One in Six Children with Asthma Still End Up in ER or Urgent Care

On February 6, 2018, the CDC published a report that found, in 2016, one in six children with asthma still ended up in the emergency department or urgent care. In 2013, approximately one in 20 children with asthma was hospitalized. More than half of all children with asthma had one or more attacks in 2016.


The report showed that the percentage of children with asthma who experienced one or more asthma attacks in the preceding 12 months declined from 2001 (61.7 percent) to 2016 (53.7 percent). Even so, approximately half of all children with asthma had one or more asthma attacks in 2016.


“We are making progress – but healthcare providers, parents, caregivers, and schools can do more to help children avoid asthma attacks,” said CDC Acting Director Anne Schuchat, M.D. “Asthma attacks can be terrifying for children and their families. Over the past decade, we’ve identified asthma management actions that work – not alone but in combination. Now we need to scale up these efforts nationwide.”


Asthma is the most common chronic lung disease of childhood, affecting approximately six million children in the United States. Although asthma cannot be cured, asthma symptoms can usually be controlled by avoiding or reducing exposure to asthma triggers (allergens and irritants) and by following recommendations for appropriate medical care.


The report showed that some children are more likely to have asthma than others, including boys, children ages five to 17 years, non-Hispanic black children, children of Puerto Rican descent, and children from low-income families. In 2016, asthma attacks were most common among the youngest children, four years old and under.


The report showed some progress. For example, asthma hospitalizations for children with asthma declined from 9.6 percent in 2003 to only 4.7 percent in 2013. The percentage of children who reported asthma-related missed school days also was lower in 2013 than it was in 2003. More children with asthma are getting asthma action plans and being taught how to recognize the signs and symptoms of an asthma attack and how to respond quickly.


No single strategy is the magic bullet that prevents asthma attacks. But recent evidence shows that a combination of actions can be highly effective. First, healthcare providers should work with children and parents to determine the severity of each child’s asthma; develop an action plan for each child; and share the plan with families, schools, and others. Second, healthcare providers should teach children and parents how to manage asthma by using control and rescue medicine properly and avoiding asthma triggers such as tobacco smoke, mold, pet dander, and outdoor air pollution. Third, healthcare providers should work with community health workers, pharmacists, and other community providers to help ensure that children with asthma receive the services they need.


The CDC promotes proven medical management of asthma. Such management includes proven actions such as trigger reduction, guidelines-based medical management, and self-management education. The CDC also promotes flu and pneumonia vaccination for all children, improvements in indoor air quality through smoke-free air laws and policies, and partnering with healthcare providers and others to lower asthma costs through improved control.


While the nation is currently focused on influenza, it is notable that flu can be very hard on people with asthma. In fact, of the children who have been hospitalized for influenza so far this flu season, asthma has been the most common underlying medical condition, which mirrors data from past flu seasons. In a surveillance study of 180 children who were hospitalized with influenza, approximately half of the children did not have an underlying medical condition. Approximately 24 percent of the children had asthma. A respiratory virus like the flu can be particularly difficult to fight off for children with asthma. Additionally, the flu can trigger children’s asthma.


See the CDC Announcement


See the CDC Report


See the CDC Transcript for VitalSigns Teleconference: Asthma in Children


See also Medical Law Perspectives Report: Asthma Risks and Liabilities: Taking a Deep Breath


See also Medical Law Perspectives Report: Pneumonia Complications, Hospitalizations, Deaths: Risks and Liabilities