With nationwide rates of asthma at epidemic levels, a report released by the Trust for America''s Health (TFAH) shows that 12 of the 20 states with the highest air pollution known to affect asthma do not track the disease at state and community levels.
Nationwide, more than half (27) of the states have no ongoing tracking and monitoring of asthma, a disease that affects more than 17 million Americans -- nearly 5 million of whom are children.
The TFAH report, "Short of Breath: Our Lack of Response to the Growing Asthma Epidemic and The Need For Nationwide Tracking," analyzed the levels of three pollutants public health officials believe are linked to asthma: particulate matter, ozone and suspected respiratory toxicants.
The 12 high pollution states failing to track asthma are: Alabama, Georgia, Idaho, Indiana, Nevada, New Jersey, Ohio, Pennsylvania, Tennessee, Texas, Virginia and West Virginia.
The remaining states that do not track asthma are: Alaska, Colorado, Delaware, Kansas, Kentucky, Louisiana, Maine, Maryland, Minnesota, Mississippi, Montana, New Hampshire, New Mexico, South Dakota and Wyoming.
Public health officials consider chronic disease tracking -- pinpointing when and where diseases occur and information on associated environmental factors -- a critical step in preventing asthma and other chronic diseases such as cancer.
The United States does not have a comprehensive and coordinated network to track and monitor chronic diseases and conditions, like birth defects and asthma, and potential environmental exposures that may be linked to those diseases.
The TFAH report states that if health tracking were in place, then doctors, scientists and public health officials could compare community asthma rates with associated triggers throughout the country to develop prevention strategies to deal with the disease.
"It is a tragedy that we can measure down to the pound how much air pollution there is in a community but yet we have no idea how many people have been hit by asthma in the same area," said Shelley Hearne, TFAH''s executive director. "This report makes clear that we need nationwide chronic disease tracking so we can better prevent asthma and stop sending our kids to school with an inhaler and pray that the disease doesn''t strike."
"More than 90 percent of our national healthcare dollars are spent on treatment. Our inability to prevent diseases is a very critical part of the growing burden of health care costs today," said Dr. Neil Schlackman and senior medical director for Aetna US Healthcare. "Moreover, the cost of an effective tracking program is a mere fraction of what we already pay to treat asthma and deal with its consequences."
TFAH estimates that a nationwide health tracking system for chronic diseases like asthma, cancer, Parkinson''s and Alzheimer''s would cost approximately $275 million -- or less than one dollar for every American.
According to the Centers for Disease Control and Prevention, asthma alone costs our economy $14.5 billion per year in health-related costs and lost productivity each year.
"Twenty-seven states not tracking asthma is an indictment of our commitment to public health. It is sheer negligence," said former Governor and three-term U.S. Senator, Lowell Weicker, a board member of TFAH. "With an epidemic like asthma we need to stop the disease and not just manage it. Tracking is cost effective and critical in preventing chronic diseases like asthma."
The TFAH report has earned support from a wide variety of ally groups including public health, scientific, academic, medical, environmental and private sector organizations.
"Asthma is the number one chronic disease among children, and it''s the major cause of school absenteeism in the country. So when you put all of that together, there is not only a social cost but there''s a cost in terms of the education of a child," said John Kirkwood, chief executive officer for the American Lung Association. "The American Lung Association is fully supportive of the concept of health tracking. I think this is a very important step in the right direction, now we need to move forward with this."
In addition to the lack of tracking, the TFAH analysis found that states reporting to track asthma are in reality only tracking a few elements of the asthma epidemic. Some focus on a small group instead of a larger population while some fail to track routine trends over time or especially vulnerable sub-populations.
by Virginia Sutcliffe