Asthma Trends and Burden
Asthma impacts those with the disease in many ways that may differ by demographic group and can change over time. This page describes trends and disparities in asthma mortality (deaths), prevalence (number of cases), healthcare use, number of missed school and work days, and economic costs. Prevalence includes lifetime, current, and attack, and healthcare use includes hospitalizations and emergency department visits.
Asthma Mortality
- In 2016, 3,518 people died from asthma.
- The asthma death rate decreased 41 percent from 1.7 per 100,000 population in 1999 to 1.0 in 2016, although progress has slowed since 2007.
- In 2016, 61 percent of asthma deaths were in women, and the asthma death rate was 32 percent higher among women than men.
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The asthma death rate was 2.8 times greater among Blacks than Whites in 2016.
Trends in Asthma Mortality by Sex and Race/Ethnicity
Total Male Female White Non-Hispanic Black Other Hispanic Year Number Rate Number Rate Number Rate Number Rate Number Rate Number Rate Number Rate 1999 4,657 1.7 1,620 1.3 3,037 2.0 3,011 1.4 1,134 4.0 179 1.4 320 1.4 2000 4,487 1.6 1,632 1.3 2,855 1.8 2,836 1.3 1,145 3.9 183 1.3 292 1.3 2001 4,269 1.5 1,479 1.2 2,790 1.8 2,717 1.2 1,092 3.7 167 1.2 274 1.2 2002 4,261 1.5 1,580 1.2 2,681 1.7 2,720 1.2 1,083 3.5 147 1.2 287 1.2 2003 4,099 1.4 1,493 1.2 2,606 1.6 2,589 1.1 1,019 3.2 178 1.1 299 1.1 2004 3,816 1.3 1,386 1.1 2,430 1.5 2,377 1.0 1,001 3.2 146 1.0 281 1.0 2005 3,884 1.3 1,315 1.0 2,569 1.5 2,475 1.1 1,002 3.1 149 1.1 248 1.1 2006 3,613 1.2 1,296 1.0 2,317 1.4 2,246 1.0 943 2.8 154 1.0 257 1.0 2007 3,447 1.1 1,274 0.9 2,173 1.2 2,151 0.9 893 2.6 163 0.9 239 0.9 2008 3,397 1.1 1,186 0.8 2,211 1.2 2,070 0.9 892 2.5 153 0.9 271 0.9 2009 3,388 1.1 1,220 0.8 2,168 1.2 2,012 0.8 905 2.5 159 0.8 302 0.8 2010 3,404 1.0 1,283 0.9 2,121 1.2 2,082 0.9 862 2.4 155 0.9 292 0.9 2011 3,345 1.0 1,262 0.8 2,083 1.1 2,023 0.8 899 2.4 171 0.8 244 0.8 2012 3,531 1.0 1,357 0.9 2,174 1.2 2,159 0.9 948 2.5 136 0.9 277 0.9 2013 3,630 1.1 1,410 0.9 2,220 1.2 2,100 0.8 991 2.6 204 0.8 327 0.8 2014 3,651 1.1 1,392 0.9 2,259 1.2 2,163 0.9 991 2.5 182 0.9 301 0.9 2015 3,615 1.0 1,388 0.9 2,227 1.1 2,119 0.8 966 2.4 195 0.8 305 0.8 2016 3,518 1.0 1,356 0.8 2,162 1.1 2,042 0.8 951 2.3 174 0.8 334 0.8 Year Number Rate Number Rate Number Rate Number Rate Number Rate Number Rate Number Rate Sources:
Centers for Disease Control and Prevention, National Center for Health Statistics. CDC Wonder On-line Database, compiled from Compressed Mortality File 1999-2016 Series 20 No. 2U, 2019.- Age-adjusted rates are per 100,000 population and should be used for comparisons as they account for important underlying differences between populations.
- Deaths are coded by the 10th revision of International Classification of Diseases, codes J45-J46.
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Both the number and rate of deaths from asthma are much greater among older age groups. Fortunately, death rates have been decreasing among those ages 45-64 and 65 years and older.
