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The kids attended the camp to frolic, but also to better understand the chronic lung disease that makes breathing more difficult for them and about \u003ca href=\"http://www.kidsdata.org/topic/238/asthma/table#fmt=97&loc=2,127,1657,331,1656,171,1655,345,357,324,369,362,360,337,364,356,217,328,354,320,339,334,365,343,367,344,355,366,368,265,349,361,4,273,59,370,326,341,338,350,342,359,363,340,335&tf=89&sortColumnId=0&sortType=asc\" target=\"_blank\" rel=\"noopener noreferrer\">1 in 6 California children\u003c/a>.\u003c/p>\n\u003cp>“Dust! Cockroaches! Cigarette smoke! Pets!” the kids yelled out in response to a question about what triggers their wheezing, shortness of breath and tightness in the chest. Some of the children, who ranged in age from 6 to 12, said they’d been to the emergency room multiple times. Asthma, if not properly treated, can be fatal.\u003c/p>\n\u003cp>Most of the children had been diagnosed when they were babies or toddlers and completely dependent on their parents or guardians. As they grow older and become physically less dependent on adults, they need to take more responsibility for managing their disease. \u003ca href=\"http://www.annallergy.org/article/S1081-1206(10)60377-8/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">Studies show\u003c/a> that asthma camps can instill knowledge and encourage habits that help children better control their conditions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For most of the week, parents dropped their kids off in the morning and picked them up at the end of the day. But one of the highlights of the camp is the sleepover, held at a local elementary school. That’s when kids who want to can spend the night at camp without their parents. For those who do, it’s another step in assuming responsibility for their own health.\u003c/p>\n\u003cp>“Our camp song says, ‘Your parents are not in charge of your asthma; you’re in charge of your asthma,’” said Sienna Grant, 9, as she climbed a ladder and prepared to swing rung to rung across a jungle gym. She used to be reluctant to stop playing, even for a puff of her inhaler. But now she’s learning “to take things more seriously,” she said.\u003c/p>\n\u003cp>Asthma camps sprang up in the late 1970s and early 1980s, when there were far fewer medications to treat the condition.\u003c/p>\n\u003cp>“There was no way to control or prevent asthma,” said Dr. Steven Prager, who is the camp’s medical director and a physician with the Salinas Valley Memorial Healthcare System, one of the camp’s co-sponsors.\u003c/p>\n\u003cp>Instead of shooing kids out of the house to play, nervous parents often blocked their path, relegating asthmatic children to a summer on the couch, Prager said.\u003c/p>\n\u003cp>For some children, asthma camp can provide a safe space to play and learn.\u003c/p>\n\u003cp>“I hear from prior campers and their parents all the time that the camp helped the kids take a more active, productive role in the management of their asthma,” Prager said. Parents reported a decrease in school absences and emergency room visits after their kids attended the program, he added.\u003c/p>\n\u003cp>Dr. Michael Welch, a physician at Rady Children’s Hospital-San Diego, studied the effectiveness of asthma camps a decade ago, but he said there is little research on the topic.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.annallergy.org/article/S1081-1206(10)60377-8/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">2007 study\u003c/a> co-authored by Welch found that a year after attending an asthma camp, kids had “assumed greater responsibility for taking their medication.” The study was based on a survey of nearly 1,800 participants at 24 asthma camps around the United States.\u003c/p>\n\u003cp>Welch noted that numerous camps cater to children with a wide range of chronic illnesses.\u003c/p>\n\u003cp>“Kids learn right away that they’re not the only ones with this chronic disease, so they [feel] a little less abnormal, which is good for their self-esteem,” he said.\u003c/p>\n\u003cp>Despite a profusion of camps dedicated to other conditions, the number of asthma camps is dwindling, Welch said. There are 90 asthma camps across the country — a third fewer than a decade ago — serving about 4,000 children, according to Jill Heins Nesvold, executive director of the \u003ca href=\"http://www.asthmacamps.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Consortium on Children’s Asthma Camps\u003c/a>.\u003c/p>\n\u003cp>There used to be at least five \u003ca href=\"http://www.asthmacamps.org/campdetails.cfm?longst=California&state=CA\" target=\"_blank\" rel=\"noopener noreferrer\">asthma camps in California\u003c/a>, but in the past few years, two of them — one in Los Angeles and another in San Diego — have closed.\u003c/p>\n\u003cp>“Funding has been a problem with keeping asthma camps alive,” said Welch, who was the medical director for more than three decades at the now-shuttered San Diego camp.\u003c/p>\n\u003cp>Part of the problem, he said, is that groups such as the American Lung Association have decided to focus their funding to research and lobbying, diverting it from direct community services like asthma camps.\u003c/p>\n\u003cp>The Salinas camp is funded by the Salinas Valley Memorial Healthcare System, \u003ca href=\"https://childrensmiraclenetworkhospitals.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Children’s Miracle Network\u003c/a> (CMN), a nonprofit that raises money for children’s hospitals nationwide, and individual donors. CMN gets most of its funding from corporate donors across a wide range of industries. The financial contributions help make the camp more affordable for families: Parents pay $55 per child, and scholarships are available.\u003c/p>\n\u003cp>While the Salinas camp has benefited from a solid endowment over the years, “it’s slowly being whittled down,” Prager said. “At the moment, we’re fine, but it’s going to be a challenge in the years to come.”\u003c/p>\n\u003cp>But as long as asthma camps keep their doors open, children will likely attend.\u003c/p>\n\u003cp>In the middle of the week, their confidence growing, about two-thirds of the Salinas campers tackled the overnight.\u003c/p>\n\u003cp>It sounds simple, but “many of these kids have never spent a night away from home,” Prager said. “It’s a big deal … and for the parents sometimes an even bigger deal.”\u003c/p>\n\u003cp>Dario Aldaco, 6, declared he would do the overnight even though his two older brothers — and running buddies — were skipping it.\u003c/p>\n\u003cp>“I want to do this, even if they don’t want to,” he told his mom, Aidee Aldaco.\u003c/p>\n\u003cp>“I was anxiety central,” she said. “I asked him, ‘Are you sure? Without your brothers?’”\u003c/p>\n\u003cp>On the big night, counselors stoked a fire pit near an outside play area and kids gathered around to socialize and munch s’mores. Later, inside the school’s gym, they unrolled sleeping bags and conked out on the floor, with counselors from the local YMCA and Prager nearby.\u003c/p>\n\u003cp>The next day, when the parents saw their kids had survived without them, they breathed a sigh of relief. On the final day, camp administrators asked the parents to vow that they would not curtail their children’s activities out of fear.\u003c/p>\n\u003cp>As they said their goodbyes, campers left with a better understanding of their illness, newfound confidence and backpacks full of gadgets and meds to ease their breathing.\u003c/p>\n\u003cp>Dario came home with the confidence to ask his father not to smoke on the side of the house where the fumes get inside and can trigger his and his brothers’ asthma.\u003c/p>\n\u003cp>Dario’s older brother, Aaron, 8, who also attended the camp and has mild to moderate autism, began to use a new word: “independent.”\u003c/p>\n\u003cp>The asthma camp had made him think twice about his mother’s plan to move closer to her children when they go off to college.\u003c/p>\n\u003cp>“If you move with me,” Aaron asked, “then how am I going to be independent?”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“So,” Aidee Aldaco said with a chuckle, “my husband and I are not going to be able to follow them.”\u003c/p>\n\n","disqusIdentifier":"360898 https://ww2.kqed.org/stateofhealth/?p=360898","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/08/24/kids-find-breathing-room-at-asthma-camp/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":1338,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":38},"modified":1503614265,"excerpt":"Camps teach children how to rely less on grownups and more on themselves.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Camps teach children how to rely less on grownups and more on themselves.","title":"Kids Find Breathing Room At Asthma Camp | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Kids Find Breathing Room At Asthma Camp","datePublished":"2017-08-24T15:37:45-07:00","dateModified":"2017-08-24T15:37:45-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"kids-find-breathing-room-at-asthma-camp","status":"publish","nprByline":"\u003ca href=\"http://californiahealthline.org/news/author/pamela-k-johnson/\">\u003cstrong>Pamela K. Johnson\u003c/strong>\u003c/a> \u003c/span>","path":"/stateofhealth/360898/kids-find-breathing-room-at-asthma-camp","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A third of the kids had finished their pancakes when camp counselor Bryan “The Lungs” Wegley hopped up to lead them in “The Penguin Song.” The children flapped their arms and shuffled their feet like snazzy Antarctic seabirds.\u003c/p>\n\u003cp>Later, when the room had grown quiet, another camp staffer showed a Smurf movie for 15 minutes worth of giggles, before everyone dashed off to swim.\u003c/p>\n\u003cp>For the 37 children attending this annual summer camp in Salinas, Calif., days packed with fun helped make doses of asthma education go down as smoothly as sweetened cough syrup. The kids attended the camp to frolic, but also to better understand the chronic lung disease that makes breathing more difficult for them and about \u003ca href=\"http://www.kidsdata.org/topic/238/asthma/table#fmt=97&loc=2,127,1657,331,1656,171,1655,345,357,324,369,362,360,337,364,356,217,328,354,320,339,334,365,343,367,344,355,366,368,265,349,361,4,273,59,370,326,341,338,350,342,359,363,340,335&tf=89&sortColumnId=0&sortType=asc\" target=\"_blank\" rel=\"noopener noreferrer\">1 in 6 California children\u003c/a>.\u003c/p>\n\u003cp>“Dust! Cockroaches! Cigarette smoke! Pets!” the kids yelled out in response to a question about what triggers their wheezing, shortness of breath and tightness in the chest. Some of the children, who ranged in age from 6 to 12, said they’d been to the emergency room multiple times. Asthma, if not properly treated, can be fatal.