Preface
Asthma is a complex disease that is increasing in prevalence in the United States. Poor, inner-city minorities have disproportionately high rates of mortality from asthma. We still don’t know what causes this disease or how to cure it, but science shows us that asthma can be well controlled.
This slide presentation depicts the pathophysiology of the disease; prevalence, mortality, and morbidity measures at the national level; risk factors; medical management; and the public health response needed to successfully fight asthma.
The public health response to asthma has several components. The first is surveillance, which allows us to quantify how much asthma exists in the population, how severe it is, how well it is being controlled, and how much it costs. Sound data will allow us to make sound decisions when developing asthma programs.
Education is another component and can be either a part of a larger intervention or a stand-alone activity. Coalition building is a third component of the public health response, because a disease of this complexity requires the joint and committed efforts of a variety of partners. Advocacy is also required because asthma needs to be addressed in a comprehensive manner by multiple government agencies. Legislative issues include students’ access to medication at school and third-party reimbursement for patient asthma education.
Interventions are a key component and fall into the areas of medical management, environment, and schools. Finally, evaluation is needed to allow us to assess whether we are doing things right and whether we are doing the right things. A well-designed surveillance system coupled with appropriate process measures will provide sound evaluation results.
Introduction
- Slide 1: A Presentation on Asthma
Management and Prevention
Asthma is a complex disease that requires a long-term and multifaceted solution. This includes educating, treating, and providing ongoing medical care and monitoring for people with the disease, changing behaviors that lead to asthma or make it worse, and eliminating or avoiding triggers. All the topics we discuss today total "A Public Health Response to Asthma." - Slide 2: What is Asthma?
Asthma is a chronic disease of the airways that causes recurrent and distressing episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. Asthma can be difficult to diagnose and to differentiate from other respiratory illnesses. - Slide 3: Pathology of Asthma
Airways are the passages that carry air to the lungs. As the airways progress through the lungs, they become smaller, like branches of a tree. It is currently thought that asthma produces its effects by leading to airway inflammation and airflow limitation. This inflammation may even be present when a person's asthma is asymptomatic (that is, when the person does not have any symptoms).
When asthma is under control, as in the diagram on the left, the airways are clear, and air flows easily in and out. When asthma is not under control, the sides of the airways in the lungs become inflamed and swollen, as in the diagram on the right. During an attack, muscles around the airways constrict, and less air passes in and out of the lungs. Excess mucus forms in the airways, clogging them even further. The attack, also called an episode or exacerbation, can include coughing, chest tightness, wheezing, and difficulty breathing.
Asthma can be difficult to diagnose in infants, young children, the elderly, smokers, workers exposed to chemical inhalants, people with seasonal allergies, and people with recurrent acute respiratory infections. Regular physical exams that include measurements of lung function and evaluations of a patient's allergic status can help ensure a proper diagnosis.
