One of the more vexing public health issues facing Chicago is the existence of significant racial/ethnic disparities in asthma. Chicago has been identified as an epicenter for asthma, with higher prevalence in minority communities on the city’s west and south sides. The 2016 Healthy Chicago Survey estimated that 216,000 adults in Chicago have asthma, with the rate among African Americans nearly 75% higher than among Whites and almost 85% greater than the rate among Hispanic adults.i The most recently available data on youth suggests that 22.3% of Chicago high school students have been diagnosed with asthma, including 15% of White students and 27% of African American students.ii
In the absence of a comprehensive source of surveillance data for childhood asthma in Chicago, less traditional public health sources have been used to better understand the scope of the problem. For this report, we examined hospital discharge data, specifically asthma-related emergency department (ED) visits. Asthma is one of the leading causes of ED visits for children ages 0-17.
To better understand the impact of asthma in Chicago, we looked at three types of indicators: (1) the number of pediatric asthma ED visits, over time, which we stratified by age group and race/ethnicity; (2) the rates of these visits per 10,000 population, also demographically stratified, and; (3) racial and ethnic disparities in these rates over time. The data revealed that between 2009 and 2015 the number of annual asthma-related ED visits among Chicago children declined, however, the racial and ethnic disparities in rates of visits showed only modest decreases.
Date of Publication: May 2018
Download report: RHA-SUHI-IDPH_Business Case_Asthma Care_ Final
Asthma education and environmental management are evidence-based strategies that reduce asthma-related emergency department (ED) visits and hospitalizations and reduce health care costs. Despite the economic benefits, reimbursement for these strategies tends to be lower and/or less comprehensive than other recommended asthma management approaches.
Our goal is to expand access to evidence-based, home-based asthma education and environmental interventions for Illinois residents living with asthma through sustainable financing mechanisms. While there are a number of mechanisms described in this report that are available to accomplish this, we recommend the following for immediate exploration:
- Expand reimbursement for asthma educators, community health workers (CHW) and others currently outside of Illinois’ clinical licensure system;
- Establish a Health Homes Program that incorporates asthma care best practices;
- Apply for Section 1115 Research and Demonstration Waiver that includes home-based asthma education and environmental interventions;
- Utilize reimbursement through existing Medicaid channels such as early and periodic screening, diagnostic, and treatment and administrative costs;
- Amend contracts between state Medicaid and Medicaid Managed Care Organizations (MCO) to enable and provide guidance for the use of CHWs, and;
Encourage Medicaid MCOs to expand in-home asthma education and environmental interventions, by providing these services or reimbursing other providers.