Epidemiology of asthma

File:asthma prevalence.png of childhood asthma in the United States has increased since 1980, especially in younger children.]]

Rates of asthma have increased significantly between the 1960s and 2008 {{cite journal | vauthors = Grant EN, Wagner R, Weiss KB | title = Observations on emerging patterns of asthma in our society | journal = J. Allergy Clin. Immunol. | volume = 104 | issue = 2 Pt 2 | pages = S1–9 | date = August 1999 | pmid = 10452783 | doi=10.1016/S0091-6749(99)70268-X }}{{cite journal | vauthors = Anandan C, Nurmatov U, van Schayck OC, Sheikh A | title = Is the prevalence of asthma declining? Systematic review of epidemiological studies | journal = Allergy | volume = 65 | issue = 2 | pages = 152–67 | date = February 2010 | pmid = 19912154 | doi = 10.1111/j.1398-9995.2009.02244.x | s2cid = 19525219 | doi-access = free }} with it being recognized as a major public health problem since the 1970s.{{cite book|vauthors = Mason RJ, Broaddus VC, Martin T, King TE, Schraufnagel DE, Murray JF, Nadel JA|title=Murray and Nadel's textbook of respiratory medicine.|year=2010|publisher=Saunders/Elsevier|location=Philadelphia, PA|isbn=978-1416047100|pages=Chapter 38|edition=5th}} Some 9% of US children had asthma in 2001, compared with just 3.6% in 1980. The World Health Organization (WHO) reports that some 10% of the Swiss population have asthma as of 2007, compared with 2% some 25–30 years ago.{{cite book |author=World Health Organization |author-link=World Health Organization|title=Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach|format=PDF |pages=15–20, 49 |year=2007 |publisher=World Health Organization |url=https://www.who.int/gard/publications/GARD_Manual/en/index.html|access-date=2010-05-14 |isbn=978-92-4-156346-8 | archive-url=https://web.archive.org/web/20100518223824/http://www.who.int/gard/publications/GARD_Manual/en/index.html| archive-date= 18 May 2010| url-status= live}} In the United States the age-adjusted prevalence of asthma increased from 7.3 to 8.2 percent during the years 2001 through 2009.{{cite journal | vauthors = ((Centers for Disease Control and Prevention (CDC)))| title = Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001--2009 | journal = MMWR Morb. Mortal. Wkly. Rep. | volume = 60 | issue = 17 | pages = 547–52 | date = May 2011 | pmid = 21544044 }}

Asthma affects approximately 7% of the population of the United States and causes approximately 4,210 deaths per year.{{cite journal |author=Fanta CH|title=Asthma |journal=New England Journal of Medicine |volume=360|issue=10 |pages=1002–14 |date=March 2009|pmid=19264689 |doi=10.1056/NEJMra0804579 }}{{cite journal | vauthors = Lazarus SC | title = Clinical practice. Emergency treatment of asthma | journal = N. Engl. J. Med. | volume = 363 | issue = 8 | pages = 755–64 | date = August 2010 | pmid = 20818877 | doi = 10.1056/NEJMcp1003469 }}{{cite journal | vauthors = Getahun D, Demissie K, Rhoads GG | title = Recent trends in asthma hospitalization and mortality in the United States | journal = J Asthma | volume = 42 | issue = 5 | pages = 373–8 | date = June 2005 | pmid = 16036412 | doi = 10.1081/JAS-62995| s2cid = 25298857 }} In 2005, asthma affected more than 22 million people, including 6 million children, and accounted for nearly 500,000 hospitalizations that same year.{{harvnb|NHLBI Guideline|2007|p=1}} In 2010, asthma accounted for more than one-quarter of admitted emergency department visits in the U.S. among children aged 1–9 years, and it was a frequent diagnosis among children aged 10–17 years.Wier LM, Hao Y, Owens P, Washington R. Overview of Children in the Emergency Department, 2010. HCUP Statistical Brief #157. Agency for Healthcare Research and Quality, Rockville, MD. May 2013. [http://hcup-us.ahrq.gov/reports/statbriefs/sb157.jsp] {{Webarchive|url=https://web.archive.org/web/20131203025643/http://hcup-us.ahrq.gov/reports/statbriefs/sb157.jsp|date=2013-12-03}} From 2000 through 2010, the rate of pediatric hospital stays for asthma declined from 165 to 130 per 100,000 population, respectively, whereas the rate for adults remained about 119 per 100,000 population.{{cite journal | vauthors = Barrett ML, Wier LM, Washington R | title = Trends in Pediatric and Adult Hospital Stays for Asthma, 2000-2010. | journal =HCUP Statistical Brief |issue=169 | publisher = Agency for Healthcare Research and Quality | location = Rockville, MD | date = January 2014 | pmid = 24624462 | url = http://hcup-us.ahrq.gov/reports/statbriefs/sb169-Asthma-Trends-Hospital-Stays.jsp | access-date = 2014-03-28 | archive-date = 2014-03-28 | archive-url = https://web.archive.org/web/20140328234058/http://hcup-us.ahrq.gov/reports/statbriefs/sb169-Asthma-Trends-Hospital-Stays.jsp | url-status = dead }}

