Mid-Atlantic Regional Asthma Network (MARAN) Newsletter: Fall 2009

Fall 2009

Print version of this newsletter (PDF, 10pp, 59KB, about PDF)

In This Issue

MARAN Network Partners and Mid-Atlantic Programs in the News:

PROMOTING HEALTHY HOMES AND HEALTHY SCHOOLS

By Prentiss Ward, U.S. EPA, Region 3, Philadelphia, PA

By Since 1928, the President has proclaimed one day each October as National Child Health Day with people across the nation working together to prevent problems and improve child health. In October 2001, the U.S. Environmental Protection Agency began celebrating Children’s Health Month. Each year, the Agency celebrates Children's Health Month by developing publications and activities that highlight the importance of protecting children from environmental risks. The themes are kicked-off during October and are carried out throughout the year.

This year, the Agency featured work to protect children in their homes and schools. The 2009 Children’s Health Month calendar: Healthy Living; Healthy Learning; Healthy environments can be found at EPA's Children’s Health Month 2009: Healthy Living; Healthy Learning; Healthy Environments. This calendar has daily tips on how to protect children from environmental hazards. EPA also encourages continued participation in the new campaign to educate middle and high school students about climate change and its effects on children's health. Health issues such as asthma and allergies are addressed. Presentations, carbon calculators, sample proclamations and more are available, at Climate Change and Children's Health. These tools will aid teens in creating a new “climate for action” by taking action to address global climate change and encouraging their friends and families to do the same.

There are approximately 6.6 million children in the mid-Atlantic Region and about 9.7% of them have asthma. Since the average person spends 90% of their time indoors, this means that it is critical for home and school environments to be healthy for children, especially asthmatic children. The Region 3 Pediatric Environmental Health Specialty Unit, the Mid-Atlantic Center for Children’s Health and the Environment developed a Healthy Homes Guidebook for families of the mid-Atlantic region. This guidebook is designed to answer questions about some of the most common environmental problems affecting families in their homes, including drinking water, household chemicals, indoor air pollution, and lead, and to provide specific state and Federal contacts and Internet links for more information about these concerns. This guide book may be downloaded at Environmental Health Concerns and Your Home. (PDF,44 pp., 684 KB, About PDF)

At the end of this article you will find a list of various EPA programs and other Federal Agency links that promote healthy environments where children live, learn and play. We encourage you to familiarize yourself with various programs that promote healthy homes and healthy schools and incorporate as many of these programs as possible into the goals and objectives of your organization. Where appropriate, we also recommend you share EPA literature that could be of benefit to your constituency. If we can be of assistance to your organization in promoting healthy home and school environments, please contact the children’s health coordinator, Prentiss Ward at (215) 814-2813 or the asthma coordinator, Janice Lewis (215) 814-2185.

EPA programs for protecting children's health at home

EPA programs addressing environmental health in school

Healthy School Environments
Clean School Bus USA - Program to reduce children's exposure to diesel exhaust and air pollution created by diesel school buses. Brings together partners from business, education, transportation, and public-health to eliminate unneccessary school bus idling, perform diesel retrofits, and replace the oldest buses.
Drinking Water in Schools and Child Care Facilities - Web site provides information about drinking water quality in schools and child care facilities. Site includes Guidance & Tools, Laws & Regulations, and information about Partners.
ENERGY STAR for K-12 School Districts - Web site provides information about energy efficiency in schools. Site includes Guidance & Tools and information for students and parents.
Healthy School Environments Assessment Tool (HealthySEAT) - EPA's software tool to help school districts evaluate and manage school facilities for key environmental, safety and health issues. Designed to be customized and use to conduct voluntary self-assessments of schools.
Indoor Air Quality (IAQ) Tools for Schools Program - Developed to reduce exposures to indoor environmental contaminants in schools through voluntary adoption of sound indoor air quality management practices. Resources to help schools identify, correct, and prevent IAQ problems.
Integrated Pest Management (IPM) in Schools - Provides safe and usually less costly options for effective integrated pest management options for schools. School IPM programs use strategies to reduce sources of food, water and shelter for pests.
Schools Chemical Cleanout Campaign (SC3) - SC3 aims to ensure that all schools are free from hazards associated with outdated and unnecessary chemicals. SC3 gives K-12 schools information and tools to responsibly manage chemicals.
Smart Growth and Schools
HUD
CDC Healthy Homes
Surgeon General Call to Action (PDF, 4 pp., 78 KB, About PDF)