Trends in Asthma Mortality by Age
<5 5-14 15-44 45-64 65+ Year Number Rate Number Rate Number Rate Number Rate Number Rate 1999 32 0.2 126 0.3 891 0.7 1,190 2.0 2,418 6.9 2000 40 0.2 129 0.3 874 0.7 1,154 1.9 2,290 6.5 2001 41 0.2 99 0.2 828 0.7 1,156 1.8 2,145 6.1 2002 47 0.2 123 0.3 876 0.7 1,144 1.7 2,070 5.8 2003 44 0.2 110 0.3 796 0.6 1,194 1.7 1,955 5.5 2004 36 0.2 105 0.3 732 0.6 1,082 1.5 1,861 5.1 2005 41 0.2 97 0.2 707 0.6 1,115 1.5 1,924 5.3 2006 32 0.2 99 0.2 702 0.6 1,058 1.4 1,722 4.6 2007 45 0.2 107 0.3 654 0.5 999 1.3 1,640 4.3 2008 43 0.2 112 0.3 631 0.5 967 1.2 1,644 4.2 2009 43 0.2 114 0.3 674 0.5 1,021 1.3 1,536 3.9 2010 37 0.2 119 0.3 645 0.5 1,084 1.3 1,519 3.8 2011 41 0.2 128 0.3 647 0.5 1,038 1.3 1,491 3.6 2012 39 0.2 113 0.3 685 0.5 1,153 1.4 1,540 3.6 2013 38 0.2 145 0.4 718 0.6 1,133 1.4 1,596 3.6 2014 31 0.2 130 0.3 801 0.6 1,163 1.4 1,526 3.3 2015 28 0.1 161 0.4 763 0.6 1,119 1.3 1,544 3.2 2016 35 0.2 134 0.3 798 0.6 1,115 1.3 1,436 2.9 Year Number Rate Number Rate Number Rate Number Rate Number Rate Sources:
Centers for Disease Control and Prevention, National Center for Health Statistics. CDC Wonder On-line Database, compiled from Compressed Mortality File 1999-2016 Series 20 No. 2U, 2019.- Death rates are age-specific and per 100,000 population.
- Deaths are coded by the 10th revision of International Classification of Diseases, codes J45-J46.
Asthma Prevalence
Lifetime Asthma Prevalence
- In 2018, 41.9 million Americans, or 13.0 percent, had ever been diagnosed with asthma by a health professional.
- This was an increase of 43 percent from 9.1 percent in 1999.
- Adults ages 18-55 years had the highest lifetime prevalence rates compared to other age groups at 14.7 percent in 2018.
- Females (14.1%) were about 10 percent more likely than males (11.8%) to ever have been diagnosed with asthma in 2018.
- Blacks are generally more likely than other races and ethnicities to be diagnosed with asthma over their lifetime. In 2018 they had the second-highest lifetime prevalence rate at 16.1 percent.
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At 14.9 percent, those with some college had the highest lifetime prevalence rate compared to other education levels in 2018.
