Asthma - Children in Washington

Washington

Asthma is a serious chronic disease that affects the lungs and commonly causes wheezing, difficulty breathing and coughing. However, not everyone who has asthma has these symptoms and having these symptoms doesn't always mean someone has asthma. Although deaths due to asthma are relatively uncommon and largely preventable, asthma can be life-threatening if not properly treated. Approximately 1 in 6 children with asthma visits the emergency department every year. 

There are many risk factors for childhood asthma, including:

• Having allergies or a family history of allergies.
• Getting frequent respiratory infections.
• Having a low birth weight. 
• Being exposed to secondhand smoke.
• Living in areas with high levels of air pollution.

According to a 2025 meta-analysis, the prevalence of asthma-related school absenteeism was 29% and children with asthma were three times more likely to miss school than those without asthma. Pediatric asthma is one of the most costly chronic conditions among children and adolescents. A 2024 study found that children with treated asthma had an additional medical cost of $3,363 between 2016 and 2021 compared with children without treated asthma.

According to America’s Health Rankings analysis, the prevalence of asthma is higher among:

• Boys compared with girls.
• Black children compared with Asian children.
• Children who have a caregiver with some post-high school education compared with children who have a caregiver with a college degree.

• Children with special health care needs compared with children without special health care needs.

A study published in 2024 found that long-term exposure to nitrogen dioxide from gas and propane stoves is likely responsible for approximately 50,000 current cases of pediatric asthma in the United States.

Physicians can determine if a child has asthma by asking questions about their breathing and family history. To assess how well the child’s lungs are working, they may also perform a spirometry test. This non-invasive test involves the child blowing into a device. Asthma symptoms can be controlled by avoiding triggers and following a doctor’s advice. Common asthma triggers include tobacco smoke, dust mites, outdoor air pollution, pets and mold. Other interventions, like home visits and school-centered asthma programs, can reduce asthma complications in children and lower costs for families. 

Clinical and environmental strategies for caregivers to manage children’s asthma include:

• Scheduling regular well-child visits and discussing questions and concerns about asthma with a pediatrician. 
• Developing a written asthma action plan to manage symptoms and emergencies.
• Monitoring for signs, such as frequent symptom flares or asthma attacks, that suggest a child may need a change in treatment. 
• Controlling dust and mold within the home, especially in sleeping areas. This may involve regular vacuuming and washing blankets. 
• Minimizing children’s exposure to secondhand smoke and vaping.
• Encouraging regular physical activity, which has been shown to improve fitness and asthma symptoms in children. 

The Community Preventive Services Task Force recommends school-based asthma self-management education to reduce hospitalizations and emergency room visits among children with asthma. The American Lung Association’s Open Airways for Schools program aims to educate children ages 8-11 about asthma self-management. Through interactive activities, the program teaches children with asthma to recognize warning signs, such as shortness of breath and chest tightness, avoid triggers and make informed decisions about their health.

County Health Rankings & Roadmaps found that having a professional perform a healthy home environment assessment reduces exposure to allergens, improves air quality and leads to better asthma self-management. While healthy home assessments can significantly reduce health care costs by preventing urgent care visits and hospitalizations, insurance coverage for these services can vary. Families should check with their health insurance plan to see if an assessment is a covered benefit.

Healthy People 2030 has multiple objectives related to asthma, including:

• Reducing emergency department visits for children younger than 5 years with asthma.
• Reducing emergency department visits for people age 5 and older with asthma.
• Reducing hospitalizations for asthma in children younger than 5 years.
• Reducing hospitalizations for asthma in people ages 5-64.

Kashtan, Yannai, Metta Nicholson, Colin J. Finnegan, Zutao Ouyang, Anchal Garg, Eric D. Lebel, Sebastian T. Rowland, et al. “Nitrogen Dioxide Exposure, Health Outcomes, and Associated Demographic Disparities Due to Gas and Propane Combustion by U.S. Stoves.” Science Advances 10, no. 18 (May 3, 2024): eadm8680. https://doi.org/10.1126/sciadv.adm8680.

Lu, Kim D., and Erick Forno. “Exercise and Lifestyle Changes in Pediatric Asthma.” Current Opinion in Pulmonary Medicine 26, no. 1 (January 2020): 103–11. https://doi.org/10.1097/MCP.0000000000000636.

Marshall, Erica T., Jing Guo, Elizabeth Flood, Megan T. Sandel, Matthew D. Sadof, and Jean M. Zotter. “Home Visits for Children With Asthma Reduce Medicaid Costs.” Preventing Chronic Disease 17 (2020). https://doi.org/10.5888/pcd17.190288.

Merghani, Magda Mubarak, Ragaa Gasim Ahmed Mohmmed, Khaled Mohammed Al-Sayaghi, Nawal Saad M. Alshamrani, Eltayeb Mohammed Awadalkareem, Hassan Shaaib, Ahmed Alharbi, et al. “Asthma-Related School Absenteeism: Prevalence, Disparities, and the Need for Comprehensive Management: A Systematic Review and Meta-Analysis.” Dialogues in Health 7 (December 2025): 100239. https://doi.org/10.1016/j.dialog.2025.100239.

Nurmagambetov, Tursynbek, Robin Kuwahara, and Paul Garbe. “The Economic Burden of Asthma in the United States, 2008–2013.” Annals of the American Thoracic Society 15, no. 3 (March 1, 2018): 348–56. https://doi.org/10.1513/AnnalsATS.201703-259OC.

Wang, Nianyang. “Sociodemographic Factors of Asthma Prevalence and Costs Among Children and Adolescents in the United States, 2016–2021.” Preventing Chronic Disease 21 (2024). https://doi.org/10.5888/pcd21.230449.