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Floyd J. Malveaux, M.D., Ph.D. Headshot

Rebuilding the Health of New Orleans' Children From the Ground Up)

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The headlines still haunt us. New Orleans is under water. Hurricane Katrina leaves thousands without food, water and shelter. Entire communities destroyed by flooding. But while life for many over the past six years has returned to normal, it's an uncomfortable fact that for others, the damage that lingers in Katrina's aftermath may be worse than the storm itself.

Even simple routines like dropping off kids at school, taking them to doctor's appointments and enjoying time with family are still not, in fact, routine. This is especially true for parents living in or near poverty who have children with asthma. For many, access to basic health care services and the ability to monitor and track health was blown away by the storm -- and has yet to return. In fact, about 80,000 residents in eastern New Orleans have been without a full-service hospital since the 2005 storm.

The disappearance of reliable healthcare services in New Orleans left many children with asthma no choice but to seek out treatment in emergency rooms across town -- if they seek care at all. And while there have been strides to restore services for this very vulnerable population, work to rebuild hospitals and medical practices has been moving slowly. But that doesn't mean healthcare needs have slowed -- particularly for children burdened by asthma. It does mean that innovative ways to provide asthma management directly to where they live and go to school is necessary. And while we don't know everything about childhood asthma, we know enough to do better in controlling its symptoms and effects.

A report from The George Washington University found that asthma adds about 50 cents to every health care dollar spent on children with asthma compared to children without asthma. And those most at risk -- low income, medically underserved, and African-American and Hispanic children -- have the least access to preventive care and the most visits to the emergency room. Access to quality, affordable care plus healthier communities can control costs and improve health.

Regular access to health care can also help families better manage the disease, get on a schedule of taking medication and establish a routine of care for their child. Results from the Head-Off Environmental Asthma in Louisiana (HEAL) program is proof. The program was launched in the months following Hurricane Katrina to provide education and counseling to caregivers on how to manage their child's asthma in a transformed environment. It provided in-home surveys for asthma triggers and community-based asthma services that led to fewer children being rushed to the hospital, a reduction in symptoms and fewer days of school missed.

Another outcome of the program is that more parents felt confident that they could better manage their child's asthma. This is a large feat considering too many families in New Orleans and across the country seek care in the ER only when their child's asthma symptoms occur rather than attempt to prevent them before they happen. So access and innovation in healthcare delivery will go a long way to helping alleviate the burden of childhood asthma and bring more peace of mind to the families of these children.

The good news is that we are starting to see examples of healthcare delivery innovation in New Orleans. A unique partnership is forming between Xavier University, Daughters of Charity Services of New Orleans and the Children's Health Fund to advance the HEAL program in innovative ways. This fall, the new partnership will bring asthma care services directly to children through community health centers and mobile units as well as mitigate asthma triggers in the home with hopes of empowering families and improving health outcomes.

Other positive developments are happening, too. Mayor Landrieu and his team have made rebuilding health care in New Orleans a priority and groups like the National Association of Free Clinics have staged a number of health screening events in the area since 2009. The recent opening of an urgent care clinic in eastern New Orleans and the upcoming opening of a Daughters of Charity primary care facility signals that things are on the right track.

The truth is, even when things are back to "normal," it will likely be a "new normal." And this will demand that unlikely partners come together to pool knowledge and resources to implement programs that reach deep into communities where the neediest children live. Let's not pass another anniversary without committing to meaningful solutions to getting children with asthma in New Orleans the help they need.