Asthma Morbidity Disparities Increase Despite Known Management Strategies: Study
The Merck Foundation worked with partners in local communities, as well as other nonprofit organizations, foundations and government agencies to create a report on the increasing disparities in asthma morbidity despite the presence of known management strategies.
The Merck Childhood Asthma Network, Inc. released a report Oct. 13, "Translating Evidence into Practice," which analyzes the influence the organization has had over the last decade in regards to childhood asthma care. The report also focuses on associated mobility of childhood asthma, covering the scope of MCAN's work.
According to the U.S. Department of Health and Human Services Office of Minority Health, 2,145,000 Hispanics reported that they currently have asthma in 2012. Also, U.S. Latinos are 60 percent more likely to visit the hospital for asthma, compared to non-Hispanic whites. Hispanic children are 40 percent more likely to die from asthma and Puerto Rican children are nearly three times as likely and non-Latino whites to have asthma. The causes remain unclear, however the development of asthma has been attributed to second has smoking.
Between 2005 and 2015, MCAN funded the implementation of medically underserved communities and evidence-based interventions. The private charitable foundation MCAN was created after a decade of persisting inequalities. Today, more than 6 million children in U.S. have asthma, which is the third-leading cause of hospitalization for those under the age of 15. Also, the chronic condition is the leading cause of school absenteeism, which results in the loss of nearly 15 million school days each year.
MCAN rose to the challenge by launching Phase I of its community-based model (2005-2009), awarding grants to asthma management programs at five sites throughout the United States and Puerto Rico. The MCAN-funded initiative was responsible for emergency room visits decreasing by 30 percent. Additionally, 80 percent of children across all sites missed fewer days of school due to asthma. Local care coordinators, evidence-based interventions and community-based partnerships contributed to successful innovative care coordination.
The care coordination programs were designed to meet the specific needs of a community. For example, MCAN and partners provided patient-tailored asthma counseling and mitigation of triggers of asthma symptoms to address allergens from flooding and lack of adequate healthcare during the aftermath of Hurricane Katrina, which led to a spike in childhood asthma symptoms. MCAN contribution led to a 45 percent decrease in asthma symptoms
"It takes more than dusting off the clinical research findings and parachuting one-size fits all models into different parts of the country," said Dr. Floyd Malveaux, executive director, Merck Childhood Asthma Network, in a release. "We need to understand how research translates in each community and adapt accordingly."
MCAN launched Phase II (2010-2015) to expand on the successes of Phase I. Evidence-based interventions played an important role in managing adverse childhood asthma outcomes in the U.S. and Puerto Rico, particularly in high-risk communities. MCAN has produced sustainable change in the quality of asthma care. The Centers for Disease Control and Prevention and Department of Housing and Urban Development, as well as federal and state level policies, helped to lessen exposure to asthma triggers in homes and schools, and they advanced quality healthcare.
MCAN has partnered with the Centers for Medicare and Medicaid Services to provide Medicaid funding for asthma care in the school setting. Findings show that they reduce disparities in childhood asthma outcomes and there's an ongoing effort to close the gaps.
Asthma affects children in every community across the nation. However impoverished and non-white children are most likely to face disease and consequences. Compared with white non-Hispanic children, asthma prevalence, hospitalizations and emergency room visits are twice as high among African-American and Puerto Rican children.