Catch your breath: Asthma prevention efforts get national attention
30th July 2012 · 0 Comments
By Zoe Sullivan
What do you do when you can’t breath? For some, fighting to fill their lungs happens regularly. According to Dr. Floyd Malveaux, 12 to 15 percent of New Orleans’ children suffer from asthma, a rate higher than the national average (10%), but this disparity is one experienced by other African-American communities in the U.S.. Roughly seven million children nationally suffer from the disease, and, according to Malveaux, it is the highest cause of emergency room visits for children as well as the leading reasons for absence from school.
Between July 28 and August 2, more than 5,000 African-American physicians will assemble in the city for the National Medical Association (NMA) conference where they will discuss health disparities affecting African-American communities and possible solutions to these issues. The Allergy, Asthma and Immunology (AAI) Section of the Association will discuss asthma, and, in particular, an initiative called HEAL—Head-off Environmental Asthma in Louisiana.
Xavier University’s Center for Minority Health and Health Disparities Research and Education has spearheaded the project, which is now in its second phase, after an initial launch shortly after Hurricane Katrina. The University has partnered with Daughters of Charity Health Services and the NMA to take a comprehensive approach to decreasing asthma rates and episodes.
Asthma started receiving attention in the aftermath of Katrina when mold invaded the city. “Mold can be a trigger,” Malveaux told The Louisiana Weekly. “You have to be genetically predisposed to develop asthma,” he explained, but if one has the physiological determinants, exposure to “certain environmental insults …trigger the onset of the disease.”
Mold isn’t the only culprit however. Dust, animal dander, cigarette smoke, dust mites and cockroaches can all irritate the respiratory system and impair one’s ability to breathe. Children and families living in poverty “have disproportionate exposure to these kinds of things,” Malveaux said, and the consequences can be serious. Those living in poverty experience a “disproportionately high number of emergency room visits and even deaths from asthma.”
“The 7th Ward and the lower 9th Ward, there’s significant asthma in those neighborhoods, and significant hospitalizations,” Malveaux went on. “If you go Uptown, then you won’t see as much asthma, and it has do with it access to care.” Malveaux sketched a challenging picture for New Orleans: roughly half of the children in the city who are diagnosed with asthma have “persistent asthma,” which means that they “would wheeze on a daily basis unless they take some measure.”
New Orleans Health Commissioner Dr. Karen DeSalvo told The Louisiana Weekly: “Asthma remains a public health challenge and I applaud the continuation of this work to understand the causes and consequences so that we can improve the health of our children.”
The HEAL initiative is working to help children with asthma learn how to manage the disease better so that they can live full lives without becoming familiar with the emergency room. One of the ways that it is aiming to do this is through home visits, which can identify some of the environmental triggers that set off attacks. Another is by pushing for policy reform in insurance companies so that the medical provider can receive reimbursements for these visits.
One of the people on the front lines of this battle is Margaret “Peggy” Sanders. Sanders earned a certificate in asthma education by working for over 1,000 hours under supervision on the first HEAL project. Ti is the most common childhood disease, highest cause of school absenteeism, and second highest causes of hospital visits and one of the highest causes of emergency room visits for children.
Sanders says that she makes sure that the patient understands what the action plan lays out as well as how to make sure she is using the inhaler properly. “I explain to them how each medicine targets the lungs. If they can understand that proper physiology, they can understand what the medicine is doing,” she told The Louisiana Weekly.
Currently Sanders has 78 patients, but she says that “summer is a little slower because asthma is a little better in the summer.” Those with “uncontrolled asthma” are eligible for home visits, Sanders says, although part of her work aims to head off the need for that kind of intervention.
Any policy change that assists and helps… especially in home visits, is good. We have to identify more kids and grow our database and are able to evaluate the impact of this program, then we’re able to effect this policy change….we know anecdotally that training of patients and their compliance helps…but they will react more heavily to data.”
Michael Griffin, president and CEO of Daughters of Charity Health Services, explained that by collecting data on the HEAL program’s efforts, they are building a database to prove statistically that home case management works. He said that it should “decrease utilization of the emergency room, which is very, very costly.” Griffin expressed his confidence that insurance providers would be open to considering reimbursements for this kind of care, as long as it shows results. “We feel we’re on the right track to effect the policy change as we grow this program.”
This article was originally published in the July 30, 2012 print edition of The Louisiana Weekly newspaper