Trends in Lifetime Asthma Rate by Age, Sex and Race/Ethnicity
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Rate Count (thousands) Total 9.1% 10.1% 11.3% 11.1% 10.4% 10.5% 11.2% 11.6% 11.5% 12.9% 13.2% 12.9% 12.9% 13.0% 12.0% 12.9% 12.7% 13.6% 13.3% 13.0% 41,935 Age <5 7.0% 7.8% 7.9% 7.3% 7.5% 7.3% 8.6% 7.5% 8.0% 7.2% 7.9% 8.0% 8.3% 7.0% 5.9% 5.6% 5.7% 5.1% 5.6% 4.9% 963 5-17 12.2% 14.0% 14.4% 14.0% 14.3% 14.0% 14.2% 15.7% 15.0% 16.4% 16.1% 15.8% 16.3% 16.6% 15.2% 16.4% 15.7% 15.6% 15.7% 14.1% 7,572 18-44 9.3% 9.8% 11.8% 11.5% 10.1% 9.9% 11.2% 11.5% 11.7% 13.5% 14.3% 13.6% 13.6% 13.4% 12.2% 14.0% 13.5% 15.3% 14.8% 14.7% 16,932 45-64 8.0% 8.7% 10.4% 10.6% 9.8% 9.9% 10.5% 10.5% 10.4% 12.0% 12.3% 12.1% 12.2% 12.7% 12.1% 12.1% 12.7% 13.7% 13.0% 12.6% 10,458 65+ 6.5% 8.4% 8.7% 8.0% 8.1% 9.7% 9.9% 10.6% 9.7% 11.0% 11.3% 11.1% 10.4% 10.4% 10.3% 10.9% 10.3% 10.9% 11.1% 11.7% 6,010 Sex Male 8.7% 9.9% 10.8% 10.6% 9.7% 10.2% 10.3% 11.1% 11.0% 12.2% 12.6% 11.9% 12.1% 12.1% 11.3% 12.0% 11.9% 12.7% 12.6% 11.8% 18,627 Female 9.5% 10.3% 11.9% 11.6% 11.1% 10.8% 12.1% 12.1% 12.0% 13.5% 13.9% 13.9% 13.8% 13.8% 12.7% 13.9% 13.5% 14.5% 14.0% 14.1% 23,309 Race/Ethnicity White 9.1% 10.2% 11.5% 11.1% 10.3% 10.5% 11.2% 11.7% 11.4% 12.9% 13.3% 12.6% 12.6% 13.0% 12.0% 12.8% 12.8% 13.7% 13.6% 13.1% 25,869 Black 10.3% 11.4% 12.4% 13.8% 12.8% 13.0% 13.4% 13.3% 13.0% 15.7% 16.3% 17.0% 16.6% 16.7% 14.8% 16.0% 15.2% 17.0% 15.2% 16.1% 6,732 Asian 18.0% 10.9% 14.3% 14.1% 17.3% 15.2% 12.6% 16.8% 13.7% 18.8% 14.4% 11.6% 21.8% 18.1% 12.3% 17.4% 16.1% 15.5% 13.4% 8.3% 1,634 American Indian/Alaska Native 5.4% 7.3% 7.8% 8.6% 6.0% 6.4% 8.5% 9.3% 8.9% 8.7% 9.5% 9.9% 8.6% 7.6% 7.4% 9.2% 7.7% 9.5% 8.8% 18.1% 610 Hispanic 8.0% 8.2% 9.5% 8.3% 8.8% 8.4% 9.2% 9.8% 10.2% 10.1% 11.0% 10.9% 11.5% 11.1% 10.4% 11.6% 11.1% 11.4% 12.0% 11.7% 6,945 Education Less Than High School 8.2% 9.2% 10.2% 9.6% 10.2% 10.8% 10.3% 10.9% 10.1% 11.3% 12.9% 11.6% 12.2% 11.5% 11.3% 11.6% 11.6% 11.7% 12.3% 11.4% 2,823 High School Diploma or GED 7.7% 7.9% 9.5% 9.3% 8.4% 8.6% 9.1% 9.5% 9.2% 11.0% 11.2% 10.3% 11.7% 11.0% 10.6% 11.0% 12.0% 12.5% 11.9% 11.1% 5,836 Some College 8.4% 9.8% 11.2% 11.3% 10.5% 10.8% 11.4% 12.3% 11.8% 13.1% 14.2% 14.0% 13.0% 13.9% 12.5% 13.6% 13.9% 14.8% 14.7% 14.9% 9,359 Bachelors Degree or Higher 7.5% 8.7% 10.2% 9.9% 8.9% 9.3% 10.4% 10.0% 10.8% 11.5% 11.9% 12.1% 11.3% 11.8% 11.4% 11.9% 11.3% 13.1% 12.7% 12.4% 9,802 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Source:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 2001-2018. Harmonized by Minnesota Population Center and State Health Access Data Assistance Center. Integrated Health Interview Series data analyzed by the American Lung Association Research and Program Services Division.- Lifetime prevalence is defined as answering yes to "Have you ever been told by a doctor or other health professional that you had asthma?"
- Education categories include only adults ages 25 years and older.
Current Asthma Prevalence
- In 2018, 24.8 million Americans, or 7.7 percent, had ever been diagnosed with asthma by a health professional and reported that they still had asthma.