Asthma prevalence in the U.S. is higher than in most other countries in the world, but varies drastically between ethnic populations.{{cite journal | vauthors = Gold DR, Wright R | title = Population disparities in asthma | journal = Annu Rev Public Health | volume = 26 | pages = 89–113 | date = 2005 | pmid = 15760282 | doi = 10.1146/annurev.publhealth.26.021304.144528 | doi-access = free }} Asthma prevalence is highest in Puerto Ricans, Latino, African Americans, Filipinos, Irish Americans, and Native Hawaiians, and lowest in Mexicans and Koreans.{{cite journal | vauthors = Lara M, Akinbami L, Flores G, Morgenstern H | title = Heterogeneity of childhood asthma among Hispanic children: Puerto Rican children bear a disproportionate burden | journal = Pediatrics | volume = 117 | issue = 1 | pages = 43–53 | date = January 2006 | pmid = 16396859 | doi = 10.1542/peds.2004-1714 | s2cid = 38317718 }}{{cite journal | vauthors = Davis AM, Kreutzer R, Lipsett M, King G, Shaikh N | title = Asthma prevalence in Hispanic and Asian American ethnic subgroups: results from the California Healthy Kids Survey | journal = Pediatrics | volume = 118 | issue = 2 | pages = e363–70 | date = August 2006 | pmid = 16882779 | doi = 10.1542/peds.2005-2687 | s2cid = 21651814 }}{{cite journal | vauthors = Johnson DB, Oyama N, LeMarchand L, Wilkens L | title = Native Hawaiians mortality, morbidity, and lifestyle: comparing data from 1982, 1990, and 2000 | journal = Pac Health Dialog | volume = 11 | issue = 2 | pages = 120–30 | date = September 2004 | pmid = 16281689 }}{{Cite journal |last1=Israel |first1=Elliot |last2=Cardet |first2=Juan-Carlos |last3=Carroll |first3=Jennifer K. |last4=Fuhlbrigge |first4=Anne L. |last5=She |first5=Lilin |last6=Rockhold |first6=Frank W. |last7=Maher |first7=Nancy E. |last8=Fagan |first8=Maureen |last9=Forth |first9=Victoria E. |last10=Yawn |first10=Barbara P. |last11=Hernandez |first11=Paulina Arias |date=2022-02-26 |title=Reliever-Triggered Inhaled Glucocorticoid in Black and Latinx Adults with Asthma |journal=New England Journal of Medicine |volume=386 |issue=16 |pages=1505–1518 |language=en |doi=10.1056/NEJMoa2118813|pmid=35213105 |pmc=10367430 |s2cid=247106044 |doi-access=free }} Rates of asthma-related hospital admissions in 2010 were more than three times higher among African American children and two times higher for African American and Latino adults compared with White and Asian and Pacific Islander people. Also, children who are born in low-income families have higher risk of asthma.{{Cite web|url=https://www.epa.gov/c-ferst/c-ferst-issue-profile-childhood-asthma|title=C-FERST Issue Profile: Childhood Asthma|date=2016-03-30|website=EPA|access-date=15 February 2017}}

