Targeting Improvements in Asthma Morbidity in Chicago: Consortia

CAC

The CAC was formed in January 1996 as a collaborative effort of the ALAMC and the American College of Chest Physicians. The vision for the CAC was to bring individuals and organizations together as a community health network in an effort to work collectively, interdependently, and in synergy to combat the Chicago asthma epidemic. Cofounders Sydney Parker, PhD, and the late Alan Shaw, ALAMC Deputy Executive Director, envisioned an integrated network of regional leaders and organizations working together to improve the status of asthmatics in Chicago. The Otho S.A. Sprague Memorial Institute provided the major funding for the CAC; the CAC received supplemental support from the CHEST Foundation of the American College of Chest Physicians.

The CAC provides an opportunity for health professionals, health-care organizations, community organizations, and families affected by asthma to share information and resources. It serves as a common platform for these groups to organize policy and advocacy efforts. The success of the CAC is due largely to the efforts of its school, data, education, and community task forces.

The CAC has held > 30 quarterly meetings that typically feature clinical reviews, updates on asthma advocacy and policy efforts, and informal networking. The CAC Web site is an important resource for the community, providing a resource directory, list of community clinics, and a community calendar for all asthma activities in the state. The CAC list server promotes communication, education, information, and resource sharing. The CAC facilitates projects with many local, city, and state organizations.

The CAC is the vanguard organization for all local/regional asthma consortia in America. The CAC has provided leadership at annual American College of Chest Physicians meetings to bring consortia together for information and sharing experiences. In 1999, the Illinois Department of Public Health was one of four state health departments to receive CDC funding for replication of the consortium model across Illinois. With the support of this grant, the Illinois Asthma Partnership was established and several grants were provided to local communities through Illinois to address asthma education and awareness. The CAC has provided leadership locally and nationally for groups interested in forming col-laboratives. There are now 15 consortia in Illinois alone.

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Chest Physicians

Community Initiatives

There have been many asthma programs targeted to underserved communities in Chicago. More than 50 community asthma programs have been conducted in Chicago, mainly in high-prevalence or high-morbidity areas as characterized by “asthma maps”.

Trained community health workers are widely used in city asthma programs and provide a grassroots connection within their communities. The programs were funded by grants from the Environmental Protection Agency, the CHA, the Department of Human Services, the National Institute for Environmental Health Sciences, the CDC, the National Asthma Education and Prevention Program, and the National Institutes of Health. Community health worker-based models for addressing asthma needs in urban communities with high asthma prevalence are believed to be an important model for sustainable community empowerment for asthma.

The Otho S.A. Sprague Memorial Institute-funded Head Start community asthma program deployed mothers of children with asthma to teach other parents about asthma management, leading to improved asthma control and fewer ED visits and hospitalizations for these children. This approach has since been used as a model for many other community asthma programs in the city. Lung

In the decade following the identification of Chicago as an urban center with extraordinary asthma morbidity, the Chicago community has responded with a broad mix of activities, from quality improvement in clinical sites to public policy to community action. This action agenda would not have been possible without support from philanthropy (The Otho S.A. Sprague Memorial Institute), the CDC, the Robert Wood Johnson, the CHEST Foundation, and the National Institutes of Health. The CAC, ALAMC, and the American College of Chest Physicians have played major leadership roles. Perhaps most encouraging has been the grassroots response of community organizations that have forged effective partnerships that keep asthma on the front burner of politicians and health officials. The dedication and voluntary efforts of dozens, if not hundreds, of Chicago citizens from persons with asthma to health-care providers, and community leaders has been an inspiration. While progress has been made to address the asthma epidemic, this progress required major effort by a single philanthropic organization, constant guidance by the ALAMC and CAC, and consistent and persistent asthma champions. For distinct areas as large and diverse as Chicago, it is the focused efforts of clinical, organizational, community, and public health leadership that bring to the table the many parties needed to address asthma issues in an effective collaborative fashion. As the capacity for electronic means of asthma surveillance improves, data need to be widely shared and used to drive asthma care improvement if asthma health outcomes are to improve. It has been through such efforts that Chicago is beginning to successfully change its position as asthma ground zero, to that of an “asthma safe zone.”

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