Objective Status

  • 6 Baseline only
  • 4 Developmental
  • 0 Research

Learn more about objective types

About the Workgroup

Approach and Rationale

Asthma1 and chronic obstructive pulmonary disease (COPD)2 are significant public health burdens. Specific methods of detection, intervention, and treatment exist that may reduce this burden and promote health.3,4,5,6 Outdoor air pollution was estimated to cause 4.2 million premature deaths worldwide in 2016.7 Air pollution is strongly associated with premature death, asthma prevalence, increased asthma attacks, cardiovascular disease, developmental damage in children, and lung cancer (the leading cause of cancer-related death in the United States).8 Cigarette smoke is responsible for the large majority of COPD cases, but it’s estimated that up to 25 percent of COPD patients never smoked.9

Objectives selected by the RD Workgroup aim to reduce the rates of disease and death associated with asthma and COPD. Achieving these objectives will save lives and help people with asthma or COPD lead healthier lives. In addition, the cost savings to the nation is substantial. The burden of respiratory diseases affects individuals and their families, schools, workplaces, neighborhoods, cities, and states. Because of the cost to the health care system, the burden of respiratory diseases also falls on society — it’s paid for with tax dollars, higher health insurance rates, and lost productivity. In 2013, the total cost of asthma — including costs from absenteeism and deaths — was $81.9 billion.10 Medical expenditures for COPD are estimated to reach $49 billion in 2020.11

Understanding Respiratory Diseases

Asthma burden is disproportionately distributed by race/ethnicity, age, and income.12 For example, rates of hospitalizations due to asthma are more than 3 times higher among African Americans than whites.13 Reducing asthma disparities requires multisector collaboration and innovative strategies to reduce triggers and barriers to guidelines-based asthma management.14



Moorman, J.E., et al. (2013). National Surveillance of Asthma: United States, 2001-2010 [PDF file]. Retrieved from https://www.cdc.gov/nchs/data/series/sr_03/sr03_035.pdf


Ford, E.S., et al. (2013). Chronic Obstructive Pulmonary Disease (COPD) Surveillance–United States, 1999–2011: Chest, 144(1), 284-305. DOI: 10.1378/chest.13-0809


National Heart, Lung and Blood Institute. (2007) Guidelines for the Diagnosis and Management of Asthma (EPR-3) Retrieved from https://www.nhlbi.nih.gov/health-topics/all-publications-and-resources/expert-panel-report-3-epr-3-guidelines-diagnosis-and


Global Initiative for Chronic Obstructive Lung Disease. (n.d). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Lung Disease. Retrieved from http://goldcopd.org/gold-reports/


Rabe, K.F., et al. (2007). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. American Journal of Respiratory Critical Care Medicine, 176(6), 532-55. https://doi.org/10.1164/rccm.200703-456SO


Centers for Disease Control and Prevention. (2018). EXHALE. Retrieved from https://www.cdc.gov/asthma/pdfs/EXHALE_technical_package-508.pdf


World Health Organization. (2018). Ambient (Outdoor) Air Pollution. Retrieved from http://www.who.int/en/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health


American Lung Association. (2018). The Terrible 10: Air Pollution’s Top 10 Health Risks. Retrieved from http://www.lung.org/about-us/blog/2017/04/air-pollutions-top-10-health-risks.html


Wheaton, A.G., et al. (2019). Chronic Obstructive Pulmonary Disease and Smoking Status - United States, 2017. Morbidity and Mortality Weekly Report, 68(24), 533-538. DOI: 10.15585/mmwr.mm6824a1


Nurmagambetov, T., Kuwahara, R., & Garbe, P. (2018). The Economic Burden of Asthma in the United States, 2008-2013. Annals of the American Thoracic Society, 15(3), 348-356. DOI: 10.1513/AnnalsATS.201703-259OC


Ford, E.S. et al. (2015). Total and State-Specific Medical and Absenteeism Costs of COPD Among Adults Aged ≥ 18 years in the United States for 2010 and Projections Through 2020. Chest, 147(1), 31-45. DOI: 10.1378/chest.14-0972


National Heart, Lung and Blood Institute. (2012). Reducing Asthma Disparities. 


Centers for Disease Control and Prevention. (2019). Healthcare Use Data 2016. Retrieved from https://www.cdc.gov/asthma/healthcare-use/healthcare-use-2016.htm


The President’s Task Force on Environmental Health Risks and Safety Risks to Children. (2017). Asthma Disparities. https://ptfceh.niehs.nih.gov/activities/asthma/index.htm