\u003c/p>\n\u003cp>Most of the children had been diagnosed when they were babies or toddlers and completely dependent on their parents or guardians. As they grow older and become physically less dependent on adults, they need to take more responsibility for managing their disease. \u003ca href=\"http://www.annallergy.org/article/S1081-1206(10)60377-8/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">Studies show\u003c/a> that asthma camps can instill knowledge and encourage habits that help children better control their conditions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For most of the week, parents dropped their kids off in the morning and picked them up at the end of the day. But one of the highlights of the camp is the sleepover, held at a local elementary school. That’s when kids who want to can spend the night at camp without their parents. For those who do, it’s another step in assuming responsibility for their own health.\u003c/p>\n\u003cp>“Our camp song says, ‘Your parents are not in charge of your asthma; you’re in charge of your asthma,’” said Sienna Grant, 9, as she climbed a ladder and prepared to swing rung to rung across a jungle gym. She used to be reluctant to stop playing, even for a puff of her inhaler. But now she’s learning “to take things more seriously,” she said.\u003c/p>\n\u003cp>Asthma camps sprang up in the late 1970s and early 1980s, when there were far fewer medications to treat the condition.\u003c/p>\n\u003cp>“There was no way to control or prevent asthma,” said Dr. Steven Prager, who is the camp’s medical director and a physician with the Salinas Valley Memorial Healthcare System, one of the camp’s co-sponsors.\u003c/p>\n\u003cp>Instead of shooing kids out of the house to play, nervous parents often blocked their path, relegating asthmatic children to a summer on the couch, Prager said.\u003c/p>\n\u003cp>For some children, asthma camp can provide a safe space to play and learn.\u003c/p>\n\u003cp>“I hear from prior campers and their parents all the time that the camp helped the kids take a more active, productive role in the management of their asthma,” Prager said. Parents reported a decrease in school absences and emergency room visits after their kids attended the program, he added.\u003c/p>\n\u003cp>Dr. Michael Welch, a physician at Rady Children’s Hospital-San Diego, studied the effectiveness of asthma camps a decade ago, but he said there is little research on the topic.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.annallergy.org/article/S1081-1206(10)60377-8/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">2007 study\u003c/a> co-authored by Welch found that a year after attending an asthma camp, kids had “assumed greater responsibility for taking their medication.” The study was based on a survey of nearly 1,800 participants at 24 asthma camps around the United States.\u003c/p>\n\u003cp>Welch noted that numerous camps cater to children with a wide range of chronic illnesses.\u003c/p>\n\u003cp>“Kids learn right away that they’re not the only ones with this chronic disease, so they [feel] a little less abnormal, which is good for their self-esteem,” he said.\u003c/p>\n\u003cp>Despite a profusion of camps dedicated to other conditions, the number of asthma camps is dwindling, Welch said. There are 90 asthma camps across the country — a third fewer than a decade ago — serving about 4,000 children, according to Jill Heins Nesvold, executive director of the \u003ca href=\"http://www.asthmacamps.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Consortium on Children’s Asthma Camps\u003c/a>.\u003c/p>\n\u003cp>There used to be at least five \u003ca href=\"http://www.asthmacamps.org/campdetails.cfm?longst=California&state=CA\" target=\"_blank\" rel=\"noopener noreferrer\">asthma camps in California\u003c/a>, but in the past few years, two of them — one in Los Angeles and another in San Diego — have closed.\u003c/p>\n\u003cp>“Funding has been a problem with keeping asthma camps alive,” said Welch, who was the medical director for more than three decades at the now-shuttered San Diego camp.\u003c/p>\n\u003cp>Part of the problem, he said, is that groups such as the American Lung Association have decided to focus their funding to research and lobbying, diverting it from direct community services like asthma camps.\u003c/p>\n\u003cp>The Salinas camp is funded by the Salinas Valley Memorial Healthcare System, \u003ca href=\"https://childrensmiraclenetworkhospitals.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Children’s Miracle Network\u003c/a> (CMN), a nonprofit that raises money for children’s hospitals nationwide, and individual donors. CMN gets most of its funding from corporate donors across a wide range of industries. The financial contributions help make the camp more affordable for families: Parents pay $55 per child, and scholarships are available.\u003c/p>\n\u003cp>While the Salinas camp has benefited from a solid endowment over the years, “it’s slowly being whittled down,” Prager said. “At the moment, we’re fine, but it’s going to be a challenge in the years to come.”\u003c/p>\n\u003cp>But as long as asthma camps keep their doors open, children will likely attend.\u003c/p>\n\u003cp>In the middle of the week, their confidence growing, about two-thirds of the Salinas campers tackled the overnight.\u003c/p>\n\u003cp>It sounds simple, but “many of these kids have never spent a night away from home,” Prager said. “It’s a big deal … and for the parents sometimes an even bigger deal.”\u003c/p>\n\u003cp>Dario Aldaco, 6, declared he would do the overnight even though his two older brothers — and running buddies — were skipping it.\u003c/p>\n\u003cp>“I want to do this, even if they don’t want to,” he told his mom, Aidee Aldaco.\u003c/p>\n\u003cp>“I was anxiety central,” she said. “I asked him, ‘Are you sure? Without your brothers?’”\u003c/p>\n\u003cp>On the big night, counselors stoked a fire pit near an outside play area and kids gathered around to socialize and munch s’mores. Later, inside the school’s gym, they unrolled sleeping bags and conked out on the floor, with counselors from the local YMCA and Prager nearby.\u003c/p>\n\u003cp>The next day, when the parents saw their kids had survived without them, they breathed a sigh of relief. On the final day, camp administrators asked the parents to vow that they would not curtail their children’s activities out of fear.\u003c/p>\n\u003cp>As they said their goodbyes, campers left with a better understanding of their illness, newfound confidence and backpacks full of gadgets and meds to ease their breathing.\u003c/p>\n\u003cp>Dario came home with the confidence to ask his father not to smoke on the side of the house where the fumes get inside and can trigger his and his brothers’ asthma.\u003c/p>\n\u003cp>Dario’s older brother, Aaron, 8, who also attended the camp and has mild to moderate autism, began to use a new word: “independent.”\u003c/p>\n\u003cp>The asthma camp had made him think twice about his mother’s plan to move closer to her children when they go off to college.\u003c/p>\n\u003cp>“If you move with me,” Aaron asked, “then how am I going to be independent?”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“So,” Aidee Aldaco said with a chuckle, “my husband and I are not going to be able to follow them.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/360898/kids-find-breathing-room-at-asthma-camp","authors":["byline_stateofhealth_360898"],"categories":["stateofhealth_11","stateofhealth_12","stateofhealth_1"],"tags":["stateofhealth_23","stateofhealth_3159","stateofhealth_96","stateofhealth_2808","stateofhealth_2519"],"affiliates":["stateofhealth_3036"],"featImg":"stateofhealth_360900","label":"stateofhealth_3036"},"stateofhealth_76380":{"type":"posts","id":"stateofhealth_76380","meta":{"index":"posts_1716263798","site":"stateofhealth","id":"76380","score":null,"sort":[1442011572000]},"parent":0,"labelTerm":{"site":"stateofhealth"},"blocks":[],"publishDate":1442011572,"format":"standard","disqusTitle":"In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire","title":"In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire","headTitle":"State of Health | KQED News","content":"\u003cp>Fresno health officials are alerting county residents to limit all outdoor activities as the Rough Fire \"\u003ca href=\"http://ww2.kqed.org/news/2015/x08/18/campgrounds-closed-as-fast-moving-sierra-fire-burns-20000-acres\" target=\"_blank\">rains ash\u003c/a>\" on Fresno.\u003c/p>\n\u003cp>Fresno County's department of public health reports an \"unprecedented increase\" in emergency room visits. Over the last 72 hours, local ERs have seen:\u003c/p>\n\u003cul>\n\u003cli>411 percent increase in visits due to respiratory issues\u003c/li>\n\u003cli>90 percent increase in visits due to cough\u003c/li>\n\u003c/ul>\n\u003cp>Health officials say that half of the patients affected fall into two groups: those aged 15-24 and those over age 65. KQED's Sasha Khokha \u003ca href=\"http://ww2.kqed.org/news/2015/x08/18/campgrounds-closed-as-fast-moving-sierra-fire-burns-20000-acres\" target=\"_blank\">reports\u003c/a> that even children with healthy lungs are showing up in the ER with burning eyes and a hacking cough.\u003c/p>\n\u003cp>\"It's definitely scary,\" said Dolores Weller, head of the Central Valley Air Quality Coalition, an advocacy group. \"We've been getting a lot of phone calls from concerned parents, coaches, school officials, and day care centers.\"\u003c/p>\n\u003cp>Weller said that many callers were confused because air district monitors are designed to measure fine particulate matter and not larger particulates like ash. So air quality levels \u003ca href=\"http://www.valleyair.org/programs/raan/raan_index.htm?x=FRSGRLND\" target=\"_blank\">measure lower \u003c/a>than a reflection of the true risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"If you see ash or smell smoke it is a level 4 hazard,\" says \u003ca href=\"http://www.co.fresno.ca.us/uploadedFiles/Departments/Public_Health/Divisions/PPC/Health_Messages/NEW%20DPH%20ALERT%20Increased%20Health%20Impact%20to%20Fresno%20County%20Residents%20Due%20to%20Rough%20Fire%209-11-15%20Final.pdf\" target=\"_blank\">the alert\u003c/a>, \"and all outdoor activities should be limited.\"\u003c/p>\n\u003cp>In response to the health alert, Fresno Unified School District has canceled all sporting events, including football games, scheduled for Friday evening. All practices, both indoor and outdoor, are also canceled. Fresno Unified's middle school football games are canceled Saturday.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Smoky conditions are expected to continue over the next several days.