Skip directly to searchSkip directly to the site navigationSkip directly to the page's main content

Complete Health Indicator Report of Asthma: Adult Prevalence

Definition

Adults aged 18+ (unless otherwise noted), who reported having been told by a doctor that they have asthma and who currently have asthma.

Numerator

Total number of respondents answering "yes" to both of the BRFSS asthma core questions:[[br]] 1. Have you ever been told by a doctor, nurse, or other health professional that you had asthma?[[br]] 2. Do you still have asthma?

Denominator

Includes all survey respondents ages 18 years and older except those with missing, don't know, or refused answers to the core asthma questions.

Data Interpretation Issues

Beginning in 2011, BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. This methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: [https://ibis.utah.gov/ibisph-view/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Why Is This Important?

Asthma is a serious personal and public health issue that has far reaching medical, economic, and psychosocial implications. The burden of asthma can be seen in the number of asthma-related medical events, including emergency department visits, hospitalizations, and deaths.

How Are We Doing?

Adult asthma rates show no sign of declining in Utah or in the U.S. In Utah and the U.S., adult asthma prevalence is higher for women than men in almost every age category.

How Do We Compare With the U.S.?

In 2022, Utah had a higher adult asthma prevalence rate when compared to the national average (10.9% vs. 10.0%).

What Is Being Done?

The Utah Asthma Program (UAP) works with the Utah Asthma Task Force and other partners to maximize the reach, impact, efficiency, and sustainability of comprehensive asthma control services in Utah. This is accomplished by providing a seamless alignment of asthma services across the public health and health care sector, ensuring that people with asthma receive all of the services they need. The UAP focuses on building program infrastructure and implementing strategies that improve asthma control, reduce asthma-related emergency department visits and hospitalizations, and reduce health care costs. Program infrastructure is strengthened through a focus on strategies to create and support a comprehensive asthma control program, these strategies include: strengthening leadership, building strategic partnerships, and using strategic communication, surveillance, and evaluation. In addition, the UAP implements strategies outlined in the Centers for Disease Control and Prevention (CDC) EXHALE technical package to improve asthma control. The six strategy areas outlined in the EXHALE technical package are:[[br]] 1. Education on asthma self-management.[[br]] 2. e-Xtinguishing smoking and secondhand smoke.[[br]] 3. Home visits for trigger reduction and asthma self-management.[[br]] 4. Achievement of guidelines-based medical management.[[br]] 5. Linkages and coordination of care across settings.[[br]] 6. Environmental policies or best practices to reduce asthma triggers from indoor, outdoor, and occupational sources. These strategies are expected to improve asthma control and quality of life by increasing access to health care and increasing coordination and coverage for comprehensive asthma control services both in the public health and health care sectors. Specifically, these strategies include identifying people with poorly controlled asthma, linking them to health care providers and NAEPP EPR-3 guidelines-based care, educating them on asthma self-management strategies, providing a supportive school environment, and referring to or providing home trigger reduction services for those who need them.

Available Services

A list of Utah Asthma Program services for clinicians, community health workers, and people with asthma can be found at [https://asthma.utah.gov/]

Health Program Information

Utah Asthma Program website: [https://asthma.utah.gov/] CDC EXHALE package: [https://www.cdc.gov/national-asthma-control-program/php/exhale/index.html]


Related Indicators

Related Relevant Population Characteristics Indicators:


Risk Factors

People with respiratory diseases, including asthma, that make their lungs more vulnerable to ozone may experience health effects earlier and at lower ozone levels than other people. When ozone levels are high, more people with asthma have attacks that require a doctor's attention or use of medication. One reason this happens is that ozone makes people more sensitive to allergens such as pets, pollen, and dust mites, which are common triggers of asthma attacks.

Related Risk Factors Indicators:


Related Health Status Outcomes Indicators:




Graphical Data Views

Asthma lifetime prevalence among adults aged 18 and older, Utah and U.S., 2021-2022

::chart - missing::
confidence limits

Utah vs. U.S.YearAge-adjusted percentage of adultsLower LimitUpper Limit
Record Count: 4
Utah202114.9%14.0%15.8%
Utah202216.9%15.9%17.9%
U.S.202114.6%14.4%14.8%
U.S.202215.2%15.0%15.4%

Data Notes

Rates have been age-adjusted to the U.S. 2000 standard population. Note: At the time of this update, the BRFSS U.S. dataset did not include an age variable but did include five age categories up to age 80+ (vs. the typical weighting scheme that includes 85+). Comparisons with both weighting schemes were compared using Utah data, and the difference was about 1/100 of a percentage point. In 2011, the BRFSS changed its methodology from a landline only sample and weighting based on post-stratification to a landline/cell phone sample and raking as the weighting methodology. Raking accounts for variables such as income, education, marital status, and home ownership during weighting and has the potential to more accurately reflect the population distribution.

