San Francisco County Asthma Profile

In San Francisco County, approximately 104,000 children and adults have been diagnosed with asthma.

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County Population

AgePopulation%
0-4 42,401 5.2
5-17 74,939 9.3
18-64 579,890 71.6
65+ 112,848 13.9
Total 810,078  

County Population

Race/Ethnicity1%
White 45.1
Black 6.7
Hispanic 13.5
Asian/PI 31.7
Other 3.0

datasource:

California Department of Finance, 2008 (2007 release)

Lifetime Asthma Prevalence,2 2011-2012

Percent with Lifetime Asthma (95% Confidence Interval3)

 AgeSan Francisco CountyCalifornia
Children0-4 -- 9.7 (7.2-12.3)
5-17 28.2 (12.1-44.3) 17.1 (15.5-18.7)
Adults18-64 11.4 (7.7-15.1) 14.0 (13.4-14.7)
65+ 13.4 (7.4-19.4) 12.0 (11.1-12.8)
Totals:0-17 23.2 (10.9-35.4) 15.4 (14.0-16.7)
18+ 11.7 (8.4-15.0) 13.7 (13.1-14.3)
All Ages 13.2 (9.9-16.6) 14.1 (13.6-14.6)
datasource: California Health Interview Survey (CHIS), 2011-2012

Active Asthma Prevalence,4 2011-2012

Percent with Active Asthma (95% Confidence Interval3)

 AgeSan Francisco CountyCalifornia
Children0-4 -- 6.3 (4.6-8.0)
5-17 -- 11.6 (10.2-13.0)
Adults18-64 7.5 (4.1-10.9) 7.6 (7.1-8.1)
65+ -- 8.2 (7.5-8.9)
Totals:0-17 -- 10.1 (9.0-11.3)
18+ 7.5 (4.5-10.5) 7.7 (7.3-8.2)
All Ages 9.0 (5.9-12.1) 8.3 (7.9-8.7)
datasource: California Health Interview Survey (CHIS), 2011-2012

Asthma Management Plans

National guidelines recommend that health care providers give all patients with asthma a written self-management plan. In San Francisco County, 18.0% (95% CI 12.4-23.6) of people with asthma have NOT received an asthma management plan from a health care provider.

datasource: CHIS, 2009

Asthma Risk Factors, 2009

San Francisco County Risk Factors

Risk FactorPercent (95% Confidence Interval)
Percent of adults who are current smokers 11.5 (6.2-16.9)
Percent of adults and children exposed to second-hand smoke in the home 8.2 (4.9-11.5)
Percent of adults who are obese7 (BMI>=30) 18.0 (12.4-23.6)
Percent of people below the Federal Poverty Level 11.1 (NA)
Unemployment Rate 9.0 (NA)
datasource: CHIS, 2009

Asthma Deaths,9 2008-2010

datasource: California Death Statistical Master Files, 2008-2010

Asthma Emergency Department Visits,10 2010

Number of ED Visits Due to Asthma (N) and Age-Adjusted Rate11 (per 10,000 residents)

 San Francisco CountyCalifornia
 AgeNRateNRate
Children0-4 499 115.4 30,344 109.7
5-17 393 47.6 42,112 59.0
Adults18-64 1,944 36.9 90,989 36.8
65+ 553 46.9 16,527 37.6
Totals:0-17 892 65.8 72,456 72.6
18+ 2,497 38.6 107,516 36.9
All Ages 3,389 45.6 179,972 46.1
datasource: Office of Statewide Health Planning and Development (OSHPD), 2010

Expected Source of Payment for Asthma ED Visits

Payment SourceSan Francisco CountyCalifornia
Medicare 21.4% 12.6%
Medi-Cal 30.2% 37.1%
Private 33.2% 31.1%
Other 15.2% 19.3%
datasource: Office of Statewide Health Planning and Development (OSHPD), 2010

Asthma Hospitalizations,12 2010

Number of Hospitalizations Due to Asthma (N) and Age-Adjusted Rate11 (per 10,000 residents)

 San Francisco CountyCalifornia
 AgeNRateNRate
Children0-4 83 19.2 6,187 22.3
5-17 48 5.7 4,884 6.9
Adults18-64 270 4.7 14,671 5.7
65+ 270 22.3 9,054 20.7
Totals:0-17 131 9.4 11,071 11.0
18+ 540 7.7 23,725 8.3
All Ages 671 8.1 34,796 9.0
datasource: Office of Statewide Health Planning and Development (OSHPD), 2010

Average Charges13 Per Asthma Hospitalization

 AgeSan Francisco CountyCalifornia
Children0-17 $20,621 $19,508
Adults18+ $48,912 $40,853
TotalAll Ages $42,974 $33,749
datasource: Office of Statewide Health Planning and Development (OSHPD), 2010

Expected Source of Payment for Asthma Hospitalizations

Payment SourceSan Francisco CountyCalifornia
Medicare 40.5% 29.4%
Medi-Cal 27.7% 35.7%
Private 26.1% 24.9%
Other 5.7% 10.0%
datasource: Office of Statewide Health Planning and Development (OSHPD), 2010