Current Announcements:

US EPA’s The Communities in Action for Asthma-Friendly Environments National Forum-2010 National Asthma Forum

The 2010 National Asthma Forum will be held June 17-18, 2010, in Washington, DC. The Communities in Action for Asthma-Friendly Environments National Forum provides a venue for dedicated asthma care leaders to learn from one another and from some of the highest performing asthma programs in the world. The Forum explores successful approaches to asthma care with leading programs, scientists, policy makers, and others; enables participants to benchmark their programs against the best national strategies for improving outcomes and sustaining their programs; and provides the access to the strategies, resources, tools and community of support to help program leaders to transform the delivery, impact, and scale of asthma care in their communities. What brings us together is our commitment to transforming the quality, scope and reach of community asthma care to ensure that everyone who needs it receives the best possible care in every community in the U.S. Get more information on the forum. Learn more about the National Environmental Leadership Award.

CDC Chronic Disease Indicators Web Site

The Centers for Disease Control and Prevention’s (CDC) Community Health and Program Services branch in the Division of Adult and Community Health has updated their Chronic Disease Indicators Web Site to include large metropolitan areas. This update provides users with an online tool that now allows them to compare data on the prevalence of chronic diseases in large metropolitan areas, as well as at state and national levels. Users will be able to generate profiles comparing the prevalence of chronic disease in 38 large metropolitan areas, such as Fulton County (Atlanta), King County (Seattle), Maricopa County (Phoenix), and New York City. The CDC Web site draws upon numerous data sets to collect information on 98 chronic disease indicators, including measures related to physical activity, tobacco use, cancer, diabetes, arthritis, cardiovascular disease, and other conditions and behaviors. The information is used by state health departments, chronic disease directors, academic institutions, and researchers to guide and inform public health practice. The web site can be available at Chronic Disease Indicator.

NIH Funding Opportunity to Build Sustainable Infrastructure for CBPR

The National Institutes of Health has announced this unique funding opportunity to support the development, expansion, or reconfiguration of infrastructures needed to facilitate meaningful community-based participatory research (CBPR). This infrastructure must include a “Community Research Associate” who will be a community representative and serve as a primary liaison between the academic health center and the local community. More information can be found at: NIH Funding Opportunity.

Strengthening Environmental Justice Research and Decision Making: A Symposium on the Science of Disproportionate Environmental Health Impacts –

Save-The-Date & Call for Poster Abstracts

March 17 – 19, 2010 Walter E. Washington Convention Center Washington, DC

Registration will be open to the general public on December 15, 2009.

Abstract submission deadline is December 15 2009.

To register please visit: http://www.scgcopr.com/envirjusticesym

The overall goal of the symposium is to lay the foundation for developing analytical and decision frameworks that can be used by EPA and other federal, state, and local governments to better quantify and characterize disproportionate environmental health impacts on minority and low-income populations that may result from their programs, policies, and activities.

The Symposium will feature interdisciplinary presentations, discussions, and technical input on the scientific bases for factors that may cause disproportionate environmental health impacts, and frameworks for assessing disproportionate burdens of environmental exposures and disease.

MARAN Network Partners and Mid-Atlantic Programs in the News:

CHILDREN WITH ASTHMA MORE VULNERABLE TO H1N1 VIRUS

- HHS Secretary Kathleen Sebelius Highlights Philadelphia MCAN Project As Model for Managing Childhood Asthma and Reducing H1N1 Risk-You can read more at: Merck Childhood Asthma Network.(PDF, 2 pp., 35 KB, About PDF)

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Internet and Education Resources:

The Community-Engaged Scholarship (CES) Toolkit from CCPH

Community-Campus Partnerships for Health (CCPH) introduces the Community-Engagement Scholarship Toolkit. The CES Toolkit is designed to provide community-engaged health professional faculty with a set of tools to carefully plan, document their community-engaged scholarship, and produce strong portfolios for promotion and tenure. The CES includes the following components:

Planning for Promotion and Tenure – role of mentors, developing a vision for community work and strategies for documenting the value of work
Creating a Strong Portfolio – details for preparing a portfolio for promotion and tenure review
Portfolio Examples – biosketches and portfolio materials from select faculty members
References and Resources – citations, glossary of terms, example of schools that support community-engaged faculty, a list of agencies that fund community-engaged scholarship.

