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

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

Aim of CDC asthma program 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) Not sure how to end, this could go at the beginning, alternatively could summarize HP2010 goals very briefly here

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

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

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

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

From Research To Practice Evaluation Translation This simple diagram demonstrates the steps that emanate from intervention research. First comes translation which I will describe in detail in a few minutes using NCICSA as an example. Once translated and made widely available, the intervention can be implemented, and, of course, all interventions should have an evaluation which feeds information back into the intervention activity and also helps define additional research needs. Let me emphasize, the program evaluation is not a repetition of the research. We already know that the research model is effective if implemented appropriately. Implementation

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

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 Looks a little bit to much like alphabet soup. This slide should take a while to go through and should concentrate on brief number of specific projects

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

www.cdc.gov/asthma/

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

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 Case definition Age groupings Data suppression

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

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