Health equity is the state in which everyone has a fair and just opportunity to reach their highest level of health. Achieving this requires focused and ongoing societal efforts to:
- Address historical and contemporary injustices
- Overcome economic, social, and other obstacles to health and health care
- End preventable health disparities
If a health condition, like asthma or allergy, affects one group of people differently than another group, it is a health disparity.
Health disparities not only have an impact on affected groups but also limit the overall quality of health care for the entire population.
Asthma and allergies can affect any person, but they don’t affect everyone equally. Asthma rates, deaths, and hospitalizations are often different for people based on their income or race/ethnicity. These differences in asthma are documented by a large amount of research. Researchers are also trying to better understand racial/ethnic differences when it comes to other diseases, such as allergies or eczema.
Health disparities exist when the difference in health outcomes across different groups of people is caused by systematic (carefully planned), avoidable, unjust policies and actions.1
The major causes of health disparities in asthma and allergy include:
- Systemic racism (including bias in health care, segregation, discrimination, and historical trauma)
- Social determinants (such as socioeconomic status, education, neighborhood and physical environment, employment, social support networks, and access to health care)
AAFA’s Commitment to Creating Health Equity: HEAL Program
The Asthma and Allergy Foundation of America’s (AAFA) mission is to save lives and reduce the burden of disease for people with asthma and allergies through support, advocacy, education, and research. We can only achieve our mission if we focus efforts on promoting equity. We know the issues contributing to health inequities are complex and require strong, coordinated efforts to address the systems, policies, and biases that are causing harm to many communities.
In May 2022, AAFA launched the new Health Equity Advancement and Leadership (HEAL) program to address findings from our Asthma Disparities in America report. The HEAL program reinforces AAFA’s commitment to drastically reducing the burden of asthma in communities that bear the heaviest burden of asthma.
As part of AAFA’s HEAL program, AAFA is funding local interventions (programs) through our HEAL awards.
This is a multiyear project with the goal of building and supporting community-based interventions to address inequities in asthma and allergic diseases. Each year, HEAL will award funding and resources to local, pilot programs tailored to at-risk populations most impacted by asthma and allergies.
The overall goal of HEAL is to reduce asthma deaths and illness among high-risk populations. This is done by partnering with and strengthening local community programs. AAFA recognizes the importance of combining national leadership with community-driven action.
Year 1 (2022-2023)
In the first round of awards, AAFA funded programs in Chicago, Detroit, Los Angeles, and St. Louis. These four programs focused on adults and teens with asthma. While there are many proven and effective community-based asthma programs for children with asthma, there are very few programs that serve adults. Using best practices from pediatric programs, the HEAL sites developed adult and adolescent programs to meet the unique need of this population.
Early enrollment and evaluation data from these sites show that these programs are reaching adults and adolescents with asthma experiencing a disproportionate burden of asthma. Many program participants report having competing priorities and needs relating to their health. Food security, the risk of losing utilities, and the lack of reliable transportation are a few of the top needs households are facing to manage their asthma. Additionally, exposure to outdoor and indoor pollution continues to be a barrier to asthma management.
AAFA will continue to work with the HEAL program sites to measure the success of the programs. The long-term vision is that AAFA’s investment in these pilot programs will allow our local partners to seek sustainable funding from payors and other health care stakeholders in the future.
The first year of AAFA’s HEAL program was supported by a $1 million sponsorship from Amgen.
Year 2 (2023-2024)
For the second round of awards, AAFA is supporting two new programs in New York and Alabama. As these new programs are launched, AAFA will continue to support and work with the existing four HEAL programs in Detroit, Chicago, Los Angeles, and St. Louis.
The New York City program will develop a unique asthma care program to help the Hispanic population in the Bronx and surrounding areas. In several high-poverty neighborhoods of the South Bronx—where the majority of residents are Hispanic or Black—rates of asthma deaths and burden are consistently higher than the rest of New York City.
