The Prevalence and Cost of Asthma in New York State.
Full citation and abstract?DiNapoli, Thomas P. 2014. The Prevalence and Cost of Asthma in New York State.
Where do the authors work, and what are their areas of expertise? Note any other publications by the authors with relevance to the 6Cities project. Thomas P. DiNapoli is the New York State Comptroller. He is listed as the author on numerous publications listed on the Office of State Comptroller's website. Of interest to this project many include: 1. Environmental Funding in New York State, December 2014 2. Green Initiative 2013 Annual Report 3. Effective Management of the Environmental Protection Fund, June 2010
What are the main findings or arguments presented in the article or report? 1. The cost of asthma includes the direct expense that taxpayers experience through the Medicaid program as well as expenses due to lost productivity. In New York, the estimated annual overall cost of asthma is $1.3 billion according to the State Department of Health. 2. Throughout a period of five years from State Fiscal Year 2008-09 to State Fiscal Year 2012-13, the number of New York Medicaid recipients diagnosed with asthma rose by more than 30 percent. 3. Within New York City, the highest prevalence of asthma rates were in the Bronx, specifically Hunts Point and Longwood-Morrisania with 130.2 people with asthma per thousand enrollees total. 4. Asthma death rates fell by 18.1 percent and hospitalizations due to asthma fell by 8.3 percent annually between 2009 and 2011. 5. Asthma prevalence has declined nearly 12 percent among children in the Medicaid program between 2008 and 2012.
Describe at least three ways that the argument is supported. 1. Based on the CDC’s Behavioral Risk Factor Surveillance System, 9.3 percent (1.4 million individual) of adult New Yorkers had self-reported asthma in 2012 and 7.4 percent (315,000 individuals) of New Yorkers under 18 years of age had asthma in 2010. 2. In New York City, the rate of asthma deaths is 20.9 deaths per million residents in 2011 while New York State is 13.1 deaths per million residents. 3. The Bronx had an annual death rate due to asthma of 57.7 deaths per million residents, corrected to 43.5 deaths per million residents based on age adjustment which according to the DOH Bureau of Biometrics and Health Statistics is the highest in New York State. 4. Asthma prevalence grew to 98.7 people with asthma per thousand Medicaid enrollees by 2013. 5. Based on asthma prevalence rates among Medicaid recipients Schenectady has the highest prevalence rate at 131.3 recipients per one thousand Medicaid enrollees. However, Bronx has a prevalence rate of 130.2 recipients per one thousand Medicaid enrollees with 103,654 recipients compared to Schenectady’s 4,803 recipients. For comparison, the statewide average is 98.7 recipients per one thousand Medicaid enrollees. 6. Asthma prevalence rates were highest among Medicaid recipients aged 0 to 17 despite dropping 12 percent between 2008 and 2013. 7. The total costs of asthma hospitalizations in 2011 was $660 million, a 61 percent increase since 2002.
What three (or more) quotes capture the message of the article or report? 1. “State and local policymakers in New York, as well as various advocacy groups, support next steps in combating asthma that include: additional school-based programs to make children and their parents more aware of asthma triggers and the precursors to asthma attacks; further training for school nurses who are often on the front lines of addressing student asthma; mold remediation programs in public and private housing; and greater asthma self-management education among children and adults.” This shows that New York State is aware of the issues in regards to asthma within the state and is starting to take steps to keep the prevalence of asthma in a downwards trend. In this way, they are acknowledging the issue and trying to show they care. 2. “Despite reductions in deaths and hospitalizations from the disease, overall asthma rates in New York remain a concern.” A large part of the article was focused on the idea that asthma rates were getting better (decreasing). However, the Department of Health is still acknowledging that although it is decreasing, it is important to continue to help those affected by asthma. Even though it is decreasing, the government is still concerned about and tracking the asthma issue. 3. “Asthma is a major public health problem with both human and economic costs.” Part of the article considered, to a small extent, the fact that asthma does not only increase costs due to hospitalizations or medication but also due to loss of work or premature deaths due to asthma. Therefore, there are social and economic concerns surrounding asthma, both of which need to be analyzed and understood in order to successfully combat this issue.