Data Sources

  • Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]
  • Behavioral Risk Factor Surveillance System Survey Data, US Department of Health and Human Services Centers for Disease Control and Prevention (CDC).


Asthma prevalence by disability, Utah adults aged 18 and older, 2022

::chart - missing::
confidence limits

Disability typeAge-adjusted percentage of adultsLower LimitUpper Limit
Record Count: 7
Cognitive disability22.0%18.9%25.3%
Mobility disability26.8%21.5%32.7%
Self-care disability32.4%24.5%41.5%
Independent living disability21.5%17.1%26.6%
Difficulty seeing or blind16.5%11.0%23.9%
Difficulty hearing or deaf22.9%16.7%30.5%
No disability8.4%7.6%9.3%

Data Notes

Rates have been age-adjusted to the U.S. 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Asthma prevalence among adults aged 18 and older, Utah and U.S., 2001-2022

::chart - missing::
confidence limits

BRFSS Utah vs. U.S.YearAge-adjusted percentage of adultsLower LimitUpper Limit
Record Count: 46
UT Old Methodology20017.0%5.9%8.0%
UT Old Methodology20027.9%6.8%9.0%
UT Old Methodology20037.1%6.0%8.1%
UT Old Methodology20048.0%7.1%8.9%
UT Old Methodology20057.8%7.0%8.8%
UT Old Methodology20068.3%7.4%9.3%
UT Old Methodology20078.2%7.3%9.2%
UT Old Methodology20088.4%7.5%9.5%
UT Old Methodology20097.9%7.3%8.6%
UT Old Methodology20109.0%8.2%9.8%
US Old Methodology20017.2%7.0%7.4%
US Old Methodology20027.5%7.3%7.6%
US Old Methodology20037.7%7.5%7.9%
US Old Methodology20048.3%8.1%7.9%
US Old Methodology20057.8%7.7%8.0%
US Old Methodology20068.2%8.0%8.4%
US Old Methodology20078.2%8.1%8.4%
US Old Methodology20088.5%8.3%8.7%
US Old Methodology20098.5%8.3%8.7%
US Old Methodology20108.7%8.5%8.8%
UT New Methodology20098.3%7.6%9.0%
UT New Methodology20108.7%8.1%9.4%
UT New Methodology20118.7%8.0%9.3%
UT New Methodology20128.9%8.3%9.6%
UT New Methodology20139.1%8.5%9.7%
UT New Methodology20148.7%8.2%9.2%
UT New Methodology20159.0%8.4%9.7%
UT New Methodology20168.3%7.6%9.0%
UT New Methodology20178.8%8.2%9.5%
UT New Methodology20189.3%8.6%10.0%
UT New Methodology20199.9%9.2%10.6%
UT New Methodology202010.8%10.1%11.5%
UT New Methodology20219.7%9.0%10.5%
UT New Methodology202210.9%10.1%11.8%
US New Methodology20118.7%8.6%8.9%
US New Methodology20128.8%8.6%9.0%
US New Methodology20138.9%8.7%9.1%
US New Methodology20148.9%8.7%9.1%
US New Methodology20158.8%8.6%9.0%
US New Methodology20168.9%8.7%9.1%
US New Methodology20179.0%8.9%9.2%
US New Methodology20189.3%9.1%9.4%
US New Methodology20199.0%8.8%9.2%
US New Methodology20209.2%9.0%9.4%
US New Methodology20219.8%9.6%10.0%
US New Methodology202210.0%9.8%10.2%

Data Notes

Rates have been age-adjusted to the U.S. 2000 standard population. Note: At the time of this update, the BRFSS U.S. dataset did not include an age variable but did include five age categories up to age 80+ (vs. the typical weighting scheme that includes 85+). Comparisons with both weighting schemes were compared using Utah data, and the difference was about 1/100 of a percentage point. In 2011, the BRFSS changed its methodology from a landline only sample and weighting based on post-stratification to a landline/cell phone sample and raking as the weighting methodology. Raking accounts for variables such as income, education, marital status, and home ownership during weighting and has the potential to more accurately reflect the population distribution.

