in 12-month asthma prevalence from 1980 to 1996. After 1996, the question about asthma was changed to ask about lifetime, medically diagnosed asthma. We can no longer measure asthma prevalence comparable to the 12-month prevalence value. In the graph, the yellow line indicates the percentage of the U.S. population affected by asthma each year. The prevalence of asthma increased from 3.1% in 1980 to 5.5% in 1996. The red and green lines show the difference in the prevalence of asthma for children and adults. The prevalence of asthma in children (under age 18 years) is higher than it is in adults (age 18 and older). Asthma is the second most prevalent chronic condition among children. It results in approximately 14 million days of missed school each year. In 1980, 3.6% of children had asthma. By 1995, the prevalence had increased to 7.5%, or approximately 5 million children. The decline to 6.2% for children in 1996 may be the beginning of a new trend, or it may simply result from random variation due to survey sampling procedures. In 1996, the sample size was considerably smaller than it was in earlier years, whi
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