\u003c/p>\n\n","disqusIdentifier":"76380 http://ww2.kqed.org/stateofhealth/?p=76380","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/09/11/in-fresno-unprecedented-increase-in-er-visits-due-to-rough-fire/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":259,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":10},"modified":1442014614,"excerpt":"Health officials urge people to stay indoors, and schools have canceled all sporting events. ","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Health officials urge people to stay indoors, and schools have canceled all sporting events. ","title":"In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In Fresno, 'Unprecedented Increase' in ER Visits Due to Rough Fire","datePublished":"2015-09-11T15:46:12-07:00","dateModified":"2015-09-11T16:36:54-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"in-fresno-unprecedented-increase-in-er-visits-due-to-rough-fire","status":"publish","path":"/stateofhealth/76380/in-fresno-unprecedented-increase-in-er-visits-due-to-rough-fire","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Fresno health officials are alerting county residents to limit all outdoor activities as the Rough Fire \"\u003ca href=\"http://ww2.kqed.org/news/2015/x08/18/campgrounds-closed-as-fast-moving-sierra-fire-burns-20000-acres\" target=\"_blank\">rains ash\u003c/a>\" on Fresno.\u003c/p>\n\u003cp>Fresno County's department of public health reports an \"unprecedented increase\" in emergency room visits. Over the last 72 hours, local ERs have seen:\u003c/p>\n\u003cul>\n\u003cli>411 percent increase in visits due to respiratory issues\u003c/li>\n\u003cli>90 percent increase in visits due to cough\u003c/li>\n\u003c/ul>\n\u003cp>Health officials say that half of the patients affected fall into two groups: those aged 15-24 and those over age 65. KQED's Sasha Khokha \u003ca href=\"http://ww2.kqed.org/news/2015/x08/18/campgrounds-closed-as-fast-moving-sierra-fire-burns-20000-acres\" target=\"_blank\">reports\u003c/a> that even children with healthy lungs are showing up in the ER with burning eyes and a hacking cough.\u003c/p>\n\u003cp>\"It's definitely scary,\" said Dolores Weller, head of the Central Valley Air Quality Coalition, an advocacy group. \"We've been getting a lot of phone calls from concerned parents, coaches, school officials, and day care centers.\"\u003c/p>\n\u003cp>Weller said that many callers were confused because air district monitors are designed to measure fine particulate matter and not larger particulates like ash. So air quality levels \u003ca href=\"http://www.valleyair.org/programs/raan/raan_index.htm?x=FRSGRLND\" target=\"_blank\">measure lower \u003c/a>than a reflection of the true risk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If you see ash or smell smoke it is a level 4 hazard,\" says \u003ca href=\"http://www.co.fresno.ca.us/uploadedFiles/Departments/Public_Health/Divisions/PPC/Health_Messages/NEW%20DPH%20ALERT%20Increased%20Health%20Impact%20to%20Fresno%20County%20Residents%20Due%20to%20Rough%20Fire%209-11-15%20Final.pdf\" target=\"_blank\">the alert\u003c/a>, \"and all outdoor activities should be limited.\"\u003c/p>\n\u003cp>In response to the health alert, Fresno Unified School District has canceled all sporting events, including football games, scheduled for Friday evening. All practices, both indoor and outdoor, are also canceled. Fresno Unified's middle school football games are canceled Saturday.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Smoky conditions are expected to continue over the next several days.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/76380/in-fresno-unprecedented-increase-in-er-visits-due-to-rough-fire","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_21","stateofhealth_23","stateofhealth_280"],"featImg":"stateofhealth_76381","label":"stateofhealth"},"stateofhealth_65276":{"type":"posts","id":"stateofhealth_65276","meta":{"index":"posts_1716263798","site":"stateofhealth","id":"65276","score":null,"sort":[1440193370000]},"parent":0,"labelTerm":{"site":"stateofhealth"},"blocks":[],"publishDate":1440193370,"format":"standard","disqusTitle":"Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust","title":"Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust","headTitle":"State of Health | KQED News","content":"\u003cp>It’s almond season in the Central Valley, when loud mechanical harvesters with long arms grip and shake the trees, knocking down the nuts.\u003c/p>\n\u003cp>But the process also sends up huge dust clouds. Farm machines and trucks make multiple trips on dirt roads between fields, and that creates dust, too.\u003c/p>\n\u003cp>The drought has been contributing to a dust bowl in Central Valley farm country. The dust, in turn, exacerbates the region's high rates of asthma. To keep dust down, farmers usually use a watering truck, spraying the roads to knock down the dust and comply with air pollution rules.\u003c/p>\n\u003cp>But now, in the fourth year of a crippling drought, the approach is changing.\u003c/p>\n\u003cp>It’s the job of the San Joaquin Valley Air Pollution Control District to oversee dust rules, and the district’s Ryan Hyashi says farmers have been very responsive. Now the district is trying to balance competing tensions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s potable water that they’re usually putting on these roads,\" Hyashi says. \"People don’t have water to drink, and we’re putting it on roadways. It sends a poor message\u003cstrong>.\"\u003c/strong>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/220309181\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Instead, the air district is encouraging farmers to limit access to dirt roads, or cover them with things like gravel. If those options won’t work, farmers can now \u003ca href=\"http://www.valleyair.org/busind/comply/AssistanceDocuments/Dust_Control_Agricultural_Advisory.pdf\" target=\"_blank\">sign up for a program\u003c/a> to avoid enforcement penalties as long as they meet certain requirements, such as not being within 1,000 feet of a school or hospital.\u003c/p>\n\u003cp>\"[Farmers] want to do their part and be good stewards,” says Hayashi. But if there's no water for dust control, they may “just have no alternative.\"\u003c/p>\n\u003cp>But air quality advocates say the air district is essentially giving farmers a free pass to pollute.\u003c/p>\n\u003cp>\"When we see any relaxation in the rules, we get very nervous,\" says Kevin Hamilton, with the Central California Asthma Collaborative.\u003c/p>\n\u003cp>As we're talking, Hamilton watches a cloud of dust billow up on a farm road west of Fresno.\u003c/p>\n\u003cfigure id=\"attachment_65299\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-e1440192126284.jpg\">\u003cimg class=\"size-thumbnail wp-image-65299\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-400x300.jpg\" alt=\"Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno.\" width=\"400\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno. \u003ccite>(Sasha Khokha)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"So here goes another truck with more dust coming up,\" he says. \"This is dangerous stuff. This is actually a health hazard.\"\u003c/p>\n\u003cp>Hamilton treats patients for asthma and says this kind of dust can travel for miles, ending up in people’s lungs. He criticized air regulators not only for the new dust guidelines, but also that they’re allowing \u003ca href=\"http://www.arb.ca.gov/msprog/ordiesel/faq/waterwelldrillingfaq.pdf\" target=\"_blank\">well-drilling rigs\u003c/a> from out of state that may have dirtier engines than California trucks.\u003c/p>\n\u003cp>\"I understand that we’re in an emergency,\" he says, \"but we’ve all fought so long to begin making progress here -- and I feel we are making progress. At this moment, it feels like we’re going to go backward again.\"\u003c/p>\n\u003cp>Just a few miles away, farmer Paul Betancourt says he doesn’t want his family breathing dusty air either. But he also doesn’t want the dust on his almond trees because it can cause mites. Watering down the roads on his farm, he says, means he uses fewer pesticides.\u003c/p>\n\u003cp>\"We want to use less chemicals on the farm,\" Betancourt says. \"You want us to use less chemicals on the farm. But in a year like this, when we’re really short of water, it’s balancing out how to keep the dust down.\"\u003c/p>\n\u003cp>Betancourt’s almond farm near the Fresno County town of Kerman has very fine, silty soil. For now, Betancourt says as long as he has water in his well, he’ll still periodically spray down the roads. Gravel is too expensive, and road oil just doesn’t work, he says.\u003c/p>\n\u003cp>“We need to use the water carefully and keep the dust down,” Betancourt said. “At this point, it’s still the most cost-effective way.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He doesn’t plan to apply for the air district’s emergency drought relief programs. Farmers who do can avoid using water to control dust through Nov. 1. After that, the valley’s particulate matter season starts, and the air district says it will require farmers to use water to spray down roads again.\u003c/p>\n\n","disqusIdentifier":"65276 http://ww2.kqed.org/stateofhealth/?p=65276","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/08/21/another-drought-casualty-controlling-dust-with-water-in-the-central-valley/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":754,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":22},"modified":1440203689,"excerpt":"Health advocates say it's a step backward in region with soaring rates of asthma.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Health advocates say it's a step backward in region with soaring rates of asthma.","title":"Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust","datePublished":"2015-08-21T14:42:50-07:00","dateModified":"2015-08-21T17:34:49-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"another-drought-casualty-controlling-dust-with-water-in-the-central-valley","status":"publish","path":"/stateofhealth/65276/another-drought-casualty-controlling-dust-with-water-in-the-central-valley","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s almond season in the Central Valley, when loud mechanical harvesters with long arms grip and shake the trees, knocking down the nuts.\u003c/p>\n\u003cp>But the process also sends up huge dust clouds. Farm machines and trucks make multiple trips on dirt roads between fields, and that creates dust, too.\u003c/p>\n\u003cp>The drought has been contributing to a dust bowl in Central Valley farm country. The dust, in turn, exacerbates the region's high rates of asthma. To keep dust down, farmers usually use a watering truck, spraying the roads to knock down the dust and comply with air pollution rules.\u003c/p>\n\u003cp>But now, in the fourth year of a crippling drought, the approach is changing.