What were the methods, tools and/or data used to produce the claims or arguments made in the article or report? Much of the data used in this article was from the CDC. The CDC conducted a series of tests to collect data in New York State, from Behavioral Risk Factor Surveillance System (BRFSS) monitors to landline and cellphone surveys. This data was analyzed and charts were created in order to easily see trends in the data through the years of study as well as compare to other data previously collected. Other data was collected by the DOH Bureau of Biometrics and Health Statistics which was again analyzed and presented in an easy to understand format. Finally, information on Medicaid recipients was utilized, although through the DOH and CDC.
How (if at all) are health disparities or other equity issues addressed in the article or report? The main focus is on how prevalent asthma is in Medicaid recipients. As Medicaid is only for less financially stable or lower economic class citizens, the equity issues of wealth in these areas is hinted at, although not directly mentioned. There was a brief discussion about the increase in people being accepted into the Medicaid program in these areas, and the sheer amount of people on Medicaid in the Bronx, one of the highest prevalence of asthma, can be seen in a table. Finally, there was a single paragraph which discussed how the mortality rates for Non-Hispanic Blacks and Hispanics was “slightly higher” than Non-Hispanic Whites at 31.7 deaths per million residents and 22.1 deaths per million residents respectively compared to 6.7 deaths per million residents.
Where has this article or report been referenced or discussed? (In some journals, you can see this in a sidebar.) As a DOH report, there is a good chance this article has been referenced multiple times. However, this report was found through the article: The Bronx is Breathing.
Can you learn anything from the article or report’s bibliography that tells us something about how the article or report was produced? It was produced by the New York State Department of Health in conjunction with the CDC. All the data used came from these two sources. Therefore, it is supposed to be a non-biased report but there is the possibility that the data was presented in a fashion which helps the New York State Comptroller, Thomas P. DiNapoli since downwards trends are emphasized to seem like New York State is doing a significant amount to reduce asthma.
Does the article provide information or perspective on any of the thematics already identified as important for the 6Cities project? Although not specifically air pollution, the article provides information on the economic impacts asthma prevalence rates, especially for those with Medicaid, is having on the people of New York State. There is also a strong push to help people understand what asthma is and the impacts it has on the livelihood of those it affects. Finally, to a small degree, there is a discussion about how improving asthma rates in New York City differs from in the larger and more rural upstate areas of New York.
The Prevalence and Cost of Asthma in New York State.
Thomas P. DiNapoli is the New York State Comptroller. He is listed as the author on numerous publications listed on the Office of State Comptroller's website. Of interest to this project many include:
1. Environmental Funding in New York State, December 2014
2. Green Initiative 2013 Annual Report
3. Effective Management of the Environmental Protection Fund, June 2010
1. The cost of asthma includes the direct expense that taxpayers experience through the Medicaid program as well as expenses due to lost productivity. In New York, the estimated annual overall cost of asthma is $1.3 billion according to the State Department of Health.
2. Throughout a period of five years from State Fiscal Year 2008-09 to State Fiscal Year 2012-13, the number of New York Medicaid recipients diagnosed with asthma rose by more than 30 percent.
3. Within New York City, the highest prevalence of asthma rates were in the Bronx, specifically Hunts Point and Longwood-Morrisania with 130.2 people with asthma per thousand enrollees total.
4. Asthma death rates fell by 18.1 percent and hospitalizations due to asthma fell by 8.3 percent annually between 2009 and 2011.
5. Asthma prevalence has declined nearly 12 percent among children in the Medicaid program between 2008 and 2012.
1. Based on the CDC’s Behavioral Risk Factor Surveillance System, 9.3 percent (1.4 million individual) of adult New Yorkers had self-reported asthma in 2012 and 7.4 percent (315,000 individuals) of New Yorkers under 18 years of age had asthma in 2010.
2. In New York City, the rate of asthma deaths is 20.9 deaths per million residents in 2011 while New York State is 13.1 deaths per million residents.
