TheAsthmaFiles2015 - Texas Asthma Burden Report 2014

Texas Department of State Health Services. Prepared by Erin W. Wu, MPH. Texas Asthma Control Program. (2014). 2014 Texas Asthma Burden Report. Austin, Texas. http://www.dshs.state.tx.us/asthma/data.shtm
Most of the authors credited work under either the Office of Surveillance, Evaluation, and Research, or the Chronic Disease Branch, which are both in the Texas Department of State Health Services The primary author of this report, Erin W. Wu, is an epidemiologist and has featured in other publications by the Texas Department of State Health Services. One notable publication by her that The Asthma Files should look into is a publication analyzing the rates of hospital admissions for asthma-related issues in pediatric patients (link to the article: https://cste.confex.com/cste/2015/webprogram/Paper4443.html ). Nimisha Bhakta, another contributor to the report, has worked on a study on race and ethnicity and how it relates to asthma risk factors, hospitalization rates, and mortality ( link to the article: https://cste.confex.com/cste/2014/webprogram/Paper3025.html ).
The study reported that 2 million people in Texas suffered from asthma. With a total population of 27 million, that means that about 7.4% percent of the state's citizens have asthma. Some other important findings of the study are that blacks tend to have higher asthma prevalence rates and hospital discharge rates than other ethnicities. Since only 12% of the population is African American compared to 70% of the population being white/Hispanic, this is a noteworthy statistic.
They back up the data on race and asthma prevalence by showing the data collected from phone surveys conducted in conjunction with the CDC's Behavioral Risk Factor Surveillance System (BRFSS). They back up their hospital discharge data by collecting information from the Texas Health Care Information Council, which is a state run group that collects data on hospitals and health care maintenance. Finally, they use Medicaid statistics to highlight the low income population that has less access to proper treatment of asthma.
Three Quotes:
1. “Half of children with current asthma missed one or more days of school due to their asthma in the past 12 months.”
2. “Nearly 1 in 4 adults with current asthma had at least one cost barrier to asthma care (seeing a primary care doctor, seeing a specialist, or buying needed asthma medication) in the past 12 months.”
3. “Among adult Medicaid beneficiaries with asthma, inpatient hospitalization claims made up 1.7% of total asthma Medicaid claims, but about 25.0% of asthma Medicaid expenditures.”
They used the BRFSS, which is a series of phone surveys conducted by the CDC, to get information on patients, as well as hospitals to collect information on discharge rates, and Medicaid to get information on claims made by people on the service and what they were used for.
Health disparities based on race or education are addressed in the report head on by showing statistics of asthma prevalence among people of different ethnicities, income, and education levels. Adults with an income under $15,000 per year had the highest prevalence of asthma, and blacks had the highest asthma prevalence among racial groups.
Because this paper was released very recently, there are not many journal articles or reports that cite this report.
All of the references are provided by the CDC. This may be indicative of both collaboration, since the TDSHS uses the BRFSS, a CDC service, to collect data on Texas citizens. The TDSHS also receives $10 million from the CDC every year to fund programs to fight chronic diseases, so this may be another reason for collaborating with the CDC (http://www.cdc.gov/nccdphp/dch/programs/communitytransformation/funds/ ).
I followed up on a link provided in the report that gave information on the Texas Health Care Information Collection (THCIC) to understand how they collect data from hospitals (http://www.dshs.state.tx.us/thcic/hospitals/HospitalReportingRequirements.shtm ). All hospitals in Texas are required to release discharge claims for inpatient and outpatient operations. I also looked into the Texas BRFSS questionnaire to see what questions they asked related to asthma and see where they differentiated from the CDC. The questionnaire available online only asks the responder if he or his children have ever had asthma, and states that a follow-up questionnaire will be given to collect more information for those who stated that they have asthma. The follow-up is not available on the TDSHS website (https://www.dshs.state.tx.us/chs/brfss/pages/questions.shtm ). However, I did follow up on a link at the CDC that has the asthma callback survey. It asks questions about the environment that the person lives in and the medications that the person is taking (http://www.cdc.gov/brfss/acbs/2013/pdf/asthma_adult_2013_questionnaire.pdf ). This does seem to indicate that the CDC wants people to make changes by getting them to invest in hypoallergenic pillows and cleaning their carpets. Both the CDC and the TDSHS also want to make medicine more accessible to those who cannot afford it.