\u003c/p>\n\u003cp>It’s the job of the San Joaquin Valley Air Pollution Control District to oversee dust rules, and the district’s Ryan Hyashi says farmers have been very responsive. Now the district is trying to balance competing tensions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s potable water that they’re usually putting on these roads,\" Hyashi says. \"People don’t have water to drink, and we’re putting it on roadways. It sends a poor message\u003cstrong>.\"\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/220309181&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/220309181'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Instead, the air district is encouraging farmers to limit access to dirt roads, or cover them with things like gravel. If those options won’t work, farmers can now \u003ca href=\"http://www.valleyair.org/busind/comply/AssistanceDocuments/Dust_Control_Agricultural_Advisory.pdf\" target=\"_blank\">sign up for a program\u003c/a> to avoid enforcement penalties as long as they meet certain requirements, such as not being within 1,000 feet of a school or hospital.\u003c/p>\n\u003cp>\"[Farmers] want to do their part and be good stewards,” says Hayashi. But if there's no water for dust control, they may “just have no alternative.\"\u003c/p>\n\u003cp>But air quality advocates say the air district is essentially giving farmers a free pass to pollute.\u003c/p>\n\u003cp>\"When we see any relaxation in the rules, we get very nervous,\" says Kevin Hamilton, with the Central California Asthma Collaborative.\u003c/p>\n\u003cp>As we're talking, Hamilton watches a cloud of dust billow up on a farm road west of Fresno.\u003c/p>\n\u003cfigure id=\"attachment_65299\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-e1440192126284.jpg\">\u003cimg class=\"size-thumbnail wp-image-65299\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-400x300.jpg\" alt=\"Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno.\" width=\"400\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno. \u003ccite>(Sasha Khokha)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"So here goes another truck with more dust coming up,\" he says. \"This is dangerous stuff. This is actually a health hazard.\"\u003c/p>\n\u003cp>Hamilton treats patients for asthma and says this kind of dust can travel for miles, ending up in people’s lungs. He criticized air regulators not only for the new dust guidelines, but also that they’re allowing \u003ca href=\"http://www.arb.ca.gov/msprog/ordiesel/faq/waterwelldrillingfaq.pdf\" target=\"_blank\">well-drilling rigs\u003c/a> from out of state that may have dirtier engines than California trucks.\u003c/p>\n\u003cp>\"I understand that we’re in an emergency,\" he says, \"but we’ve all fought so long to begin making progress here -- and I feel we are making progress. At this moment, it feels like we’re going to go backward again.\"\u003c/p>\n\u003cp>Just a few miles away, farmer Paul Betancourt says he doesn’t want his family breathing dusty air either. But he also doesn’t want the dust on his almond trees because it can cause mites. Watering down the roads on his farm, he says, means he uses fewer pesticides.\u003c/p>\n\u003cp>\"We want to use less chemicals on the farm,\" Betancourt says. \"You want us to use less chemicals on the farm. But in a year like this, when we’re really short of water, it’s balancing out how to keep the dust down.\"\u003c/p>\n\u003cp>Betancourt’s almond farm near the Fresno County town of Kerman has very fine, silty soil. For now, Betancourt says as long as he has water in his well, he’ll still periodically spray down the roads. Gravel is too expensive, and road oil just doesn’t work, he says.\u003c/p>\n\u003cp>“We need to use the water carefully and keep the dust down,” Betancourt said. “At this point, it’s still the most cost-effective way.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He doesn’t plan to apply for the air district’s emergency drought relief programs. Farmers who do can avoid using water to control dust through Nov. 1. After that, the valley’s particulate matter season starts, and the air district says it will require farmers to use water to spray down roads again.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/65276/another-drought-casualty-controlling-dust-with-water-in-the-central-valley","authors":["254"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_21","stateofhealth_23","stateofhealth_461"],"featImg":"stateofhealth_65300","label":"stateofhealth"},"stateofhealth_29198":{"type":"posts","id":"stateofhealth_29198","meta":{"index":"posts_1716263798","site":"stateofhealth","id":"29198","score":null,"sort":[1432481401000]},"parent":0,"labelTerm":{"site":"stateofhealth"},"blocks":[],"publishDate":1432481401,"format":"standard","disqusTitle":"Despite Efforts, ER Visits Spike in California Kids with Asthma","title":"Despite Efforts, ER Visits Spike in California Kids with Asthma","headTitle":"State of Health | KQED News","content":"\u003cp>Children in California increasingly are flocking to emergency rooms for treatment of asthma, despite millions of dollars spent on programs to control the disease.\u003c/p>\n\u003cp>Statewide, the rates of ER visits for asthma symptoms rose by about 18 percent for California children ages 5 to 17 and by 6 percent for children under 5 between 2005 and 2012, according to a Kaiser Health News analysis of the \u003ca href=\"http://www.ehib.org/page.jsp?page_key=124\" target=\"_blank\">latest available rates by county\u003c/a>.\u003c/p>\n\u003cp>In some parts of the state, especially the Central Valley, the increases were far higher. The rate of emergency room visits for children 5 and older more than doubled in rural Madera County and nearly doubled In Merced. In Sacramento County, they rose by 48 percent and in Los Angeles, the largest county in the nation, by 17 percent.\u003c/p>\n\u003cp>All told, more than 72,000 California children under 18 visited the ER for asthma in 2012.\u003c/p>\n\u003cp>\"There's clearly more work to be done if this many kids are going to the emergency department,\" said Anne Kelsey Lamb, director of the Regional Asthma Management and Prevention program of the Oakland-based Public Health Institute. \"We know a lot about what works. We absolutely should be able to reduce the rates we're seeing.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At the national level, asthma-related emergency room visit rates have declined in recent years, according to federal health data through 2010, the latest available.\u003c/p>\n\u003cp>Although ER visits declined in some counties, including Alameda, San Mateo and Marin, the overall rise in California has frustrated public health experts who have spent millions of dollars and countless hours to improve and expand asthma prevention programs around the state. The state and federal governments alone spend $1.54 million annually on such projects in California, including grants to schools to improve indoor air quality and training community health workers.\u003c/p>\n\u003cp>The good news is fewer kids are actually being admitted into hospitals. Overnight-or-longer stays are \u003ca href=\"http://www.kidsdata.org/topic/239/asthma-hospitalizations/trend#fmt=2298&loc=2&tf=1,73&ch=790&pdist=7\" target=\"_blank\">declining statewide\u003c/a> and nationally. That's due largely to better medicines and more aggressive treatment in the ER, asthma specialists say.\u003c/p>\n\u003cp>The reasons for the increase in ER visits are complex, experts say. They include parents not properly administering medications, poverty and inadequate insurance coverage, persistently high levels of indoor and outdoor pollution in some regions and the limited reach of programs that seek to manage symptoms or prevent them.\u003c/p>\n\u003cfigure id=\"attachment_29220\" class=\"wp-caption alignright\" style=\"max-width: 770px\">\u003cimg class=\"wp-image-29220 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770.jpg\" alt=\"Source: Kaiser Health News\" width=\"770\" height=\"737\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770-400x383.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770-32x32.jpg 32w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Source: Kaiser Health News\u003c/figcaption>\u003c/figure>\n\u003cp>The rising rates don’t seem to reflect an actual increase in the respiratory disease – about 15 percent of California children have been diagnosed with asthma, a number that has remained \u003ca href=\"http://www.kidsdata.org/topic/238/asthma/trend#fmt=97&loc=2&tf=4,77\" target=\"_blank\">fairly steady\u003c/a> since 2001.\u003c/p>\n\u003cfigure id=\"attachment_29221\" class=\"wp-caption alignright\" style=\"max-width: 770px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg\" target=\"_blank\">\u003cimg class=\"wp-image-29221 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg\" alt=\"county-asthma-rates_5-to-17_final_052215_770\" width=\"770\" height=\"737\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770-400x383.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770-32x32.jpg 32w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: Kaiser Health News\u003c/figcaption>\u003c/figure>\n\u003cp>The rates of ER visits vary widely by county, from a high of 300 visits per 10,000 children under age 5 (Madera County) to a low of 32 (Sutter County) in 2012. Younger children visit the ER at higher rates because they are more likely to have undiagnosed asthma and because their lung function is more difficult to measure, complicating the task of finding the right combination of medicines, Kelsey Lamb said.\u003c/p>\n\u003cp>Some families seek treatment in the ER for symptoms that easily could be dealt with in a clinic because they can’t get a timely doctor's appointment or don't have a regular doctor – especially those without health insurance. Sometimes, a bad cold and flu season can aggravate asthma that is usually well-controlled.\u003c/p>\n\u003cp>Affected children often live in homes with dust, mold or pets, which trigger asthma symptoms. They may need two inhalers – one for school and one for home – but insurance sometimes only pays for one.\u003c/p>\n\u003cp>In the Central Valley, persistent poverty and outdoor air pollution levels combine to produce the highest rates of ER visits for childhood asthma in the state.\u003c/p>\n\u003cp>While particulate matter and ozone air pollution levels \u003ca href=\"http://www.kidsdata.org/topic/525/environment-airquality-ozone/trend#fmt=1086&loc=2,357,364,362,356,354&tf=4,64%20(\" target=\"_blank\">are declining somewhat\u003c/a> in the region, they still can be high enough to trigger asthma attacks, said John Capitman, a California State University-nono public health professor and executive director of the Central Valley Health Policy Institute. In \u003ca href=\"http://www.latimes.com/local/lanow/la-me-clean-air-lungs-children-20150304-story.html#page=1\" target=\"_blank\">Los Angeles\u003c/a>, the same holds true, although particulates are slightly \u003ca href=\"http://www.kidsdata.org/topic/524/environment-airquality/trend#fmt=1087&loc=357,364,362&tf=4,64\" target=\"_blank\">lower than in parts of in the Central Valley\u003c/a>\u003cu>. \u003c/u>\u003c/p>\n\u003cp>Across California, local and regional asthma programs aim to educate families and doctors to help keep kids out of the hospital. In counties including Orange and Los Angeles, medically equipped vans called “Breathmobiles” provide comprehensive care in community settings and ensure children don’t end up repeatedly in the ER.