Data Sources

  • Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]
  • Behavioral Risk Factor Surveillance System Survey Data, US Department of Health and Human Services Centers for Disease Control and Prevention (CDC).


Adult asthma prevalence by age and sex, Utah, 2022

::chart - missing::
confidence limits

Males vs. FemalesAge groupPercentage of adultsLower LimitUpper Limit
Record Count: 12
Male18-348.7%7.0%10.9%
Male35-497.5%6.0%9.5%
Male50-648.2%6.5%10.2%
Male65+8.4%6.6%10.5%
Female18-3414.9%12.2%18.1%
Female35-4912.3%10.3%14.6%
Female50-6415.5%12.9%18.4%
Female65+11.9%9.8%14.4%
Total18-3411.7%10.1%13.6%
Total35-499.9%8.6%11.4%
Total50-6411.8%10.3%13.6%
Total65+10.3%8.8%11.9%

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Adult asthma prevalence by ethnicity, Utah, 2021-2022

::chart - missing::
confidence limits

Hispanic ethnicityAge-adjusted percentage of adultsLower LimitUpper Limit
Record Count: 3
Hispanic/Latino7.2%6.0%8.6%
Non-Hispanic/Latino10.8%10.3%11.5%
All ethnicities10.3%9.8%10.9%

Data Notes

Rates have been age-adjusted to the U.S. 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Adult asthma prevalence by race, Utah, 2021-2022

::chart - missing::
confidence limits

RaceAge-adjusted percentage of adultsLower LimitUpper LimitNote
Record Count: 6
American Indian/Alaska Native11.9%7.8%17.8%
Asian6.6%3.9%10.9%
Black, African American11.3%6.7%18.4%
Native Hawaiian, Pacific Islander8.6%4.2%16.7%*
White10.9%10.3%11.5%
All races10.4%9.8%10.9%

Data Notes

*Use caution in interpreting. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health and Human Services standards. Rates have been age-adjusted to the U.S. 2000 standard population based on 3 age groups: 18-34, 35-49, and 50+.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Asthma prevalence among adults ages 25 and older by educational level, Utah, 2021-2022

::chart - missing::
confidence limits

Education levelAge-adjusted percentage of adults ages 25+Lower LimitUpper Limit
Record Count: 5
Less than high school7.9%6.1%10.2%
H.S. grad or G.E.D.10.3%9.1%11.5%
Some post high school11.3%10.3%12.4%
College graduate9.2%8.5%10.0%
Total10.1%9.5%10.6%

Data Notes

Rates have been age-adjusted to the U.S. 2000 standard population. Only adults ages 25 and older were included in the analysis.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Adult asthma prevalence by income level, Utah, 2021-2022

::chart - missing::
confidence limits

Income categoryAge-adjusted percentage of adultsLower LimitUpper Limit
Record Count: 5
<$25,00013.8%11.7%16.2%
$25,000-$49,99911.8%10.4%13.3%
$50,000-$74,99910.8%9.3%12.5%
$75,000+9.3%8.4%10.2%
Total10.3%9.8%10.9%

Data Notes

Rates have been age-adjusted to the U.S. 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Adult asthma prevalence by local health district, Utah 2021-2022 and U.S. 2022

::chart - missing::
confidence limits

Local health districtAge-adjusted percentage of adultsLower LimitUpper LimitNote
Record Count: 15
Bear River10.6%8.5%13.1%
Central11.2%8.6%14.5%
Davis County10.5%8.8%12.4%
Salt Lake County9.9%9.1%10.9%
San Juan11.8%6.5%20.5%*
Southeast14.1%10.3%19.2%
Southwest9.7%7.8%12.1%
Summit12.8%8.2%19.5%
Tooele10.7%8.0%14.1%
TriCounty13.0%10.0%16.8%
Utah County10.3%9.1%11.6%
Wasatch9.4%5.7%15.1%
Weber-Morgan11.6%9.6%13.8%
State of Utah10.3%9.8%10.9%
U.S.10.0%9.8%10.2%2022 data

Prevalence of current asthma by local health district, Utah, 2021-2022

supplemental image
This map was made using an interval break method called "natural breaks" where classes are based on natural groupings inherent in the data.


Data Notes

*Use caution in interpreting. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health and Human Services standards. Percentages have been age-adjusted to the U.S. 2000 standard population.

Data Sources

  • Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]
  • Behavioral Risk Factor Surveillance System Survey Data, US Department of Health and Human Services Centers for Disease Control and Prevention (CDC).


