Reducing Asthma Disparities

In August 2010, the Asthma Disparities Working Group presented a draft framework for coordinated federal action to reduce asthma disparities to the Task Force on Environmental Health Risks and Safety Risks to Children that became the foundation for this workshop. The framework presented recommended actions, milestones, a timeline and metrics in three function areas: research, policy and public health interventions. Two webinars were conducted for the Asthma Disparities Working Group: 1) an overview of national asthma surveillance systems and data as it relates to asthma disparities, and 2) a review of key policy reports and an in-depth discussion of the George Washington University report Changing p02licy: The Elements for Improving Childhood Asthma Outcomes. To give participants a mutual knowledge base, all of this information was sent prior to the workshop. In addition, an inventory of key federal activities to reduce asthma disparities was compiled and distributed.

The workshop provided an opportunity for individuals involved in key federal activities that target populations most affected by asthma disparities to share information, accomplishments, challenges, and lessons learned on their projects. In interactive exercises, small and large groups of participants generated specific ideas and priorities for coordinated federal action in the areas of research, policy and public health interventions.

The workshop opened with inspirational remarks from the Task Force Steering Committee co-leads Nadine Gracia, M.D. and Peter Grevatt, Ph.D., whose messages touched on the critical importance of accelerating action creatively and collaboratively, especially in this challenging fiscal climate. They also mentioned the two other working groups of the Task Force, Healthy Settings and Chemical Exposure and Safety, each of which may contribute recommendations that can align with the asthma disparities action plan.

Kevin Weiss, M.D. and Noreen Clark, Ph.D. delivered two motivating keynote addresses that provided an excellent framework for the workshop discussions; for example, Dr. Weiss emphasized the need to identify a sharp focus for future action and to look for game changers that may serve as levers to call attention to and accelerate action on reducing asthma disparities Dr. Clark highlighted the importance of designing interventions so that, while providing benefits to all patients who have asthma, they would give an extra boost of benefit to those most in need in order to close the disparities gap.

The workshop had a series of interactive exercises designed to create a full list of ideas for Federal action and then generate top priorities and specific activities from that list. The workshop’s first exercise featured a series of dynamic small group exchanges to quickly learn about each other’s projects. To catalyze ideas for potential coordinated Federal activity in the areas of policy, research and public health, there were three discussion groups that participants could join: built environment, health care and community capacity-building. Participants then grouped themselves according to their area of specialty -- policy, research or public health intervention. In these groups, they discussed each activity idea and how it might be addressed through coordinating federal agency work and made suggestions for prioritizing among the ideas. In addition, these groups suggested possible means for measuring progress on each action.

Participants were enthusiastic about the workshop and expressed strong interest in continuing cross-agency conversations on this issue. In addition, the group emphasized that programs on Asthma Disparities might expand their opportunities by coordinating wherever possible with programs on disparities in other chronic conditions.

To this end, the Working Group agrees that a formal process for ensuring regular cross-agency engagement is essential to the success of the Federal Action Plan. Ideas for implementing this include webinars and a website to serve a clearinghouse function in order to keep the coordination, collaboration, and information exchanges an ongoing outcome of the workshop.

Already the Working Group is engaged in the next steps of synthesizing ideas and priorities generated at the workshop with the draft framework prepared before the meeting. An updated draft framework will then be distributed to Federal workshop participants for comment and endorsement.

Working Group Members

Co-Chairs

• James Kiley, Ph.D., M.S., National Heart, Lung, and Blood Institute
• David Rowson, M.S., U.S. Environmental Protection Agency
• Peter J. Ashley, Dr.PH., U.S. Dept of Housing and Urban Development
• Virginia Taggart, M.P.H., National Heart, Lung, and Blood Institute
• Alisa Smith, Ph.D., U.S. Environmental Protection Agency