\u003c/p>\n\u003cp>It worked for Daniel Lee, 5, of Buena Park, who was still experiencing severe asthma symptoms after five trips to the ER last year. It turned out the doctors at the hospital had mixed his medications incorrectly -- a common mistake when kids are treated in emergency rooms rather than by asthma-trained pediatricians, said Dr. Olga Guijon, associate medical director of the Breathmobile for Children’s Hospital of Orange County.\u003c/p>\n\u003cfigure id=\"attachment_29214\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/er-asthma-10-e1432333735519.jpg\" target=\"_blank\">\u003cimg class=\"wp-image-29214 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/er-asthma-10-400x267.jpg\" alt=\"The Childrens Hospital of Orange County Breathmobile is a mobile asthma clinic dedicated to serving low-income communities in the area. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Childrens Hospital of Orange County Breathmobile is a mobile asthma clinic dedicated to serving low-income communities in the area. \u003ccite>(Photo by Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“All he wants to do is play soccer,” said his mother Young Lee, during a recent visit to the Breathmobile in Anaheim. “But every time he’s running around on the field, he says: ‘I feel weird’. So he has to stop.”\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">Daniel has improved drastically after being treated at the Breathmobile and having his medication adjusted, his mother said.\u003c/span>\u003cbr>\nThough often effective, these programs are expensive and can't serve enough children to make a real difference statewide, Capitman said. And health outreach workers have found it difficult to get reimbursed by insurers, including Medi-Cal, for proven strategies including home visits to minimize risks, Capitman said.\u003c/p>\n\u003cp>Dr. Amy Harrison, a pediatric pulmonologist at Children's Hospital Orange County, suggested that the recession had driven some families to her hospital's ER, because they had lost their insurance or had high-deductible insurance that led them to forego prescriptions and regular doctor visits.\u003c/p>\n\u003cp>Because the data don’t extend beyond 2012, it remains unclear how expanded coverage offered since last year under the Affordable Care Act and California's Medicaid program will \u003ca href=\"http://www.vox.com/2015/5/4/8547375/obamacare-emergency-room\" target=\"_blank\">affect emergency room visits\u003c/a>. But experts like Capitman hope to see more funding for programs that manage or prevent asthma symptoms through the Affordable Care Act's \u003ca href=\"http://www.hhs.gov/open/prevention/index.html\" target=\"_blank\">Prevention and Public Health Fund\u003c/a>.\u003c/p>\n\u003cp>Asthma care for kids has improved markedly in recent years, in part because of the wider use of steroid inhalers. Influential asthma management \u003ca href=\"http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines\" target=\"_blank\">guidelines\u003c/a> released in 2007 also have helped.\u003c/p>\n\u003cp>But some families simply don't know how to manage their child's condition at home, or know when to seek medical care before an ER visit becomes necessary, \u003cspan class=\"Apple-style-span\">said Dr. Rami Keisari, medical director of the Pediatric Asthma Disease Management Program at the county-run Santa Clara Valley Medical Center in San Jose\u003cb>.\u003c/b>\u003c/span>\u003c/p>\n\u003cp>\"One of the biggest challenges we have is getting parents to use the medications every day,\" Keisari said. \"We have a really hard time convincing parents that this is a chronic condition.\"\u003c/p>\n\u003cp>Some of the few large counties with declining ER visits have invested heavily in targeting kids who are at risk. Alameda County children who have been treated in ERs are referred to the county's free Asthma Start program, which offers free home visits during which health workers identify asthma triggers, offer education and provide equipment such as spacers and nebulizers – even vacuum cleaners, said program director Brenda Yamashita of the Alameda County Department of Public Health.\u003c/p>\n\u003cp>Parents learn to freeze stuffed animals to kill asthma-triggering dust mites, track their children's symptoms on a calendar, and clean surfaces without bleach, which can aggravate symptoms. Alameda Alliance for Health, the county's public, nonprofit health insurance plan, reimburses Yamashita's program for home visits.\u003c/p>\n\u003cp>For parents in substandard rental housing, staffers call on the county's Healthy Homes department to press landlords to get rid of vermin, fix leaks and address other code violations.\u003c/p>\n\u003cp>In Santa Clara County, Keisari's staff keeps tabs on kids for as long as three years. Every month, a public health nurse calls parents and asks about their children's symptoms and medications.\u003c/p>\n\u003cp>The county's overall child ER visit rates are low compared to other counties. Even so, the number of children the program serves is limited compared to the need. And while the county's asthma ER visit rates declined by 21 percent for children under 5, they rose 12 percent for children aged 5 to 17.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We're doing better with all these programs, but is it adequate? No. Every time a kid winds up in the ER with bad exacerbation of asthma, it's a failure,\" said Stanford University child health policy researcher Dr. Paul Wise.\u003c/p>\n\n","disqusIdentifier":"29198 http://ww2.kqed.org/stateofhealth/?p=29198","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/05/24/despite-efforts-er-visits-spike-in-california-kids-with-asthma/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":1472,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":32},"modified":1432922646,"excerpt":"Statewide, asthma visits to the ER went up 18 percent, and more than doubled in parts of the Central Valley.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Statewide, asthma visits to the ER went up 18 percent, and more than doubled in parts of the Central Valley.","title":"Despite Efforts, ER Visits Spike in California Kids with Asthma | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Despite Efforts, ER Visits Spike in California Kids with Asthma","datePublished":"2015-05-24T08:30:01-07:00","dateModified":"2015-05-29T11:04:06-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"despite-efforts-er-visits-spike-in-california-kids-with-asthma","status":"publish","nprByline":"\u003cstrong>Barbara Feder Ostrov\u003cbr />Kaiser Health News\u003c/strong>","path":"/stateofhealth/29198/despite-efforts-er-visits-spike-in-california-kids-with-asthma","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Children in California increasingly are flocking to emergency rooms for treatment of asthma, despite millions of dollars spent on programs to control the disease.\u003c/p>\n\u003cp>Statewide, the rates of ER visits for asthma symptoms rose by about 18 percent for California children ages 5 to 17 and by 6 percent for children under 5 between 2005 and 2012, according to a Kaiser Health News analysis of the \u003ca href=\"http://www.ehib.org/page.jsp?page_key=124\" target=\"_blank\">latest available rates by county\u003c/a>.\u003c/p>\n\u003cp>In some parts of the state, especially the Central Valley, the increases were far higher. The rate of emergency room visits for children 5 and older more than doubled in rural Madera County and nearly doubled In Merced. In Sacramento County, they rose by 48 percent and in Los Angeles, the largest county in the nation, by 17 percent.\u003c/p>\n\u003cp>All told, more than 72,000 California children under 18 visited the ER for asthma in 2012.\u003c/p>\n\u003cp>\"There's clearly more work to be done if this many kids are going to the emergency department,\" said Anne Kelsey Lamb, director of the Regional Asthma Management and Prevention program of the Oakland-based Public Health Institute. \"We know a lot about what works. We absolutely should be able to reduce the rates we're seeing.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At the national level, asthma-related emergency room visit rates have declined in recent years, according to federal health data through 2010, the latest available.\u003c/p>\n\u003cp>Although ER visits declined in some counties, including Alameda, San Mateo and Marin, the overall rise in California has frustrated public health experts who have spent millions of dollars and countless hours to improve and expand asthma prevention programs around the state. The state and federal governments alone spend $1.54 million annually on such projects in California, including grants to schools to improve indoor air quality and training community health workers.\u003c/p>\n\u003cp>The good news is fewer kids are actually being admitted into hospitals. Overnight-or-longer stays are \u003ca href=\"http://www.kidsdata.org/topic/239/asthma-hospitalizations/trend#fmt=2298&loc=2&tf=1,73&ch=790&pdist=7\" target=\"_blank\">declining statewide\u003c/a> and nationally. That's due largely to better medicines and more aggressive treatment in the ER, asthma specialists say.\u003c/p>\n\u003cp>The reasons for the increase in ER visits are complex, experts say. They include parents not properly administering medications, poverty and inadequate insurance coverage, persistently high levels of indoor and outdoor pollution in some regions and the limited reach of programs that seek to manage symptoms or prevent them.\u003c/p>\n\u003cfigure id=\"attachment_29220\" class=\"wp-caption alignright\" style=\"max-width: 770px\">\u003cimg class=\"wp-image-29220 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770.jpg\" alt=\"Source: Kaiser Health News\" width=\"770\" height=\"737\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770-400x383.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770-32x32.jpg 32w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Source: Kaiser Health News\u003c/figcaption>\u003c/figure>\n\u003cp>The rising rates don’t seem to reflect an actual increase in the respiratory disease – about 15 percent of California children have been diagnosed with asthma, a number that has remained \u003ca href=\"http://www.kidsdata.org/topic/238/asthma/trend#fmt=97&loc=2&tf=4,77\" target=\"_blank\">fairly steady\u003c/a> since 2001.