We evaluated asthma control status among children and adults with current asthma. Consistent with the methodology used with previous CDC publications, respondents were considered to have current asthma if they answered “yes” to both questions “Have you ever been told by a doctor, nurse, or other health professional that you (the child) had asthma?” and “Do you (the child) still have asthma?” [1 ].
We used three impairment measures: daytime symptoms, night-time symptoms, and use of short-acting (β2-agonists (SABA) for symptom control (not for prevention of exercise-induced bronchospasm) to create an asthma control variable. We created a control variable with three mutually exclusive categories: well-controlled asthma, not-well-controlled asthma, and very-poorly-controlled asthma. Respondents were assigned to each category based on the most impaired level across the three impairment measures (Table 1) [2 ,17 ]. In addition, we used the term “controlled asthma” instead of well-controlled asthma, and “uncontrolled asthma” instead of not-well-controlled or very-poorly-controlled asthma. This is an adaptation of the 2007 NAEEP guidelines because the ACBS did not include all required measures for current impairment (e.g. pulmonary function measures) and for future risk assessment (e.g. asthma exacerbations, progressive decline in lung function in adults, or reduced lung growth in children) [2 ,17 ,18 ]. Also, we did not include one of the impairment measures, interference with normal activities, because the reference time for the question was the past 12 months and should only include more recent experiences.
For both children and adults, the variables included in the analysis were demographic characteristics (age, sex, race/ethnicity), annual household income, cost as barriers to medical care (being unable to see a primary care physician or specialist for asthma care or unable to buy medication for asthma in the past 12 months), long-term control medications (inhaled corticosteroids, systemic corticosteroids, long-acting beta2 agonist, leukotriene receptor antagonists, methylxanthines, and immunomodulators), and environmental factors (secondhand smoke (SHS) [environmental tobacco smoke[, pets allowed in bedroom, saw cockroach inside home in past 30 d, and saw or smelled mold in the past 30 d). In addition for adults, body mass index (BMI) (defined as weight in kilograms divided by height in square meter; obese = BMI ≥ 30), the presence of chronic obstructive pulmonary disease (COPD), depression, and smoking status were included in the analysis. The COPD variable includes responses to questions asking: “have you ever been told by a doctor or other professional that you have emphysema/chronic bronchitis/COPD?”