Asthma prevalence by local health district, all ages, Utah, 2022

::chart - missing::
confidence limits

Local health districtAge-adjusted percentage of persons (all ages)Lower LimitUpper LimitNote
Record Count: 14
Bear River9.8%7.4%12.9%
Central11.3%8.2%15.4%
Davis County10.4%8.1%13.2%
Salt Lake County10.7%9.3%12.3%
San Juan8.3%3.2%20.2%*
Southeast12.9%8.9%18.4%
Southwest7.6%5.8%10.0%
Summit10.0%6.1%16.0%
Tooele9.4%6.4%13.7%
TriCounty10.2%7.2%14.3%
Utah County9.6%8.1%11.2%
Wasatch7.9%4.8%12.8%
Weber-Morgan11.0%8.7%13.7%
State of Utah10.1%9.4%10.9%

Data Notes

All ages prevalence includes adult-reported children and self-reported adults who have been told by a doctor that they have asthma and who currently have asthma. *Use caution in interpreting, the estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health and Human Services standards.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Current doctor-diagnosed asthma by Utah Small Area, 2018-2022

::chart - missing::
confidence limits

Utah Small AreasAge-adjusted percentage of adultsLower LimitUpper LimitNote
Record Count: 100
Brigham City13.6%9.8%18.7%Similar to state
Box Elder Co (Other) V214.3%9.6%20.8%Similar to state
Tremonton10.5%7.0%15.4%Similar to state
Logan V29.9%7.7%12.6%Similar to state
North Logan10.4%6.9%15.5%Similar to state
Cache (Other)/Rich (All) V26.7%4.4%10.2%Similar to state
Hyrum12.5%7.5%20.1%Similar to state
Smithfield9.8%6.1%15.3%Similar to state
Ben Lomond9.0%7.1%11.3%Similar to state
Weber County (East)8.8%6.5%11.8%Similar to state
Morgan County7.7%3.3%17.0%*Similar to state
Ogden (Downtown)11.5%8.8%14.9%Similar to state
South Ogden13.0%10.0%16.6%Similar to state
Roy/Hooper14.4%11.1%18.6%Higher than state
Riverdale14.0%10.1%18.9%Higher than state
Clearfield Area/Hooper11.8%9.4%14.6%Similar to state
Layton/South Weber11.4%9.4%13.8%Similar to state
Kaysville/Fruit Heights11.7%8.7%15.7%Similar to state
Syracuse9.2%6.2%13.5%Similar to state
Centerville12.1%7.9%18.3%Similar to state
Farmington9.5%6.4%14.0%Similar to state
North Salt Lake9.8%5.5%16.7%*Similar to state
Woods Cross/West Bountiful7.4%4.2%12.5%Similar to state
Bountiful10.3%7.7%13.6%Similar to state
SLC (Rose Park)9.0%6.1%13.0%Similar to state
SLC (Avenues)9.1%5.8%13.9%Similar to state
SLC (Foothill/East Bench)11.5%7.4%17.3%Similar to state
Magna9.4%6.7%13.1%Similar to state
SLC (Glendale) V29.0%5.6%14.1%Similar to state
West Valley (Center)8.2%6.0%11.2%Similar to state
West Valley (West) V28.2%5.4%12.3%Similar to state
West Valley (East) V29.3%7.0%12.3%Similar to state
SLC (Downtown) V211.9%8.8%15.9%Similar to state
SLC (Southeast Liberty)8.5%5.5%12.9%Similar to state
South Salt Lake8.0%5.4%11.7%Similar to state
SLC (Sugar House)10.6%7.5%14.7%Similar to state
Millcreek (South)5.7%3.4%9.4%Lower than state
Millcreek (East)8.8%5.9%12.8%Similar to state
Holladay V217.1%11.2%25.1%Higher than state
Cottonwood7.9%5.5%11.1%Similar to state
Kearns V215.9%12.2%20.4%Higher than state
Taylorsville (E)/Murray (W)10.1%7.5%13.4%Similar to state
Taylorsville (West)10.9%7.9%14.8%Similar to state
Murray11.0%8.3%14.4%Similar to state
Midvale9.4%6.9%12.9%Similar to state
West Jordan (Northeast) V216.9%12.7%22.0%Higher than state
West Jordan (Southeast)10.8%7.8%14.6%Similar to state
West Jordan (W)/Copperton8.0%5.7%11.2%Similar to state
South Jordan V211.7%8.7%15.5%Similar to state
Daybreak10.4%7.4%14.5%Similar to state
Sandy (West)9.0%6.4%12.6%Similar to state
Sandy (Center) V213.1%9.4%17.8%Similar to state
Sandy (Northeast)9.9%6.3%15.2%Similar to state
Sandy (Southeast)10.5%7.3%15.0%Similar to state
Draper11.2%8.3%15.0%Similar to state