Asthma prevalence also differs between populations of the same ethnicity who are born and live in different places.{{cite journal | vauthors = Gold DR, Acevedo-Garcia D | title = Immigration to the United States and acculturation as risk factors for asthma and allergy | journal = J. Allergy Clin. Immunol. | volume = 116 | issue = 1 | pages = 38–41 | date = July 2005 | pmid = 15990770 | doi = 10.1016/j.jaci.2005.04.033 | doi-access = free }} U.S.-born Mexican populations, for example, have higher asthma rates than non-U.S. born Mexican populations that are living in the U.S.{{cite journal | vauthors = Eldeirawi KM, Persky VW | title = Associations of acculturation and country of birth with asthma and wheezing in Mexican American youths | journal = J Asthma | volume = 43 | issue = 4 | pages = 279–86 | date = May 2006 | pmid = 16809241 | doi = 10.1080/0277090060022869 | s2cid = 29050101 }}

Asthma affects approximately 5% of the United Kingdom's population.{{cite journal | vauthors = Anderson HR, Gupta R, Strachan DP, Limb ES | title = 50 years of asthma: UK trends from 1955 to 2004 | journal = Thorax | volume = 62 | issue = 1 | pages = 85–90 | date = January 2007 | pmid = 17189533 | pmc = 2111282 | doi = 10.1136/thx.2006.066407 }} In England, an estimated 261,400 people were newly diagnosed with asthma in 2005; 5.7 million people had an asthma diagnosis and were prescribed 32.6 million asthma-related prescriptions.{{cite journal | vauthors = Simpson CR, Sheikh A | title = Trends in the epidemiology of asthma in England: a national study of 333,294 patients | journal = J R Soc Med | volume = 103 | issue = 3 | pages = 98–106 | date = March 2010 | pmid = 20200181 | pmc = 3072257 | doi = 10.1258/jrsm.2009.090348 }}

Data depicts an increasing trend in asthma prevalence among Canada's population. In 2000-2001 asthma prevalence was monitored at 6.5%; by 2010-2011 a 4.3% increase was shown, with asthma prevalence totaling 10.8% of Canada's population.{{Cite web|url=https://www.canada.ca/en/public-health/services/publications/diseases-conditions/asthma-chronic-obstructive-pulmonary-disease-canada-2018.html#a1.2|title=Asthma and Chronic Obstructive Pulmonary Disease (COPD) in Canada, 2018|last1=Canada|first1=Public Health Agency of|date=2018-05-01|website=aem|access-date=2018-11-26}}

Furthermore, asthma prevalence varies among the provinces of Canada; the highest prevalence is Ontario at 12.1%, and the lowest is Nunavut at 3.8%. Though there is an overall decrease in the incidence of new asthma cases in Canada, prevalence is rising. This can be attributed to a decrease in case-specific mortality due to improved management and control of asthma and its symptoms.

It is approximated that 40 million Latin Americans live with asthma.

In some reports, urban residency within Latin America has been found to be associated with an increased prevalence of asthma.{{cite journal | vauthors = Forno E, Gogna M, Cepeda A, Yañez A, Solé D, Cooper P, Avila L, Soto-Quiros M, Castro-Rodriguez JA, Celedón JC | title = Asthma in Latin America | journal = Thorax | volume = 70 | issue = 9 | pages = 898–905 | date = September 2015 | pmid = 26103996 | pmc = 4593416 | doi = 10.1136/thoraxjnl-2015-207199 }} Childhood asthma prevalence was found to be higher than 15 percent in a majority of Latin American countries.{{cite journal | vauthors = Mallol J, Solé D, Baeza-Bacab M, Aguirre-Camposano V, Soto-Quiros M, Baena-Cagnani C | title = Regional variation in asthma symptom prevalence in Latin American children | journal = The Journal of Asthma | volume = 47 | issue = 6 | pages = 644–50 | date = August 2010 | pmid = 20642377 | doi = 10.3109/02770901003686480 | s2cid = 23993282 }} Similarly, a study published relating to asthma prevalence in Havana, Cuba estimated that approximately 9 percent of children under the age of 15 are undiagnosed for asthma, possible due to lack of resources in the region.

