Asthma Initiative

Asthma is a common disease among New York City's children and adults. People with asthma have chronic lung inflammation and episodes of airway tightening that cause symptoms such as wheezing, coughing, and shortness of breath. Asthma is a leading cause of missed school among children and is the most common cause of hospitalization for children 14 years and younger. Among adults, asthma causes missed work, emergency department visits, and limitation of activity. In the past two decades, the number of people with asthma has increased, although some improvements, such as fewer hospitalizations, have occurred in recent years. Although we do not yet know how to prevent asthma, we do know that asthma can be controlled both by avoiding exposure to triggers and by taking anti-inflammatory medicines. With good control, almost all people with asthma can lead normal, active lives.

Asthma is common among New York City’s children and adults. People with asthma have chronic lung inflammation (swelling) and episodes of airway tightening that cause symptoms such as wheezing, coughing, chest tightness, and shortness of breath. Asthma can’t be cured, but it can be controlled with proper treatment and management.

The New York City Department of Health and Mental Hygiene, continues to work towards reducing illness and death asthma. The New York City Asthma Initiative’s (NYCAI) strategic focus has shifted away from administering direct services, to activities that support broader system improvements. The Initiative’s primary target continues to be children 0-14 years old in communities with the highest asthma rates, however its program scope includes enhancement of clinical and self-management support for adults with asthma.

New York City Asthma Initiative is working to:

• • Improve medical standards of care for children and adults with asthma
• • Enhance self-management support for individuals with asthma
• • Enhance citywide asthma education standards and delivery
• • Promote “asthma friendly” schools and daycare settings
• • Reduce asthma triggers in both homes and communities
• • Monitor and track asthma prevalence, emergency department visits, hospitalizations, and deaths.

The New York City Asthma Initiative continues to coordinate the New York City Asthma Partnership (NYCAP), a citywide coalition of over 400 organizations and individuals initiated in 1999. NYCAP brings together representatives from schools, daycare, health care institutions, pharmacies, community based organizations, government, and others who make recommendations to improve citywide policies and systems that affect people with asthma. NYCAP addressee the following: the environment, asthma education, data and research, health care delivery, and issues affecting children in schools, early childhood, and recreation programs.

In addition, the Department continues to support the following programs:

The Asthma Training Institute offers a schedule of courses on various topics including asthma basics, asthma self-management, skill building for community educators, and other clinical topics for medical providers, educators, social workers, nurses, community health workers, and homeless shelter workers in New York City. The program also provides free educational materials, including Asthma Action Plans, posters, and health bulletins to medical and community providers.

Managing Asthma in Schools (MAS) is a comprehensive program designed to improve the coordination of care for children with asthma in public elementary schools. A key component of the program is the use of an automated student health record (ASHR) to track asthma and other medical care. The program also provides enhanced asthma training to school nurses and physicians, and works to improve communication between school health clinicians, parents, and community providers.

Managing Asthma in Early Childhood Programs supports the enhancement of health tracking and coordination of care for children with asthma in over 250 Early Childhood Programs in New York City. The project targets neighborhoods with consistently high rates of asthma-related hospitalizations and emergency department visits among children: East and Central Harlem, North and Central Brooklyn, and the South Bronx.

Community Integrated Pest Management Program (IPM): DOHMH works with pest control agencies, and community partners to eliminate cockroaches and mice, common asthma triggers in low-income apartments where people with asthma reside.

DOHMH’s East and Central Harlem District Public Health Office (E/CH DPHO) focuses on improving asthma care and management in East and Central Harlem which have historically high rates of asthma and asthma-related hospitalizations. DPHOThrough the East Harlem Asthma Center of Excellence, the DPHO provides comprehensive coverage of neighborhood schools to ensure that children with poorly controlled asthma are identified and supported. The office also assistanceworks with medical providers to ensure that children are treated with appropriate medications and have access to medications in school. In addition, the East Harlem Asthma Center of Excellence also partners with community organizations, health insurance companies, hospitals, and health centers to improve coordination of care for children with asthma. Services include case management, integrated pest management, asthma care coordinator services, and asthma counselor services.

DOHMH continues to educate NYC residents and providers about asthma. We encourage individuals with asthma to understand and manage it: (KICK Asthma):

• • Know what worsens your asthma.
  
• • Inform your doctor about frequent asthma symptoms (i.e daytime symptoms more than 2 days per week or nighttime symptoms more than 2 times per month may be an indication of persistent asthma).
  
• • Control frequent symptoms by using long-term control asthma medicines (inhaled corticosteroids are the most effective) and by avoiding tobacco smoke and other triggers.
  
• • Keep regular doctor’s visits, and ask your doctor for a written Asthma Action Plan.

DOHMH recommends that medical providers:

• • Assess each patient’s asthma control at each visit.
• • Prescribe an Inhaled Corticosteroids for people with persistent asthma.
• • Promote asthma self-management through education, joint development of treatment goals with patient and family, use of asthma action plans, and referrals to case management when available.
• • Provide specific guidance to families on reducing exposure to environmental asthma triggers.

Call 311 to request asthma action plans, health bulletins, and other materials.

Key Publications and Programs

• • Creating a Medical Home for Asthma
• • Asthma Facts, Second Edition (May, 2003) [Erratum]
  Asthma Facts, Second Edition provides information on asthma deaths and hospitalizations in New York City residents as well as prevalence among adults and 4-5 year old children. An examination of the data is presented in tables and figures.
• • Updated Asthma Hospitalization Data by NYC Neighborhood:
  Ages 0-14 | Ages 15-34 | Ages 35+ NEW
• • NYC Vital Signs: Asthma Can Be Controlled (April 2003)
• • Asthma Initiative Info Newsletter, Volume 4 (Fall 2002) [Archive]
• • More Asthma publications