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Epidemiology of Asthma

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Epidemiology of Asthma:

Asthma is a chronic inflammatory disease of the airways which causes episodic wheezing, shortness of breath ,chest tightness, and coughing. Asthma effects people of all ages, backgrounds , religion and gender. According to one article no one risk factor is responsible for asthma morbidity; rather asthma risk factors include living in poverty, in the inner city being uninsured or Medicaid enrolled and being African American. (Kimberly P Toole, 2013) Asthma is a significant health problem in the United States and Massachusetts. Asthma is one of the most common chronic childhood illnesses in the United States where prevalence nearly tripled from 3.6% in 1980 to 9.1% in 2007. Asthma impacts both society and the individual causing millions of lost school days. (Woodin, Tin, Moy, Palella, & Brugge, 2010) Nationally the total cost of asthma in 2007 was 19.7 billion dollars, in Massachusetts the total charges for acute care hospital utilization for asthma was over 136 million dollars in 2006. (Zotter & huisingh, 2009). According to the CDC 1:11 children have asthma in the U.S., that amounts to seven million children in 2010 and the prevalence of asthma is increasing in the United States and in Massachusetts. Studies done by the CDC indicate that in children more boys than girls have asthma. The surveys also indicated that socioeconomic status plays apart in asthma prevalence. Families with an annual household income of 75,000 dollars or less are more likely to have asthma than families with higher incomes. Black children are two times more likely to have Asthma than white children. (CDC, 2009) Asthma is a serious health and economic concern in the United States and Massachusetts. It is both expensive and deadly . Asthma is a chronic condition that continues into adult hood and if it is not managed can become a burden in the children's lives. In Gloucester, Mass the prevalence of asthma is not as high as in other cities and towns, However
Both Massachusetts and the city of Gloucester have initiated objections to reduce asthma in the population.
The objectives in Healthy People 2010 for the city of Gloucester includes: 1. reducing the prevalence of asthma in the Gloucester population 2. reducing asthma related deaths amongst children and adolescents 3. reducing hospitalizations for asthma among children under 5 years of age. 4. Reduce hospitalizations among adolescents in Gloucester
(MassCHIP, 2010)
Ways to achieve the healthy people goals is by educating the public. As one research showed communication between nurses parents and children with asthma can reduce the need for health services. (Peter Callery RN & Linda Milnes RN, 2012)

Cost of asthma Nationally: * $56 billion each year * $1,036 per child/per year

Consequences of asthma: * 10.5 missed school days * decreased physical activity * 9 deaths per day * 479,300 hospitalizations * sleep disturbance

Rates of asthma Amongst income levels in Massachusetts (2005-2007)TABLE ONE

(masschip, 2011)

Rates of asthma amongst children/race/ethnicity in Mass. (2005-2007)Table 2 (masschip, 2011)

Asthma Hospitalizations in Gloucester By Age (2005-2010) Table 3

Asthma trends/prevalence in the United States From 1980-2007 (Table 4)

(Woodin, Tin, Moy, Palella, & Brugge, 2010)

WEB OF CAUSALITY

Prevention of asthma in the adolescence population of Gloucester, Ma and the Added Value of Public Health Nurse.

ASTHMA

Added Value of the public health nurse in reducing asthma in Gloucester:

The public health nurse can educate the public in the ways that asthma affects the whole community and ways to reduce the prevalence of asthma in the Gloucester community. She can advocate in the political realm for more funding to educate the public and she can get the community involved in addressing some of the modifiable risk factors associated with the asthma prevalence.

Primary prevention Strategy:

* PHN can educate the community on how to reduce clutter in home and classrooms * PHN can educate the community on how to reduce dust mites and pests in the home * PHN can educate the community on how to prevent obesity in children in order to reduce asthma * PHN can educate the community on how to assess asthma triggers and ways to reduce them * PHN can educate minority populations of their increase risk of having asthma related complications * PHN can educate adolescents on not smoking to prevent asthma

Secondary prevention strategy:

* PHN/school nurse can teach families and students how to use their asthma action plan and adhere to medication and treatment

* PHN can provide information to low socioeconomic families about available resources in their community to help reduce asthma hospitalizations.

* PHN can provide clinics and teaching on how to properly use an inhaler to families already diagnosed with asthma.

Tertiary Prevention Strategy:

* encourage adolescents to quit smoking

* PHN will refer patients to specialists and pulmonologists as needed for treatment of recurrent asthma exacerbations.

* PHN will encourage patients to follow up with appointments and adhere to medication regime.

* PHN will provide simple health pamphlets to increase health literacy on asthma to low educated community members.

REFERENCES

CDC. (2009). CDC.gov. Retrieved july 22, 2013, from CDC national asthma control program: www.cdc.gov/asthma/ http://www.cdc.gov/asthma/asthmadata.htm. (2013, july). Retrieved july 22, 2013, from http://www.cdc.gov/asthma/asthmadata.htm: http://www.cdc.gov/asthma/asthmadata.htm http://www.mass.gov/eohhs/docs/dph/com-health/asthma/state-plan.pdf. http://www.mass.gov/eohhs/docs/dph/com-health/asthma/state-plan.pdf.
Kimberly P Toole, D. (2013). Helping children gain asthma control:Bundled school-based interventions. Pediatric Nursing , 115-124.
MassCHIP. (2010). healthy people of gloucester 2010. masschip. (2011, May). mass.gov. Retrieved July 22, 2013, from mass.gov/masschip: http://www.mass.gov/eohhs/researcher/community-health/masschip/
MD, G. B., PhD, P. M., PhD, C. B., MD, A. B., MD, A. V., MD, L. V., et al. (2012). Risk factors for pediatric intensive care admission in children with acute asthma. Respiratory Care , 1391-1397.
Peter Callery RN, M., & Linda Milnes RN, P. (2012). Communication between nurses,children and their parents in asthma review consultations. Journal of Clinical Nursing , 1641-1650.
Woodin, M., Tin, A., Moy, S., Palella, M., & Brugge, D. (2010). Lessons for primary prevention of Asthma:Foreign-born children have less association of SES and pests with asthma diagnosis. Springer , 463-469.
Zotter, J., & huisingh, C. (2009). Strategic Plan for Asthma and control Program. 1-3.

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