The prevalence of asthma in adults in Japan is rapidly increasing, however there is a significant difference for the children in Japan. The mean prevalence of asthma in Japan has increased from about 1% to 10% or higher in children and to about 6–10% in adults since the 1960s.{{Cite journal|date=2017-04-01|title=Japanese guidelines for adult asthma 2017|journal=Allergology International|language=en|volume=66|issue=2|pages=163–189|doi=10.1016/j.alit.2016.12.005|issn=1323-8930|last1=Ichinose|first1=Masakazu|last2=Sugiura|first2=Hisatoshi|last3=Nagase|first3=Hiroyuki|last4=Yamaguchi|first4=Masao|last5=Inoue|first5=Hiromasa|last6=Sagara|first6=Hironori|last7=Tamaoki|first7=Jun|last8=Tohda|first8=Yuji|last9=Munakata|first9=Mitsuru|last10=Yamauchi|first10=Kohei|last11=Ohta|first11=Ken|author12=Japanese Society of Allergology|pmid=28196638|doi-access=free}} There has been a 1.5 fold increase in the prevalence of asthma per decade in Japan from the 1960s. Three surveys done from 1985, 1999 and 2006 show adult asthma is increasing, while the same surveys indicate that the prevalence of asthma in children is decreasing.{{Cite journal|last1=Iwanaga|first1=Takashi|last2=Tohda|first2=Yuji|date=October 2016|title=Epidemiology of asthma in Japan|url=https://pubmed.ncbi.nlm.nih.gov/30551268/|journal=Nihon Rinsho. Japanese Journal of Clinical Medicine|volume=74|issue=10|pages=1603–1608|issn=0047-1852|pmid=30551268}} To compare this to another Asia-Pacific country the estimated prevalence of asthma in male and female children in Mongolia in a 2009 ISSAC study was 20.9% and 21.0%{{Cite journal|date=2016-01-01|title=Prevalence of childhood asthma in Ulaanbaatar, Mongolia in 2009|journal=Allergology International|language=en|volume=65|issue=1|pages=62–67|doi=10.1016/j.alit.2015.07.009|issn=1323-8930|last1=Yoshihara|first1=Shigemi|last2=Munkhbayarlakh|first2=Sonomjants|last3=Makino|first3=Sohei|last4=Ito|first4=Clyde|last5=Logii|first5=Narantsetseg|last6=Dashdemberel|first6=Sarangerel|last7=Sagara|first7=Hironori|last8=Fukuda|first8=Takeshi|last9=Arisaka|first9=Osamu|pmid=26666488|doi-access=free}}

Data regarding the epidemiology of asthma in the continent of Asia as whole is scarce, particularly regarding adult populations. However, similarly to much of the rest of the globe, prevalence of childhood asthma appears to be rising. Systematic childhood studies, such as the International Study of Asthma and Allergies in Childhood (ISAAC), provide data regarding the epidemiology of asthma among Asia's youth population. Asthma prevalence among Asia's adult population is less clear in comparison due to the comparatively higher monitoring of younger populations. However, the data available points to a positive correlation between age and asthma prevalence. Findings indicate that the prevalence of asthma among the Asian adult population is less than 5%; while findings pertaining to elderly populations illustrate a rate somewhere between 1.3 and 15.3%.{{cite journal | vauthors = Song WJ, Kang MG, Chang YS, Cho SH | title = Epidemiology of adult asthma in Asia: toward a better understanding | journal = Asia Pacific Allergy | volume = 4 | issue = 2 | pages = 75–85 | date = April 2014 | pmid = 24809012 | pmc = 4005350 | doi = 10.5415/apallergy.2014.4.2.75 }}

In a review of studies on the prevalence of asthma among migrant populations, those born in high-income countries were found to have higher rates of asthma than migrants. Second-generation migrants had a higher risk of asthma than first-generation migrants, and the prevalence of asthma increases with longer time of residence in the host country.{{cite journal |last1=Cabieses |first1=B |title=A Systematic Review on the Development of Asthma and Allergic Diseases in Relation to International Immigration: The Leading Role of the Environment Confirmed |journal=PLOS ONE |volume=9 |issue=8 |pages=e105347 |date=2014 |doi=10.1371/journal.pone.0105347|pmid=25141011 |pmc=4139367 |bibcode=2014PLoSO...9j5347C |doi-access=free }} This confirms the role of the environment in the development of asthma.{{citation needed|date=May 2023}}