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From 2001 to 2010, current asthma prevalence rates increased at a statistically-significant average rate of 0.1 points per year. From 2010 to 2018, the average change per year has not been statistically significantly different and has remained flat.
Trends in Current Asthma Rate by Age, Sex and Race/Ethnicity
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Rate Count (thousands) Total 7.4% 7.2% 7.0% 7.1% 7.7% 7.8% 7.7% 7.8% 8.2% 8.5% 8.5% 8.3% 7.3% 7.7% 7.8% 8.3% 7.9% 7.7% 24,753 Age <5 5.7% 6.0% 5.9% 5.6% 6.8% 5.8% 6.8% 6.2% 6.3% 6.0% 6.9% 5.4% 4.2% 4.3% 4.7% 3.8% 4.4% 3.8% 744 5-17 9.8% 9.2% 9.5% 9.6% 9.7% 10.7% 10.0% 10.7% 11.0% 10.7% 10.6% 10.7% 9.9% 10.2% 9.8% 10.0% 9.9% 8.9% 4,786 18-44 7.2% 6.9% 6.3% 6.4% 7.0% 7.3% 7.2% 7.2% 7.6% 8.1% 8.0% 8.1% 6.7% 7.5% 7.5% 8.1% 7.5% 7.2% 8,315 45-64 6.7% 7.1% 6.9% 7.0% 7.3% 7.5% 7.2% 7.5% 7.8% 8.4% 8.7% 8.4% 7.8% 7.6% 8.4% 9.2% 8.5% 8.3% 6,880 65+ 6.0% 5.9% 5.8% 7.0% 7.6% 7.0% 7.5% 7.2% 7.7% 8.1% 7.6% 7.0% 6.3% 6.9% 6.6% 7.4% 7.0% 7.8% 4,029 Sex Male 6.4% 6.2% 5.9% 6.4% 6.4% 7.0% 6.5% 7.1% 7.0% 7.0% 7.2% 7.0% 6.2% 6.3% 6.5% 6.9% 6.4% 6.2% 9,786 Female 8.3% 8.1% 8.0% 7.9% 8.8% 8.6% 8.9% 8.5% 9.3% 9.9% 9.7% 9.5% 8.3% 9.0% 9.1% 9.7% 9.3% 9.1% 14,967 Race/Ethnicity White 7.4% 7.2% 6.9% 7.3% 7.6% 7.9% 7.6% 7.8% 8.1% 8.1% 8.2% 8.1% 7.4% 7.6% 7.8% 8.3% 8.1% 7.7% 15,122 Black 8.5% 9.6% 9.2% 9.2% 9.7% 9.1% 10.0% 10.3% 11.1% 12.1% 11.6% 11.9% 9.9% 9.9% 10.3% 11.6% 10.1% 10.9% 4,522 Asian 4.7% 4.4% 2.8% 3.4% 4.7% 5.6% 4.1% 4.6% 5.2% 5.7% 5.2% 4.6% 3.7% 4.8% 4.2% 5.5% 4.4% 4.0% 785 American Indian/Alaska Native 8.4% 10.6% 12.3% 9.5% 8.5% 11.0% 9.0% 14.3% 9.9% 10.0% 16.5% 11.2% 7.1% 13.7% 11.6% 11.4% 9.6% 12.0% 405 Hispanic 5.9% 4.9% 5.5% 5.2% 6.2% 6.4% 6.8% 5.8% 6.3% 7.3% 7.3% 7.0% 5.9% 6.7% 6.6% 6.6% 6.4% 6.4% 3,814 Education Less Than High School 6.9% 6.8% 7.5% 8.0% 8.1% 8.2% 7.8% 8.0% 9.3% 8.2% 8.5% 8.7% 7.2% 7.9% 8.3% 8.3% 8.4% 8.5% 2,092 High School Diploma or GED 6.1% 6.2% 5.7% 6.1% 6.5% 6.7% 6.4% 6.5% 7.1% 7.3% 8.4% 7.3% 7.0% 7.0% 7.1% 8.5% 7.7% 6.7% 3,484 Some College 7.1% 7.4% 6.9% 7.2% 8.0% 8.1% 8.3% 7.5% 8.3% 9.6% 8.8% 8.8% 7.6% 7.9% 8.4% 9.0% 8.7% 8.8% 5,509 Bachelors Degree or Higher 6.2% 6.1% 5.5% 6.0% 6.3% 6.3% 6.5% 6.2% 6.6% 7.0% 7.1% 6.9% 6.2% 6.6% 6.8% 7.2% 6.8% 6.8% 5,349 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Source:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 2001-2018. Harmonized by Minnesota Population Center and State Health Access Data Assistance Center. Integrated Health Interview Series data analyzed by the American Lung Association Research and Program Services Division.- Current prevalence was defined as answering "yes" to both "Have you EVER been told by a health professional that you had asthma?" and "Do you still have asthma?"
