Promising Programs in Racial and Ethnic Disparities in Health and Health Care Addressing...

Asthma

researched and compiled by Sarah McCloskey, Erin Kennedy, and Michele Sloan December 2004 and updated November 2007

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Background
In 2005, there were 22.2 million people with asthma in the United States, accounting for 7.7% of the population. Puerto Ricans are the ethnic group suffering most from this condition, and have asthma prevalence rates 125% higher than non-Hispanic whites and 80% higher than non-Hispanic blacks. Evidence shows that asthma is more prevalent among those with lower socioeconomic standing or minority status, possibly due to poor healthcare quality and access, environmental conditions, financial restrictions, and lingual/cultural barriers. Among minorities, there are significantly higher rates of diagnosis, hospitalization, and death from asthma. Nationally, African Americans have 18 percent higher rates of asthma induced office visits than whites, 350 percent higher asthma-related emergency room visits, and 240 percent higher asthma-related hospitalization rates. African- American children are three times as likely to die from asthma as white children.*

*National Center for Health Statistics, Asthma Prevalence
www.cdc.gov/nchs/products/pubs/pubd/hestats/ashtma03-05/asthma03-05.htm#fig1

State Programs
Current state programs most frequently focus on distributing information to high-risk populations; allowing students to carry their medications in school; housing environment assessments; enhanced education, outreach and disease management; and other proactive measures that focus on prevention, rather than reaction to the condition (e.g., limiting exposure to environmental and housing stimulants like dust and animal fur.)

California

California Asthma Public Health Initiative (CAPHI) – State, local, and
community efforts are coordinated to promote consistent and equal asthma management, education and trainings, treatment, and prevention. CAPHI provides funding for community interventions, treatment services, and provider education. California law focuses greater attention on data surveillance, data analysis, and evidence-based care. www.dhs.ca.gov/ps/cdic/cdcb/Medicine/Asthma

Illinois

Asthma Information Program – This program targets high-risk groups for
distribution of information regarding asthma causes, prevention techniques, and treatment. Target groups include African Americans, Hispanics, the elderly, children, people with a family history of asthma, and those exposed to environmental factors associated with high risk of asthma. (20 ILCS 2310/2310- 337) www.ilga.gov/legislation/publicacts/pubact91/acts/91-0515.html

Self-administration of Asthma Medication – State legislation that allows students to possess and use their asthma mediations at their own discretion. (105 ILCS 5/ 22-30) www.ilga.gov/legislation/publicacts/pubact92/acts/92-0402.html

Mississippi

Caffee, Caffee, and Associates PHF Inc. (Hattiesburg) – The group developed partnerships with faith-based groups, NGOs, and tribes in order to address the issue of secondhand smoke. The program designs events to encourage the community to reduce exposure to secondhand smoke. Events motivate people to declare their homes and cars “tobacco-free” environments. This is an APHA Statistics to Solutions program example. For more information, contact Brenda Caffee at 601-583-0599.

New York

Action Against Asthma: Healthy Neighborhoods Program – Asthma education and management is promoted in households where a member has asthma. Seeks to cut asthma hospitalizations through proactive interventions such as dust control, pillow and mattress covers, and mold/mildew removal in the home. www.health.state.ny.us/nysdoh/asthma/ny_action.htm

Pennsylvania

Health Promotion Council: Smokeless Homes in Philadelphia – This program is geared toward educating African Americans and Latinos about the link between asthma and smoking. Program administrators attend community health fairs and distribute information about smoking to teachers, parents, and healthcare providers. This is an APHA Statistics to Solutions program example. For more information, contact Tawanda Hayes at 215-731- 6106. www.phillyhealthinfo.org/index.php/general/philadelphia_allies_against_asthma_coalition

Healthy Hoops Program, Philadelphia – Healthy Hoops is a program created by the Keystone Mercy Health Plan, a medical assistance group in Greater Philadelphia, whose goal is to improve the health status of communities, particularly those who are underprivileged. Healthy Hoops is a community service program which aims at teaching children ages 3-15 how to manage asthma. Through programs such as health screenings, asthma education sessions, and healthy hoops challenges, this program has received national recognition for innovation and success. In 2005, Healthy Hoops observed a 35% reduction in rescue medication usage, or use of medication necessary to provide instant relief for asthma symptoms, in children who have been constant participants in the program. www.keystonemercy.com/community/healthyhoops

Washington

Washington State Department of Health-Washington State Asthma Plan – The Washington State Asthma Plan seeks to improve prevention, diagnosis, and management of asthma through the mobilization of communities and organizations. This plan describes asthma disparities as a “cross cutting” issue which needs to be addressed. The Washington State DOH believes that low income is the strongest prediction of asthma and that racial disparities can be explained by income disparities. The Asthma Plan seeks to involve representatives from communities suffering from asthma disparities in policy planning and implementation, minimize the language barriers through educational materials, and increase public awareness through data collection methods. In addition, they believe the “Attack Asthma” bill which addresses adolescence with asthma should be more forcibly enacted in school districts that suffer heavily from disparities. www.doh.wa.gov/cfh/asthma/health_disparities.htm

Seven Major U.S. Cites

Results of a Home-Based Environmental Intervention Among Urban Children with Asthma – This study was used to determine if an environmental intervention specific to a child’s allergies would improve asthma-related health conditions over the course of one year. 937 children with asthma were randomly chosen from seven major U.S. cities. Their households received education and remediation for exposure to allergens and tobacco smoke. Each Promising Programs to Eliminate Racial and Ethnic Health Disparities 9 household was evaluated every six months, and the child’s asthma-related health complications were evaluated every two months. The study concluded that, after each two-week interval, the intervention group had fewer days with symptoms and significant declines in the levels of allergens in the home. As a result, morbidity caused by asthma-related illness was reduced.*

*New England Journal of Medicine 9/9/04

For more information, contact Eric Jacobson (302-831-1711).

photo on this page courtesy of the Administration on Aging

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