Improving Life, One Breath at a Time

1. Improving Life, One Breath at a Time 1-800-LUNG-USA www.lungusa.org

2. Our Mission Prevent lung disease and promote lung health in Mississippi. www.lungusa.org

3. What does the Lung Association do? Education Advocacy Research www.lungusa.org

4. Lung health focus areas: Asthma Clean Air Chronic Obstructive Pulmonary Disease (COPD) Tobacco Control www.lungusa.org

5. What is Asthma? • Asthma is a chronic inflammatory disease of the airways. • Produces recurring symptoms such as shortness of breath, tightness in the chest, wheezing and coughing. • Asthma cannot be cured, but can be controlled. www.lungusa.org

6. Burden of Asthma in Schools • Asthma is the #1 cause of school absenteeism among children accounting for more than 14 million total missed days of school. • 1 out of 10 children have asthma in the U.S. • Out of a classroom of 30 – 3 have asthma, and 2 have had an asthma attack within the last year. www.lungusa.org

7. Burden of Asthma in Mississippi • Based on the 2003 National Survey of Children’s Health (NSCH): • an estimated 96, 835 (12.8%) children less than 18 years of age have a history of asthma • 68,855 (9.1%) currently have asthma in Mississippi. Source: MS Asthma Surveillance Summary Report 2006

8. Childhood Asthma Prevalence

9. Burden of Childhood Asthma in Mississippi • During the 12 months preceding the 2003 NSCH, an estimated 46,497 (6.1%) Mississippi children had an episode of asthma or an asthma attack. • About 40% of all persons visiting a Jackson metro area hospital (Hinds/ Madison/ Rankin counties) between 1999-2003 due to asthma are under age 15; four out of five of these children are African-American. • Between 1999-2003, 11 Mississippi children died due to asthma. Source: MS Asthma Surveillance Summary Report 2006

10. Early Warning Signs of Asthma Flare • Dry cough • Feeling tired • Feeling restless • Trouble sleeping • Stuffy nose, runny nose • Watery eyes • Stomachache • Headache • Chest Pain or Tightness • Drop in peak flow meter scores Dr. Rubina Inamdar, UMC

11. Triggers/Irritants in the School: • tobacco smoke • hair spray, cleansers • powder, perfume • chalk dust, marker odors • potpourri, room deodorizers • paint fumes • air pollution • dust mites • cats, dogs, other pets • cockroaches • mold, mildew • pollen Dr. Rubina Inamdar, UMC

12. Other Triggers of Asthma: • Colds, flu, sinus problems • exercise • bursts of emotion • some medicines in sensitive individuals (aspirin, NSAIDs, sulfites) • anxiety Dr. Rubina Inamdar, UMC

13. B-agonists cause tremors, restlessness, racing of the heart, reduce attention span, and worsen hyperactivity Oral corticosteroids - increased appetite, mood swings, irritability, and worsen hyperactivity. Antihistamines - may cause drowsiness Asthma medications that may affect school performance

14. Anxious Stooped body posture Diaphoresis Respiration rate >20 Retractions Decreased peak flow Dyspnea Nasal Flaring Depressed Sternal Notch Nausea/Vomiting Fatigue Treatment of Asthma Exacerbations at School – What to look for www.lungusa.org

15. Review the student’s asthma action plan Have student sit upright and check peak flow Administer prescribed medication Inhaled or nebulized Reassure Student – keep calm Treatment of an Asthma Exacerbation at School www.lungusa.org

16. Has trouble breathing even after taking the short-acting β-agonist. Gets winded after speaking or playing quietly. Has a fever Has an infection or sore throat Peak flow is in the yellow or red zone after taking the short-acting β -agonist When the Child Should Stay Home with Asthma Dr. Rubina Inamdar, UMC

17. Coordinated School Health Program Implemented through Office of Healthy Schools Asthma included in School Health Index School Health Councils formed 2006 MS Dept of Education

18. Healthy School Environment Health Services in School Asthma Education Supportive policies Sound/effective communication NAEPP Asthma Goals for School Health

19. School Asthma Programs Environmental Protection Agency (Publications)

20. Coaches Care Basics: • Power Point Presentation • 30-45 minutes • Training developed by an Asthma/Allergy physician • Conducted by a healthcare provider (MD, RN, NP, RT, HE) & an ALA of MS employee • Handouts and asthma brochures given out • Evaluation • Coaches Care mugs & door prize • Coaches Care certificates mailed • FOOD provided! www.alams.org

21. 4 Legislators American Lung Association of MS Department of Health Department of Education Superintendent’s office Office of Healthy Schools Medicaid Representative BCBS Representative State Employees Health Insurance Representative MS School Nurses Association MS Chapter - Academy of Pediatrics 2007 Asthma Study Committee

22. Asthma Action plans required to be on file for every student with asthma in grades K-12 A nebulizer provided to every school Address barriers to compliance: Asthma Education Spacers and peak flow meters Coaches trained on asthma (education & preparedness) Asthma Emergency Policies adopted by school districts Inhaler law to be strengthened and enforced Asthma Study CommitteeProjected Outcomes

