Helping Low-Income Families Manage Childhood Asthma: Solutions for Healthcare and Beyond


Asthma is the most common chronic illness among children and affects nearly 1 in 5 children in the District. But the rate is 3 times as high among low-income children as among their more affluent peers. In fact, children from the District’s poorest neighborhoods visit emergency departments for uncontrolled asthma at 10 times the rate of children from the District’s wealthier neighborhoods.

DC Appleseed, along with our partners at Children National Health System and Urban Institute, set out to learn why this was so and, more importantly, what we could do about it. The result is a policy brief, just released today, called Helping Low-Income Families Manage Childhood Asthma: Solutions for Healthcare and Beyond.

Here’s what we learned:

  • Asthma is a chronic, non-curable disease, but it is manageable. The challenge is that managing asthma is both time and resource intensive.
  • The District’s low-income families often lack the time and resources necessary to manage their child’s asthma.
  • It takes time to monitor a young child morning and evening taking inhaled medications, which can be complicated and difficult to deliver properly;
  • It takes resources, like paid leave, to take children with moderate to severe asthma to all of their necessary medical appointments;
  • It takes resources, like information and money, to eliminate asthma triggers from a home, and it takes systematic support to reduce asthma triggers at schools.

The health care system is not designed to address these challenges, nor is it well-designed to deal with chronic illness in children at all. It’s much better at fixing acute problems, and sending children on their way.

Another challenge is that children who are asymptomatic at any given time resist taking daily controller medications because it feels unnecessary. Yet without daily medications, these children are at risk for life-threatening asthma flare-ups, ER visits, hospitalizations and time away from school, and, for their caregivers, time away from work.

Just as we’ve done with our HIV/AIDS project, DC Appleseed has pulled together best practices and policy recommendations to help make the District a healthier place for children with asthma. We look forward to working with you to help the District make progress on this important issue.

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