Find the CES Toolkit on CCPH’s Website can be found at Community-Campus Partnerships for Health.

EPA/CDC/ATSDR Federal Grants Guide for Community Environmental and Public Health Activities

The U.S. Environmental Protection Agency (EPA), the Centers for Disease Control and Prevention (CDC), and the Agency for Toxic Substances and Disease Registry (ATSDR) have developed a comprehensive guide on current funding opportunities available to groups interested in improving the environmental health of their communities. This guide is targeted to community groups, non-profit organizations, academic institutions, state and local governments, and tribes that are working on projects related to identifying, monitoring, and cleaning up toxic contaminants in their communities. This guide includes:

Useful tips for groups to identify and apply for funding;
A quick reference matrix guide; and
A comprehensive description of Federal grants. You can find the comprehensive guide at EPA and CDC Collaborate to Support Communities or be directly linked at EPA/CDC/ATSDR Grants Guide for Community Environment and Public Health Activities. (PDF, 29 pp., 543 KB, About PDF)

ACU Training: Realistic Measures for the Reduction of Indoor Asthma Triggers

To promote reduction of indoor asthma triggers and the NHLBI guidelines, Association of Clinicians for the Underserved (ACU) developed a curriculum targeted to primary care providers serving low-income, underserved populations. The training focuses on teaching indoor air trigger reduction by incorporating the concepts of health literacy and cultural competency in asthma prevention education. It looks at individual triggers and discusses how families with limited financial resources can reduce those triggers in the home. Developed with the guidance of an expert advisory committee, the training uses the Care Model, link at Improving Chronic Illness Care. as a framework to encourage a transdisciplinary approach to asthma care and team building between clinicians, consumers and community. The curriculum focuses on practical and realistic measures providers can offer to their patients for better control of environmental triggers of asthma, while remaining sensitive to cultural and linguistic issues. Association of Clinicians for the Underserved (ACU) has developed an Asthma Essential Resources and Bibliography (PDF) - Information and links to various resources for clinicians and patients. To see the vast list of resources link to Realistic Measures for Reduction of Indoor Asthma Triggers.

The ACU Pediatric Asthma Indoor Air Quality Improvement project was supported for 4 years through a cooperative agreement with the EPA, Indoor Environments Division. As part of the project, ACU developed a training curriculum, tool card and resource list which it updates regularly. Measuring Health Disparities (Interactive CD-ROM) MHDIR0705 – For additional information please link to Realistic Measures for Reduction of Indoor Asthma Triggers .

Course Description

This interactive CD-ROM course focuses on some basic issues for public health practice -- how to understand, define and measure health disparity. This CD-ROM examines the language of health disparity to come to some common understanding of what that term means, explains key measures of health disparity and shows how to calculate them. This CD-ROM provides a durable tool that is useful to daily activities in the practice of public health.

The material is divided into four content sections. Parts I and II review what health disparities are, how they are defined, and provide an overview of common issues faced in measuring health disparities. Parts III and IV introduce users to a range of health disparity measures, providing advantages and disadvantages of each, and discuss how best to use different measures to communicate and evaluate health disparity in our communities.

Health Disparities Video and PowerPoint Presentation

The Robert Wood Johnson Foundation (RWJF) collaborated with the George Washington University Medical Center to create a video and PowerPoint presentation that define health care disparities and review evidence of their existence as well as the lessons drawn from experience in quality improvement and cardiovascular care that show how health disparities can be reduced. View the video online or download the slides.

Clinical Tool Cards

Association of Clinicians for the Underserved (ACU) has developed a number of clinical tool cards that serve as a concise pocket-size reference card for busy practitioners. Download a sample here or use the publications order form to order laminated cards. An electronic version of the Asthma Trigger Management tool card can be downloaded to a PDA (free of charge) in either English or Spanish at the Apprisor Website.