\u003c/p>\n\u003cfigure id=\"attachment_29221\" class=\"wp-caption alignright\" style=\"max-width: 770px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg\" target=\"_blank\">\u003cimg class=\"wp-image-29221 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg\" alt=\"county-asthma-rates_5-to-17_final_052215_770\" width=\"770\" height=\"737\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770-400x383.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770-32x32.jpg 32w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: Kaiser Health News\u003c/figcaption>\u003c/figure>\n\u003cp>The rates of ER visits vary widely by county, from a high of 300 visits per 10,000 children under age 5 (Madera County) to a low of 32 (Sutter County) in 2012. Younger children visit the ER at higher rates because they are more likely to have undiagnosed asthma and because their lung function is more difficult to measure, complicating the task of finding the right combination of medicines, Kelsey Lamb said.\u003c/p>\n\u003cp>Some families seek treatment in the ER for symptoms that easily could be dealt with in a clinic because they can’t get a timely doctor's appointment or don't have a regular doctor – especially those without health insurance. Sometimes, a bad cold and flu season can aggravate asthma that is usually well-controlled.\u003c/p>\n\u003cp>Affected children often live in homes with dust, mold or pets, which trigger asthma symptoms. They may need two inhalers – one for school and one for home – but insurance sometimes only pays for one.\u003c/p>\n\u003cp>In the Central Valley, persistent poverty and outdoor air pollution levels combine to produce the highest rates of ER visits for childhood asthma in the state.\u003c/p>\n\u003cp>While particulate matter and ozone air pollution levels \u003ca href=\"http://www.kidsdata.org/topic/525/environment-airquality-ozone/trend#fmt=1086&loc=2,357,364,362,356,354&tf=4,64%20(\" target=\"_blank\">are declining somewhat\u003c/a> in the region, they still can be high enough to trigger asthma attacks, said John Capitman, a California State University-nono public health professor and executive director of the Central Valley Health Policy Institute. In \u003ca href=\"http://www.latimes.com/local/lanow/la-me-clean-air-lungs-children-20150304-story.html#page=1\" target=\"_blank\">Los Angeles\u003c/a>, the same holds true, although particulates are slightly \u003ca href=\"http://www.kidsdata.org/topic/524/environment-airquality/trend#fmt=1087&loc=357,364,362&tf=4,64\" target=\"_blank\">lower than in parts of in the Central Valley\u003c/a>\u003cu>. \u003c/u>\u003c/p>\n\u003cp>Across California, local and regional asthma programs aim to educate families and doctors to help keep kids out of the hospital. In counties including Orange and Los Angeles, medically equipped vans called “Breathmobiles” provide comprehensive care in community settings and ensure children don’t end up repeatedly in the ER.\u003c/p>\n\u003cp>It worked for Daniel Lee, 5, of Buena Park, who was still experiencing severe asthma symptoms after five trips to the ER last year. It turned out the doctors at the hospital had mixed his medications incorrectly -- a common mistake when kids are treated in emergency rooms rather than by asthma-trained pediatricians, said Dr. Olga Guijon, associate medical director of the Breathmobile for Children’s Hospital of Orange County.\u003c/p>\n\u003cfigure id=\"attachment_29214\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/er-asthma-10-e1432333735519.jpg\" target=\"_blank\">\u003cimg class=\"wp-image-29214 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/er-asthma-10-400x267.jpg\" alt=\"The Childrens Hospital of Orange County Breathmobile is a mobile asthma clinic dedicated to serving low-income communities in the area. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Childrens Hospital of Orange County Breathmobile is a mobile asthma clinic dedicated to serving low-income communities in the area. \u003ccite>(Photo by Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“All he wants to do is play soccer,” said his mother Young Lee, during a recent visit to the Breathmobile in Anaheim. “But every time he’s running around on the field, he says: ‘I feel weird’. So he has to stop.”\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">Daniel has improved drastically after being treated at the Breathmobile and having his medication adjusted, his mother said.\u003c/span>\u003cbr>\nThough often effective, these programs are expensive and can't serve enough children to make a real difference statewide, Capitman said. And health outreach workers have found it difficult to get reimbursed by insurers, including Medi-Cal, for proven strategies including home visits to minimize risks, Capitman said.\u003c/p>\n\u003cp>Dr. Amy Harrison, a pediatric pulmonologist at Children's Hospital Orange County, suggested that the recession had driven some families to her hospital's ER, because they had lost their insurance or had high-deductible insurance that led them to forego prescriptions and regular doctor visits.\u003c/p>\n\u003cp>Because the data don’t extend beyond 2012, it remains unclear how expanded coverage offered since last year under the Affordable Care Act and California's Medicaid program will \u003ca href=\"http://www.vox.com/2015/5/4/8547375/obamacare-emergency-room\" target=\"_blank\">affect emergency room visits\u003c/a>. But experts like Capitman hope to see more funding for programs that manage or prevent asthma symptoms through the Affordable Care Act's \u003ca href=\"http://www.hhs.gov/open/prevention/index.html\" target=\"_blank\">Prevention and Public Health Fund\u003c/a>.\u003c/p>\n\u003cp>Asthma care for kids has improved markedly in recent years, in part because of the wider use of steroid inhalers. Influential asthma management \u003ca href=\"http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines\" target=\"_blank\">guidelines\u003c/a> released in 2007 also have helped.\u003c/p>\n\u003cp>But some families simply don't know how to manage their child's condition at home, or know when to seek medical care before an ER visit becomes necessary, \u003cspan class=\"Apple-style-span\">said Dr. Rami Keisari, medical director of the Pediatric Asthma Disease Management Program at the county-run Santa Clara Valley Medical Center in San Jose\u003cb>.\u003c/b>\u003c/span>\u003c/p>\n\u003cp>\"One of the biggest challenges we have is getting parents to use the medications every day,\" Keisari said. \"We have a really hard time convincing parents that this is a chronic condition.\"\u003c/p>\n\u003cp>Some of the few large counties with declining ER visits have invested heavily in targeting kids who are at risk. Alameda County children who have been treated in ERs are referred to the county's free Asthma Start program, which offers free home visits during which health workers identify asthma triggers, offer education and provide equipment such as spacers and nebulizers – even vacuum cleaners, said program director Brenda Yamashita of the Alameda County Department of Public Health.\u003c/p>\n\u003cp>Parents learn to freeze stuffed animals to kill asthma-triggering dust mites, track their children's symptoms on a calendar, and clean surfaces without bleach, which can aggravate symptoms. Alameda Alliance for Health, the county's public, nonprofit health insurance plan, reimburses Yamashita's program for home visits.\u003c/p>\n\u003cp>For parents in substandard rental housing, staffers call on the county's Healthy Homes department to press landlords to get rid of vermin, fix leaks and address other code violations.\u003c/p>\n\u003cp>In Santa Clara County, Keisari's staff keeps tabs on kids for as long as three years. Every month, a public health nurse calls parents and asks about their children's symptoms and medications.\u003c/p>\n\u003cp>The county's overall child ER visit rates are low compared to other counties. Even so, the number of children the program serves is limited compared to the need. And while the county's asthma ER visit rates declined by 21 percent for children under 5, they rose 12 percent for children aged 5 to 17.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're doing better with all these programs, but is it adequate? No. Every time a kid winds up in the ER with bad exacerbation of asthma, it's a failure,\" said Stanford University child health policy researcher Dr. Paul Wise.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/29198/despite-efforts-er-visits-spike-in-california-kids-with-asthma","authors":["byline_stateofhealth_29198"],"categories":["stateofhealth_11","stateofhealth_13"],"tags":["stateofhealth_23","stateofhealth_96"],"featImg":"stateofhealth_29232","label":"stateofhealth"},"stateofhealth_23071":{"type":"posts","id":"stateofhealth_23071","meta":{"index":"posts_1716263798","site":"stateofhealth","id":"23071","score":null,"sort":[1418864459000]},"parent":0,"labelTerm":{"site":"stateofhealth"},"blocks":[],"publishDate":1418864459,"format":"aside","disqusTitle":"Schools Are at the Front Line of Asthma Fight","title":"Schools Are at the Front Line of Asthma Fight","headTitle":"State of Health | KQED News","content":"\u003cfigure id=\"attachment_23076\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/asthma.jpg\">\u003cimg class=\"size-large wp-image-23076\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/asthma-640x404.jpg\" alt=\"Shameka Bibb gives her son Sarquan Holland Jr., age 5, his asthma inhaler at school before she leaves him for the day. Hollands asthma is so severe that he has been on Prednisone since he was three and is on the strongest dose of inhaler, not usually given to children. (Deborah Svoboda/KQED)\" width=\"640\" height=\"404\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Shameka Bibb gives her son Sarquan Holland, Jr., age 5, his asthma inhaler at school before she leaves him for the day. Holland's asthma is so severe that he has been on prednisone since he was three and is on the strongest dose of inhaler, not usually given to children. (Deborah Svoboda/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>California’s network of 230 school-based health clinics are set to incubate a new education program meant to address the environmental factors that trigger asthma attacks. The Environmental Protection Agency (EPA) awarded a $600,000 grant to the Oakland-based Public Health Institute’s \u003ca href=\"http://www.rampasthma.org/\">Regional Asthma Management & Prevention\u003c/a> (RAMP) program. RAMP is now set to design a training program for the state’s school-based clinic staff on how to prevent and manage environmental asthma triggers in school, at home and in the community.