Update on CDC efforts in asthma control

1. Update on CDC efforts in asthma control Stephen C. Redd, M.D.Chief, Air Pollution and Respiratory Health Branch scr1@cdc.gov www.cdc.gov/asthma

2. Asthma issues • Rising prevalence • Rising measures of burden (stabilizing?) • Disparity in outcomes • 4 year old CDC program • HP2010 goals

3. Reduce the burden of asthma through better application of current knowledge of medical and environmental management Reduce death rate, hospitalization rate, ED visit rate, missed school and work days, activity limitation Improve adherence to NAEPP guidelines Improve tracking capability (www.healthypeople.gov) Aim of CDC asthma program

4. Who works on asthma at CDC • National Center for Environmental Health • NCCDPHP / Division of Adolescent and School Health • National Institute for Occupational Safety and Health • National Center for Health Statistics • Agency for Toxic Substances and Disease Registry

5. CDC’s asthma program • Surveillance • Implement scientifically proven interventions • Partnership / Training

6. Components of asthma surveillance system • Assist states in evaluating existing data • Mortality data / Hospitalization data • Develop and implement telephone surveys • Behavioral Risk Factor Surveillance System • National Asthma Survey (AL, CA, IL, NY, TX) • Develop new tools for tracking • Surveillance for incident cases • ED department surveillance

7. Identify and implement science-based asthma interventions • Identify • Translate into programs • Fund • Inner City Asthma Intervention (based on NIAID funded research) • Open Airways • Asthma Care Training

8. From Research To Practice Research Evaluation Translation Implementation

9. Controlling Asthma in American Cities Project • 7 city-based collaborative groups funded to plan a broad-based, multi-sector asthma intervention • Develop collaborative group / Define interventions / Determine evaluation • Entering 2nd year of planning period • Planning 5 yr intervention beginning October 2003

10. Work through partnership / Training • Federal partners: Federal Liaison Working Group on Asthma • State and local public health agencies • Cooperative agreements to 29 states and DC for planning and surveillance • Training—National Asthma Training Curriculum • Providers and purchasers of health care • NAEPP project on essential elements of asthma care • Non-profit and professional organizations • ALA, AAFA, AAN/MA, AAAAI, ATS

11. For information on CDC State Asthma Programs: • Go to: www.cdc.gov/asthma • Select “State Asthma Contacts and Programs” • Click on any state to get contact information for partnership, surveillance and intervention grant activities

12. www.cdc.gov/asthma/

13. 2001 CDC funded State Asthma Programs, 2002 1999 2000 2002 Hawaii

14. CDC approach to support state health departments • Hired of epidemiologist in Program Section • Assigned an epidemiologist to each grantee • Standard approach to surveillance • Handbook for epi support • National Asthma Training Curriculum • Standards proposed • Advice on data sources

15. Program Elements Guidebook for state health department asthma programs • Intended for grant applicants and newly funded programs • Identifies elements of successful programs • Examples of overcoming barriers to successful implementation

16. Future priorities for CDC asthma program • Increase support for state asthma programs • Implement National Asthma Survey • Implement tracking for incident cases of asthma • Implement Controlling Asthma in American Cities Project