Pediatric Asthma & Indoor Environmental Trigger Management (English)

Pediatric Asthma & Indoor Environmental Trigger Management (Spanish)

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Science Articles and Publications:

Keeping Kids Smokefree: Lessons Learned on Community Participation

Health Education Research (Epublication Sept. 9, 2009) by Charlier N, Glover M, Robertson J

Abstract: Community participation in program decision-making and implementation is an ideal that community and academic stakeholders aspire to in participatory research. This ideal, however, can be difficult to achieve. We describe lessons learned about community participation from a quasi-experimental trial aimed at reducing the uptake of smoking among pre-adolescents in a community with a high percentage of Maori and Pacific Island people. The intervention involves students, parents, school teachers and management, extended families and members of the wider community. A total of approximately 4000 students (and their parents) of four urban Auckland schools were enrolled in the study over 3 years. The intervention is carried out through collaborations between public health professionals, academic institutions and school personnel. In order to enhance community participation, we conclude that (i) time commitment is needed to establish long-term ongoing relationships through face-to-face communication, (ii) research team members should ideally share similar cultural and ethnic backgrounds to the target audience and have in-depth understanding of and experience in the community milieu and (iii) collaborative partnerships between academic institutions and public health services are necessary to create strength and cohesion, and assist with clear articulation of the research project mission and objectives.

Perspectives of Cumulative Risks and Impacts

International Journal of Toxicology (Epublication Sept. 29, 2009)- by Faust JB Abstract: Cumulative risks and impacts have taken on different meanings in different regulatory and programmatic contexts at federal and state government levels. Traditional risk assessment methodologies, with considerable limitations, can provide a framework for the evaluation of cumulative risks from chemicals. Under an environmental justice program in California, cumulative impacts are defined to include exposures, public health effects, or environmental effects in a geographic area from the emission or discharge of environmental pollution from all sources, through all media. Furthermore, the evaluation of these effects should take into account sensitive populations and socioeconomic factors where possible and to the extent data are available. Key aspects to this potential approach include the consideration of exposures (versus risk), socioeconomic factors, the geographic or community-level assessment scale, and the inclusion of not only health effects but also environmental effects as contributors to impact. Assessments of this type extend the boundaries of the types of information that toxicologists generally provide for risk management decisions.

The Economic Burden of Health Inequalities in the United States

This study, commissioned by the Joint Center for Political and Economic Studies and carried out by leading researchers from Johns Hopkins University and the University of Maryland, provides important insight into how much of a financial burden racial disparities are putting on our health care system and society at large. The researchers examined the direct costs associated with the provision of care to a sicker and more disadvantaged population, as well as the indirect costs of health inequities such as lost productivity, lost wages, absenteeism, family leave, and premature death.

Date Published: September 2009

Download the file (PDF, 16 pp., 429 KB, About PDF)

Trends in Child Health 1997-2006: Assessing Racial/Ethnic Disparities in Activity Limitation

To provide fuller detail on disparities in child health, the Joint Center for Political and Economic Studies analyzed selected child health indicators [low birth weight, health status (excellent, very good, good, fair, poor or unknown), unmet dental care needs, ADHD/ADD diagnosis, asthma diagnosis, learning disability diagnosis, and activity limitation] by sociodemographic characteristics of the families in which children reside. This brief examines disparities in the prevalence of an activity limitation of any type among children under the age of 18 who are African American, Hispanic or white. Comparisons of the prevalence of any activity limitation are made between the racial/ethnic groups of children overall and between children of various racial/ethnic groups in families with comparable sociodemographic characteristics (such as family type, educational attainment of householder, employment status of household, poverty status, and health insurance coverage). Activity limitations are reported less frequently for Hispanic children as a group than for either white children or black children, although it is unclear whether this pattern reflects a difference in the frequency of occurrence, or a difference in frequency of diagnosis.

Date Published: July 2009

Download the file (PDF, 20 pp., 1000 KB, About PDF)

A Child’s IQ Can Be Affected by Mother’s Exposure to Urban Air Pollutants

- A mother’s exposure to urban air pollutants known as poly cyclic aromatic hydrocarbons (PAH's) can adversely affect a child’s intelligence quotient or IQ, a study reports. PAH's are chemicals released into the air from the burning of coal, diesel, oil and gas, or other organic substances such as tobacco. In urban areas, motor vehicles are a major source of PAH's. You can read more at: National Institute of Health News

A Collaborative Approach to Preventing and Treating Asthma in Infants and Young Children – An article by Lois Wessel, ACU, and Jacqueline Spain, Holyoke Health Center; reprinted from Zero to Three. Please read more at: The Chronic Care Model. (PDF, 8 pp., 302 KB, About PDF)

Index of Air Topics || Directions & Accommodations || State & Local Agencies