July 2008-Allies Against Asthma Results Released
New Study Shows That Broad-Based Local Coalitions Can Reduce the Burden of Asthma in Low-Income and Minority Communities
Ann Arbor, Michigan - The Center for Managing Chronic Disease at the University of Michigan has released the results of a groundbreaking project, Allies Against Asthma, a national six-year program funded by the Robert Wood Johnson Foundation. Researchers found that asthma among children improved significantly in the designated low-income communities across the country where community coalitions worked. Coalitions comprising health care providers, caregivers, patients and their families, schools, local officials, environmental agencies, grass-roots advocacy groups and insurers collaborated to develop innovative policy change to reduce the burden of disease on patients and the health care system.
Dr. Noreen M. Clark, Director of the Center for Managing Chronic Disease, and the lead researcher said, "Initial results are promising and demonstrate that coalitions are able to bring about changes in policies and practices in their communities that have a direct and positive impact on families living with asthma. These coalitions hold promise because they draw on diverse groups to address issues of common concern, and pool their resources to address issues system-wide. In essence, the whole is greater than the sum of the parts."
The Allies Against Asthma program supported seven community-based coalitions that implemented comprehensive policy and system change strategies in: Long Beach, California; Philadelphia, Pennsylvania; Washington, DC; King County, Washington; Milwaukee, Wisconsin; Hampton Roads, Virginia; and San Juan, Puerto Rico. Policy changes focused on access to and quality of medical services, asthma education, family and community support, and improved physical environments. The combined efforts of the seven coalitions resulted in 93 policy improvements across the country and significant reductions in asthma symptoms in children and teens in targeted areas.
Among the policy improvements implemented were:
• A requirement in Long Beach (and subsequently in the state of California) that requires health plans to cover necessary asthma treatment equipment such as spacers;
• In Milwaukee, a "prior authorization" requirement for asthma and allergy drugs has been blocked on an annual basis to make it easier for families to obtain their medicines.
• In Hampton Roads, Virginia, a standardized asthma action plan and authorization for asthma medication was adopted by the seven city school districts
• In Washington, DC, the local health plan and hospitals adopted a protocol and referral procedure for children seen in the emergency department for asthma
• In Long Beach, ordinances that prohibit idling of diesel trucks in neighborhoods passed.
In addition, children with asthma exposed to the work of these coalitions compared to other children experienced improvements in asthma symptoms.
For instance:
• Children targeted by coalitions showed a 48 percent decrease in the number of daytime symptoms they experienced (over a two week period) - more than twice the decrease seen in children who were not in coalition target areas.
• Children in coalition target areas showed a 40 percent decrease in the number of nighttime symptoms they experienced (over a two week period) - nearly twice the decrease in children not exposed to coalition efforts.
• Targeted children showed a 57 percent decrease in the number of nighttime symptoms they experienced (over a year period) -- more than five times the decrease in children who were not in coalition target areas.
The decrease refers to the mean for the combined group of participants from six sites.
Asthma is the most common chronic disease of childhood, affecting an estimated six million children. Prevalence has been consistently increasing for all age groups with children having the highest prevalence. In 1980, approximately 3.6 percent of children in the U.S. had asthma. By 2004, that number had nearly doubled to 7.1 percent. Low-income and minority communities, where access to quality health services is usually scarce and where the allies coalitions worked, tend to have the highest rates of children with asthma and asthma-related problems.
Dr. Clark added, "Allies Against Asthma shows how important it is for communities to come together and form strong partnerships in the fight against chronic disease. The data demonstrate that the policy and practice improvements brought about through community and family mobilization contribute to decreased asthma symptoms among children and young people."
For more information on the study, please visit: http://cmcd.sph.umich.edu/allies-against-asthma.html
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