- Education categories include only adults ages 25 years and older.
- Children ages 5-17 years had the highest current prevalence rates compared to other age groups at 8.9 percent in 2018.
- Females (9.1%) were about 46 percent more likely than males (6.2%) to still have asthma in 2018.
Asthma Attack Prevalence
- In 2018, 11.9 million, or 48.2 percent of those ever diagnosed with asthma by a health professional and still had asthma had at least one asthma attack.
- This proportion was a decrease of 14 percent from 56.3 percent in 2001.
- Children less than 5 years of age had the highest attack rates compared to other age groups at 75.4 percent in 2018.
- Females (50.3%) were 12 percent more likely than males (44.8%) to have had an asthma attack in 2018.
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Estimates of asthma attack rates are not accurate for some racial and ethnic groups for single years due to small sample sizes. To allow for accurate comparisons between groups, we combined five years of data and found that in 2014 to 2018, asthma attack rates were very similar for most racial and ethnic groups, although slightly lower for American Indians and Alaska Natives:
- Hispanics – 45.6 percent
- Whites – 45.7 percent
- Asians – 46.0 percent
- Blacks – 45.1 percent
- American Indians/Alaska Natives – 39.4 percent
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Asthma attack rates in 2018 were highest for those with some college (49.5%) and less than high school (49.1%), lower for those with a bachelor’s degree or higher, and lowest among those with a high school diploma or GED.
Trends in Asthma Attack Rate by Age, Sex and Race/Ethnicity
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Rate Count (thousands) Total 56.3% 56.6% 53.8% 54.3% 53.2% 52.0% 51.7% 52.6% 49.5% 51.6% 49.1% 50.7% 49.9% 44.7% 46.9% 46.9% 45.6% 48.2% 11,921 Age <5 70.7% 77.3% 69.7% 65.1% 60.8% 69.9% 59.0% 64.4% 66.2% 68.3% 60.9% 60.8% 66.5% 56.5% 60.6% 62.4% 58.7% 75.4% 561 5-17 59.8% 61.9% 61.0% 60.4% 55.6% 53.2% 53.7% 55.6% 51.1% 56.1% 54.1% 54.2% 56.6% 46.7% 45.2% 52.5% 50.4% 53.7% 2,570 18-44 56.2% 55.0% 51.8% 51.8% 55.8% 50.0% 51.0% 52.0% 50.1% 48.5% 46.6% 49.4% 46.8% 41.8% 46.7% 41.1% 38.9% 43.2% 3,596 45-64 54.4% 51.0% 51.4% 54.8% 53.1% 56.4% 52.6% 53.4% 49.4% 53.6% 49.5% 53.4% 51.7% 48.8% 49.8% 52.3% 50.7% 50.9% 3,504 65+ 43.2% 49.9% 38.8% 42.5% 37.7% 37.5% 44.3% 40.5% 36.9% 41.6% 40.7% 37.8% 36.5% 37.8% 39.4% 38.7% 40.6% 42.0% 1,690 Sex Male 54.1% 55.1% 52.7% 55.2% 51.5% 47.3% 48.9% 50.1% 47.7% 49.8% 45.9% 49.8% 46.8% 43.0% 41.9% 44.8% 42.2% 44.8% 4,387 Female 57.9% 57.7% 54.6% 53.6% 54.5% 55.7% 53.6% 54.7% 50.8% 52.9% 51.4% 51.3% 52.2% 45.9% 50.3% 48.4% 47.8% 50.3% 7,534 Race/Ethnicity White 55.7% 56.0% 52.8% 53.9% 53.8% 51.9% 51.3% 51.5% 48.9% 52.0% 49.8% 50.7% 50.4% 44.1% 46.6% 46.7% 45.5% 48.9% 7,398 Black 60.6% 56.9% 53.3% 56.1% 45.3% 49.7% 49.8% 52.1% 48.1% 47.7% 50.3% 51.5% 49.5% 46.5% 44.0% 48.5% 41.6% 45.4% 2,052 Asian -- -- -- -- -- -- -- -- 59.5% 57.2% 50.7% 44.5% 51.2% 41.9% 48.3% -- 52.6% -- -- American Indian/Alaska Native -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Hispanic 54.7% 57.7% 