Organization Works to Reduce Asthma Deaths

(Cover Story, Breathe Easy Magazine, Spring/Summer 2001)

Asthma Triggers Secondhand Smoke Air Pollution Wood Smoke House Dust Mold Animal Fur or Feathers Pollen Respiratory Infections Cold Weather Exercise Strong Odors or Fumes

Asthma rates have been steadily rising in California over the past few decades, and sadly, so have asthma deaths. While death rates from asthma are relatively low, they are preventable. The American Lung Association is working across California to help people with asthma understand how to manage the chronic lung disease and educate health care providers on the national guidelines for treating asthma, as well as reach out to communities at greater risk of developing asthma.

An estimated 2.2 million Californians have asthma, a lung disease that restricts the airways and causes wheezing, coughing and shortness of breath. With early diagnosis and proper treatment, asthma can be controlled. But without proper treatment, asthma can be a debilitating disease.

Asthma is a leading cause of school absenteeism for children in California. It creates a heavy burden for adults as well and is responsible for a significant number of missed work days and lost productivity.

The American Lung Association offers a variety of programs to help educate people about asthma, including Open Airways For Schools, Sesame Street A is For Asthma, and asthma camps for children, as well as breathing improvement classes and support groups for adults with asthma. These programs are aimed at helping people understand what triggers their asthma and ways to avoid those triggers, proper use of medications, and other health information.

These programs have been very successful in improving the quality of life for people with asthma. But as asthma rates continue to rise, the American Lung Association is looking for ways to actually turn that around.

There is a Lack of Asthma Data in California

Unfortunately, there isn’t a large amount of comprehensive data on asthma in California, only estimates. Complete statewide data is available only for hospital discharges and deaths. Without incidence and prevalence rates at the state and local levels, health planners can’t accurately gauge the full extent of the problem.

"This lack of data does cause frustration in the health community," says Julie VonBehren, research scientist for the California Department of Health Services. "There just hasn’t been the funding to collect the data."

We do know that certain communities are disproportionately burdened by asthma. For example, African Americans face asthma rates three to four times higher than other groups. Asthma mortality rates are two to three times higher for African Americans.

But no correlative data exists to help explain these numbers, only deductive reasoning. The number of African Americans living in urban settings is disproportionately higher. There are a large number of asthma triggers in urban settings, including air pollution and older buildings with indoor air quality problems like increased molds and toxic materials.

American Lung Associations Assess Community Needs

American Lung Associations across California have started doing their own needs assessments to determine what is happening with asthma in their own communities. They are working with schools and other organizations to identify asthma early, and coordinating with health care workers to ensure that the National Institutes of Health guidelines for the diagnosis and management of asthma are being followed.

"The NIH guidelines need to be better implemented," says Eileen Yamada, MD, chief of Asthma Programs for the Chronic Disease Control Branch of the California Department of Health Services and a member of the American Lung Association of California’s Asthma Technical Advisory Group. "There’s a gap between what we know works and what is happening out in the real world."

For example, the NIH guidelines specify that every asthma patient should have a written action plan, which lists daily prevention efforts and what steps should be taken when asthma symptoms occur.

The American Lung Association of California is bringing together local American Lung Associations and asthma experts for a two-day summit to identify ways the association can have the most significant impact on reducing asthma morbidity and mortality in California. The Asthma Summit will be held June 27 and 28 in San Diego.

"We need to look at factors contributing to the excess of asthma — indoor and outdoor air quality, health policies, medical management, use of national guidelines, and access to medical care," says Harriet Charney, MPH, program services director for the American Lung Association of California. "Then we need to ask ourselves, ‘What do we know that would contribute to improving asthma outcomes?’"