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Asthma Disparities

Purpose

A Little Girl Uses Her Inhaler

The purpose of the Asthma Disparities Subcommittee (formerly Asthma Disparities Working Group) is to address preventable factors that impact disparities in the burden of asthma in poor and minority children relative to their peers.

In May 2012, the group combined the efforts of federal agencies to launch the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities(1MB). The plan identified four strategies:

  • Reduce barriers to the implementation of guidelines-based asthma management. This strategy has been addressed in a variety of activities including Asthma Reimbursement Summits that HUD created in collaboration with CDC and EPA. These Summits bring together diverse stakeholders in cities across the United States to address changes to homes that impact children with asthma.

  • Enhance capacity to deliver integrated, comprehensive asthma care to children in communities with racial and ethnic asthma disparities. This strategy has been addressed through funding opportunity announcements from the National Heart, Lung, and Blood Institute (NHLBI) that challenge investigators to create systems that provide such integrated care. This goal is also supported by another activity, Asthma Community Network.org. This online network, coordinated by EPA, allows organizations to share effective practices to help community-based asthma programs and accelerate the improvement of health and quality of life outcomes for people with asthma.

  • Improve capacity to identify the children most impacted by asthma disparities. The CDC led the Subcommittee in developing Measures to Identify and Track Racial Disparities in Childhood Asthma in response to this strategy.

  • Accelerate efforts to identify and test interventions that may prevent the onset of asthma among ethnic and racial minority children. Efforts to address this strategy include the creation of the Asthma Birth Cohorts Database by the National Institute of Allergy and Infectious Diseases (NIAID), following a workshop supported by NLHBI, NIAID, and Mechanisms of the Development of Allergy (MeDALL, FP7, a project supported by the European Union). Such databases are intended to facilitate research to identify the origins of asthma.

Having made progress on all four strategies, in May 2015, the Subcommittee identified three priority areas that remain the current focus of the group:

  • Broaden interagency and stakeholder collaboration on initiatives for reimbursement of care for asthma
  • Expand research coordination to leverage resources to address asthma disparities across federal agencies
  • Explore opportunities to partner and leverage efforts to provide comprehensive asthma care in tribal communities

Accomplishments

Asthma and the Environment: A Strategy to Protect Children

Asthma is one of the original focus areas of the Task Force. In 1998, the Task Force conducted a review of Federal efforts to address asthma in children and released a report, Asthma and the Environment: A Strategy to Protect Children(1013KB), that made recommendations for action.

Asthma Reimbursement Summits

Asthma Reimbursement Summits are meetings held throughout the United States to promote the concept of health insurance coverage of assessments and interventions in the homes of children with poorly controlled asthma, with a focus on children covered by public health insurance. The meetings present research findings on the return-on-investment and efficacy of in-home interventions and highlight program models for the delivery of these services. These summits, coordinated by HUD with the CDC and the EPA, have been held in Cleveland, Kansas City, Denver, Baltimore, Philadelphia, Los Angeles, Atlanta, Raleigh/Durham, Seattle, New York City, and Chicago.

Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities

The Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities(1MB), released in May 2012, presents a framework to maximize the use of existing federal resources for addressing the major public health challenge of asthma disparities among children.

Create Asthma Empowerment Collaborations to Reduce Childhood Asthma and Asthma Empowerment Collaborations to Reduce Childhood Asthma Disparities

The purpose of Create Asthma Empowerment Collaborations to Reduce Childhood Asthma and Asthma Empowerment Collaborations to Reduce Childhood Asthma Disparities paired funding opportunity announcements is to support investigators planning and conducting a clinical trial to evaluate Asthma Care Implementation Programs (ACIP) for children at high risk of poor asthma outcomes. In the first announcement, investigators had to propose an ACIP for this population that translates research into community practice by integrating interventions with demonstrated efficacy from multiple sectors into a comprehensive program. The second announcement will support clinical trials to evaluate community-based ACIPs, which are expected to address the needs of the U.S. community in which the study is conducted and integrate interventions with demonstrated efficacy from four different sectors (medical care, family, home, and community).

Measures to Identify and Track Racial Disparities in Childhood Asthma

The Centers for Disease Control (CDC) is leading response to the Asthma Disparities Subcommittee’s recommendations to standardize definitions, measures, outcomes, and data/information collection methods across federal programs and in state, local, and community settings. This work is expected to maximize the availability and use of collected data across federal asthma programs.

Resources

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