Care Coordination: How to Reduce Health Disparities among Black and Hispanic School Age Children with Asthma

Background: Asthma is more severe and hospitalization rates are three times higher for the Black population. Latino children with asthma experience nearly twice as many activity level limitations compared to Whites. Purpose: The LAUSD Asthma Program seeks to reduce health disparities in Black and Hispanic children with asthma through intensive care coordination, in-home environmental assessments/mitigation, health education, and collaboration with community clinic providers and schools to improve asthma outcomes. Significance: School personnel can decrease asthma symptoms, improve asthma management, and reduce school absences through a multi-component intervention. Methodology: Students with high absenteeism, frequent ER visits, recent hospitalization, or numerous school health office visits for asthma were referred to the program. School Nurses provided care coordination, home and school visitation, and addressed the multiple areas that impact asthma outcomes. Data was collected at baseline, 3-, 6- and 12- months to assess the impact of the intervention. Findings/Results: 830 students were enrolled in the program. 200 students/families were contacted 12 months after participation in the Asthma Program. The program reached a greater proportion of Black students (22%) than found in the overall student population (11%). Participants had a significant reduction in asthma symptoms, improved asthma control and fewer school days missed in the year of the intervention compared with the previous year. Outcomes were also analyzed controlling for race/ethnicity. Conclusions: A school district initiated asthma care coordination program can improve asthma outcomes and reduce health disparities. These reductions may translate into greater social justice through improved academic achievement and life opportunities.