In the year 1900 in the United States, the average life span was about 47 years of age, many dying from acute infections such as flu, tuberculosis, diarrhea, and pneumonia. Asthma, however, was extremely rare. As medical advances were made, vaccines and antibiotics were developed which drastically improved the overall survival rate from infections. The government recently released statistics which estimated the average longevity rate of a child born today to be over 78 years. Shockingly, the rates of morbidity and mortality from asthma have not improved as well.

Today, asthma has grown into nothing less than an epidemic and affects over 20 million Americans. Each year over 5000 people in this country die from asthma. Over nine million children have asthma, and the number, which had somewhat stabilized for almost a decade, is now beginning to climb again. Children miss 14.7 million school days per year due to asthma. Adults miss 24.5 million days of work per year from asthma. In the Annual U.S. Prevalence Statistics for Chronic Diseases, it is estimated that every day in America 40,000 people miss school or work, 30,000 people have an asthma attack, 5000 people visit the emergency room, 1,000 people are admitted to the hospital and 11 people die due to asthma.

The costs to our economy from asthma are staggering. In a study by the Asthma and Allergy Foundation, “The Costs of Asthma (2000 Update),” it was estimated that the direct cost in the U.S. including hospitalizations, physician visits, and medications was over 10 billion dollars annually. Indirect costs from lost work productivity totaled over eight billion dollars annually.

Even those who do not have asthma themselves are indirectly and directly touched by its effects. Employers have the burden of lost productivity in the workplace. All of us face rising healthcare costs, partially buoyed by the increasing burden that allergies and asthma are placing on our society.

Why is this happening? The answers are not completely clear. In many countries that are considered to be underdeveloped, including many rural areas in Africa, the incidence of asthma is actually still quite rare. Theories include the increased exposure of those living in cities to pollution, smoking, cockroach antigen, and dust mites. One factor that seems to be consistent is the increased incidence of asthma in children who tend to spend more time playing inside. Another popular theory is that with increased sanitation and hygiene in developed nations, we are no longer routinely exposed to parasites that may actually help us develop an improved immune response.

In any case, it is clear that we can no longer consider asthma to be simply a benign children’s disease, but one that affects every one of our lives. Improved asthma education, particularly in schools and the workplace, is a necessity. Cities must make and enforce regulations to improve the quality of our air both indoors and outdoors. Continuing and increased funding for research into the causes and treatment of asthma is critical. As we work together to accomplish these tasks, we will all be able to breathe easier.