\u003c/p>\n\u003cp>Asthma affects 900,000 children in California and seven million children nationwide. The disease causes airways in the lungs to swell and narrow. This makes breathing difficult. Oakland’s network of school-based clinics have been on the forefront of providing asthma education and treatment to its school-aged children, but will now have an added resource to address the environmental risk factors.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Even a child with the best medications is going to continue to suffer from asthma if he or she is exposed to environmental asthma triggers in their school or home or community.'\u003c/aside>\n\u003cp>“There’s a stigma around having asthma and how you deal with it,” said Hana Shirriel-Dia, adolescent services coordinator at the \u003ca href=\"http://www.lifelongmedical.org/Services/school-based-services.html\" target=\"_blank\">West Oakland Middle School Health Center\u003c/a>. She and her colleagues work with an Oakland Unified School District nurse and physical education teacher to identify kids at the school who have breathing problems. Clinic staff then provide medical treatment and counseling on asthma management, so kids can continue to play sports and run around with other students.\u003c/p>\n\u003cp>“I always tell myself I can fight through my asthma no matter what, and that’s not an excuse to say I can’t play sports,” said 11-year-old Maurice Patton III. He’s been taking the asthma class offered at the health center, which helped him identify the environmental triggers at school, home and in his community. He’s also learned some techniques to slow down, take deep breaths and calm himself when he’s having an asthma attack.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Shirriel-Dia says about 25 percent of the students at West Oakland Middle School suffer from asthma and others have breathing problems. The clinic is focused on the student population, but doesn't turn way other children in the neighborhood who seek care there.\u003c/p>\n\u003cp>“Asthma is a disease that we see great disparities by race, ethnicity and socioeconomic status,” said Anne Kelsey Lamb, director of RAMP. “Here in Alameda county, African-Americans are hospitalized or go to emergency departments five times more often than whites [for asthma-related incidences].”\u003c/p>\n\u003cp>The new focus on identifying and managing environmental triggers for asthma is an effort to reduce these severe asthma attacks and \u003ca href=\"http://www.schoolhealthcenters.org/healthlearning/asthma/\" target=\"_blank\">expensive trips to the hospital\u003c/a>. “Even a child with the best medications is going to continue to suffer from asthma if he or she is exposed to environmental asthma triggers in their school or home or community,” Lamb said.\u003c/p>\n\u003cp>RAMP plans to compile a guide for schools to use when identifying triggers in their own buildings, such as poor ventilation, \u003ca href=\"http://www.rampasthma.org/2010/03/green-cleaning-in-schools-a-guide-for-advocates/\" target=\"_blank\">harmful cleaning products\u003c/a> or exposure to diesel buses that could be adversely affecting students. Staff will also be trained to educate parents about the factors at home that can cause asthma to flare, like mold and cigarette smoke.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>After developing a guide to environmental asthma triggers and developing a training curriculum, RAMP, in partnership with the \u003ca href=\"http://www.schoolhealthcenters.org/\" target=\"_blank\">California School-Based Health Alliance\u003c/a>, will train clinic staff around the state so they can help their own communities avoid or address environmental asthma triggers. With California as a training ground, the program will then expand to New York, Michigan, and Connecticut, states with high asthma prevalence and school-based clinics.\u003c/p>\n\n","disqusIdentifier":"23071 http://blogs.kqed.org/stateofhealth/?p=23071","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/12/17/schools-are-at-the-front-line-of-asthma-fight/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":693,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":12},"modified":1418862335,"excerpt":"Federal EPA grants Oakland-based institute $600,000 grant to fight environmental asthma triggers.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Federal EPA grants Oakland-based institute $600,000 grant to fight environmental asthma triggers.","title":"Schools Are at the Front Line of Asthma Fight | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Schools Are at the Front Line of Asthma Fight","datePublished":"2014-12-17T17:00:59-08:00","dateModified":"2014-12-17T16:25:35-08:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"schools-are-at-the-front-line-of-asthma-fight","status":"publish","path":"/stateofhealth/23071/schools-are-at-the-front-line-of-asthma-fight","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23076\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/asthma.jpg\">\u003cimg class=\"size-large wp-image-23076\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/asthma-640x404.jpg\" alt=\"Shameka Bibb gives her son Sarquan Holland Jr., age 5, his asthma inhaler at school before she leaves him for the day. Hollands asthma is so severe that he has been on Prednisone since he was three and is on the strongest dose of inhaler, not usually given to children. (Deborah Svoboda/KQED)\" width=\"640\" height=\"404\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Shameka Bibb gives her son Sarquan Holland, Jr., age 5, his asthma inhaler at school before she leaves him for the day. Holland's asthma is so severe that he has been on prednisone since he was three and is on the strongest dose of inhaler, not usually given to children. (Deborah Svoboda/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>California’s network of 230 school-based health clinics are set to incubate a new education program meant to address the environmental factors that trigger asthma attacks. The Environmental Protection Agency (EPA) awarded a $600,000 grant to the Oakland-based Public Health Institute’s \u003ca href=\"http://www.rampasthma.org/\">Regional Asthma Management & Prevention\u003c/a> (RAMP) program. RAMP is now set to design a training program for the state’s school-based clinic staff on how to prevent and manage environmental asthma triggers in school, at home and in the community.\u003c/p>\n\u003cp>Asthma affects 900,000 children in California and seven million children nationwide. The disease causes airways in the lungs to swell and narrow. This makes breathing difficult. Oakland’s network of school-based clinics have been on the forefront of providing asthma education and treatment to its school-aged children, but will now have an added resource to address the environmental risk factors.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Even a child with the best medications is going to continue to suffer from asthma if he or she is exposed to environmental asthma triggers in their school or home or community.'\u003c/aside>\n\u003cp>“There’s a stigma around having asthma and how you deal with it,” said Hana Shirriel-Dia, adolescent services coordinator at the \u003ca href=\"http://www.lifelongmedical.org/Services/school-based-services.html\" target=\"_blank\">West Oakland Middle School Health Center\u003c/a>. She and her colleagues work with an Oakland Unified School District nurse and physical education teacher to identify kids at the school who have breathing problems. Clinic staff then provide medical treatment and counseling on asthma management, so kids can continue to play sports and run around with other students.\u003c/p>\n\u003cp>“I always tell myself I can fight through my asthma no matter what, and that’s not an excuse to say I can’t play sports,” said 11-year-old Maurice Patton III. He’s been taking the asthma class offered at the health center, which helped him identify the environmental triggers at school, home and in his community. He’s also learned some techniques to slow down, take deep breaths and calm himself when he’s having an asthma attack.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Shirriel-Dia says about 25 percent of the students at West Oakland Middle School suffer from asthma and others have breathing problems. The clinic is focused on the student population, but doesn't turn way other children in the neighborhood who seek care there.\u003c/p>\n\u003cp>“Asthma is a disease that we see great disparities by race, ethnicity and socioeconomic status,” said Anne Kelsey Lamb, director of RAMP. “Here in Alameda county, African-Americans are hospitalized or go to emergency departments five times more often than whites [for asthma-related incidences].”\u003c/p>\n\u003cp>The new focus on identifying and managing environmental triggers for asthma is an effort to reduce these severe asthma attacks and \u003ca href=\"http://www.schoolhealthcenters.org/healthlearning/asthma/\" target=\"_blank\">expensive trips to the hospital\u003c/a>. “Even a child with the best medications is going to continue to suffer from asthma if he or she is exposed to environmental asthma triggers in their school or home or community,” Lamb said.\u003c/p>\n\u003cp>RAMP plans to compile a guide for schools to use when identifying triggers in their own buildings, such as poor ventilation, \u003ca href=\"http://www.rampasthma.org/2010/03/green-cleaning-in-schools-a-guide-for-advocates/\" target=\"_blank\">harmful cleaning products\u003c/a> or exposure to diesel buses that could be adversely affecting students. Staff will also be trained to educate parents about the factors at home that can cause asthma to flare, like mold and cigarette smoke.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>After developing a guide to environmental asthma triggers and developing a training curriculum, RAMP, in partnership with the \u003ca href=\"http://www.schoolhealthcenters.org/\" target=\"_blank\">California School-Based Health Alliance\u003c/a>, will train clinic staff around the state so they can help their own communities avoid or address environmental asthma triggers. With California as a training ground, the program will then expand to New York, Michigan, and Connecticut, states with high asthma prevalence and school-based clinics.