Persisting Racial Disparities Among Chicago Children with Asthma

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Background

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

Home-Based Asthma Education and Environmental Interventions in Illinois: The Case for Sustainable Financing

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.

Stock Asthma Rescue Medication in Schools

Download the Issue Brief – Stock Asthma Rescue Medication in Schools.

Stock asthma rescue medication in schools is a viable policy solution to help prevent the poor health outcomes that can result when a child experiences an asthma emergency at school, but does not have access to medication. After years of studying this critical policy gap, Respiratory Health Association (RHA) and Legal Council for Health Justice came together in 2017 to actively explore pursuing a stock asthma rescue medication policy in Illinois. In furtherance of that end, we are now proud to present this issue brief assessing the fit and feasibility of stock asthma rescue medication in Illinois schools.

This issue brief explores the burden of asthma and the asthma policy landscape in Illinois and outlines elements of stock asthma rescue medication policies and lessons learned from other states. It concludes with recommendations for adoption of a stock asthma rescue medication in schools policy for Illinois. It is our conclusion that a stock asthma rescue medication policy for Illinois schools could achieve a safer school environment for those living with asthma, and that the most appropriate framework for adoption ofsuch a policy would be via the state’s existing stockundesignated epinephrine auto-injector law in the School Code (105 ILCS 5/22-30). RHA and Legal Council for Health Justice hope this paper will serve as a useful educational tool for asthma policy stakeholders statewide to better understand the need for a stock asthma rescue medication policy and how one could be best implemented in Illinois.

Date of Publication: March 2018