3. The Bronx had an annual death rate due to asthma of 57.7 deaths per million residents, corrected to 43.5 deaths per million residents based on age adjustment which according to the DOH Bureau of Biometrics and Health Statistics is the highest in New York State.
4. Asthma prevalence grew to 98.7 people with asthma per thousand Medicaid enrollees by 2013.
5. Based on asthma prevalence rates among Medicaid recipients Schenectady has the highest prevalence rate at 131.3 recipients per one thousand Medicaid enrollees. However, Bronx has a prevalence rate of 130.2 recipients per one thousand Medicaid enrollees with 103,654 recipients compared to Schenectady’s 4,803 recipients. For comparison, the statewide average is 98.7 recipients per one thousand Medicaid enrollees.
6. Asthma prevalence rates were highest among Medicaid recipients aged 0 to 17 despite dropping 12 percent between 2008 and 2013.
7. The total costs of asthma hospitalizations in 2011 was $660 million, a 61 percent increase since 2002.
1. “State and local policymakers in New York, as well as various advocacy groups, support next steps in combating asthma that include: additional school-based programs to make children and their parents more aware of asthma triggers and the precursors to asthma attacks; further training for school nurses who are often on the front lines of addressing student asthma; mold remediation programs in public and private housing; and greater asthma self-management education among children and adults.”
This shows that New York State is aware of the issues in regards to asthma within the state and is starting to take steps to keep the prevalence of asthma in a downwards trend. In this way, they are acknowledging the issue and trying to show they care.
2. “Despite reductions in deaths and hospitalizations from the disease, overall asthma rates in New York remain a concern.”
A large part of the article was focused on the idea that asthma rates were getting better (decreasing). However, the Department of Health is still acknowledging that although it is decreasing, it is important to continue to help those affected by asthma. Even though it is decreasing, the government is still concerned about and tracking the asthma issue.
3. “Asthma is a major public health problem with both human and economic costs.”
Part of the article considered, to a small extent, the fact that asthma does not only increase costs due to hospitalizations or medication but also due to loss of work or premature deaths due to asthma. Therefore, there are social and economic concerns surrounding asthma, both of which need to be analyzed and understood in order to successfully combat this issue.
Much of the data used in this article was from the CDC. The CDC conducted a series of tests to collect data in New York State, from Behavioral Risk Factor Surveillance System (BRFSS) monitors to landline and cellphone surveys. This data was analyzed and charts were created in order to easily see trends in the data through the years of study as well as compare to other data previously collected. Other data was collected by the DOH Bureau of Biometrics and Health Statistics which was again analyzed and presented in an easy to understand format. Finally, information on Medicaid recipients was utilized, although through the DOH and CDC.
The main focus is on how prevalent asthma is in Medicaid recipients. As Medicaid is only for less financially stable or lower economic class citizens, the equity issues of wealth in these areas is hinted at, although not directly mentioned. There was a brief discussion about the increase in people being accepted into the Medicaid program in these areas, and the sheer amount of people on Medicaid in the Bronx, one of the highest prevalence of asthma, can be seen in a table. Finally, there was a single paragraph which discussed how the mortality rates for Non-Hispanic Blacks and Hispanics was “slightly higher” than Non-Hispanic Whites at 31.7 deaths per million residents and 22.1 deaths per million residents respectively compared to 6.7 deaths per million residents.
As a DOH report, there is a good chance this article has been referenced multiple times. However, this report was found through the article: The Bronx is Breathing.
It was produced by the New York State Department of Health in conjunction with the CDC. All the data used came from these two sources. Therefore, it is supposed to be a non-biased report but there is the possibility that the data was presented in a fashion which helps the New York State Comptroller, Thomas P. DiNapoli since downwards trends are emphasized to seem like New York State is doing a significant amount to reduce asthma.
Although not specifically air pollution, the article provides information on the economic impacts asthma prevalence rates, especially for those with Medicaid, is having on the people of New York State. There is also a strong push to help people understand what asthma is and the impacts it has on the livelihood of those it affects. Finally, to a small degree, there is a discussion about how improving asthma rates in New York City differs from in the larger and more rural upstate areas of New York.