While asthma affects people of all ages, races, genders and segments of society, the burden is not equally shared across racial and ethnic groups. It is most often a disease of the young and of the poor. In 2018, 24.8 million Americans reported a diagnosis of asthma. Of those, 19.2 million were adults and 5.5 million were children. Nearly half of children (52.7%) and adults with asthma living below the poverty level reported an asthma attack in the past year1, which is an indication of poor asthma control. Children and people living below the poverty level are among the groups most likely to have asthma, and to suffer from severe asthma attacks, hospitalization, and even death. Asthma morbidity and mortality is disproportionably burdensome for African Americans and Hispanics, who are least likely to have access to health education and adequate healthcare.
Using Proven-Effective Strategies
The American Lung Association’s project, Promoting Asthma Friendly Environments through Partnerships and Collaborations, will use proven effective strategies outlined in the CDC EXHALE technical package to improve asthma control in populations. By engaging a network of asthma control programs, healthcare professionals, public health and professional health organizations, local, state and federal governments, and non-governmental organizations, the Lung Association will increase knowledge and adoption of strategies that improve asthma morbidity and mortality in communities with the highest burden of asthma.
What Is EXHALE?
The CDC’s EXHALE technical package represents a group of strategies, which, based upon the best available evidence, can improve asthma control and reduce healthcare costs. It is intended as a resource to inform decision-making in communities, organizations, and states. Learn more about each strategy and approach in the chart below.
Expand the panels below to learn more about how the Lung Association is implementing EXHALE strategies in our Promoting Asthma Friendly Environments through Partnerships and Collaborations project.
American Lung Association provides training on asthma self-management education (AS-ME) by preparing a workforce of healthcare professionals to educate adults, children, and families in asthma. The Lung Association provides professional development education courses, such as Asthma Basics and the Asthma Educator Institute. Also, the Lung Association prepares school nurses, school personnel and community health educators to facilitate asthma programs for elementary-aged children, adolescents, and adults using American Lung Association evidenced-based programs that include Open Airways For Schools®, Kickin’ Asthma, and Breathe Well, Live Well®.
The American Lung Association is committed to helping educate , intervene, and prevent the use of tobacco and nicotine by the next generation. The Lung Association is the leading organization working to prevent youth tobacco use, eliminate exposure to secondhand smoke and help all tobacco users end their addition through quitting. Our work in these areas is accomplished by:
- Preparing a workforce of healthcare professionals to facilitate evidenced-based programs (Freedom From Smoking & Not-on Tobacco Facilitator Trainings)
- Providing evidence-based smoking cessation programs for teens who want to quit tobacco.
- Supporting and expanding the number of tobacco/nicotine free communities
- Reducing tobacco products through public policy
The American Lung Association focuses on increasing the coverage of home visits for trigger reduction and asthma self-management education (AS-ME) by promoting evidenced-based programs and strategies.
Achieving widespread guidelines-based medical care management can improve health outcomes and quality of life for people living with asthma. It can improve medicine adherence, reduce asthma-related hospitalizations and emergency department visits, reduce healthcare costs from fewer hospitalizations and emergency department visits, as well as reduce the number missed work and school days due to asthma symptoms. At the Lung Association we work towards the widespread adoption of guidelines-based care through:
- Strengthening systems that support guidelines-based medical care using Clinical Quality Improvement initiatives
- Preparing a workforce of healthcare professionals using the Asthma Educator Institute and Spirometry Training: Implementation and Interpretation of Spirometry in the Primary Care Practice
- Educating clinicians and educators on the NHLBI Asthma Clinical Guidelines 2020 Focused Update
- Educating decision makers about Medicaid coverage of asthma guidelines-based care using the American Lung Association’s Asthma Care Coverage project
Successful promotion and implementation of coordinated care for people living with asthma can help improve asthma control and reduce healthcare costs. At the Lung Association we promote expanding coordinated care for people living with asthma through our work on:
- Clinical Quality Improvement initiatives to strengthen health systems
- Partnerships with health systems (e.g., Children’s Hospitals, Federally Qualified Health Centers, School-Based Health Centers)
- Individualized or customized approaches to meet the needs of the partner or the community
People spend most of their times indoors and much of this time is spent at home. Avoiding and removing asthma triggers from indoor, outdoor, and occupational spaces is a key step to preventing symptoms. By removing asthma triggers air quality can be improved, while reducing symptoms in children and adults. Additionally, this step has been proven to decrease hospitalizations, emergency department visits, and the use of rescue medicine. At the Lung Association we work to help establish and expend environmental policies and best practices to reduce asthma triggers through:
- Educating and helping communities establish smokefree policies
- Collaborating with schools to implement a comprehensive asthma plan using the Asthma-Friendly Schools Initiative and end the epidemic to e-cigarettes with Vape Free Schools Initiative, and
- Educating employers to improve exposure to asthma triggers in the workplace using resources such as – “Create an Asthma-Friendly Work Environment”; infographic: “How Lung Friendly is Your Workplace?”
About the Project
The American Lung Association builds partnerships with State Asthma Programs (including those who are CDC-funded), state and local asthma coalitions, and community stakeholders to implement effective interventions. In September of 2020, the Lung Association received funding from the CDC to Promote Asthma Friendly Environments through Partnerships (Asthma Friendly Environments Project) for a five-year funding period.
The purpose of the Asthma Friendly Environments project is to support an informed network of strategic community partners to improve asthma among high-burden populations through coordinated dissemination and evaluation of the CDC EXHALE technical package across the United States.
The overall goals for the Asthma Friendly Environments project are to:
- increase the implementation of EXHALE by engaging strategic community partners to disseminate messages and effective interventions,
- increase the number of people that live, work, or go to school in asthma friendly environments by providing training, technical assistance, and resources; and
- advance the CCARE goal to prevent 500,000 hospitalization and emergency department visits among children with asthma.
The project focuses on reaching specific, high-burden populations which include adults and children with asthma through stakeholders, such as healthcare professionals and local organizations, that serve them. These stakeholders include but are not limited to:
- Organizations with access to high-burden populations (e.g. - Health Systems, Federally Qualified Health Centers, Community Clinics, School-based Health Centers, Rural Health Practitioners)
- People with asthma and their families
- Asthma care providers and healthcare professionals (Primary Care Physicians, Pediatricians, Allergists, Pulmonologists, Physician Assistants, Nurses, Nurse Practitioners, Respiratory Therapists, Pharmacists, Certified Asthma Educators, Health Educators, and Community Health Workers)
- Policy and Decision Makers
Read more about how to use each EXHALE strategy, individually or in combination, to help people with asthma achieve better health outcomes by downloading the CDC’s EXHALE Guides. The guides are available for:
- Healthcare Professionals
- Healthcare system executive leaders
- Managed care leaders and staff
- Medicaid and Children’s Health Insurance Program leaders
- People with asthma, their families, and their caregivers
- Public health professionals
Centers for Disease Control and Prevention. Health Outcomes. https://www.cdc.gov/asthma/data-visualizations/health-outcomes.htm. Accessed March 31, 2020.
Page last updated: April 2, 2021