Understanding how policy changes impact real kids and their families
By Mike Odeh
October 2, 2019
Did you know…
- 1.2 million California kids have asthma
- 58% of those kids had an asthma attack in the past year
- Due to asthma, kids in California miss 1,200,000 days of school or day care, every year
- In 2014, more than 73,000 kids visited the emergency room for asthma, especially in rural areas
- While 16% of Black children and 7% of white children have asthma, it is three times more deadly for Black kids than for white kids
Asthma affects the lungs, making it difficult to breathe; people with asthma can experience coughing, wheezing, tightness in the chest, loss of breath, and in severe situations, even death. It is one of the most common chronic diseases in the United States and while there is no cure, and we don’t often know what causes it, asthma can be managed with medication, and by eliminating environmental triggers in the home. For example, making small changes like using dust-proof mattress and pillow covers and asthma-friendly cleaning products, can help reduce asthma-related symptoms.
In California, where more than five million people have asthma, the highest prevalence rates are among children, ages 5 to 17. In fact, childhood asthma rates are often 20 to 40 percent higher than among adults. Asthma is one of the leading causes of hospitalizations and school absences among children, and research has shown it can impact students’ academic performance and success.
While it affects people of all racial and economic backgrounds, asthma disproportionately burdens low-income children and communities of color, who are more likely to miss school, and have higher rates of hospitalization and emergency department visits. The costs associated with asthma are not only personal, but also incurred by the state as whole: in 2014, hospitalizations for asthma cost $1 billion, and K-12 public schools lost an estimated $37 million in revenue due to student absences. In fact, the state bears significant costs for uncontrolled asthma – almost 90 percent of all pediatric asthma emergency department visits were for children in Medi-Cal in 2016, up from less than 50 percent in 2012.
It was clear the state had to do more to improve the lives of children growing up with asthma in California, and this year, the state made much-needed progress in the form of a one-time $15 million down payment to invest in access to asthma preventive and environmental remediation services.
The budget win was championed by Senator Melissa Hurtado to specifically address the great needs of kids and adults with poorly controlled asthma on Medi-Cal that disproportionately impact constituents like hers in the Central Valley.
The Asthma Mitigation Project is designed to increase access to asthma home visiting – which incorporates asthma education, home environmental asthma trigger assessments and home environmental trigger remediation – provided by qualified professionals, such as trained community health workers. There are currently several asthma home visiting programs and models across the state, however, many of these lack the sufficient and sustainable resources needed to reach the entire community at scale, so the vision of the Asthma Mitigation Project is to support an expansion of existing programs and develop new ones in underserved areas.
Increasing the reach and number of asthma home visiting programs is critical, and must be structured to ensure that families are aware of these services and feel safe accessing them. As one pediatrician, who works with a culturally competent and congruent health care team in an asthma clinic states, “Our asthma clinic does a good job of employing community health workers from the community. They have strong ties to the area and are able to establish long-lasting relationships and good rapport with families because of their continuity in the asthma clinic.”
This policy change is an incredible opportunity because the models have been shown to improve health outcomes, more efficiently use health care resources, and empower patients and their families around prevention and health. One parent whose child received asthma home visits said, “We were connected to an asthma specialist and education program who taught both my son and me how to manage his asthma in order to prevent another asthma attack, including how to use his inhaler, how to recognize triggers and what to do in an emergency. I love this program. It has helped my son and me a lot. I hope every parent can have this and be a part of a program like this.”
Children Now and our advocacy partners at the California Pan-Ethnic Health Network (CPEHN) and Regional Asthma Management and Prevention (RAMP) are working very closely with the state, health providers, community health workers, and other trained professionals, to launch the Asthma Mitigation Project in a way that will help increase access to preventive asthma care home visiting programs, and educate families about the health care options available to them. Together, we can work to improve asthma outcomes for all children living in California, especially those who are most vulnerable.