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SFSU Public Affairs Press Release

Published by the Public Affairs Office at San Francisco State University, Diag Center.

#065--January 25, 2000; FOR IMMEDIATE RELEASE
Contact: Merrik Bush-Pirkle
phone: 415/338-1665
e-mail: pubcom@sfsu.edu

Million-Dollar Grant Breathes Life into Fight Against Urban Asthma

SAN FRANCISCO, Calif.- Children suffering from asthma in San Francisco's poorest communities may soon breathe easier, thanks to the "YES WE CAN Urban Asthma Partnership," an unprecedented prevention and care program developed to combat this debilitating respiratory disease.

The demonstration program, newly funded by a $941,000 grant from The California Endowment (the state's largest health foundation), is a collaborative effort of health agencies, community-based organizations, nonprofit hospitals, educators and others that have, until now, been fighting this disease on separate fronts. Sponsors such as the American Lung Association hope this new model of care can be translated to poor urban communities throughout the nation.

California asthma rates are among the nation's highest, with an estimated 15,000 children in San Francisco alone suffering from this chronic disease, the most common cause of hospitalization among youths. YES WE CAN partners agree that the reasons for asthma's increased presence in urban areas are complex but that the epidemic is controllable. Triggered by mold, mildew, dust mites, cockroaches, cigarette smoke, fumes, and worsened by stress, asthma can suffocate its young victims if left untreated. Factors exacerbating the problem include inconsistent health care, deficiencies in health education, poverty, poor housing conditions and air pollution.

"Low-income children of color have nearly the same rate of asthma as affluent white communities, yet their hospitalization rates are up to 21 times higher," said Dr. Mary Beth Love, chair of San Francisco State's Department of Health Education and principal investigator on the grant. "The issue is quality of care. Too often, low-income children do not receive prevention-oriented care and close follow-up, nor do families get the health education and support they need to manage the disease at home."

Starting next summer, YES WE CAN plans to launch the new model, described below, with about 300 children at San Francisco General Hospital, expanding in phases to include the Mission Neighborhood Health Center and Department of Public Health clinics in low-income communities throughout San Francisco.

The YES WE CAN Partnership is coordinated by Community Health Works of San Francisco, a community health innovation center sponsored by SFSU and City College of San Francisco. YES WE CAN Partners include the Bayview/Hunters Point Healthy Start Collaborative, the San Francisco Department of Public Health and its Community Health Network, the San Francisco Health Plan, staff of the Kaiser Medical Group, the Mission Neighborhood Health Center, the Regional Asthma Management Program Initiative (RAMP), the Health and Environmental Resource Center (HERC) and the American Lung Association, with others still joining.

"This is an exciting opportunity for the medical system to create a truly comprehensive asthma management system," says Melissa Welch, MD, chief medical officer of the Department of Public Health Community Health Network.

YES WE CAN will use a health team consisting of a doctor, nurse care coordinator and community health worker to address the problems associated with asthma prevalence. In one complete session, the doctor will diagnose the child, and then the nurse will conduct a two-hour educational session with the family to discuss prevention strategies and the medical regimen. Additionally, nurses will track the children's progress through a computer software program that red-flags signs that a child's asthma is not in control.

A community health worker (CHW) will then assist the family with home-based disease management by assessing the child's home for common asthma triggers and providing mitigation supplies such as mattress and pillow covers to combat dust mites. The CHW will also reinforce health education messages, help families navigate paperwork and eligibility issues surrounding health coverage, serve as a language translator and culture broker, and ensure that school's are aware of the child's condition.

"The role of the community health worker (CHW) is critical because it addresses the non-medical realm of managing asthma," says Diedra Epps-Miller, manager of Healthy Start, a collaborative of Bayview/Hunter's Point schools and community agencies.

Trained and certified through City College of San Francisco, CHWs are effective because they live in these same hard-hit inner-city neighborhoods and have already been working with Healthy Start and other community groups.

"What we're trying to do, with a manageable size group, is develop a standard system that can be implemented nationwide, so that every poor child with asthma can get state-of-the-art, prevention-oriented care," says Dr. Guillermo Mendoza of the Kaiser Medical Group.

"Once a child is pulled into the YES WE CAN model," says Love, "they will be tracked for life."

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The California Endowment's mission is to expand access to affordable, quality health care for underserved individuals and communities, and to improve the health status of all Californians.

Press Contacts: Vicki Legion, YES WE CAN Project Director, 415/338-3034; 338-3480; Mary Beth Love, Ph.D., Chair of the SFSU Dept. of Health Education, 415/338-2708; Diedra Epps-Miller, Bayview/Hunters Point Healthy Start, 415/656-2553; Melisa Welch, MD, Chief Medical Officer, Dept. of Public Health, 415/206-2323;Guillermo Mendoza, MD, Chief of Allergy, Kaiser Napa-Solano, 707/453-5616; Mike Powers, The California Foundation, 800/449-4149, ext. 228.



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