Participants

• Terry Adirim, M.D., M.P.H., Health Resources and Services Administration
• Lara Akinbami, M.D., Centers for Disease Control and Prevention
• Matthew Ammon, M.S., U.S. Dept of Housing and Urban Development
• M. Beth Benedict, Dr.P.H., J.D., Centers for Medicare & Medicaid Services
• John Bolecek, M.U.E.P., Department of Transportation
• Herb Bolton, Ph.D., National Institute of Food and Agriculture
• Crystal Brown, J.D., U.S. Department of Justice
• Tyra Bryant-Stephens, M.D., The Children’s Hospital of Philadelphia
• Rebekah Buckley, M.P.H., C.R.T., A.E.-C., Centers for Disease Control and Prevention
• Rita Carreón, America's Health Insurance Plans
• Stacey Chacker, Health Resources in Action, Inc.
• Noreen M. Clark, Ph.D., University of Michigan
• Charlotte Collins, J.D., Asthma and Allergy Foundation of America
• Jean Cox-Ganser, Ph.D., National Institute for Occupational Safety and Health
• Sally Darney, Ph.D., U.S. Environmental Protection Agency
• David Diaz-Sanchez, Ph.D., U.S. Environmental Protection Agency
• Greg Diette, M.D., M.H.S., Johns Hopkins University
• T.J. Dunlap, Merck Childhood Asthma Network, Inc
• Paul Garbe, D.V.M., M.P.H., National Center for Environmental Health
• Amy Garcia, R.N., M.S.N., National Association of School Nurses
• Peter Gergen, M.D., M.P.H., National Institute of Allergy and Infectious Diseases
• Mark Glaze, Federal Highway Administration
• J. Nadine Gracia, MD, MSCE, Office of the Assistant Secretary for Health
• Leslie Grammer, M.D., Northwestern University
• David Greenberg, M.B.A., Centers for Medicare and Medicaid Services
• Peter Grevatt, Ph.D., U.S. Environmental Protection Agency
• Judy Harvey, J.D., U.S. Department of Justice
• Seiji Hayashi, M.D., M.P.H., Health Resources and Services Administration
• Elizabeth Herman, M.D., M.P.H., Centers for Disease Control and Prevention
• Michelle Hindi-Alexander, Ph.D., National Institute of Child Health and Human Development
• Polly Hoppin, Sc.D., University of Massachusetts, Lowell
• Karen Huss, Ph.D., R.N., A.P.R.N-B.C., F.A.A.N., F.A.A.A.A.I., National Institute of Nursing Research
• Chazeman Jackson, Ph.D., National Institute of Minority Health and Health Disparities
• Carol Kemker, BISyE, U.S. Environmental Protection Agency
• Marielena Lara-Greenberg, M.D., RAND Corporation
• Sarah Lyon-Callo, M.S., M.A., Michigan Department of Community Health
• Iris Mabry-Hernandez, M.D., M.P.H., Agency for Healthcare Research and Quality
• Floyd Malveaux, M.D., Ph.D., Merck Childhood Asthma Network, Inc.
• Anne Markus, J.D., Ph.D., M.H.S., George Washington University
• William Martin, M.D., National Institutes of Health
• Joanne Matheson, Ph.D., U.S. Consumer Product Safety Commission
• Leyla McCurdy, M.Phil., National Environmental Education Foundation
• Suril Mehta, M.A., U.S. Environmental Protection Agency
• Acklema Mohammed, M.D., Urban Health Plan
• Rebecca Morley, M.S.P.P., National Center for Healthy Housing
• Shahla Ortega, M.A., U.S. Department of Education
• Dalton Paxman, Ph.D. Office of Assistant Secretary for Health
• Carol Payne, R.N., M.S.N., U.S. Department of Housing and Urban Development
• Devon Payne-Sturges, Dr.P.H., U.S. Environmental Protection Agency
• Katherine Pruitt, American Lung Association
• Cynthia S. Rand, Ph.D., Johns Hopkins University
• Derek Robinson, M.D., M.B.A., F.A.C.E.P., Centers for Medicare and Medicaid Services
• Lori Saltzman, M.S., Consumer Product Safety Commission
• Megan Sandel, M.D., Boston University School of Medicine; Boston University School of Public Health
• Nancy Sander, Allergy and Asthma Network Mothers of Asthmatics
• Robyn Schulof, M.A., Health Resources and Services Administration
• Michelle Sever, M.S., National Institute of Environmental Health Sciences
• Sally Seymour, M.D., U.S. Food and Drug Administration
• Michael Stebbins, Ph.D., Office of Science and Technology Policy
• Michelle Sternthal, Ph.D., U.S. Department of Housing & Urban Development
• Susan Stone, M.P.H., U.S. Environmental Protection Agency
• Perdita Taylor-Zapata, M.D., National Institute of Child Health and Human Development
• Stephen Teach, M.D., Children’s National Medical Center
• Theresa Watkins-Bryant, M.D., Health Resources and Services Administration
• Kevin Weiss, M.D., M.P.H., American Board of Medical Specialties
• Kathie Westpheling, M.P.H., Association of Clinicians for the Underserved
• Lani Wheeler, M.D., F.A.A.P., F.A.S.H.A.,The Cadmus Group, Inc.
• Darryl Zeldin, M.D., National Institute of Environmental Health Sciences

NHLBI Staff

• James Kiley, Ph.D., M.S., Division of Lung Diseases
• Virginia Taggart, M.P.H., Division of Lung Diseases
• Robinson Fulwood, Ph.D., M.S.P.H., Division for the Application of Research Discoveries
• Sue Rogus, R.N., M.S., Division for the Application of Research Discoveries

Last Updated: April 2011