The Alabama program will expand a virtual model to complete asthma management home visits and provide asthma health education. The program will build a community health worker network to address the rural health disparity needs through collaborations with schools, local and state departments of health, and other state-based organizations and partners.
The second year of AAFA’s HEAL program is supported by Amgen, AstraZeneca, Genentech, Sanofi, and Regeneron.
Press Release: AAFA Announces New Health Equity Program Sites Serving Communities Facing Highest Burden of Asthma and Allergic Diseases
Health Equity Sites and Collaborations
AAFA supports and works with local community organizations and groups including hospital systems, state asthma control programs, housing advocates and more across the nation. These programs serve disadvantaged populations who are at highest risk of having asthma, needing emergency medical care, or even dying from asthma.
Alabama is one of AAFA’s HEAL program sites. AAFA is working with the Young Teen Asthma & Wellness Camp to support a new program using a virtual model to complete asthma management home visits and provide asthma health education. The program will work to address the rural health disparity needs through collaborations with schools, local and state departments of health, and other state-based organizations and partners.
Chicago is one of AAFA’s HEAL program sites. AAFA is working with the American Lung Association in Greater Chicago to launch a pilot program for adults and adolescents with asthma. The Environmental Improvements for COPD and Asthma Program will include asthma education, home visits, and other resources for families managing asthma in the Chicago area. AAFA and the Lung Association are members of the Chicago Asthma Consortium.
AAFA is working with the Food Allergy Buddies program at Massachusetts General Hospital for Children and the AAFA New England Chapter. The mission of the Food Allergy Buddies Program is to build a positive and supportive community for children, teens and their families, promote self-efficacy, support quality of life, and reinforce self-respect and safety. As part of AAFA’s health equity work, AAFA will support an expansion of the existing Food Buddies program. The expansion will help serve Hispanic and Black families with food allergies in the Boston area. The focus is on children who may not otherwise have access to an allergy community or food allergy management resources.
AAFA is working with the Connecticut Department of Public Health to serve people with asthma in Bridgeport, Hartford, and New Haven. The program will feature AAFA’s ASTHMA Care for Adults curriculum.
Detroit is one of AAFA’s HEAL program sites. AAFA is working with the AAFA Michigan Chapter (AAFA-MI) to conduct this pilot program. AAFA-MI will implement a multi-component intervention that will improve asthma control through general health and wellness, access to specialty care, assessment of home environments, and will use AAFA’s ASTHMA Care for Adults curriculum for self-management education. This program will serve 50 or more families in the greater Detroit area.
Los Angeles is one of AAFA’s HEAL program sites. AAFA is working with Breathe Southern California (Breathe SoCal). The BEAM: Breathe Easier Asthma Management program will address the needs of adults with asthma in underserved communities of Southeast Los Angeles County. Interventions will include asthma management education and home visits with an asthma educator.
New York is one of AAFA’s HEAL program sites. AAFA is working with AIRnyc to develop a unique asthma care intervention targeted toward the Hispanic population in the Bronx and surrounding areas. AAFA previously funded a pilot project led by AIRnyc to connect 50 families managing asthma with health education, health care, and social programs. As an innovator in community health, AIRnyc works to improve health outcomes while reducing disparities throughout New York City. AIRnyc leads a variety of partnerships and pilot programs with health care delivery organizations, Managed Care Organizations (MCOs), and other stakeholders including community-based organizations, government agencies, and health technology companies. For two decades, AIRnyc’s Community Health Workers have provided in-home services for families who are managing asthma and complex social needs by providing easy-to-understand health education and facilitating connections to health care and social services. Published results regarding AIRnyc’s asthma intervention with the NYC Health and Hospitals system showed a 25% reduction in hospitalizations. Data from a Bronx community hospital partner showed a 51% reduction in asthma admissions and a 21% reduction in Emergency Department use because of the program.
