Community Health Worker

Introducing the Wisconsin Asthma Plan, 2015-2020, a blueprint for addressing asthma in Wisconsin for the next five years. This plan represents the best efforts of Wisconsin Asthma Coalition's (WAC) leadership and members to develop a strategic plan to reduce the burden of asthma as a public health problem in Wisconsin.

The WAC has made great strides in improving asthma management since the release of the Wisconsin Asthma Plan 2003, but the burden of disease and its disproportionate impact remains a priority. The intent of the Wisconsin Asthma Plan, 2015-2020 is to focus activities on disparately impacted populations in Wisconsin.

The Wisconsin Asthma Plan 2015-2020 is divided into four priority areas that are in direct alignment with the four components of care outlined in the NIH asthma guidelines. The four priority areas include:

• Routine health care
• Pharmaceutical care
• Education
• Environment

When people get sick or develop a disability, they often ask their health care providers, “How did this happen?” The answer could be clear and obvious but many times it is more complicated.  A Story of Health multimedia eBook explores this question and delves into how our environments interact with our genes to influence health across the lifespan. We tell A Story of Health through the lives of fictional characters and their families - Brett, a young boy with asthma; Amelia, a teenager with developmental disabilities; and toddler Stephen, recently diagnosed with leukemia. Each fictional case features the latest scientific research about disease origin and helpful facts about disease prevention. “Although our characters are fictional, the risk factors they face are real,” says Mark Miller MD, MPH, co-author and director of the University of California, San Francisco, Pediatric Environmental Health Specialty Unit.  “Our eBook brings stories of health to life through an interactive format that we believe will engage a wide range of audiences.”  

METHODS

As part of the Children’s Health Study, we measured lung function annually in 2120 children from three separate cohorts corresponding to three separate calendar periods: 1994–1998, 1997–2001, and 2007–2011. Mean ages of the children within each cohort were 11 years at the beginning of the period and 15 years at the end. Linear-regression models were used to examine the relationship between declining pollution levels over time and lung-function development from 11 to 15 years of age, measured as the increases in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) during that period (referred to as 4-year growth in FEV1 and FVC).

RESULTS

Over the 13 years spanned by the three cohorts, improvements in 4-year growth of both FEV1 and FVC were associated with declining levels of nitrogen dioxide (P<0.001 for FEV1 and FVC) and of particulate matter with an aerodynamic diameter of less than 2.5 μm (P= 0.008 for FEV1 and P<0.001 for FVC) and less than 10 μm (P<0.001 for FEV1 and FVC). These associations persisted after adjustment for several potential confounders. Significant improvements in lung-function development were observed in both boys and girls and in children with asthma and children without asthma. The proportions of children with clinically low FEV1 (defined as <80% of the predicted value) at 15 years of age declined significantly, from 7.9% to 6.3% to 3.6% across the three periods, as the air quality improved (P=0.001).

CONCLUSIONS

We found that long-term improvements in air quality were associated with statistically and clinically significant positive effects on lung-function growth in children. (Funded by the Health Effects Institute and others.)