A survey was conducted by the ISSAC Steering Committee from 1992 to 1993 in adults aged 22 to 44, comparing the prevalence of asthma in 10 developed countries. The population differences between these countries should be noted.{{why|date=April 2024}} The United States population in 1992 was 256.9 million, 14.5 times that of Australia (17.5 million), and 4.5 times that of the United Kingdom (57.51 million).{{Cite web|publisher=United States Census Bureau|title=Statistical Abstract of the United States: 1992|url=https://www.census.gov/library/publications/1992/compendia/statab/112ed.html|access-date=2020-12-03|website=The United States Census Bureau|language=EN-US}}{{Cite web|title=Population, total - Australia {{!}} Data|url=https://data.worldbank.org/indicator/SP.POP.TOTL?locations=AU|access-date=2020-12-03|website=data.worldbank.org}}{{Cite web|title=Population, total - United Kingdom {{!}} Data|url=https://data.worldbank.org/indicator/SP.POP.TOTL?locations=GB|access-date=2020-12-03|website=data.worldbank.org}} However, Australia and the UK have a higher prevalence than the US by 2.4 times on the lower end and 4.6 times on the higher end. In another study taken in 1992 for Japan the prevalence of asthma in Japan was 13%{{Cite journal|date=2017-04-01|title=Japanese guidelines for adult asthma 2017|journal=Allergology International|language=en|volume=66|issue=2|pages=163–189|doi=10.1016/j.alit.2016.12.005|issn=1323-8930|last1=Ichinose|first1=Masakazu|last2=Sugiura|first2=Hisatoshi|last3=Nagase|first3=Hiroyuki|last4=Yamaguchi|first4=Masao|last5=Inoue|first5=Hiromasa|last6=Sagara|first6=Hironori|last7=Tamaoki|first7=Jun|last8=Tohda|first8=Yuji|last9=Munakata|first9=Mitsuru|last10=Yamauchi|first10=Kohei|last11=Ohta|first11=Ken|author12=Japanese Society of Allergology|pmid=28196638|doi-access=free}} with a population of 124.2 million.{{Cite web|title=Population, total - United Kingdom, Japan {{!}} Data|url=https://data.worldbank.org/indicator/SP.POP.TOTL?locations=GB-JP|access-date=2020-12-03|website=data.worldbank.org}}

Disparities in the prevalence of asthma have been shown between different socioeconomic statuses.{{Cite journal|last1=Litonjua|first1=Augusto A.|last2=Carey|first2=Vincent J.|last3=Weiss|first3=Scott T.|last4=Gold|first4=Diane R.|date=1999|title=Race, socioeconomic factors, and area of residence are associated with asthma prevalence|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/%28SICI%291099-0496%28199912%2928%3A6%3C394%3A%3AAID-PPUL2%3E3.0.CO%3B2-6|journal=Pediatric Pulmonology|language=en|volume=28|issue=6|pages=394–401|doi=10.1002/(SICI)1099-0496(199912)28:6<394::AID-PPUL2>3.0.CO;2-6|pmid=10587412 |s2cid=43744145 |issn=1099-0496}} In the United States, socioeconomic status is associated with race, due to population trends, Black and Hispanic populations are more likely to have asthma, due to higher concentrations in low-income areas. In other areas of the world, the same trend that lower socioeconomic status is related to higher severity of asthma symptoms. Airway reactivity and symptoms for children of low socioeconomic status in Canada tend to be higher than those of higher-income areas. The contrast between residents of rural and suburban areas can be seen in a study of Kenya{{Cite journal|last1=Odhiambo|first1=J.A.|last2=Ng'ang'a|first2=L.W.|last3=Mungai|first3=M.W.|last4=Gicheha|first4=C.M.|last5=Nyamwaya|first5=J.K.|last6=Karimi|first6=F.|last7=MacKlem|first7=P.T.|last8=Becklake|first8=M.R.|date=1998-11-01|title=Urban–rural differences in questionnaire-derived markers of asthma in Kenyan school children|journal=European Respiratory Journal|volume=12|issue=5|pages=1105–1112|doi=10.1183/09031936.98.12051105|pmid=9864005 |issn=0000-0000|doi-access=free}} and Ethiopia,{{Cite journal|last1=Yemaneberhan|first1=Haile|last2=Bekele|first2=Zegaye|last3=Venn|first3=Andrea|last4=Lewis|first4=Sarah|last5=Parry|first5=Eldryd|last6=Britton|first6=John|date=July 1997|title=Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia|url=http://dx.doi.org/10.1016/s0140-6736(97)01151-3|journal=The Lancet|volume=350|issue=9071|pages=85–90|doi=10.1016/s0140-6736(97)01151-3|pmid=9228959 |s2cid=36933263 |issn=0140-6736}} where prevalence of asthma is lower in rural areas, and higher in urban areas. A similar trend can be seen in the United States, where an urban-rural gradient shows the increase in the prevalence of asthma closer to the inner city.{{Cite journal|last1=Lawson|first1=Joshua A.|last2=Rennie|first2=Donna C.|last3=Cockcroft|first3=Don W.|last4=Dyck|first4=Roland|last5=Afanasieva|first5=Anna|last6=Oluwole|first6=Oluwafemi|last7=Afsana|first7=Jinnat|date=2017-01-05|title=Childhood asthma, asthma severity indicators, and related conditions along an urban-rural gradient: a cross-sectional study|journal=BMC Pulmonary Medicine|volume=17|issue=1|page=4 |doi=10.1186/s12890-016-0355-5|pmid=28056923 |pmc=5216545 |issn=1471-2466 |doi-access=free }}

