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

For Some Children, Every Day Is Asthma Day

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World Asthma Day provides an opportunity to stop to consider the challenges of combating a disease that affects almost 7 million children in the United States. But for some children and their families, every day is asthma day.

This is especially true for those most at risk for daily wheezing, chest tightness, coughing, emergency room visits and hospitalizations. Poor and medically-underserved children are disproportionately affected, having the least access to preventive care and the most frequent symptoms and school absenteeism. Whether or not the rest of the world is focused on this disease, these children don't get a break from their asthma symptoms and poor quality of life. They don't get a break from limited play and activities that other children enjoy. And their parents don't get a break from missed days of work and lost income.

While we don't know everything about childhood asthma, we know enough about its financial and human costs to do better in helping control symptoms and life-threatening effects. A new study shows childhood asthma could be a life-long affliction if we don't take the necessary steps to provide appropriate management. Indeed, better access to quality, affordable care plus healthier communities can control costs and improve health. That is why I am urging policymakers, health providers, parents and communities to give children with asthma the help they need and deserve.

What can policymakers do? They can start by making childhood asthma a health priority. And since we know a lot about effective ways to manage childhood asthma and keep children out of the emergency room, this prioritization can be a win-win for our health care system and our families. But in order to provide children with proper care, we must ensure continuous insurance coverage and access to health care providers. There are still too many children in our country falling into a gap where there's no health insurance or access to quality asthma care. It's time we committed to closing that gap!

A bright spot in the childhood asthma story is the investment the country has made in community health centers (CHCs). In many cases, CHCs serve as the front door to better disease management for children with asthma. They are often located in communities with the highest childhood asthma rates and serve as the primary place where as many as 20 percent of low-income children with asthma receive care. Twenty percent! That's why the Merck Childhood Asthma Network (MCAN) is partnering with several CHCs across the country to combine that community presence with evidence-based approaches to asthma management.

Health care providers also play an important role in this battle. A great first step is applying what we've learned about the benefits of care-coordinated case management, an approach that combines evidence-based science, asthma education and community engagement. MCAN's programs around the country have found that care-coordinated case management and home visitations (when needed) cut the rate of ER visits and asthma-related hospitalizations by at least half. And asthma-related school absences are reduced by 80 percent. Health care providers need to recognize and emphasize the important role of asthma educators and counselors as part of the health care team. Their expertise addresses elements of care that are often neglected, such as patient education, behavioral risks, health literacy and chronic disease management.

Lastly, communities and parents are essential pieces of the puzzle. Partnerships with school districts, community-based organizations and city health departments have enabled MCAN program sites to connect families with critical asthma services and resources. Many parents don't realize how easy it can be to take control over certain asthma triggers often found at home. Through in-home environmental assessments, parents and other caregivers can learn the dangers of tobacco smoke, dust mites, pet dander, strong perfume odors and even some cleaning products and take steps to remove those triggers.

While childhood asthma can't be cured, it can be managed. World Asthma Day is a perfect time to be hopeful about the possibilities and the real potential to improve the health of children with asthma. If we all make childhood asthma a priority every day, the chances for achieving long-term and widespread change is a lot closer than we think.

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