Focus Area 24: Respiratory Diseases: Objectives and Subobjectives

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

Asthma

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

24-1.

Reduce asthma deaths.

Target and baseline:

Objective	Age Group	1999¹ Baseline Rate per Million	2010 Target Rate per Million
24-1a.	Children under age 5 years	1.7²	0.9³
24-1b.	Children aged 5 to 14 years	3.1⁴	0.9⁵
24-1c.	Adolescents and adults aged 15 to 34 years	5.6⁶	1.9⁷
24-1d.	Adults aged 35 to 64 years	15.5⁸	8.0⁹
24-1e.	Adults aged 65 years and older	69.5¹⁰	47.0¹¹

Target setting method: Better than the best.

Data source: National Vital Statistics System—Mortality (NVSS—M),¹² CDC, NCHS.

¹ Baseline year revised from 1998 after November 2000 publication.
² Baseline revised from 2.1 after November 2000 publication.
³ Target revised from 1.0 because of baseline revision after November 2000 publication.
⁴ Baseline revised from 3.3 after November 2000 publication.
⁵ Target revised from 1.0 because of baseline revision after November 2000 publication.
⁶ Baseline revised from 5.0 after November 2000 publication.
⁷ Target revised from 2.0 because of baseline revision after November 2000 publication.
⁸ Baseline revised from 17.8 after November 2000 publication.
⁹ Target revised from 9.0 because of baseline revision after November 2000 publication.
¹⁰ Baseline revised from 86.3 after November 2000 publication.
¹¹ Target revised from 60.0 because of baseline revision after November 2000 publication.
¹² Name of data source changed from National Vital Statistics System [NVSS] after November 2000
publication.

NO CHANGE IN OBJECTIVE

24-2.

Reduce hospitalizations for asthma.

Target and baseline:

Objective	Age Group	1998 Baseline Rate per 10,000	2010 Target Rate per 10,000
24-2a.	Children under age 5 years	45.6	25.0
24-2b.	Children and adults aged 5 to 64 years*	12.5	7.7
24-2c.	Adults aged 65 years and older*	17.7	11.0

* Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

Data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

NO CHANGE IN OBJECTIVE

24-3.

Reduce hospital emergency department visits for asthma.

Target and baseline:

Objective	Age Group	1995–97 Baseline Rate per 10,000	2010 Target Rate per 10,000
24-3a.	Children under age 5 years	150.0	80.0
24-3b.	Children and adults aged 5 to 64 years	71.1	50.0
24-3c.	Adults aged 65 years and older	29.5	15.0

Target setting method: Better than the best.

Data source: National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

24-4.

Reduce activity limitations among persons with asthma.

Target: 6¹ percent.

Baseline: 10² percent of persons with asthma experienced activity limitations in 1997² (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

¹ Target revised from 10 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 20 and 1994–96 after November 2000 publication.

ORIGINAL OBJECTIVE
24-5.	(Developmental) Reduce the number of school or work days missed by persons with asthma due to asthma. Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
24-5.	~~(Developmental)~~ Reduce the number of school or work days missed by persons with asthma due to asthma. Target: 2.0 days. Baseline: The number of school or work days missed by persons aged 5 to 64 years with asthma due to asthma was 6.1 days in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
24-5.	Reduce the number of school or work days missed by persons with asthma due to asthma. Target: 2.0 days. Baseline: The number of school or work days missed by persons aged 5 to 64 years with asthma due to asthma was 6.1 days in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE

24-6.

Increase the proportion of persons with asthma who receive formal patient education, including information about community and self-help resources, as an essential part of the management of their condition.

Target: 30.0 percent.

Baseline: 8.4 percent of persons aged 18 years and older with asthma received formal patient education in 1998 (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE

24-7.

(Developmental) Increase the proportion of persons with asthma who receive appropriate asthma care according to the NAEPP Guidelines.

24-7a. Persons with asthma who receive written asthma management plans from their health care provider.

24-7b. Persons with asthma with prescribed inhalers who receive instruction on how to use them properly.

24-7c. Persons with asthma who receive education about recognizing early signs and symptoms of asthma episodes and how to respond appropriately, including instruction on peak flow monitoring for those who use daily therapy.

24-7d. Persons with asthma who receive medication regimens that prevent the need for more than one canister of short-acting inhaled beta agonists per month for relief of symptoms.

24-7e. Persons with asthma who receive followup medical care for long-term management of asthma after any hospitalization due to asthma.

24-7f. Persons with asthma who receive assistance with assessing and reducing exposure to environmental risk factors in their home, school, and work environments.

Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.

OBJECTIVE WITH REVISIONS

24-7.

~~(Developmental)~~ Increase the proportion of persons with asthma who receive appropriate asthma care according to the NAEPP Guidelines.

Target and baseline:

Objective	Persons With Asthma Who Receive Appropriate Care	2002 Baseline (unless noted) Percent	2010 Target Percent
24-7a.	Written asthma management plans from their health care provider	32	38
24-7b.	With prescribed inhalers who receive instruction on how to use them properly	96.0 (2003)	98.8
24-7c.	Education about recognizing early signs and symptoms of asthma episodes and how to respond appropriately, including instruction on peak flow monitoring for those who use daily therapy	68 (2003)	71
24-7d.	Medication regimens that prevent the need for more than one canister of short-acting inhaled beta agonists per month for relief of symptoms	80 (2003)	92
24-7e.	Followup medical care for long-term management of asthma after any hospitalization due to asthma	76 (2003)	87
24-7f.	Assistance with assessing and reducing exposure to environmental risk factors in their home, school, and work environments	42	50

Target setting method: Better than the best.