23. Asthma Management: • See physician regularly • Take meds as prescribed • Know signs & symptoms • Control/avoid triggers • Know what to do during an asthma attack • Ask questions to fully understand asthma • Have a support team • Use an asthma action plan 1-800-LUNG-USA www.lungusa.org

24. Statewide Asthma Plan To Promote Education, Prevention and Management of Asthma throughout the State of Mississippi. “Funding provided through a sub grant from the Mississippi Department of Health from federal funds provided by the Centers for Disease Control and Prevention to the State under Cooperative Agreement #U59/CCU423193-02, ‘Addressing Asthma from a Public Health Perspective’.”  www.lungusa.org

25. Statewide Asthma Plan • Describes the things that need to be done to address the problem of asthma in Mississippi. • Purpose: provide a systematic way for communities to deliver asthma programs and to eliminate duplication of efforts. • Utilize input from all regional coalitions to make it usable statewide.  • Asthma partners (coalition members, etc.) will implement specific portions of the state plan because of their own interest in asthma. www.lungusa.org

26. Statewide Asthma Plan Goals • Reduce Asthma Hospitalization rates among children and adults • Decrease Asthma disparities in all Public Health Districts • Reduce burden of asthma on Mississippians • Increase provider and patient education • Encourage the use of Asthma Action Plans • Enhance community health education www.lungusa.org

27. How do we achieve these goals in MS? • Programs • Science-based Interventions • Surveillance • Evaluation • State partnerships • Addressing disparities • Communications As related to Healthy People 2010 Goals, CDC

28. Statewide Asthma Plan – addressing disparities • Quality of care • Access to health care • Social determinants (neighborhood resources or exposures, individual resources, opportunity structure, etc…) • Socioeconomic Status • The condition or fact of being unequal, as in age, rank, or degree; difference: “narrow the economic disparities among regions and industries” (Courtenay Slater). • Unlikeness; incongruity www.cdc.gov

29. State Partnerships • MS Department of Health – state and local • Asthma Coalitions of Mississippi • MS Department of Education • MS Department of Environmental Quality • MS Alliance for School Health • The Partnership for a Healthy Mississippi • Hospitals, Physicians, Provider groups • Faith-based groups • Other coalitions • Other stakeholders (pharmaceutical companies, foundations, funding organizations, etc…)

30. www.lungusa.org

31. Regional Asthma Coalitions Nine coalitions in each public health district Leadership Team Regional meetings held every other month www.lungusa.org

32. WORKGROUPS • Advocacy/Policy • Community • Data and Surveillance • Environment • Healthcare • School Health www.lungusa.org

33. What are we doing in MS?

34. Asthma Camps for children in MS North Camp Tishomingo State Park May 28 – June 1 Central/South Camp Camp Wesley Pines July 16 – 20

35. Tobacco programs & services

36. Superkids Purpose: • To provide tobacco education to students grades K-6 • To teach the value of community service • To promote lung health and prevent lung disease • To encourage physical activity www.alams.org

37. Superkids Basics: Phase 1-Tobacco education presentation Phase 2-Students raise funds for the ALA Phase 3- Distribution of incentive prizes and SuperKids Field Day Income from the SuperKids program accounts for approximately one-third of the ALA’s budget. www.alams.org

38. Development Opportunities:

39. Asthma Awareness Events Hattiesburg September 29, 2007 Corinth October 27, 2007 McComb October 13, 2007 Flowood /Jackson November 12, 2007 Register: www.asthmawalk.org

40. F.L.A.R.E. for hospitals • Developed by the Asthma Coalition • One-page education tool for follow-up, education, compliance and management • Two different FLARE plans: • Inpatient • Emergency Department • Reviewed and approved by Asthma/Allergy doctor, Pediatric Allergy/Immunology doctor, Pulmonologist, RN’s, and Respiratory Therapists

41. How you can be involved: • Join the Asthma Coalition • Volunteer at camp or for an ALA school program • Commit to be a partner in the state plan • Letter of commitment to do an asthma activity • Tell us what you are already doing • Request patient education materials, resources, etc… • Utilize the F.L.A.R.E. plan in your Hospital • Join us for the Asthma Walk! • Host your own mini-asthma walk (with ALAM help!) • Inquire to serve on a school health council

42. Web Resources • American Lung Association – www.lungusa.org • American Lung Association of MS – www.alams.org • MS Department of Health, Asthma Program – www.msdh.state.ms.us • Centers for Disease Control and Prevention – www.cdc.gov/asthma • Environmental Protection Agency – www.epa.gov/asthma • MS Department of Environmental Quality – www.deq.state.ms.us • School Asthma Allergy – www.schoolasthmaallergy.com/ms

43. Jennifer Cofer, MPH, CHES Executive Director, ALA of MS601.206.5810 or 800.LUNG.USA jcofer@alams.org Laurie Walters, Asthma Program ManagerMS Department of Health601.576.7415 lwalters@msdh.state.ms.us Improving Life, One Breath at a Time 1-800-LUNG-USA www.lungusa.org

44. Improving Life, One Breath at a Time For 100 years, the American Lung Association has been the lead organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is “Improving life, one breath at a time”. For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or log on to www.lungusa.org.