For your child, asthma symptoms could interfere with his day at school or with his favorite activities. Perhaps you might notice on some days that he may have less stamina during play than other children, or he may be trying to limit or avoid various sports or physical activities to prevent coughing or wheezing.

This could be the story for millions of other children as well. According to the Centers for Disease Control and Prevention (CDC), nearly 9 percent of all children — 6.5 million children under the age 18 — were reported to have asthma in the United States in 2005. This was almost double the rate since 1980, when 3.6 percent of children reportedly had asthma. These numbers currently make it one of the top chronic conditions among children in the country.

Numbers Snapshot

The CDC numbers show that asthma, as a significant health problem, is making an impact on many children's lives:

• Children with at least one asthma attack in the previous year (nearly 4 million children) missed a cumulative total of 12.8 million school days due to asthma in 2003.

• Over 5 percent of all children (3.8 million) had at least one asthma attack in the past year.

• Asthma-related emergency department visits for children remained fairly stable from 1992 to 2004 — 103 visits per 10,000 children in 2004 — compared to 98 visits per 10,000 in 1992.

• Twenty-seven hospitalizations for asthma per 10,000 children were reported in 2004 for a total of 198,000 hospitalizations nationwide — or the third leading cause of hospitalization in the country for children.

• After increasing steadily between 1980 and 1998, asthma death rates among children have declined since 1999 from 3.2 deaths per one million children under age 18 in 1999 to 2.5 deaths per one million (or 186 children) in 2004.

The number of asthma-related visits to physician offices have increased sharply since the early 1990s, from less than 40 visits per 1,000 children under age 18 in 1990 to 89 visits per 1,000 in 2004. This rise continued while the rate of visits to physician offices by children for any reason did not increase.

This may not be bad news, though, according to the CDC. While part of this spike in office visits might be related to an increase in severe asthma symptoms, this also might reflect increased health care use to improve asthma control.

Disparities

Behind the numbers, though, are faces — and disparities. The numbers show that some population groups are being disproportionately affected by asthma.

Among racial and ethnic groups, Puerto Rican and non-Hispanic African American children were reported to have the highest percentages of asthma (19 percent and 13 percent respectively).

In 2005, American Indian and Alaska Native children had asthma rates 25 percent higher and African American children had rates 60 percent higher than white children. Puerto Rican children had a rate 140 percent higher than non-Hispanic white children. The rates for Asian American and Mexican American children, though, were low.

The statistics show that African American children are visiting physician offices far less than white children. This disparity may be reflected in other outcomes: African American children had a 260 percent higher emergency department visit rate, a 250 percent higher hospitalization rate, and a 500 percent higher death rate.

The State Picture

Among the 37 states for which data were available, the states with the highest percentage of children with asthma in 2005 were Massachusetts, Hawaii, Oklahoma, Maryland, and Rhode Island. The states with the lowest percentage of children with asthma were Utah, California, Iowa, Tennessee, and Washington.

Overall, the highest asthma rates among children were found in the Northeastern states and the least in the West Coast states.