The Health Department’s Chronic Disease Prevention team operates the Community Asthma Program (CAP), an intervention strategy aimed at reducing the number of children and youth in Baltimore between the ages of 2 and 18 who have trouble controlling their asthma. Through CAP, community health workers offer asthma education and visit the homes of young asthma patients.

Asthma is a chronic disease caused by inflammation of the airways in the lungs, making it hard to breathe. Symptoms include coughing, wheezing, shortness of breath, and chest tightness. Asthma may be triggered by inhaling fumes or dust. Nearly 25 million (8%) people in the United States suffer from the disease, and of those 25 million people, 6 million (9.4%) are children. In Baltimore City, 12.4% of adults and 20% of children have the disease. Furthermore, the rate of asthma-induced emergency room visits in Baltimore City is three times that of the state rate. To combat the asthma-related struggles that Baltimoreans face, CAP was established in 2009, modeled after an evidence-based program in Washington State.

“Three home visitors currently visit the homes of about 200 children each year. Each home visitor conducts three visits to each family over a period of about two to three months,” said Margaret Schnitzer, the Director of the Asthma Program. “We’re a small program and we’re not clinical. But we’ve seen an 89% decline in the severity of the symptoms that our patients experience from the first visit to the third visit.”

During the first visit, the home visitor gives the patient a spacer, a device that is added to an inhaler (or puffer) to make it easier to breathe in the medication. Over the course of the three visits, home visitors also give patients medication bags to organize their medications, a binder containing educational materials about how to care for asthma, green cleaning supplies (since toxic chemicals such as bleach exacerbate asthma symptoms), and dust mite proof mattress and pillow covers. Perhaps most importantly, CAP connects Baltimore City residents to a range of other services. For example, families are referred to 311 for free smoke detectors, to neighborhood Community Action Centers for financial and employment assistance, and to the Breathmobile for free asthma-focused medical care.

“There is a lot of confusion about asthma medication, so we work closely with the child’s provider to be sure that the family understands what has been prescribed,” said Schnitzer. “We get asthma action plans from the provider, so the family can have written reminders of what medication to take and when.”

CAP also works closely with public housing on their pest management initiatives.

Learn more about asthma, CAP, and other tools by clicking here.