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APHA Scientific Session and Event Listing

Melaine Chin, BS¹, Abby Greenberg, MD¹, Mary Ellen Laurain, BS¹, Anne Little², Daniel Kuhles, MD, MPH¹, and David M. Ackman, MD, MPH¹. (1) Division of Disease Control, Nassau County Department of Health, 240 Old Country Road, Mineola, NY 11501, 516-571-2177, melaine.chin@hhsnassaucountyny.us, (2) Asthma Coalition of Long Island, American Lung Association of NYS, 700 Veterans Memorial Highway, Hauppauge, NY 11788

Childhood asthma is a leading cause of morbidity in Nassau County, a large metropolitan suburb adjacent to New York City. An estimated 16.4% of children have been diagnosed with the condition. Hospital discharge data show that asthma disproportionately affects those children who reside in low income areas of the county.

Nassau County Health Department responded by developing an intensive asthma control program, with funding from the local asthma coalition. The initiative targets asthmatic children and their families who reside in these underserved communities. Modeled after the Inner City Asthma Study (ICAS), the initiative provides the child's caretaker with the knowledge, skills, motivation, and supplies to perform wide-ranging environmental remediation. Children are recruited from local hospitals, partnering agencies of the asthma coalition, and community based health care providers and organizations. Health educators and sanitarians perform baseline home evaluations to assess each child's current living environment and develop individualized intervention and education plans. In addition to the ICAS component, we also provide comprehensive case management services, including referrals for health and social service needs. The trust gained by providing case management has been instrumental in obtaining access to the homes and high levels of adherence to the individualized plans. Results show increased controller medication use, decreased symptoms, emergency room visits, hospitalizations, and school absenteeism. Of the 18 children who have completed the program to date, 61% (11) remain well. 22% (4) became symptomatic with bronchitis, 6% (1) with the introduction of a pet, and 11% (2) are undergoing evaluation for other pathology.

Learning Objectives:

• Describe the adaptation of a randomized, controlled trial of an environmental asthma intervention to local conditions and resources.
• Recognize the importance of individualized educational and environmental asthma interventions.
• Articulate how the provision of case management services is instrumental in gaining trust from and access to underserved populations

Keywords: Asthma, Health Disparities

Presenting author's disclosure statement:

Not Answered