Urban Health Plan (UHP) is a network of nine community health centers and nine school-based health centers located in the South Bronx, NY—the poorest congressional district in the country—and Corona, Queens, NY. Located within UHP’s catchment area, in Hunts Point, Bronx, is the largest food distribution center in the country. As a result of the traffic and pollution generated by the trucks used to distribute food, Hunts Point has one of the highest asthma rates in New York City.
Asthma Relief Street, UHP’s asthma management program, cares for more than 12,000 people with asthma using a multidisciplinary program that is fully integrated into its primary care practice. Asthma patients are assessed, treated and educated at every visit, whether they come for well-child care, a followup, or a sick walk-in visit. UHP has a robust asthma education program, with health educators located at all of its sites and in all departments. UHP’s health educators follow an asthma curriculum that was developed by UHP clinicians. It includes five lessons: (1) definition of asthma (2) the signs and symptoms of exacerbations (3) recommendations on remediation in the home to address environmental triggers (4) differences between "controller" and "rescue" medications (5) and understanding of spirometry and exhaled nitric oxide. The health educators work collaboratively with New York City Asthma Intervention and Relief (a.i.r. nyc) on home intervention and pest management programs. UHP also is one of the early adopters of nitric oxide testing in patient evaluations, which helps to diagnose asthma, measure response to steroid therapy and level of inflammation control, and monitor adherence to treatment. The program distributes nebulizers onsite and ensures that families have the skills to use them correctly. For patients with severe and uncontrollable asthma, both an allergist and a pulmonologist are on site. UHP’s Asthma Relief Street Program has resulted in improved asthma outcomes and has been sustainable and cost-effective for more than 15 years.