Asthma, a reality of daily life for more than six million American children, is even more prevalent among children living in inner cities. Now, a public-private medical partnership called HEAL is seeking ways to reduce the nation's childhood asthma challenge.
Even before Hurricane Katrina swept through Louisiana and Mississippi in 2005, Rhonda Brown had spent many sleepless nights in hospital emergency rooms while her two asthmatic sons fought to breathe. In Katrina's wake, the complications grew even greater for Jermid, 14, and Jabeaux, 7. Both of them have had asthma since infancy, and they must take a variety of medications to control it.
"The flooding in New Orleans left buildings overrun with mold, a common asthma trigger," says Floyd J. Malveaux, M.D., Ph.D., a nationally recognized asthma expert. In addition, the devastation had dramatically reduced the city's hospitals and other
health care facilities.
In response, Dr. Malveaux joined with others to help form Head-off Environmental Asthma in Louisiana (HEAL), a collaborative research project to reach out to those with childhood asthma who were affected by Katrina. Conducted by the Tulane University Health Sciences Center and the New Orleans Department of Health, the project is also examining inherited differences in children's responses to mold and indoor allergens. HEAL is funded by the National Institute of Environmental Health Sciences (NIEHS), the National Center for Minority Health and Health Disparities (NCMHD), the Foundation for the National Institutes of Health (FNIH), and the Merck Childhood Asthma Network, Inc. (MCAN), where Dr. Floyd Malveaux is the Executive Director. NIEHS and NCMHD are part of the National Institutes of Health (NIH).
Jabeaux Brown is enrolled in HEAL. He receives allergy tests and the levels of indoor allergens in the Browns' apartment are tested as well. He and his family also meet regularly with an asthma counselor, trained to help families monitor and manage asthma.
"We're in a temporary apartment while we rebuild our home, and there's a lot of mold here," says Rhonda Brown. "It is one of the boys' asthma triggers, so I want to know more about it. If we can eliminate the triggers where we live, we won't have to go to the hospital so much."
For Dr. Malveaux, the HEAL project is a critically important area of research on childhood asthma diagnosis, treatment, and control. He would like to bring similar programs to relieve childhood asthma everywhere.
"Childhood asthma is a major public health problem," he says, "and a significant burden on children, families, and society. Low-income and medically underserved populations, especially ethnic minorities and children living in inner cities, suffer disproportionately from asthma."
He also notes that asthma is the leading cause of chronic illness among children, the third leading cause of childhood hospitalization, and the number one cause of school absenteeism due to chronic conditions. Nearly 15 million days of school are lost each year due to childhood asthma.
Dr. Malveaux is at the forefront of medical professionals who want to bring "evidence-based interventions" to strengthen clinical care. Simply put, evidence-based interventions are programs proven to work.
"Asthma is manageable when children and their families have access to quality health care services," he states. "There are programs that have already proven effective." These programs combine greater knowledge of asthma, management of care, environmental control, and lifestyle modification.