General Asthma Population

ABSTRACT:

Poor quality housing is an ongoing environmental injustice placing a significant burden on low-income and minority families. The Green & Healthy Homes Initiative (GHHI) in Baltimore, MD, grew out of the historical healthy homes work of the Coalition to End Childhood Lead Poisoning, an organization dedicated to using housing as a platform for health to ensure environmental and socialjustice for families and children in low-income communities. GHHI’s Healthy Homes Demonstration Project utilized the standards and practices created by GHHI: A Holistic Housing Assessment coupled with environmental health education and combined as an integrated environmental health and energy housing intervention for children with asthma, ages 2–14. The project braids resources from healthy homes, lead hazard reduction, weatherization, and energy efficiency projects to form a single multi-component, multi-factorial intervention. Findings from the health surveys at intake and six months after the intervention provide evidence of the impact on the reduction of asthma symptomatic episodes, emergency room visits, and hospitalizations, while showingimprovementsin school attendance and parents’ work attendance. Findings will provide evidence that improved health outcomes and more stable and productive homes in primarily African American, low-income neighborhoods are related to the mitigation of asthma triggers and home-based environmental health hazards. Upstream integrated housing interventions are an effective means to improve health, economic, and social outcomes for children diagnosed with asthma.

Abstract

Introduction
The prevalence of childhood asthma in the United States increased from 8.7% in 2001 to 9.5% in 2011. This increased prevalence adds to the costs incurred by state Medicaid programs. We provide state-based cost estimates of pediatric asthma emergency department (ED) visits and highlight an opportunity for states to reduce these costs through a recently changed Centers for Medicare and Medicaid Services (CMS) regulation.

Methods
We used a cross-sectional design across multiple data sets to produce state-based cost estimates for asthma-related ED visits among children younger than 18, where Medicaid/CHIP (Children’s Health Insurance Program) was the primary payer.

Results
There were approximately 629,000 ED visits for pediatric asthma for Medicaid/CHIP enrollees, which cost $272 million in 2010. The average cost per visit was $433. Costs ranged from $282,000 in Alaska to more than $25 million in California.

Conclusions
Costs to states for pediatric asthma ED visits vary widely. Effective January 1, 2014, the CMS rule expanded which type of providers can be reimbursed for providing preventive services to Medicaid/CHIP beneficiaries. This rule change, in combination with existing flexibility for states to define practice setting, allows state Medicaid programs to reimburse for asthma interventions that use nontraditional providers (such as community health workers or certified asthma educators) in a nonclinical setting, as long as the service was initially recommended by a physician or other licensed practitioner. The rule change may help states reduce Medicaid costs of asthma treatment and the severity of pediatric asthma.

Asthma is a disease of the airways. Airways are the tubes that bring outside air to the lungs. We use this air to breathe. When airways become narrow and swollen, it becomes hard for air to flow in and out of the lungs. Dur­ing an asthma episode, a child may cough, wheeze, or experience chest tightness or shortness of breath. Asthma is responsible for many doctor and hospital visits and lost days from school. If untreated, asthma can affect everyday life. Most girls know someone with asthma or may even have asthma themselves. Each Girl Scout can benefit from learning what asthma is, how it affects breathing, and how certain lifestyle choices can affect their general health and well-being. 

Learning about the respiratory system and how we breathe is the basis of the Asthma Awareness Patch Program: Helping Girls Breathe Easier. In addition, the girls will develop knowledge of asthma triggers, anything in the environment that can make breathing difficult. Girls will learn to make healthy choices, such as avoiding cigarette smoke, eating healthy foods, exercising regularly and practicing relaxation techniques. To encourage Girl Scouts to become responsible members of the community, the patch program goes beyond the individual and incorporates helping others. Employing resources such as websites, books, and other media enhance the learning process. 

Empowering girls to take charge of their health can lead to increased self-esteem and responsible decision-making. 

Each level of Girl Scouting is included in this workbook. The following number of activities must be completed in order to earn the Asthma Awareness Patch: Helping Girls Breathe Easier. 

By earning the patch, girls can help create asthma awareness by reaching out to the community. Teens may be given the privilege and opportunity to work with younger girls on their Asthma Awareness Patch, or they may choose to volunteer their time in an asthma-related activity, such as an asthma fair or school science program. This will provide leadership opportunities as well as the chance to learn about various careers in healthcare. To order the Asthma Awareness Patch, call 1-800-221-6707 or visit your local council shop.