~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.

REVISED OBJECTIVE

24-7.

Increase the proportion of persons with asthma who receive appropriate asthma care according to the NAEPP Guidelines.

Target and baseline:

Objective	Persons With Asthma Who Receive Appropriate Care	2002 Baseline (unless noted) Percent	2010 Target Percent
24-7a.	Written asthma management plans from their health care provider	32	38
24-7b.	With prescribed inhalers who receive instruction on how to use them properly	96.0 (2003)	98.8
24-7c.	Education about recognizing early signs and symptoms of asthma episodes and how to respond appropriately, including instruction on peak flow monitoring for those who use daily therapy	68 (2003)	71
24-7d.	Medication regimens that prevent the need for more than one canister of short-acting inhaled beta agonists per month for relief of symptoms	80 (2003)	92
24-7e.	Followup medical care for long-term management of asthma after any hospitalization due to asthma	76 (2003)	87
24-7f.	Assistance with assessing and reducing exposure to environmental risk factors in their home, school, and work environments	42	50

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
24-8.	(Developmental) Establish in at least 25 States a surveillance system for tracking asthma death, illness, disability, impact of occupational and environmental factors on asthma, access to medical care, and asthma management. Potential data sources: Periodic surveys, Council of State and Territorial Epidemiologists and Public Health Foundation; Association of Schools of Public Health.
OBJECTIVE WITH REVISIONS
24-8.	Increase the number of ~~(Developmental)~~ ~~Establish in at least 25~~ States with an asthma surveillance system for tracking asthma ~~death~~cases, illness, and disability~~, impact of occupational and environmental factors on asthma, access~~ ~~to medical care, and asthma managemen~~. Target: 25 States. Baseline: 19 States had a surveillance system for tracking asthma cases, illness, and disability in 2003. Target setting method: 32 percent improvement. ~~Potential d~~Data sources: ~~Periodic surveys, Council of State and Territorial~~ ~~Epidemiologists and Public Health Foundation; Association of Schools of Public~~ ~~Health~~Behavioral Risk Factor Surveillance System (BRFSS), CDC.
REVISED OBJECTIVE
24-8.	Increase the number of States with an asthma surveillance system for tracking asthma cases, illness, and disability. Target: 25 States. Baseline: 19 States had a surveillance system for tracking asthma cases, illness, and disability in 2003. Target setting method: 32 percent improvement. Data source: Behavioral Risk Factor Surveillance System (BRFSS), CDC.

Chronic Obstructive Pulmonary Disease (COPD)

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

24-9.

Reduce the proportion of adults whose activity is limited due to chronic lung and breathing problems.

Target: 1.9¹ percent.

Baseline: 2.5² percent of adults aged 45 years and older experienced activity limitations due to chronic lung and breathing problems in 1997 (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

¹Target revised from 1.5 because of baseline revision after November 2000 publication.
² Baseline revised from 2.2 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

24-10.

Reduce deaths from chronic obstructive pulmonary disease (COPD) among adults.

Target: 62.3¹ deaths per 100,000 adults.

Baseline: 123.9² deaths from COPD (excluding asthma) per 100,000 persons aged 45 years and older occurred in 1999² (age adjusted to the year 2000 standard population).

Target setting method: 50 percent improvement.

Data source: National Vital Statistics System—Mortality (NVSS—M), CDC, NCHS.

¹ Target revised from 60 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 119.4 and 1998 after November 2000 publication.

Obstructive Sleep Apnea (OSA)

NO CHANGE IN OBJECTIVE

24-11.

(Developmental) Increase the proportion of persons with symptoms of obstructive sleep apnea whose condition is medically managed.

24-11a. Persons with excessive daytime sleepiness, loud snoring, and other signs associated with obstructive sleep apnea who seek medical evaluation.

24-11b. Persons with excessive daytime sleepiness, loud snoring, and other signs associated with obstructive sleep apnea who receive followup medical care for long-term management of their condition.

Potential data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

ORIGINAL OBJECTIVE
24-12.	(Developmental) Reduce the proportion of vehicular crashes caused by persons with excessive sleepiness. Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; Fatality Analysis Reporting System (FARS), U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA).
OBJECTIVE WITH REVISIONS
24-12.	~~(Developmental)~~ Reduce the proportion of vehicular crashes caused by persons with excessive sleepiness. Target: 1.7 percent. Baseline: 2.9 percent of motor vehicle crash victim deaths for all ages were caused by persons with excessive sleepiness. Target setting method: Better than the best. ~~Potential d~~Data sources: National Health Interview Survey (NHIS), CDC, NCHS; Fatality Analysis Reporting System (FARS), U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA).
REVISED OBJECTIVE
24-12.	Reduce the proportion of vehicular crashes caused by persons with excessive sleepiness. Target: 1.7 percent. Baseline: 2.9 percent of motor vehicle crash victim deaths for all ages were caused by persons with excessive sleepiness. Target setting method: Better than the best. Data sources: National Health Interview Survey (NHIS), CDC, NCHS; Fatality Analysis Reporting System (FARS), U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA).

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