Riverton/Bluffdale10.3%7.6%14.0%Similar to state
Herriman9.1%6.8%12.1%Similar to state
Tooele County (Other)12.0%8.3%17.0%Similar to state
Tooele Valley11.7%9.7%14.1%Similar to state
Eagle Mountain/Cedar Valley6.4%4.4%9.2%Lower than state
Lehi9.6%7.5%12.2%Similar to state
Saratoga Springs10.0%7.0%14.0%Similar to state
American Fork8.8%6.3%12.0%Similar to state
Alpine6.8%3.2%13.9%*Similar to state
Pleasant Grove/Lindon10.1%7.9%12.8%Similar to state
Orem (North)8.2%5.9%11.2%Similar to state
Orem (West)7.7%5.6%10.6%Similar to state
Orem (East)6.9%4.3%10.9%Similar to state
Provo/BYU9.6%7.2%12.6%Similar to state
Provo (West City Center)11.6%8.3%15.9%Similar to state
Provo (East City Center)11.4%7.3%17.3%Similar to state
Salem City****
Spanish Fork8.2%5.9%11.1%Similar to state
Springville10.5%7.8%14.1%Similar to state
Mapleton14.9%8.8%24.3%*Similar to state
Utah County (South) V211.2%7.1%17.4%Similar to state
Payson10.1%6.9%14.6%Similar to state
Park City9.1%6.3%13.2%Similar to state
Summit County (East)11.0%7.3%16.2%Similar to state
Wasatch County7.4%5.4%10.0%Lowe than state
Daggett and Uintah County11.4%9.4%13.6%Similar to state
Duchesne County10.3%7.7%13.5%Similar to state
Nephi/Mona10.3%5.9%17.4%Similar to state
Delta/Fillmore10.9%7.0%16.5%Similar to state
Sanpete Valley11.3%8.1%15.7%Similar to state
Central (Other)11.1%8.5%14.4%Similar to state
Richfield/Monroe/Salina12.3%8.9%16.6%Similar to state
Carbon County15.3%12.4%18.7%Higher than state
Emery County11.3%7.6%16.5%Similar to state
Grand County7.8%4.3%13.8%*Similar to state
Blanding/Monticello6.8%4.4%10.3%Similar to state
San Juan County (Other)7.1%3.6%13.5%*Similar to state
St. George10.0%7.9%12.6%Similar to state
Washington Co (Other) V25.3%2.7%10.0%*Lower than state
Washington City9.1%6.2%13.3%Similar to state
Hurricane/La Verkin9.6%6.5%13.9%Similar to state
Ivins/Santa Clara5.3%2.3%11.6%*Similar to state
Cedar City11.4%8.4%15.3%Similar to state
Southwest LHD (Other)7.6%5.3%10.6%Similar to state
State of Utah10.1%9.8%10.5%

Data Notes

Age-adjusted to U.S. 2000 standard population. A description of the Utah Small Areas may be found on IBIS at the following URL: [https://ibis.utah.gov/ibisph-view/resource/Guidelines.html]. *Use caution in interpreting. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health and Human Services standards. Comparison to the state rate is statistically different for areas that are higher or lower than state in the "Note" column.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

References and Community Resources

The Utah Asthma Program (UAP) provides data, information and education for those with asthma, physicians, and healthcare providers (e.g. school nurses, community health workers, etc.) on the UAP website: [https://asthma.utah.gov/] CDC EXHALE package: [https://www.cdc.gov/national-asthma-control-program/php/exhale/index.html] Community Resources Asthma and Allergy Foundation of America: [http://www.aafa.org] American Lung Association: [https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma] Asthma and Utah outdoor air pollution: [https://air.utah.gov/forecastLegendAQI.html#Health] Check Utah air quality: [https://air.utah.gov/]

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 08/06/2024, Published on 09/24/2024
The information provided above is from the Utah Department of Health's Center for Health Data IBIS-PH web site (http://epht.health.utah.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 22 December 2024 7:55:24 from Utah Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://epht.health.utah.gov ".

Content updated: Tue, 24 Sep 2024 11:13:18 MDT