56.5% 54.1% 56.7% 55.0% 57.4% 55.3% 50.3% 51.4% 45.9% 52.1% 47.4% 43.9% 49.1% 46.7% 46.7% 45.7% 1,744 Education Less Than High School 54.0% 51.6% 48.3% 54.3% 53.2% 49.3% 55.4% 55.5% 49.3% 49.2% 46.9% 53.4% 40.4% 48.3% 47.7% 46.2% 43.6% 49.1% 1,028 High School Diploma or GED 49.2% 53.5% 50.3% 48.4% 49.7% 51.2% 47.2% 45.4% 46.8% 44.7% 45.3% 47.1% 49.7% 46.0% 39.2% 46.8% 44.4% 42.0% 1,463 Some College 54.5% 55.7% 55.2% 53.4% 53.1% 55.1% 55.8% 55.0% 51.6% 51.5% 49.1% 54.9% 53.6% 48.4% 51.6% 45.0% 45.7% 49.5% 2,727 Bachelors Degree or Higher 57.4% 50.8% 47.5% 52.1% 52.0% 50.4% 48.8% 52.8% 47.6% 54.5% 50.1% 47.5% 45.0% 38.9% 47.4% 47.6% 43.3% 46.1% 2,467 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Source:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 2001-2018. Harmonized by Minnesota Population Center and State Health Access Data Assistance Center. Integrated Health Interview Series data analyzed by the American Lung Association Research and Program Services Division.- Attack prevalence was defined as answering yes to all of "Have you ever been told by a health professional that you had asthma?," "Do you still have asthma?," and "During the past 12 months, have you had an episode of asthma or asthma attack?"
- Education categories include only adults ages 25 years and older.
- --Estimate not reliable due to small sample size.
Missed School and Work Days
- In 2018, 2.2 million children aged 5-17 years missed more than 7.9 million school days.
- In 2018, there were 10.9 million missed work days due to asthma among employed adults ages 18 years and older, and 62.8 million missed days of housework among unemployed adults.
Healthcare Use
Hospitalizations
- In 2016, there were 188,965 hospitalizations with asthma listed as the primary cause, or 58.5 per 100,000 people.
- The asthma hospitalization rate decreased at an average rate of 1.3 points per year from 1993 to 2014, which was statistically significant, or 21 percent overall.
- From 2014 to 2016, a new disease coding system was put in place for hospitalizations. It is likely that the large decrease in asthma hospitalizations was due to this change in coding, although more years of data will be necessary to determine if other factors also contributed.
Emergency Department Visits
- In 2016, there were 1.705 million emergency room visits with asthma listed as the primary cause, or 527.5 per 100,000 people.
- The asthma emergency department visit rate increased at an average rate of 8.2 points per year from 2006 to 2014, which was statistically significant, or 10 percent overall.
- From 2014 to 2016, a new disease coding system was put in place for emergency department visits. It is likely that the decrease in asthma visits was due to this change in coding, although more years of data will be necessary to determine if other factors also contributed.
Economic Cost
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From 2008 to 2013, asthma accounted for $81.9 billion each year in total economic cost in the United States:
- Health care costs – $50.3 billion per year
- Mortality – $29.0 billion per year
- Missed school and work days – $3.0 billion per year