"The Most Challenging Places to Live with Asthma"

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1 "The Most Challenging Places to Live with Asthma" The Asthma Capitals is an annual research project of the Asthma and Allergy Foundation of America (AAFA) to identify "the most challenging places to live with." This report provides a summary of factors used to compare and the 100 largest U.S. metro areas. Visit us online to learn how to manage your better no matter where you live. Go to call ASTHMA or write to more inmation. This year's report is sponsored by QVAR (beclomethasone dipropionate HFA) Inhalation Aerosol and Teva Pharmaceuticals. (See Important Safety Inmation page 7.) Worse than Average Average* Better than Average AAFA Factors are not weighted equally death Memphis, TN Richmond, VA Philadelphia, PA Detroit, MI Oklahoma City, OK Augusta, GA Knoxville, TN Chattanooga, TN New Orleans, LA Chicago, IL Indianapolis, IN New Haven, CT Fresno, CA Providence, RI Tulsa, OK Atlanta, GA s AAFA Page 1 of 7

2 death s McAllen, TX Dayton, OH Allentown, PA Cleveland, OH Louisville, KY Milwaukee, WI Springfield, MA Toledo, OH Jacksonville, FL St. Louis, MO Pittsburgh, PA Little Rock, AR Nashville, TN Jackson, MS Akron, OH Wichita, KS Hartd, CT Cincinnati, OH New York, NY Bridgeport, CT Bakersfield, CA Youngstown, OH Dallas, TX Las Vegas, NV Scranton, PA Stockton, CA Harrisburg, PA Birmingham, AL El Paso, TX Phoenix, AZ Albuquerque, NM Washington, DC Columbus, OH Riverside, CA AAFA Page 2 of 7

3 death s Salt Lake City, UT Los Angeles, CA Columbia, SC Tampa, FL Greenville, SC Charleston, SC Virginia Beach, VA Lakeland, FL Buffalo, NY Greensboro, NC Miami, FL Syracuse, NY Grand Rapids, MI Orlando, FL San Antonio, TX Omaha, NE Winston-Salem, NC Charlotte, NC Ogden, UT Albany, NY Baton Rouge, LA Kansas City, MO Sacramento, CA Boston, MA Tucson, AZ Baltimore, MD Daytona Beach, FL Denver, CO Worcester, MA Spokane, WA Madison, WI Houston, TX Oxnard, CA Provo, UT AAFA Page 3 of 7

4 death s San Diego, CA Des Moines, IA Minneapolis, MN Colorado Springs, CO Rochester, NY Portland, OR Austin, TX Raleigh, NC Sarasota, FL Cape Coral, FL Palm Bay, FL Abilene, TX San Jose, CA Seattle, WA Boise, ID San Francisco, CA * LIST AVERAGES death 8.90% 8.70% ,000 deaths 12.60% affected popu lation Avg. C- on A to F s Avg on 0 to % 16.86% All states have an Patients* spcl s Last Year's List Averages 8.78% 8.70% ,000 deaths 13.38% affected population C- on A to F 2.39 on 0 to % 17.12% All states had an Patients* spcl s AAFA Page 4 of 7

5 REGIONAL RANKINGS (Top-5) Midwest death Detroit, MI Chicago, IL Indianapolis, IN Dayton, OH Cleveland, OH Northeast s Philadelphia, PA New Haven, CT Providence, RI Allentown, PA Springfield, MA South nationa l Memphis, TN Richmond, VA Oklahoma City, OK Augusta, GA Knoxville, TN West Fresno, CA Bakersfield, CA Las Vegas, NV Stockton, CA Phoenix, AZ AAFA Page 5 of 7

6 Asthma Capitals Methodology The U.S. Asthma Capitals research and ing is reported annually by the Asthma and Allergy Foundation of America (AAFA). The ing is based on analysis of data from the 100 most-populated Consolidated Metropolitan Statistical Areas (MSAs) in the U.S. including 13 individual factors grouped into three primary areas: (I), (II) and (III). Weights are applied to each set of data in each factor group by researchers and medical, reflecting each factor s relative effect on the quality of life people with. Factors are not equally weighted. s are calculated as a composite of all factors, and cities are ed from highest total (city #1) to lowest total (city #100). (I) PREVALENCE FACTORS Quantitative data including morbidity statistics from the most recently available sources of estimated, self-reported and crude death s. * Prevalence Asthma predicted population with (adult and pediatric) *Self-Reported Prevalence Asthma self-reported population with (adult, state-level only) * Death Rate from Asthma recorded metro area death s from (adult and pediatric) (II) RISK FACTORS Qualitative and quantitative data from the most recently available sources of comprehensive annual measurements, average length of peak seasons, outdoor air quality (including number of ozone days and annual levels of pollution particulate matter [pm]), poverty s, uninsured s, state school s and primary MSA city/county/state s prohibiting smoking in places (including workplaces, restaurants, bars and/or cars with minors). * Pollen reported Pollen each metro area * Air Quality pollution levels and number of unhealthy outdoor ozone days, d on a of: A (best) to F (worst) *Public Smoking Laws number of "100% smoke-free" smoking bans (bars, restaurants, workplaces and/or cars with minors) * Rate reported cent of metro area population in poverty * Rate reported cent of metro area population without health insurance * Inhaler Access Laws state s ensuring student to s (III) MEDICAL FACTORS Quantitative data from the most recently available sources in the 100 most populated U.S. cities the number of s, number of rescue and ler medication prescriptions, and the number of adult and pediatric s with their primary Board Certification in allergy & immunology and/or pulmonary medicine. *ER Visits Asthma number of out- plus in- Medicare and non-medicare emergency room visits *Rescue Medication Use number of rescue medication prescriptions *Controller Medication Use number of ler medication prescriptions * Asthma Specialists number of Board Certified adult/pediatric allergists/immunologists and pulmonologists Pollen is a comprehensive index of the population at risk of being affected by airborne allergenic ("-affected population") derived from actual counts, allergy each type and related factors. Public smoke-free s recognized by this report are bans only; partial smoking bans or bans with exceptions are not included. State school s recognized by this report refer to states having a single state-wide protecting students' rights to carry and medications at school. AAFA Page 6 of 7

