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Goal: Affinity is
seeking projects that will reduce morbidity and
mortality and improve functioning for populations
affected by asthma.
Overview: Asthma, a disease causing inflammation
of the lungs and breathing difficulties, is the most
common chronic disease in children, and the sixth most
common overall in the United States. In 2002, asthma
affected 20 million people nationwide, including over
6.1 million children. In 2000, one in eight adults in
New York City reported an asthma diagnosis during their
lives, 29% higher than nationally. Despite a decline in
asthma hospital admissions, adverse health outcomes have
increased nationwide, especially in New York City. Poor
inner-city residents are more likely to have
uncontrolled asthma necessitating ER visits and
hospitalizations. In New York City, the Bronx has the
highest overall rates of asthma prevalence,
hospitalizations and deaths.
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Asthma can be hard to diagnose, especially in young
children. Symptoms include coughing at night; breathing
problems after physical activity or at certain times of
the year; chest tightness, wheezing and prolonged colds.
Preventing attacks requires taking appropriate
medication and avoiding environmental triggers such as
dust mites and smoke.
Differences exist in asthma prevalence, hospitalizations
and death rates across demographic groups. Women are
more likely to be asthmatic than men; this trend is
reversed in children. Women are also more likely to be
hospitalized than men and the death rate among women is
higher as well. Asthma prevalence varies greatly by
ethnicity, with Puerto Ricans experiencing the highest
rates of asthma, followed by African-Americans and
American Indians. African-Americans experience a greater
number of asthma hospitalizations and a higher death
rate compared to other groups.
African-American and Hispanic children are also more
likely to have more severe asthma, miss more school days
and have lower health-status scores than non-Hispanic
whites. Among younger children, asthma is more than
twice as prevalent in schools in low-income areas
compared to high-income areas. New York City’s low
income children up to age four were hospitalized for
asthma more than four times as often as those in
high-income areas. Among low-income minority children,
when physicians more closely followed asthma prevention
guidelines, claims for medication rose significantly
while hospitalization rates, ER visits, and outpatient
visits fell dramatically.
Effective asthma treatment depends on access to care,
proper identification of the condition, diagnosis,
prescribing the correct drugs at the right time, proper
education on how to use the drugs, filling asthma
prescriptions, and adherence to medications. Home-based
environmental interventions also show improved outcomes
with cost efficiency as do interventions including
asthma education and case management.
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