Addressing health disparities in asthma need not be expensive: A cost-effective solution in the face of costly health care

The exponential rise in health care costs in the United States over the last 25 years amplifies the widening disparities in health outcomes. Asthma is a chronic disease that illustrates this health gap. In the United States, low-income people and people of color are disproportionately affected by asthma, experiencing higher asthma prevalence and severity relative to wealthier and white populations (Krieger et.al, 2002). More importantly, asthma greatly affects children. It is the most common chronic disease in childhood and the leading non-injury cause of hospitalization among children ages 0-15 (Krieger et.al, 2002).

The Baltimore City Health Department's Reducing Asthma Disparities (RAD) program has provided a home-visiting intervention to families of school children with moderate-severe asthma. This healthy homes approach, focused on helping the parent to reduce exposure to environmental triggers and improving the child's medication compliance, may be a cost-effective approach to reducing asthma disparities among children in Baltimore. We are in the process of estimating the health costs of asthma for Medicaid enrolled children, and we will match them against the costs averted by the RAD program. We will utilize logistic regression techniques to analyze parent-reported outcomes and Medicaid costs, and we will compare our methods with traditional approaches. We will also discuss the strengths and limitations of our cost-effectiveness approach to showcase how economic evaluation is an essential part of assessing the impact and the sustainability of public health programs.