A study published by [https://bmcpulmmed.biomedcentral.com/about?gclid=Cj0KCQiA15yNBhDTARIsAGnwe0WZVQ4DV9rP7bCYT1ydJERCEbWkqGiF1G6oAMKQbEauMRRAr9ewE18aAoOnEALw_wcB BMC Pulmonary Medicine] shows the relation between those who live in large urban, small urban, and rural areas. Large urban can be classified as the inner-city, and small urban is related to suburban areas. The inner city and rural communities have several commonalities that are important when determining socioeconomic status. They are both more likely to have higher poverty rates, and higher mortality rates, thus having a lower health status than suburban residents.{{Cite journal|last1=Blumenthal|first1=Susan J.|last2=Kagen|first2=Jessica|date=2002-01-02|title=The Effects of Socioeconomic Status on Health in Rural and Urban America|url=https://doi.org/10.1001/jama.287.1.109-JMS0102-3-1|journal=JAMA|volume=287|issue=1|pages=109|doi=10.1001/jama.287.1.109-JMS0102-3-1|issn=0098-7484}} It was found that asthma prevalence in large urban areas was 20.9%, small urban was 21.5%, and rural was 15.1%. However, it is important to acknowledge that rural residents experienced more asthma-like symptoms (wheezing, whistling, and coughing) than those in urban areas, rural residents had 5% more asthma like symptoms. Also, residents in large urban areas were less likely to use medical services for asthma symptoms.

Multiple factors contribute to socioeconomic disparities, income and education, pollutant exposures and allergens are uncontrollable influences on an individual. Stressors related to neighborhood violence and safety, behavioral risk factors, and lack of access to adequate medications and healthcare also contribute to an increased prevalence of asthma. Low income alone accounts for a significant increase in poor asthma outcomes, including severity, lung function, and morbidity rates.{{Cite journal|last1=Cardet|first1=Juan Carlos|last2=Louisias|first2=Margee|last3=King|first3=Tonya S.|last4=Castro|first4=Mario|last5=Codispoti|first5=Christopher D.|last6=Dunn|first6=Ryan|last7=Engle|first7=Linda|last8=Giles|first8=B. Louise|last9=Holguin|first9=Fernando|last10=Lima|first10=John J.|last11=Long|first11=Dayna|date=February 2018|title=Income is an independent risk factor for worse asthma outcomes|journal=Journal of Allergy and Clinical Immunology|language=en|volume=141|issue=2|pages=754–760.e3|doi=10.1016/j.jaci.2017.04.036|pmid=28535964 |pmc=5696111 }}

