Chicago Public Radio Asthma in Chicago: a Deadly Concern |
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The CHEST FOUNDATION |
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The CHEST FOUNDATION Please note: This video is presented in Real Player format. If you do not have Real Player you can download it here. |
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The Problem
Asthma is one of the most common chronic illnesses of childhood. Since the 1970s, its prevalence has risen rapidly and unequally, especially for African-Americans and Puerto Ricans. Mortality due to asthma is associated with race and community socioeconomic status in high-risk urban communities; Chicago is one of the US cities with the highest asthma mortality and the greatest disparities. The proportion of residents with diagnosed asthma in Chicago neighborhoods is related to social factors, as well as to traditional environmental triggers. Asthma symptom management in Chicago remains suboptimal despite major efforts to increase asthma awareness and education over the last decade.
Background
The rate of diagnosed asthma in elementary school-aged children is considerable. Recent national statistics indicate an overall asthma prevalence of 12.2% for people younger than 18 years. Previous research found that Puerto Rican American children had a lifetime prevalence of asthma of 26%, followed by African-American children (16%), non-Hispanic whites (13%), and Mexican-Americans (10%). One study estimated that 50% of all people with asthma between ages 14 and 40 remain undiagnosed.
We know that the costs to family and society for diagnosed pediatric asthma morbidity are substantial, including lost productivity at work for the parent and at school for the child, Estimates of lost productivity and other indirect costs ranged from $1.9 billion to $6.2 billion per year. We can only speculate about the extent to which these costs would be magnified if morbidity from possible undiagnosed asthma were included.
In the elementary school years, financial and institutional barriers to health care with limited access to high-quality, culturally and linguistically competent providers are key health system deterrents to diagnosis and treatment for asthma. Previous studies have shown that lack of health insurance is associated with a higher likelihood of respiratory symptoms without an asthma diagnosis.
Findings from a recent large study of Chicago schools highlight the importance of increasing cultural and linguistic competency among health-care providers and their staff in order to identify, evaluate, and appropriately treat respiratory symptoms in diverse populations. Efforts to increase awareness in the community about common signs and symptoms of asthma are likely necessary to improve asthma detection.
The Social Entrepreneurship Competition
Over many years, a number of initiatives in the Chicago area have failed to significantly affect the detection and treatment of children with asthma. Your task is to develop a set of interventions and a plan by which an existing or a new organization can provide the recommended interventions. Proposals should include a statement of objectives, an evaluation of previous efforts, anticipated impacts on stakeholders, suggestions for organizational structure, detailed resource requirements (eg, money, personnel, and tangible assets), budgets, sources of sustainable funding, and measurable criteria for monitoring success. Competing teams will have access to information and medical experts in asthma treatment, as well as public health experts and leaders in the asthma field. Each team will be assigned an expert advisor (see case guidelines page for details).