According to the Centers for Disease Control, asthma affects some 20 million Americans and is the most common chronic disease of childhood, affecting an estimated 6 million children. Asthma prevalence rates have been increasing for all age groups; children, however, continue to have the highest rates: childhood asthma prevalence in the U.S. has nearly doubled from 3.6% in 1980 to 7.1% in 2002-2004.
Particularly in communities with large percentages of Latino/Hispanic and African American residents, the prevalence of asthma has been shown to be inordinately high. Although in the general population of schoolchildren asthma prevalence ranges from 6-8%, in asthma hotspots-- low-income, minority neighborhoods-- prevalence two to three times this number has been reported.
In the past decade there have been significant advances in asthma management that allow most people with asthma to live active and healthy lives. Yet, many children continue to suffer with asthma due to a complex set of factors. Despite the use of practice guidelines, large variations in recommendations and practices exist among many health care providers and in treatment adherence by patients and their families. Furthermore, children living in poverty often lack access to quality health services and are exposed to high levels of environmental allergens and irritants. Schools and childcare providers may limit access to medications, and families may lack the resources to purchase medications and necessary equipment for effective self-monitoring of symptoms. Families may also lack the social support to manage the disease on a long-term basis.
Health care providers, caregivers, patients and their families need to work together to manage the disease through quality medical care, self-management of symptoms, and a reduction in exposure to allergens such as house dust mites, cockroaches, animal dander, tobacco smoke, and mold. Coalitions can be a key driver of efforts to develop, coordinate, and integrate these efforts.
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