Schools Are at the Front Line of Asthma Fight

California’s network of 230 school-based health clinics are set to incubate a new education program meant to address the environmental factors that trigger asthma attacks. The Environmental Protection Agency (EPA) awarded a $600,000 grant to the Oakland-based Public Health Institute’s Regional Asthma Management & Prevention (RAMP) program. RAMP is now set to design a training program for the state’s school-based clinic staff on how to prevent and manage environmental asthma triggers in school, at home and in the community.

Asthma affects 900,000 children in California and seven million children nationwide. The disease causes airways in the lungs to swell and narrow. This makes breathing difficult. Oakland’s network of school-based clinics have been on the forefront of providing asthma education and treatment to its school-aged children, but will now have an added resource to address the environmental risk factors.

“There’s a stigma around having asthma and how you deal with it,” said Hana Shirriel-Dia, adolescent services coordinator at the West Oakland Middle School Health Center. She and her colleagues work with an Oakland Unified School District nurse and physical education teacher to identify kids at the school who have breathing problems. Clinic staff then provide medical treatment and counseling on asthma management, so kids can continue to play sports and run around with other students.

“I always tell myself I can fight through my asthma no matter what, and that’s not an excuse to say I can’t play sports,” said 11-year-old Maurice Patton III. He’s been taking the asthma class offered at the health center, which helped him identify the environmental triggers at school, home and in his community. He’s also learned some techniques to slow down, take deep breaths and calm himself when he’s having an asthma attack.

Shirriel-Dia says about 25 percent of the students at West Oakland Middle School suffer from asthma and others have breathing problems. The clinic is focused on the student population, but doesn't turn way other children in the neighborhood who seek care there.

“Asthma is a disease that we see great disparities by race, ethnicity and socioeconomic status,” said Anne Kelsey Lamb, director of RAMP. “Here in Alameda county, African-Americans are hospitalized or go to emergency departments five times more often than whites [for asthma-related incidences].”

The new focus on identifying and managing environmental triggers for asthma is an effort to reduce these severe asthma attacks and expensive trips to the hospital. “Even a child with the best medications is going to continue to suffer from asthma if he or she is exposed to environmental asthma triggers in their school or home or community,” Lamb said.

RAMP plans to compile a guide for schools to use when identifying triggers in their own buildings, such as poor ventilation, harmful cleaning products or exposure to diesel buses that could be adversely affecting students. Staff will also be trained to educate parents about the factors at home that can cause asthma to flare, like mold and cigarette smoke.

After developing a guide to environmental asthma triggers and developing a training curriculum, RAMP, in partnership with the California School-Based Health Alliance, will train clinic staff around the state so they can help their own communities avoid or address environmental asthma triggers. With California as a training ground, the program will then expand to New York, Michigan, and Connecticut, states with high asthma prevalence and school-based clinics.