Asthma Disparities

Age-Adjusted Asthma Hospitalizations and ED Visits per 10,000 San Francisco County Residents by Race/Ethnicity, 2010

EventsWhiteBlackHispanicAsian/PI
Hospitalizations 5.5 28.4 7.4 7.0
ED Visits 42.3 186.1 48.5 22.4

Data Source: datasource: Office of Statewide Health Planning and Development (OSHPD), 2010

Hospitalization Rates Over Time

Age-Adjusted Asthma Hospitalizations per 10,000 Residents, San Francisco County and California, 1998-2008

YearSan Francisco CountyCalifornia
1998 16.3 11.7
1999 14.7 12.1
2000 12.3 11.0
2001 10.6 10.5
2002 11.0 10.5
2003 9.7 11.1
2004 9.4 9.8
2005 9.2 9.9
2006 8.5 9.1
2007 8.6 8.6
2008 7.8 9.1

Data Source: datasource: Office of Statewide Health Planning and Development (OSHPD) , 1998- 2008.

Healthy People 201014

Asthma Hospitalizations per 10,000 Residents by Age, Compared to HP2010 Targets, California and San Francisco County, 2008

EventsSan Francisco CountyCaliforniaHP2010
0-4 20.4 22.0 25
5-64 4.3 6.0 7.7
65+ 23.6 21.9 11

Data Source: datasource: Office of Statewide Health Planning and Development (OSHPD), 2008 .

Asthma ED Visits per 10,000 Residents by Age, Compared to HP2010 Targets, California and San Francisco County, 2008

AgesSan Francisco CountyCaliforniaHP2010
0-4 72.2 102.5 80
5-64 33.0 39.8 50
65+ 43.1 37.7 15

Data Source: datasource: Office of Statewide Health Planning and Development (OSHPD), 2008.


Notes

  1. PI = Pacific Islander; Please see technical notes for more information on race/ethnicity categorizations.
  2. Lifetime asthma prevalence is the proportion of people in the population who have ever been diagnosed with asthma by a health provider.
  3. The 95% confidence interval (CI) is a range that expresses a level of certainty about an estimate based on the margin of error.
    The 95% CI means that we are 95 percent confident that this range contains the true population percent. A narrow CI means that there is less variability in the estimate and/or there is a larger sample size. A wide CI indicates more variability and/or a smaller sample size.
  4. Active asthma prevalence is the proportion of people in the population who have ever been diagnosed with asthma by a health provider and report that they still have asthma and/or report that they had an episode or attack within the past 12 months.
  5. Work-related asthma is asthma that is caused or triggered by conditions or substances in the workplace.
  6. Balmes J, Becklake M, Blanc P, et al. Environmental and Occupational Health Assembly, American Thoracic Society. American Thoracic Society Statement: Occupational Contribution to the Burden of Airway Disease. Am J Respir Crit Care Med. 2003;167:787-797; Lutzker L, Rafferty A, Brunner W, et al. Prevalence of Work-related Asthma in Michigan, Minnesota, and Oregon. Journal of Asthma. 2010;47:156-161.
  7. Obesity is defined as a body mass index (BMI) of 30 or greater.
  8. Data Sources for Asthma Risk Factors: Smoking — CHIS, 2009; Obesity — CHIS, 2009; Poverty Level — American Community Survey, 2007-2009; Unemployment Rate — State of California Employment Development Department, 2009
  9. An asthma death is a death where asthma was indicated as the underlying cause on the death certificate. The rate of asthma deaths is the number of deaths per 1,000,000 residents, age-adjusted to the 2000 U.S. population.
  10. An asthma ED visit is an admission to a licensed ED in California with the primary diagnosis of asthma. The rate of asthma ED visits is the number of visits per 10,000 residents, age-adjusted to the 2000 U.S. population.
  11. Population denominators for rates are from the California Department of Finance. All rates are age-adjusted to the 2000 U.S. population. Age-adjusted rates are modified to eliminate the effect of different age distributions in different populations. Rates based on numbers <20 are not reported.
  12. An asthma hospitalization is a discharge from a licensed acute care hospital in California with the primary diagnosis of asthma. The rate of asthma hospitalizations is the number of hospitalizations per 10,000 residents, age-adjusted to the 2000 U.S. population.
  13. Charges for asthma hospitalizations are the only type of data available to assess the costs of asthma in California counties. However, there are many other costs associated with asthma, including other types of health care utilization, medications, and indirect costs due to factors such as school and work missed.
  14. Healthy People 2010 (HP2010) is a set of national benchmarks for a wide range of health topics, including asthma. For more information on HP2010, visit www.healthypeople.gov.
  15. Outdoor air quality data—including exposures such as PM2.5, PM10, ozone, and traffic pollution—can be found online through the California Environmental Health Tracking Program’s Air Quality Data Query or on the California Air Resources Board website.

Further details about the data presented in this report can be found in the accompanying Technical Notes document.