Breathe Easy

Asthma hospitalization rates in Alameda County exceed California rates in every demographic group studied. It is the second highest rate among California’s 58 counties. Alameda county also has a large African American population. African Americans are 3-5 times more likely to be hospitilized for asthma.

There is the:

ENVIRONMENT: some examples include- pollution, freeways, Port of Oakland, factories, plants, diesel emissions, high crime rates, high stress levels, few grocery stores with fresh produce

ECONOMICS: socio-economic problems, poverty level incomes, low literacy rates, low rate of high school graduates, poor/old housing, little access to health care facilities(including pharmacies), many dont have health insurance

EDUCATION: little access to asthma education, some people feel shame over the disease or find it strange, little knowledge of the ineffectiveness of emergency room visits, no in-school asthma training for students, teachers, and school nurses. children are not taught asthma management or what to do when they have attacks or symptoms or allergies

In addition, there is hereditary/genetic predisposition to asthma, behavioral patterns, and cultural patterns (Some Latinos feel it is a “winter disease,” or a “cold disease”)

Those are just some of the examples. It is important to understand that asthma is NOT just a health problem, it is a disease that is intrinsically related to socio-economics. It is as Dr. Burns says, “A community disease.”

Highest Hospitilization in Alameda County Zip Codes:

* 94612 (Downtown)

*94607 (West Oakland)

*94609 (North Oakland)

*94608 (Emeryville)

*94603 (98th Avenue, Oakland)

*94605 (Eastmont/Zoo)

Some patterns in Alameda County:

-The use of emergency room services rather than routine care by African Americans and Hispanics (both children and adults)

-African American and Hispanic children are less likely to to receive timely follow up care after an asthma-related ER visit

-There is an under-use of asthma maintenance medications,  people in this County are less likely to visit a physician or specialist

- Little availability of health care facilities, including pharmacies

-Lack of transportation and excessive waiting in lines at the clinic

- Socio-economic status, low literacy, high stress levels

So how does the Breathmobile help the Alameda County Community?

The rationale for the Breathmobile in Alameda County is that  children from low-income households with asthma, continue to engage in episodic rescue patterns of health care and experience a disproportionate level of morbidity. Adults are similar. We provide a sustainable, accessible, community-wide asthma disease management program. Programs like ours must be established to shift acute episodic care to regular preventative care in accordance to national standards.

It is:

-Accessible. It is at the schools. Parents do not have to drive to a clinic or find asthma specialists.

It provides:

Increased regular provider visits.

Education and case management.

An asthma action plan, medication, and the means to get medication.

Standardized, highest level care through a computerized asthma disease management program.

An appointment system.

*       *     *

One Breathmobile can visit 23 school sites each month.

Costs of Breathmobile Operation:

Vehicle= $2,250

Auto insurance= $5,000

Malpractice insurance= $10,000

Total= $17,250

Costs of Breathmobile:

New vehicle fully equipped: $150,000

Cost of crew: $435,000

 

Total cost of crew & operation: $452,250

Cost comparison:

94607 alone: $2.7 million

Estimate over 5 zip codes: $10 million

Cost of operation of a Breathmobile= $500,000

So the Breathmobile saves millions of dollars!

Who benefits?

Patients:

Improved health and well-being

Increased preventative care

Alameda County

1115 Waivers

Meeting MediCal Waiver goals

Schools

Reduced Absenteeism= A whole lot of $$$

Average asthma patient misses 4 days per year X 1276 Stuedents in West Oakland X $75 dollars per day= $382,800

We hope this gave you a rough idea of the asthma situation in Alameda County and how the Breathmobile has changed asthma treatment, asthma patterns, saved the county money, and impacted children’s lives.

We recently started visiting schools in West Constra Costa County and San Francisco’s Bayview Hunters Point. Please make sure to read the blog posts dedicated to those areas. Their economic, environmental, and educational problems are very similiar  to Alameda County’s.