US Pharm. 2007;32(7):10.

The 2005 National Health Interview Survey conducted by the CDC provides insights into the health conditions prevalent among noninstitutionalized Americans. Of the lung diseases shown in the graph, sinusitis had the highest prevalence in 2005, affecting 29.52 million (13.4%) Americans, followed by hay fever (18.65 million; 8.6%), asthma (15.7 million; 7.2%), and chronic obstructive pulmonary disease (COPD) (12.7 million; 5.8%). COPD comprises a large group of lung diseases, including emphysema and chronic bronchitis, which are characterized by blockage of airflow that prevents normal breathing. Of those who had COPD, 8.9 million (4.1%) Americans had chronic bronchitis and 3.8 million (1.7) had emphysema. Excluding emphysema, all of these selected lung diseases were more prevalent in females than in males.

Race: Studies have shown that Asians have lower rates of asthma than most racial groups. Although there are limited data on COPD, studies have shown that Asians may have a genetic component that reduces their risk of COPD. Native Hawaiian or other Pacific Islander adults had asthma rates more than double those for any other racial group. Hispanic adults had lower rates of emphysema, hay fever, asthma, sinusitis, and chronic bronchitis than white adults and had lower rates for asthma, sinusitis, and chronic bronchitis than did black adults. In general, Hispanics have lower prevalence and death rates due to asthma than black or white adults. Among all racial groups, Mexican Americans have the lowest asthma mortality and prevalence rates.

Employment: More than 20 million workers in the United States are exposed to gases, vapors, fumes, and dusts that can cause COPD. A study by the CDC concluded that 19% of COPD cases are attributable to work in industries that pose a risk for these illnesses. Adults in poor families had higher rates of emphysema, asthma, and chronic bronchitis than adults in families that were not poor. However, the opposite pattern was seen for hay fever.

Insurance: Of adults younger than 65, those insured by Medicaid had higher percentages of emphysema, asthma, and chronic bronchitis than those with private insurance or those who were uninsured. Similarly, in adults 65 and older, those covered by Medicaid and Medicare had higher rates of emphysema, asthma, and chronic bronchitis than did adults covered by Medicare alone.

Although chronic respiratory diseases are among the most common and costly health problems, these conditions are also among the most preventable, from progression to advanced stages. Adopting healthy behaviors, such as avoiding tobacco use or controlling the effects of the disease by seeking professional guidance, can help patients lead a relatively healthy life. Health care practitioners need to be conversant with the trends of these diseases.

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