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Complete Health Indicator Report of Environmental Burden of Childhood Diseases


This report estimates the economic cost of childhood asthma that is attributable to the environment. This estimate is based on total cost of asthma. This includes direct health care costs and indirect costs. Indirect costs include costs associated with missed school days and lost wages for parents. The estimate is also based on an environmental attributable fraction, which estimates the proportion of childhood asthma that can be credited to the environment. The environment is being defined as outdoor and indoor pollutants from sources that could potentially be reduced.


This Indicator Report contains the following measures: 1. environmental attributable fraction for childhood asthma among the child population, age 17 years or less 2. childhood asthma environmentally attributable costs



Data Interpretation Issues

Odds ratios were obtained from a literature review for each environmental exposure. When available, proportions were used from Utah specific data. When Utah-specific data was not available, a national or study proportion was used. This could skew the results if Utah has a proportion exposed at a higher or lower rate than the national estimate. Because this is a new topic of discussion, some findings, mainly traffic exposure, had odds ratios that were not considered statistically significant because of the small sample sizes or few surveys asking questions about exposure.

Why Is This Important?

The term "environmental burden" refers to what extent environmental exposures are attributable to the overall incidence and cost of a disease. Each year, modifiable environmental risk factors affect health, causing significant suffering, stress, financial strain to families, and a considerable economic impact. Calculating the environmental burden for children and then computing the proportion of overall cost that is attributable to the environment is important because it is one way to show how the environment impacts human health. Children are more susceptible to environmental factors than adults. A child's nervous, immune, reproductive, and digestive systems are still developing and because they are growing, children tend to breathe more air as well as eat and drink more in proportion to their weight. For these reasons, exposure to environmental factors such as breathing in particulate matter, ozone, or cigarette smoke can have more negative effects on children than adults.

How Are We Doing?

The EPA recognizes secondhand smoke, mold, chemical irritants, and outdoor air pollution as common triggers for asthma. Asthma is one of the most common chronic diseases among children. The American Lung Association and Center for Disease Control and Prevention estimate that about 7.1 million children under the age of 18 are affected by asthma. According to the Environmental Protection Agency (EPA), children who reported currently having asthma has risen from 8.7% in 2001 to 9.4% percent in 2010. The Utah Asthma Program has estimated that the current prevalence of asthma among children ranges from about 2 percent in younger children to almost 10 percent among children ages 15-17.

How Do We Compare With the U.S.?

This was a one-time project collaborating with other states to calculate a state specific environmental burden of disease. The contributions of environmental factors vary by state and because of this, Utah's combined environmental attributable fraction (EAF) differed from others. In Utah, PM2.5 is the largest contributor to the total EAF.

Related Indicators

Related Relevant Population Characteristics Indicators:

Graphical Data Views

Percentage of Childhood Asthma due to Environmental Exposures (Environmental Attributable Fraction), Utah, 2011

::chart - missing::

The term "Environmental Attributable Fraction" (EAF) refers to what extent the environment is responsible for cases of childhood asthma.
Air ContaminantsPercentage
Record Count: 6
Environmental Tobacco Smoke0.6%
Traffic Proximity7.6%

Data Notes

It is expected that if a child is exposed to one environmental exposure, they will also be exposed to others. For this reason the overall EAF formula accounts for some of the association between the different environmental exposures. That is why the overall EAF is not the same as the sum of the separate environmental exposures.

Data Sources

  • Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
  • U.S. Environmental Protection Agency (EPA), Office of Air and Radiation, AIRS data

Burden of Childhood Asthma: Overall and Environmental Costs, Utah, 2011

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Note: Cost estimates were rounded to the nearest million. In 2011, it is estimated that of the total cost of childhood asthma, between $9,000,000 and $15,000,000 of those dollars were likely due to environmental exposures.

Data Notes

These cost estimates include both direct and indirect costs. CDC Chronic Disease Calculator Direct Costs: expenditures for office based visits, hospital outpatient visits, emergency room visits, inpatient hospital stays, dental visits, home health care, vision aids, other medical supplies and equipment, prescription medicines, and nursing homes Indirect Costs: Number of work days missed per person due to asthma Utah Hospital and Emergency Department: Direct Costs: Inpatient Hospital and Emergency Department discharge for local health districts, 2008-2011, ICD9 code 493 Indirect Costs: Low estimate of missed school days and lost wages.

Data Sources

  • U.S. Centers for Disease Control and Prevention, on-line data - CDC WONDER
  • Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health

References and Community Resources

World Health Organization Environmental Protection Agency American Lung Association

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

Page Content Updated On 04/28/2015, Published on 04/30/2015
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site ( The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Wed, 16 June 2021 19:38:44 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: ".

Content updated: Thu, 20 Jun 2019 13:03:28 MDT