Childhood Asthma Initiative

Children’s Health Fund’s Childhood Asthma Initiative (CAI), currently implemented in New York City and Washington, D.C., was established to increase access to health care and improve management of chronic asthma for thousands of medically underserved children and families.

The South Bronx has one of the highest rates of asthma prevalence in New York City and the country. Asthma is a leading cause of hospitalization among children in the South Bronx. As many as 40% of the children temporarily living in New York City homeless or domestic violence shelters have asthma. Washington, D.C. has the highest child poverty rate (29%) and the highest asthma rate in the nation, according to the American Lung Association.

Homeless and extremely poor families are often unable to access medical care because they reside in health professional shortage areas, and experience long waiting periods for appointments. Many of these families lack health insurance, are struggling to meet basic needs such as food and income security, and have uncertain housing status.

Children's Health Fund launched the Childhood Asthma Initiative in New York City 1997 to bring clinical care that is consistent with the most recent National Heart Lung and Blood Institute Guidelines for the Diagnosis and Management of Asthma to children in poor communities where access to medical care is limited. Our success has been well-documented:

• 75% of CAI patients had persistent asthma symptoms at the time of initial asthma assessment. At the follow up visit, the incidence was reduced to 59%
• Hospitalization decreased from 18% of asthma patients for the 12 months before initial assessment, to 3% of patients for the period prior to follow-up assessment
• Emergency room use declined from 53% of patients during the year prior to initial assessment to 20% of patients for the period prior to follow-up assessment.
• Long-term tracking shows that all of these gains are sustained over time. All are statistically significant.

Through the Childhood Asthma Initiative, children with asthma have access to the highest quality care. Clinical visits and medication, asthma severity assessment, and allergy skin testing are supplemented by in-depth health education, including access to Children’s Health Fund’s Family Asthma Guide. All of these efforts help children and their families actively manage asthma symptoms. In addition, psychosocial services are available for families of asthma patients, who often experience the anxiety and depression that accompanies chronic illness.