West Oakland Asthma Initiative –
Breathmobile® …
Prescott-Joseph Center, as lead agency of the West Oakland Asthma Coalition, is spearheading the effort to establish the necessary partnerships and raise the necessary funding to bring the Breathmobile® concept to Alameda County.
The Breathmobile is a custom-built mobile pediatric asthma and allergy clinic that provides on-going asthma and allergy care. Inside the Breathmobile, there is a small waiting area, a testing area and two exam rooms. Onboard the Breathmobile, you’ll find an asthma team that includes a pediatric allergist or Pulmonologist, a pediatric nurse practitioner, a registered nurse, and a driver.
Background
West Oakland is a community affected by severe air pollution from the intersection of multiple freeways, trucking, and shipping. In the area, 10,000 diesel trucks per day move in and out of the Port of Oakland, as well as diesel emissions from ships going into the Port and non-vehicular diesel emissions from construction sites in and around the area. 70% of diesel emission is from shipping. Because of this, West Oakland residents are disproportionately affected by asthma and these individuals have historically been underserved.
A survey of providers serving patients in this community shows that only one health care provider is located in the heard of West Oakland, West Oakland Health Center. This institution lacks an Allergist, a Pulmonologist , and a pulmonary function laboratory. Because of this, most asthma patients must seek outside medical assistance. Over 70% of residents in West Oakland are covered by MediCal, the remaining 30% have no coverage at all.
The demographic composition of West Oakland is 64% African Americans, 16% Latinos, 9% Asian/Pacific Islanders. Poverty is a serious problem: 71% have incomes less than $30,000 and 50% have incomes less than $11,399. Almost half (45%) of residents 25 years and older do not have high school diplomas.
The Problem
There is an asthma epidemic in West Oakland! 20% of the children and 37% of the adults in West Oakland have asthma. Children in West Oakland are seven times more likely to be hospitalized for asthma than any other children in California. The Oakland-Berkley Asthma Coalition reviewed hospitalization rates for Alameda County in 1999-2001 and found a 28% increase in West Oakland over data collected by RAMP in 1994-1996. The rate of African Americans in Oakland is 1235 per 100,000 for children 0-14 years compared to a California State wide rate of 111 per 100,000. The second highest rate is in Latino-Americans.
Data from the Department of Health Services of the State looking at Emergency Room visits, hospitalizations and medication purchases show that generally speaking, Zip Code 94607, ranks very high for events reflecting severe asthma and/or poor access to preventive care, and ranks very low for events reflecting the standards of care (such as maintenance medication purchases).
Partners
The West Oakland Asthma Coalition has been in existence since 2001 and is very active in the community, particularly with asthma education in the schools and at the pre-discharge clinic at Children’s Hospital Oakland (CHO). We have shown in consecutive years how effective 1:1 education by dedicated educators and follow up can be with re-hospitalizations rate of 4% in 2005-2006 and 8% in 2006-2007. The Port of Oakland and other community leaders and local stakeholders have agreed to come together to begin to address the disparity and bring much needed services to West Oakland.
The Solution
One solution is the Breathmobile®. The Breathmobile has been operational for years in Los Angeles County, governed by a partnership of LA County, Asthma and Allergy Foundation of American, LA County School District, and University of Southern California. It is also in operation in Orange County, and the states of Maryland, and Arizona. The Breathmobile is a custom-built mobile pediatric asthma and allergy clinic that provides on-going asthma and allergy care. Inside the Breathmobile, there is a small waiting area, a testing area and two exam rooms. Onboard the Breathmobile, you’ll find an asthma team that includes a pediatric allergist or Pulmonologist, a pediatric nurse practitioner, a registered nurse, and a driver.
There are so many diseases that we cannot control, but asthma is a controllable disease. We can drastically reduce medical costs, absenteeism and morbidity by managing asthma (see attached financial analysis). Just last week, concern has been expressed by Oakland Unified School District (OUSD) about the absenteeism of children at Prescott Elementary due to asthma. For example, a typical child is someone like Tiffany, an 8-year old who often finds herself out of medication. Her grandmother, who is her primary caregiver frequently, does not have money for bus fare to take her to CHO out patient clinic. A local clinic would support Tiffany, her grandmother to better manage the disease.
While we are working on improving the environmental aspects, we can reduce current barriers of cost, distance to clinics and inadequate medical care by providing a well-equipped clinic with asthma expertise on board. This will ensure that patients that can not afford it. A mobile clinic can provide follow up care, case management services, and education about asthma management and at the same time drastically reduce the cost to the community.
Please consider making a donation to help bring this critical service to the West Oakland Community!
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Addressing the Asthma Disparities in Alameda County
Asthma is a major problem in West Oakland. Of the approximately 22,000 people living in West Oakland, 20% of children and 37% of adults have asthma. West Oakland children are seven times more likely to be hospitalized for asthma than any other children in California (1994–1996 RAMP study).
An Oakland-Berkeley Asthma Coalition study 1999–2001 shows a 28% increase in West Oakland hospitalizations. Asthma hospitalization rates in Alameda County exceeds rates in every demographic group studied. They are the second highest among the State’s 58 counties. Countywide African Americans are 3–5 times more likely to be hospitalized for asthma than others.
The financial burden of asthma in children in the 94607 zip code alone, for 911 calls, ER visits, and hospitalizations to Children’s Hospital Oakland totals $2,740,000 annually. For adults minimally $1.2 million.
We are working to create programs to shift people from acute episodic care to regular preventive care. One way is to create effective partnerships between Prescott-Joseph Center, Asthma and Allergy Foundation of America (AAFA), Oakland Unified School District, Alameda County and other stakeholders to establish and fund a Breathmobile® for Alameda County. Such a system reduces morbidity and saves lives, ultimately saving millions of dollars for Alameda County, the State and the school districts.
Prescott-Joseph Center, as lead agency of the West Oakland Asthma Coalition, is spearheading the effort to establish the necessary partnerships and raise the necessary funding to bring the Breathmobile® concept to Alameda County.
On October 4, 2007, 40 people attended a luncheon at Scott’s Restaurant, hosted by Asthma and Allergy Foundation of America, California Chapter, founder of the Breathmobile®. Francene Lifson, Executive Director, of the California Branch of AAFA and associates gave presentations of the history and operation of the Breathmobile® and they are excited about the prospects of having the Breathmobile® here in Alameda County.
Make a Donation!
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