Asthma

Multi-generational male family posing for a group picture in the park.

CDC’s National Asthma Control Program and its partners developed EXHALE, a set of six strategies that each contribute to better health and improved quality of life for people with asthma.

As a model anti-racist organization, NACDD promotes social justice and wellbeing so that communities can build healthier futures.

These resources will help you center equity and social justice in your EXHALE work.

 

EXHALE graphic defining what each of the letters in EXHALE Represent. E is for Education on asthma self-management. X is for X-tinguishing smoking and exposure to secondhand smoke. H is for Home visits for trigger reduction and asthma self-management education. A is for Achievement of guidelines-based medical management. L is for Linkages and coordination of care across settings. E is for Environmental policies or best practices to reduce asthma triggers from indoor, outdoor, or occupational sources.

Understanding Asthma Disparities

Black, Hispanic, and American Indian and Alaska Native people have the highest rates of asthma, hospital visits, and asthma-related deaths. Disparities are caused by social and structural disadvantages. Learn more with these resources from our partners.

Put the Social Justice Framework Into Practice

State Asthma Programs are well positioned to foster individual and communal action to advance health equity. The NACDD Social Justice Framework offers examples of steps that will help advance your EXHALE work. Reflect on the examples and identify the steps you will take at the individual, interpersonal, organizational, community, and policy levels to advance social justice and health equity through your asthma program.

Advance Equity through EXHALE

Use these ideas and resources to strengthen equity as you promote EXHALE.

Education on asthma self-management: Helping people with asthma (and their families) use asthma medications correctly, avoid exposure to asthma triggers, and manage their asthma symptoms can reduce hospitalizations, missed school or work days, and healthcare costs.

Asthma self-management education requires repetition and reinforcement. All care providers have a role in providing asthma self-management education, which is best supported through integrated programs that incorporate clinic-based, home-based, and school-based elements. Effective asthma education empowers patients to request guidelines-based care.

Example Equity Approaches

  • Expand comprehensive asthma education programs for high-risk populations.
  • Expand delivery of culturally and linguistically appropriate asthma self-management education. For example, partner with historically Black colleges and universities.
  • Expand programs for community health workers, promotoras, nurses, social workers and certified asthma educators to provide asthma education.
  • Review inhaler technique at every care touchpoint.

Resources

X-tinguishing Smoking and Exposure to Secondhand Smoke Among People with Asthma: Helping people quit smoking and avoid secondhand smoke can reduce hospitalizations, missed school, healthcare costs, and how often they have to use rescue medicine. Building strategic partnerships and understanding cultural differences can help you reach people with the greatest need.

Example Equity Approaches

  • Collaborate with your state tobacco program, cancer programs, and coalitions to promote equitable ways to reduce smoking and second-hand smoke.
  • Use culturally appropriate media and education efforts to build awareness, including youth prevention and cessation messages.
  • Help more multi-unit housing become smoke-free and adopt an anonymous reporting mechanism.
  • Involve people who experience inequities in tobacco control coalitions.
  • Remove smoking restriction exemptions such as those that impact sales limits and in-store placement.

Resources

Home Visits for Trigger Reduction and Asthma Self-Management Education: Improving access to evidence-based home visiting services can help people manage their asthma. When asthma is controlled, hospital visits, missed school or work, and healthcare costs can all decrease.

Example Equity Approaches

  • Expand home visiting programs to be led by community health workers, promotoras, nurses, social workers, case managers, and certified asthma educators.
  • Increase access to home visiting assessments by offering virtual services.
  • Maintain a partner network to facilitate free or low-cost access to resources such as food, clothing, utilities assistance, asthma-friendly cleaning, mold removal, pest management, and housing/tenant assistance.
  • Partner with organizations who can provide trigger-reduction products like vacuums with HEPA filters, transportation vouchers, and asthma friendly cleaning products.

Resources

Achievement of Guidelines-Based Medical Management Among People with Asthma: Healthcare providers and their teams can improve the care they give people with asthma by using national guidelines for medical management of asthma. Asthma programs can support healthcare providers by using the below equity approaches.

Example Equity Approaches

  • Encourage insurance companies to adopt policies and payment systems that support the delivery of guidelines-based asthma care.
    • Ensure care providers offer personalized, culturally-appropriate asthma action plans using the patients and caregivers’ language and level of health literacy.
    • Improve patient-provider shared decision-making by helping patient navigators support quality patient-provider communication.
    • Help healthcare professionals identify patients with asthma who experience social determinants of health-related issues and build community partnerships to match patients with local resources.
    • Support healthcare providers to adopt data driven quality improvement systems.
  • Encourage your state Medicaid office and public and private insurance companies to develop quality improvement goals that improve outcomes for patients with asthma.
  • Educate and provide tools for nurses, health educators, community health workers, case managers, and promotoras to provide guidelines-based asthma care and improve communication on diagnosis and treatment options.
  • Share information about how to access medication and prescription discounts.

Resources

Linkages and Coordination of Care Across Settings Among People with Asthma: When people with asthma have a team of care providers who are connected and coordinated, their health outcomes and quality of life can improve. Employers, hospitals, schools, childcare centers, and at-home care providers can work together to strengthen the support for people with asthma.

Example Equity Approaches

  • Build community partnerships and/or coalitions with local organizations who serve people with asthma.
  • Expand access to specialist care by increasing referrals from primary care, expanding specialist care coverage, and recruiting more specialists for areas with fewer available specialists.
  • Expand care teams to include case managers who address social needs and provide mental health support for patients with asthma.
  • Increase funding, awareness, and training for school-based asthma management programs.
    • Include school nurses as partners in a child’s care team.
    • Support increasing the number of school nurses.
    • Ensure schools are equipped to obtain asthma medicines and train appropriate staff to administer medicines.

Resources

Environmental Policies or Best Practices to Reduce Asthma Triggers: Helping people with asthma live, learn, work, and play in healthy environments can improve their health outcomes and quality of life. Policies that support people who are most affected by asthma can have the greatest impact.

Example Equity Approaches

  • Help housing agencies adopt and enforce housing codes that protect people with asthma from exposure to indoor air pollutants, irritants, and allergens, including use of integrated pest management.
  • Invest in healthy air protections in disproportionately impacted communities and promote the reduction of greenhouse gasses to minimize climate change.
  • Educate communities about the health impacts of hotter temperatures, more high-ozone days, extreme weather, flooding, drought, wildfires, and smoke and how to protect themselves.
  • Identify and raise awareness of home improvement incentives, loans, grants, or tax credits to help low-income families improve their home’s energy efficiency or remove health hazards such as mold, moisture, or pests.
  • Establish partnerships to eliminate workplace exposure to asthma triggers, such as engineering controls (e.g., in ventilation systems) or replacing workplace materials that can trigger asthma.

Resources

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