The National Asthma Program

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The National Asthma Program

• Gregory O. Crawford, MSPH
• Deputy Branch Chief
• Daniel J. Burrows, M.S.
• Asthma Program Team Lead
• Air Pollution and Respiratory Health Branch
• National Center for Environmental Health
• 770-488-3700

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CDC Office of the Director
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APRHB Teams

• Air Pollution Team
• Evaluation and Community Interventions Team
• Asthma Epidemiology and Research Team
• Asthma Surveillance Team
• Asthma Program Team

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The Asthma Program Team

• Assists states in developing the capacity to
  implement a public health asthma control program

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Asthma Program Mission

• Reduce the burden of asthma through effective
  control of the disease
• Reduce deaths, hospitalizations, ED visits,
  school or work days missed, activity limitations

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By

• Improving the timeliness and geographic detail of
  asthma surveillance data
• Developing and supporting the community/population
  approach to reducing the burden of asthma
• Developing the capacity of State Health
  Departments to address asthma

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and by

• Supporting partners involved in reaching
  individuals and communities at risk
• Contributing to the knowledge base through
  epidemiology and research

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• Burden of Asthma in the United States

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Asthma PrevalenceUnited States, 1980-2006
Lifetime
Current
12-Month
Attack
Source National Health Interview Survey
National Center for Health Statistics
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Asthma Mortality Rates and Number of Deaths
United States, 1979-2005
ICD-9
ICD-10
Source Underlying Cause of Death National
Center for Health Statistics Age-adjusted to
2000 U.S. population
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Asthma Hospital Discharges andRates United
States 1980 - 2005
Source National Hospital Discharge
Survey National Center for Health Statistics
First-listed diagnosis Age-adjusted to 2000
U.S. population
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Asthma Emergency Department Visits and Rates
United States, 1992 - 2004
Source National Hospital Ambulatory Care
Survey National Center for Health Statistics
First-listed diagnosis Age-adjusted to 2000
U.S. population
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• National Asthma Control Program Activities

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Supporting Non-Grantee States

• 1998 - Established State Asthma contacts
• Project Officer assigned to each state
• Provide programmatic technical assistance as
  requested
• Provide information mailings, email and asthma
  listserv
• Provide a conduit for states and grantees to
  share information
• Epi support is provided by branch staff

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Funded Health Departments

• 1998 - Surveillance Cooperative Agreements
  established with limited number of states to help
  define specific approaches to accessing asthma
  data
• 1999 - established Addressing Asthma from a
  Public Health Perspective cooperative agreements
  for capacity building/planning with four states

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Funded Health Departments

• Planning
• Develop asthma surveillance capacity
• Develop a statewide asthma partnership
• Develop a State Asthma Plan with asthma partners

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Funded Health Departments

• Implementation
• Expand asthma surveillance beyond mortality and
  prevalence
• Expand state asthma partnerships
• Implement interventions from the State Asthma
  Plan
• Evaluate program

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Current Funded Health Departments

• 2008 - 33 states, DC and Puerto Rico funded to
  implement their asthma plans
• 13.5 mil.

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State and Territorial Health Departments
Part A Enhanced/Limited Implementation Part
B/Expanded Implementation
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Current Funded Health Departments

• Asthma Program Location in Funded Health
  Departments
• Chronic Disease
• Environmental Health
• Other

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Current Funded Health Departments

• Cooperative Agreement Components
• Surveillance
• State partnerships
• Science-based interventions

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APRHBs Role in Supporting States

• Project Officer and Epidemiologist assigned to
  each grantee state
• Provide programmatic technical assistance
• Monitor and assist with grant funding
• Provide a conduit for grantees to share
  information
• Conduct site visits listen and learn as well as
  provide guidance

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Why We Do Asthma Surveillance

• Establish a baseline level against which to
  measure trends or change
• Focus effort in areas of greatest need
• Contribute to the evaluation of asthma control
  efforts

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What is needed for asthma surveillance

• Prevalence estimates to define areas with
  proportionately greater burden
• Asthma control indicators to define areas with
  greater need
• Asthma management indicators to define areas in
  need of specific interventions

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State Data Sets

• Mortality Vital Statistics
• BRFSS prevalence, measures of control,
  management indicators
• Hospitalization (most)
• ED visits (some)
• Other (Medicaid, YTS, YRBS)

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State Asthma Partnerships

• Why develop state partnerships?
• Complexity of asthma diagnosis, management, and
  surveillance
• Diverse and inclusive input for the development
  of a state asthma plan
• Crucial for implementation of the plan
• (CHEST - A Developmental Manual for Asthma
  Coalitions)

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State Asthma Partnerships

• Benefits of asthma partnerships
• Conservation of resources
• Faster implementation of programs
• Risk reduction
• Access to specialized sources
• Increased flexibility
• (CHEST - A Developmental Manual for Asthma
  Coalitions)

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State Plans and Interventions

• State asthma plans are developed by the HDs with
  state asthma partners
• The plans are implemented by the HD and state
  asthma partners
• Environmental interventions, interventions in
  schools, health care provider trainings, case
  management, and education for individuals,
  families and others.

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Examples of Interventions

• Improving quality of asthma care
• Improving asthma management in school settings
• Policies on emissions controls

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• CDC/APRHB Partnerships

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National Asthma Education Program (NGOs)

• American Lung Association
• Allergy and Asthma Network Mothers of Asthmatics
• Asthma and Allergy Foundation of America

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Other APRHB Partnerships

• American Lung Association
• Asthma and Allergy Foundation
• Asthma Allergy Network/Mothers of Asthmatics
• The Environmental Protection Agency
• Controlling Asthma in American Cities Projects
• CDC National Center for Chronic Disease
• Division of Adolescent and School Health (DASH)
• CDC NIOSH
• Environmental Public Health Tracking
• CDC Steps to a Healthier US
• National Heart, Lung and Blood Institute

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Other APRHB Partnerships

• National Asthma Education and Prevention Program
  Coordinating Committee (NAEPP)
• Centers for Medicare and Medicaid Services (CMS)
• Health Resources Services Administration (HRSA)
  
• Housing and Urban Development (HUD)
• Allies Against Asthma
• Other CDC Centers, Institutes, and Offices
• Other state, community, non-governmental,
  non-profit organizations

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FOA EH09-901Addressing Asthma from a
Public Health Perspective
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FOA EH09-901

• New Competitive Announcement
• Non-Research Projects
• 5-Year Project Period
• Budget begins September 1, 2009

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FOA 09-901 Eligible Applicants

• State Territorial Departments of Public Health
  or their Bona Fide Agents
• Federally or state- recognized American Indian /
  Alaska Native tribal governments
• Bona Fide Agents

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FOA 09-901 Eligibility

• Applicants must have
• State Asthma Plan
• Asthma Surveillance Report
• Established Partnerships

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FOA 09-901 Components

• Core Component
• Expanded Components (optional)

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FOA 09-901 Core

• Surveillance
• Partnerships
• Asthma Plan
• Focus interventions on disparate population
• Program Evaluation
• Sustainability

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FOA 09-901 Expanded

• Surveillance
• Disparities
• Interventions

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FOA 09-901

• PGO will notify grantees soon
• Funding begins on September 1, 2009

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Contact

• Gregory O. Crawford, MSPH
• Deputy Branch Chief
• Daniel J. Burrows, M.S.
• Asthma Program Team
• Air Pollution and Respiratory Health Branch
• National Center for Environmental Health
• 770-488-3700