7 Sources: Most Current Available Local-Level Data Used the Asthma Capitals Decennial U.S. Census 2000, U.S. Department of Commerce, Census Bureau, and 2014 Population Estimate Updates National Pollen Index Measurements and Reports, IMS Health Inc., Pollen.com Database, 2014 Local Tobacco Control Ordinance Database, American Nonsmokers Rights Foundation, AAFA's State Honor Roll of Asthma and Allergy Policies, 2014 National Prescription Tracking Database, IMS Health Inc., 2014 National Medical Specialist Database, American Board of Medical Specialties, Small Area Income & Estimates, U.S. Department of Commerce, Economics and Statistics Administration, 2013 Small Area Health Insurance Estimates, U.S. Department of Commerce, Economics and Statistics Administration, 2013 Mortality Statistics Database, U.S. Centers Disease Control and Prevention, CDC Wonder, National Health Interview Survey (NHIS), U.S. Centers Disease Control and Prevention, 2013 National Center Health Statistics, Behavioral Risk Factor Surveillance System (BRFSS), "Adult Self-Reported Current Asthma Prevalence Rate, 2012 Air Quality System (AQS) Air Quality and Ozone Data, U.S. Environmental Protection Agency, CMS Hospital Out Prospective Payment System (OPPS) and Provider of Service Files, 2013 CMS MEDPAR Hospital (National), 2013 Thompson Reuters Medicare Database, 2013 American Hospital Association Survey Database, 2014 Boston Scientific Master Hospital List, 2014 e (AAFA thanks Boston Scientific their in-kind donation of ER data this annual report) -AAFA - Neither this report nor its contents may be reproduced or used commercial purposes without mission, Updated 5/4/15 About QVAR QVAR (beclomethasone dipropionate HFA) Inhalation Aerosol is used in the ongoing treatment of as preventative therapy in s five years of age or older. QVAR is also used s who require systemic corticosteroid administration, where adding QVAR may reduce or eliminate the need systemic corticosteroids. Important Safety Inmation QVAR does not replace - s sudden symptoms Do not use QVAR if you are allergic to beclomethasone dipropionate or any of the ingredients in QVAR. Do not use QVAR more often than it is prescribed. Do not stop taking QVAR abruptly without talking to your healthcare provider. QVAR may cause serious side effects, including: o Fungal infections (thrush). Tell your healthcare provider if you have any redness or white-colored patches in your mouth or throat. Rinse your mouth after using QVAR to help prevent an infection in your mouth or throat o Worsening or sudden attacks. After using your rescue, contact your healthcare provider right away if you do not get from your sudden attacks o Decreased adrenal function. This potentially life-threatening condition can happen when you stop taking oral corticosteroid medicines and start using QVAR. Tell your healthcare provider right away about any symptoms such as: tiredness, weakness, nausea and vomiting, and dizziness or faintness o Immune system effects or infection. Tell your healthcare provider about any signs or symptoms, such as: fever, pain, body aches, chills, feeling tired, nausea, or vomiting o Increased wheezing right after QVAR use. Always have a rescue with you to treat sudden wheezing o Serious allergic reactions. Stop using QVAR and call your healthcare provider or get emergency medical help right away if you get any of the following: hives; swelling of your lips, tongue, or face; rash; or breathing problems o Slowed growth in children. Children should have their growth checked regularly while using QVAR o Lower bone density. This may be a problem people who already have a higher chance this condition o Eye problems. If you have had glaucoma or cataracts in the past, you should have regular eye exams while using QVAR The most common side effects of QVAR include: headache, throat irritation, and sinus irritation. Please see full Prescribing Inmation You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call FDA AAFA Page 7 of 7

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