Maryland Asthma Program

Surveillance is the cornerstone of the Maryland Asthma Control Program. The data enable the MACP to make efficient decisions in establishing priorities for the Maryland Asthma Plan.

The surveillance is based on existing data from the CDC Behavioral Risk Factor Surveillance System (BRFSS), the Maryland Health Services Cost Review Commission (HSCRC), Maryland Medicaid encounter and claims data, and the Maryland Vital Statistics Administration.  For BRFSS data, asthma is identified by report from the questionnaire respondents. For HSCRC data, asthma is identified by the use of International Classification of Disease, 9th Edition (ICD-9) codes. Asthma includes all codes from 493.0 to 493.9. For mortality data, asthma was identified through ICD-9 codes until 2001. ICD-10 codes of J45 to J46 are used for 2001-present mortality data.

Work-related asthma is identified as new-onset asthma caused by workplace exposure to allergens or irritants as well as work-aggravated asthma, in which existing asthma is worsened by workplace exposures.

Where possible, data have been age-adjusted to the 2000 U.S. estimated population in order to reliably compare populations with different age distributions.

Asthma in Maryland

In 2006:

  • Statewide, about 13.4% of Maryland adults and 13.1% of children have a history of asthma.
  • About 8.9% of adults and 9.1% of children currently have asthma.
  • Among Medicaid enrollees, 9.0% currently have asthma.  Children under the age of 14 (11.6%) have the highest asthma prevalence among Medicaid enrollees.
  • In 2006, there were approximately 9,700 asthma hospitalizations and approximately 44,300 emergency department visits in Maryland for asthma.
  • From 2002-2006, there was an average of 81 deaths per year due to asthma.
  • Many disparities can be seen in the morbidity and mortality from asthma. Persons at increased risk for asthma and its complications include the very young, the elderly, African-Americans, low-income individuals, and individuals in some jurisdictions, particularly Baltimore City.
  • Asthma prevalence data of Maryland Hispanics showed high asthma rates.  However, hospital discharge data showed low asthma hospitalization rates.
  • In 2006, charges for hospitalizations due to asthma totaled nearly $57 million. Charges for emergency department visits due to asthma totaled an additional $27 million.
  • Compared to those without asthma, adults with asthma perceive their general health less favorably than those without asthma. Asthma may interfere with all aspects of daily life, including work, sleep, and daily activities.

Racial Health Disparities related to Asthma

People from certain racial and/or ethnic minority groups have greater asthma-related morbidity and mortality. According to the Maryland Office on Minority Health and Health Disparities, health disparities exist when disease and mortality affect some communities at a higher rate than others.

In Maryland, African-Americans adults have a 1.3 times higher asthma prevalence than Caucasian adults. African-Americans have a 4.3 times higher rate of emergency department visits, a 2.4 times higher rate of hospitalization and a 2.4 times higher rate of mortality than Caucasians. Emergency department visits, hospitalizations, and mortality demonstrate a failure to properly manage asthma. These events are preventable.

BRFSS data for Maryland adults
HSCRC data for Maryland adults > 18 years.
Age adjusted to 2000 U.S. estimated population

The calculated disparity ratios indicate that the increased negative health outcomes and mortality among African-Americans cannot be fully explained by higher prevalence. Higher asthma severity, poorer asthma control, and/or more limited access to health care may further explain these differences.

Because of small sample sizes, it was not possible to conduct similar analyses for other minority groups.

Reports and Data Fact Sheets

Revised 07/2009