AAFA provided the Community Asthma Prevention Program (CAPP) at the Children’s Hospital of Philadelphia (CHOP) with donations of CERTIFIED asthma & allergy friendly® products. The goal was to improve the indoor air quality for 30 high-risk families living in predominantly Black neighborhoods located near fuel and gas refineries. CAPP offers a comprehensive and sustainable community-driven asthma management program for Black, low-income families. CAPP’s program implements asthma self-management education in the child’s home, community, school, and health care environments.
AAFA (with support from Sanofi Genzyme and Regeneron) provided Rady Children’s Hospital with a $200,000 grant to expand their AAFA Severe Asthma Program and their Community Approach to Severe Asthma (CASA) program. A clinical team of pediatric allergist/immunologists, pulmonologists, pharmacists, social workers, respiratory therapists, and registered nurses evaluate each patient and work together to ensure complete care and self-management education is provided from each team member. Children who are seen in the clinic can be referred to the CASA program, connects high-risk, low-income children and their families with trained community health workers (CHWs). Over half of the children in the program are insured by Medi-Cal (California’s Medicaid program). CHWs help families find and reduce asthma triggers in the home. They also provide free resources and allergen-control products to help reduce these triggers. Rady Children’s location near the U.S.-Mexico border positions it to serve a large Hispanic population.
AAFA provided Children’s National Hospital’s comprehensive pediatric asthma program, “Improving Pediatric Asthma Care (IMPACT DC), and its partner home visiting program, Breathe DC, with donations of CERTIFIED asthma & allergy friendly® products. These products helped 50 high-risk families in predominantly Black neighborhoods address allergen triggers in their homes. IMPACT DC aims to reduce asthma-related emergency room visits and hospitalizations through clinical care and education. Enrollment in IMPACT’s asthma clinic is triggered by recent emergency room visits and hospitalizations among children with poorly controlled asthma. The program offers individualized asthma education and facilitates care coordination among patients, primary care physicians, specialists, case managers, and school personnel. IMPACT also refers patients to home visitor programs, prescription assistance programs, financial counseling, Medicaid enrollment, legal services, tobacco cessation, and other social programs.
St. Louis is one of AAFA’s HEAL program sites. AAFA is working with the AAFA St. Louis Chapter and Oasis St. Louis to launch a new home visit program for older adults with asthma. The program will include routine check-ins, coordinate care with an asthma specialist, and provide CERTIFIED asthma & allergy friendly® products for the home. The AAFA-St. Louis and Oasis team will be using AAFA’s ASTHMA Care for Adults curriculum for asthma self-management education.
Early enrollment and evaluation data from HEAL sites show that these programs are reaching adults and adolescents with asthma experiencing disproportionate burden of asthma. Many participants in the programs report having competing priorities and needs relating to their health. Food security, the risk of losing utilities, and the lack of reliable transportation are a few of the top needs households are facing to manage their asthma. Additionally, exposure to outdoor and indoor pollution continues to be a barrier to asthma management.
Support and Funding
We are grateful for the sponsorships, financial contributions, and in-kind gifts that make AAFA’s HEAL program possible:
- American College of Allergy, Asthma, and Immunology
- Centers for Disease Control and Prevention (CDC)
- National Minority Quality Forum
- Pegasus Home Fashions
- Rabbit Air
- Renegade Brands USA, Inc.
- Sanofi and Regeneron
For more information on supporting AAFA’s health equity programs, contact gro.afaa@htlaeh.
Press Releases and Reports
Press Release: AAFA Launches New Health Equity Initiative for Communities Facing Highest Burden of Asthma
Press Release: AAFA Announces New Health Equity Program Sites Serving Communities Facing Highest Burden of Asthma and Allergic Diseases
Asthma Disparities in America – Full Report (11MB, 264 pages)
Asthma Disparities in America – Executive Summary (1MB, 16 pages)
Press Release: Asthma Disparities in America: A Roadmap to Reducing Burden on Racial and Ethnic Minorities (September 16, 2020)
1. Health Equity. (2022). Washington State Department of Health. https://doh.wa.gov/community-and-environment/health-equity