COPD, Adult Chronic Lung Disease, and Adult and Pediatric Asthma.
The Behavioral Risk Factor Surveillance Survey questionnaire asks respondents “Has a doctor, nurse, or other health professional ever told you that you had any of the following?” followed by a series of conditions. Prevalence rates in this report are based on responses to the questions:
- “(COPD) chronic obstructive pulmonary disease, emphysema or chronic bronchitis?”
- “Asthma?” and “Do you still have asthma?”
- Adult chronic lung disease is defined as answering yes to either the COPD or both asthma questions.
In states fielding the optional child asthma module, adult respondents with one or more children in the household answer the same two asthma questions for the child, if only one, or a randomly selected child, if two or more are reported.
In 2020, the Behavioral Risk Factor Surveillance System (BRFSS) survey found that approximately 23.4 million (9.2 percent) of adults residing in the United States and 7.5 percent of children from twenty-nine states and the District of Columbia reported currently having asthma. About 16.4 million adults (6.5 percent) reported ever being diagnosed with COPD. Close to 34.8 million adults (13.7 percent) reported being diagnosed with chronic lung disease.
Local area prevalence of adult asthma, COPD, and chronic lung disease is estimated by applying age-specific state prevalence rates from the 2020 BRFSS to age-specific county-level resident populations obtained from the U.S. Census Bureau web site. Local area prevalence of pediatric asthma is estimated by applying the most recent state prevalence rates, or if none are available, the national rate from the BRFSS to pediatric county-level resident populations obtained from the U.S. Census Bureau web site. Thereafter, the age-specific prevalence estimates for each county within a state are summed to determine its overall pediatric and adult prevalence.
The prevalence estimates for pediatric and adult asthma are calculated for those under 18 years of age and 18 years of age or older, respectively. Pediatric asthma data from the 2020 BRFSS was available for twenty-nine states and the District of Columbia; 2019 for Illinois and Oregon; 2018 for Maryland; 2016 for Arizona, Oklahoma, and Washington; 2015 for Louisiana; 2014 for Alabama, North Carolina, Tennessee, and West Virginia; 2012 for North Dakota and Wyoming, and 2011 for Iowa; and national data was used for the eight states (Alaska, Arkansas, Colorado, Delaware, Idaho, South Carolina, South Dakota, and Virginia) that had no data available. Data from earlier years was not used due to changes in the 2011 survey methodology.
Asthma and COPD estimates should not be compared to those from 2012 or earlier due to changes in the survey methodology and switch to a different question format, respectively.