Action Against Asthma: A Strategic Plan for the Department of Health and Human Services . Prologue


We are facing an asthma epidemic. Through newspaper stories and personal experiences, we hear more about asthma every day. A child at school has an asthma attack in the classroom. The radio reports an air pollution alert, warning anyone with breathing problems to stay indoors. The local school board debates a policy on students carrying inhaler medications. Stories of asthma are all around us.

The statistics support these impressions. From 1980 to 1996, the number of Americans with asthma more than doubled, to almost fifteen million, with children under five years old experiencing the highest rate of increase. Reasons for these increasing rates are unclear. Yet even if rates were to stop increasing, asthma would remain an enormous public health problem. Not only does it keep children in fear and pain – it keeps them out of school. In every classroom with 30 children, there are likely to be at least two with asthma. That adds up to over 10 million school days lost to asthma each year. And the problem is not limited to children. Asthma is the leading work-related lung disease. Moreover, the disease kills over 5,000 Americans and results in half a million hospitalizations every year. As serious as asthma is, it doesn’t strike evenly. Minorities and the poor are hit especially hard.

To confront this challenge, I called for a special asthma initiative in the Department of Health and Human Services. In response, the agencies of the Department worked together to assess current efforts on asthma and to develop a set of priorities for the future. This strategy identifies urgent needs for research to uncover the causes of the asthma epidemic and develop ways to prevent the disease from occurring. The strategy describes priority public health actions needed to eliminate the disparities in the burden of asthma and to reduce the impacts on all who suffer with the disease.

The success of efforts to combat asthma will depend on the joint efforts of many – providers of medical care, university researchers, non-governmental and community-based organizations, professional societies, insurance and pharmaceutical companies, other businesses, federal, state, local and tribal government agencies, and people with asthma and their families. This strategy describes the role of the Department of Health and Human Services. Others have equally important roles, and we must all work together in concerted action against asthma.

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