Secondhand smoke is a common exposure for asthmatic children in low-income households. Children who live with at least one smoker are more likely to have asthma than those who don't.{{Cite journal|last1=Ciaccio|first1=Christina E.|last2=DiDonna|first2=Anita|last3=Kennedy|first3=Kevin|last4=Barnes|first4=Charles S.|last5=Portnoy|first5=Jay M.|last6=Rosenwasser|first6=Lanny J.|date=2014-11-01|title=Secondhand tobacco smoke exposure in low-income children and its association with asthma|journal=Allergy and Asthma Proceedings|language=en|volume=35|issue=6|pages=462–466|doi=10.2500/aap.2014.35.3788|issn=1088-5412|pmc=4210654|pmid=25584913}} People living below the poverty line and with less education have a higher second-hand smoke exposure than those who do not.{{Cite web|last=CDCTobaccoFree|date=2021-04-23|title=Cigarette and Tobacco Use Among People of Low Socioeconomic Status|url=https://www.cdc.gov/tobacco/disparities/low-ses/index.htm|access-date=2021-12-02|website=Centers for Disease Control and Prevention|language=en-us}} Also, those with blue-collar jobs are more likely to be exposed at work, as well as those with service jobs (servers and bartenders) are exposed to smoke at businesses that do not have smoking restrictions.

Globally, there are 136 million women with asthma, 57% of the 235 million people living with asthma. In addition to being more common among women, women experience more severe symptoms and are more likely to die from asthma.{{Cite web |title=Asthma and Lung UK report - Asthma is worse for women (27 April 2022) |url=https://www.pslhub.org/learn/patient-safety-in-health-and-care/womens-health/asthma-and-lung-uk-report-asthma-is-worse-for-women-27-april-2022-r6694/ |access-date=2022-05-12 |website=Patient Safety Learning - the hub |date=27 April 2022 |language=en-GB}} The severity and frequency of asthma complications is related to both gender and age. Although asthma is more prevalent and more severe in boys among children, many women experience a significant worsening of symptoms around and after puberty.{{Cite journal |last1=Shah |first1=Ruchi |last2=Newcomb |first2=Dawn C. |date=2018 |title=Sex Bias in Asthma Prevalence and Pathogenesis |journal=Frontiers in Immunology |volume=9 |page=2997 |doi=10.3389/fimmu.2018.02997 |pmid=30619350 |pmc=6305471 |issn=1664-3224|doi-access=free }} The timing of the change in prevalence and severity around puberty suggest that asthma pathogenesis is related to sex hormones or hormone levels.{{Cite journal |last=Yung |first=Jeffrey A. |last2=Fuseini |first2=Hubaida |last3=Newcomb |first3=Dawn C. |date=2018-05-01 |title=Hormones, sex, and asthma |url=https://www.annallergy.org/article/S1081-1206(18)30023-1/fulltext |journal=Annals of Allergy, Asthma & Immunology |language=English |volume=120 |issue=5 |pages=488–494 |doi=10.1016/j.anai.2018.01.016 |issn=1081-1206 |pmid=29410216|pmc=5936670 }}

Between 2014-15 and 2019-20 more than 5,100 women in the United Kingdom died from an asthma attack compared with fewer than 2,300 men. Based on emergency hospital admissions in England, among all admissions 20 to 49 years old, women were 2.5 times more likely to be admitted to hospital for asthma treatment compared with men.{{citation needed|date=May 2023}}

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• {{cite web |author=National Asthma Education and Prevention Program (NAEPP) |url=http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf | title=Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma | work=National Heart Lung and Blood Institute | year=2007 |ref={{harvid|NHLBI Guideline|2007}}}}
• {{cite web| url=http://www.brit-thoracic.org.uk/Portals/0/Guidelines/AsthmaGuidelines/sign101%20revised%20June%2009.pdf| title=British Guideline on the Management of Asthma| work=British Thoracic Society| year=2009| ref={{harvid|British Guideline|2009}}| access-date=2012-12-29| archive-url=https://web.archive.org/web/20120917053956/http://www.brit-thoracic.org.uk/Portals/0/Guidelines/AsthmaGuidelines/sign101%20revised%20June%2009.pdf| archive-date=2012-09-17| url-status=dead}}
• {{cite web|url=http://www.ginasthma.org/uploads/users/files/GINA_Report2011_May4.pdf |title=Global Strategy for Asthma Management and Prevention |publisher=Global Initiative for Asthma |year=2011 |ref={{harvid|GINA|2011}} |url-status=dead |archive-url=https://web.archive.org/web/20121120205023/http://www.ginasthma.org/uploads/users/files/GINA_Report2011_May4.pdf |archive-date=2012-11-20 }}

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Category:Asthma

Asthma