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Unmanaged Asthma Takes Its Toll on Low-Income DC Children and Families

Washington, DCHealthcare providers, schools, government officials, and policymakers must undertake a powerful, coordinated response to overcome challenges faced by growing numbers of low-income children in Washington, DC suffering with unmanaged asthma.  Eighteen percent of children in DC are reported to have asthma, with a national rate of 9.5 percent.  Asthma is three times more common in African-Americans than whites.  Additionally, visits to emergency departments (ED) for uncontrolled asthma occur ten times more frequently in DC’s low-income neighborhoods than the more affluent.

Asthma is not curable, but it is controllable with proper care, education, and resources.  However, the resources that are necessary to support effective asthma management are unavailable to many of the children who need them most.  Policy actions – from improving indoor air in affordable housing to facilitating health information sharing to funding asthma intervention programs that include outreach to schools – are necessary to address this serious disease.

That’s the key message from a research project and two reports released today by Children’s National Health System, the Urban Institute,  and DC Appleseed Center for Law and Justice. This project was made possible with generous funding from the W.K. Kellogg Foundation.

The two reports  – Making Sense of Childhood Asthma – Lessons for Building a Better System of Care and Helping Low-Income Families Manage Childhood Asthma: Solutions for Healthcare & Beyond – provide insights into the experiences of low-income families trying to manage childhood asthma, and recommendations for policy makers to reduce the burden of asthma on low-income families.  Uncontrolled asthma in children means ED visits, hospitalizations, missed school and missed work for caregivers and the stress of waiting and watching for life-threatening symptoms to arise.

According to the authors, a community-wide support system to address chronic asthma in children is needed to improve care – such a system would not only involve stakeholders beyond the traditional healthcare delivery system, but would include issues not typically tackled in healthcare policy agendas. These would incorporate strategies to target asthma flare-ups where children spend most of their time, at home and school, the reports suggest. Such a support system would also ensure that parents have the time, resources and tools to manage asthma and prevent acute episodes.

For example, low-income tenants often lack the resources they need to address the environmental challenges to their children’s health inside the home.  Workers who have low wages often lack sufficient paid leave to take their children to necessary monitoring and preventive appointments.  And school nurses, often at the front line of helping children with chronic health problems, may lack the information and resources to support effective asthma management.

“This research really reinforces that we have a solvable issue here, and one that would have a tremendous effect on thousands of children and families in DC,” said Marla McDaniel, senior research associate of the Urban Institute. “If we can get this right – making sure children with a treatable chronic disease stay well managed – we may actually make a dent in some of the stubborn disparities that encumber the city.”

IMPACT DC, a comprehensive evidence-based intervention program that includes extensive asthma education and care, is located in the emergency departments of Children’s National Health System. It focuses on children with high asthma morbidity, especially those who make frequent ED visits for asthma.

“There is a big need to enhance collaborations among healthcare providers, schools, community resources, payers, and government. That’s the best way to make further progress among inner-city children and teens with asthma,” said Stephen Teach, Director and Principal Investigator of IMPACT DC.

“By targeting those specific communities and populations with the most significant asthma-related problems, and by delivering an optimal asthma management program, we can reduce misinformation about asthma and improve the quality and quantity of care. We must come together to improve education for families about what medications they should give their children with asthma, help schools do a better job of monitoring kids, and fix environmental asthma-triggers in homes and schools,” Teach said.

In the report, Making Sense of Childhood Asthma – Lessons for Building a Better System of Care, researchers found that even families who were successful for six months following intervention at IMPACT DC, eventually returned to the ED for an asthma episode.

“We need to think about making DC asthma-friendly: asthma-friendly homes, asthma-friendly schools,” says Judy Berman, Deputy Director of DC Appleseed and author of Helping Low-Income Families Manage Childhood Asthma.  “We need to turn the tide on this the way we’ve started to turn the tide on HIV/AIDS.  It will take a lot of different people working on their piece of the puzzle to reduce the burden of asthma on our low-income communities.”

Children's National Health System: Emily Hartman or Joe Cantlupe at 202-476-4500.

About DC Appleseed
A local, independent, non-partisan organization works on the biggest public policy problems facing the National Capital area, from voting rights to healthcare to environmental concerns to jobs and housing and others. It solves problems affecting the daily lives of those who live and work in the National Capital area. It works with volunteer attorneys, business leasers and community experts to identify pressing challenges, conduct research and analysis, making specific recommendation for reform and implement effective solutions.

Contact: Judy Berman
202-289-8007 ext. 16
[email protected]

About the Urban Institute
The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and delivered evidence-based solutions that improve lives, strengthen communities, and increase the effectiveness of public policy. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the fiscal health of government across a rapidly urbanizing world.

Contact: Stu Kantor
[email protected]

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