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/23071/schools-are-at-the-front-line-of-asthma-fight","authors":["234"],"categories":["stateofhealth_11"],"tags":["stateofhealth_23","stateofhealth_20"],"featImg":"stateofhealth_23076","label":"stateofhealth"},"stateofhealth_22215":{"type":"posts","id":"stateofhealth_22215","meta":{"index":"posts_1716263798","site":"stateofhealth","id":"22215","score":null,"sort":[1414432244000]},"parent":0,"labelTerm":{"site":"stateofhealth"},"blocks":[],"publishDate":1414432244,"format":"aside","disqusTitle":"Fresno Pilots Asthma Program Aimed at Tapping Investors for Funds","title":"Fresno Pilots Asthma Program Aimed at Tapping Investors for Funds","headTitle":"State of Health | KQED News","content":"\u003cfigure id=\"attachment_22223\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A.jpg\">\u003cimg class=\"size-large wp-image-22223\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A-640x426.jpg\" alt=\"Maura Vasquez tells health educator Nunu Sixay during a home visit on Tuesday, September 9, 2014, that her son, Jovani Garcia-Vasquez, 6, has not visited the emergency room since learning that administering his medication more regularly could help alleviate his asthma symptoms (Heidi de Marco/KHN).\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During a home visit Maura Vasquez (R) tells health educator Nunu Sixay that her son, Jovani, 6, has not been to the E.R. since learning that administering his medication more regularly could help alleviate his asthma. (Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman\u003c/strong>, \u003ca title=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" href=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Inside her single-story home in the dry and dusty Central Valley, Dalia Mondragon scarcely sleeps. Several times a night, she tiptoes into her children’s rooms to make sure their chests are peacefully rising and falling.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Under the approach, investors fund a social impact bond; if a social program saves money -- investors make money.\u003c/aside>\n\u003cp>“I feel like any time they could stop breathing,” she says.\u003c/p>\n\u003cp>Mondragon and all four of her children have asthma -– a disease that has sent them to the hospital more times than she can count. So she is more than willing to open her home to Nunu Sixay, an asthma prevention worker trying to figure out what is triggering the attacks. On a recent visit, Sixay found some possible culprits: mold in the bathroom and aerosol furniture polish in the kitchen.\u003c/p>\n\u003cp>Sixay’s work visiting low-income families like the Mondragons is part of a public health experiment to help asthmatic children breathe easier and stay out of costly emergency rooms – with the aim of getting investors to pay for it.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The plan is to create a “social impact bond,” a contract in which Wall Street and other investors agree to support programs with goals such as taxpayer savings and improved health outcomes. If the programs can demonstrate with solid evidence that they have met those goals, the investors recoup their principal and get a return, typically from the government.\u003c/p>\n\u003cp>The asthma project is among the first to focus on improving health outcomes. But a rising number of “pay for success” projects are planned or underway around the nation, including in Ohio, Connecticut, South Carolina and Massachusetts. One seeks to expand early childhood education in Utah, for instance, and another to reduce homelessness in Colorado.\u003c/p>\n\u003cp>Typically, private investors or foundations provide at least a portion of the seed money. Bank of America Merrill Lynch, for instance, raised $13.5 million from its investors for a New York project aimed at reducing recidivism and increasing employment among former inmates. Depending on the outcomes, which must be evaluated by an independent third party, the government will repay the investors and provide a return. Generally, it is a slice of taxpayer savings, ranging from 5 to 12 percent of the original investment.\u003c/p>\n\u003cp>“We were all excited about the idea of a whole new form of impact investing,” said Kirstin Hill, a managing director in Merrill Lynch’s global wealth management business.\u003c/p>\n\u003cp>The bonds, which first were devised in England, appeal to investors who want to see part of their portfolio go toward what they see as a social good. “People with lots of money are anxious to invest at least a portion in things like this, especially if you give them a reasonable return,” said John Vogel, who teaches business administration at Dartmouth’s Tuck School of Business.\u003c/p>\n\u003cp>Critics, however, say it’s too early to see what impact the bonds will have, and question whether the effects can be accurately measured. Some are skeptical that many private firms will invest.\u003c/p>\n\u003cp>\u003cstrong>Growing The Pie\u003c/strong>\u003c/p>\n\u003cp>Organizations are looking for ways to “grow the pie of funding that is available to the social sector” rather than relying only on philanthropic and government funds, said Rick Brush, CEO of Collective Health. The Connecticut company is helping to organize the Fresno project with Social Finance, a Boston nonprofit that designs social impact bonds.\u003c/p>\n\u003cp>Nirav Shah, director of Social Finance, said numerous health programs have a significant impact on patients but are outside of clinical settings so aren’t typically reimbursed by insurers.\u003c/p>\n\u003cp>In the asthma program, for example, a social impact bond could pay for home renovations such as stripping out carpet or getting rid of mold.\u003c/p>\n\u003cp>The Fresno project is still in its pilot stage: Organizers won’t start reaching out to investors until late next year Funding from banks, individuals and foundations would enable the asthma prevention program to expand from about 200 children to 3,500, they said. In this case, the returns could come from either the state or insurers, Shah said.\u003c/p>\n\u003cp>The pilot program, which is funded by a grant of about $1 million from The California Endowment, is using claims data to track ER visits and measure the savings before turning to investors. The estimated savings per child is more than $7,700.\u003c/p>\n\u003cp>\u003cstrong>Taking It To Heart\u003c/strong>\u003c/p>\n\u003cp>In Fresno, asthma prevention workers ask parents to commit to three changes in the home to help prevent asthma attacks. Throughout the year, they follow up with in-person visits and phone calls. “The little knowledge we give them they really take it to heart,” Sixay said.\u003c/p>\n\u003cp>One recent day, Sixay stopped by the cramped house of 6-year-old Jovani Garcia-Vasquez. His mother, Maura Vasquez, said she used to rush her son to the hospital every time he had an asthma flare-up. She said that a doctor had advised her not to give the inhaler to her son because he could get addicted to Albuterol. “So I didn’t give it to him, hardly ever,” she said.\u003c/p>\n\u003cp>After learning from Sixay that the medication actually helps relieve the asthma symptoms, Vasquez began administering it more regularly. She said she hasn’t had to take him to the ER since.\u003c/p>\n\u003cp>“I didn’t know how to help him,” she said. “Now I know.”\u003c/p>\n\u003cp>Sixay sat down with Jovani and asked him to point to faces that showed how he felt. When she asked “How is your asthma today?” he pointed to a happy face.\u003c/p>\n\u003cp>Sixay, who works for the Central California Asthma Collaborative, said she is taking small steps toward solving a big problem. Fresno has one of the highest childhood asthma rates in California, with a fifth of children ages 5 to 17 affected. The county also has high rates of asthma-related pediatric emergency room visits and hospitalizations, paid for primarily by Medi-Cal, California’s public insurance program for poor people. All told, about $35 million is spent countywide per year for hospital costs for children with asthma, according to Collective Health and Social Finance.\u003c/p>\n\u003cp>The region has relatively poor air quality, said Vipul Jain, a professor at UC San Francisco and pulmonologist at Fresno’s Community Regional Medical Center. “It’s this recurrent, vicious glob [of bad air] that never lets them free,” he said. Poverty, lack of regular care and poor housing conditions also contribute to high hospitalization rates, he said.\u003c/p>\n\u003cp>Jain said home interventions can certainly help, but good self-management, disease education and clinical care also are needed. Otherwise, “it’s not realistic to expect a significant change,” he said.\u003c/p>\n\u003cp>The Fresno project is collaborating with Clinica Sierra Vista, a community health center in Fresno, which is providing ongoing medical care. Each day, the clinic’s doctors see asthmatic children like Jose Lomelli, 11.\u003c/p>\n\u003cp>On a recent September morning, Jose’s mother, Hopie Castro, took him to the doctor because he was coughing and using his inhaler every few hours and she worried he would have to go to the emergency room.\u003c/p>\n\u003cp>Jose missed about a fifth of the last school year because of asthma and has gone to the hospital more than 15 times in the past several years, Castro said.\u003c/p>\n\u003cp>Dr. Kami Jow listened to Jose breathe and confirmed that he was having an asthma attack. He prescribed steroids, and he corrected him on using his inhaler so the medicine would flow into his lungs.\u003c/p>\n\u003cp>“How do I know when to take him to the emergency room?” she asked.\u003c/p>\n\u003cp>“You’ll see him working really hard to breathe,” he said.\u003c/p>\n\u003cp>Jow said he often sees families who don’t know what leads to asthma attacks or how or when to use medication. Rarely, he said, does he have the time to educate them thoroughly about the disease.\u003c/p>\n\u003cp>That’s where workers like Sixay come in.\u003c/p>\n\u003cp>She sees a lot of progress but faces occasional setbacks. The Mondragons, for instance, had made improvements at home –- then recently got a kitten. It’s cute, she told the family, but not good for the airways.\u003c/p>\n\u003cp>“It’s a process,” she said. “They are not all going to change overnight.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n","disqusIdentifier":"22215 http://blogs.kqed.org/stateofhealth/?p=22215","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/10/27/fresno-pilots-asthma-program-aimed-at-tapping-investors-for-funds/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":1497,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":39},"modified":1414438206,"excerpt":"If a funded program shows solid evidence that it has met a social goal, investors earn a return.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"If a funded program shows solid evidence that it has met a social goal, investors earn a return.","title":"Fresno Pilots Asthma Program Aimed at Tapping Investors for Funds | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Fresno Pilots Asthma Program Aimed at Tapping Investors for Funds","datePublished":"2014-10-27T10:50:44-07:00","dateModified":"2014-10-27T12:30:06-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"fresno-pilots-asthma-program-aimed-at-tapping-investors-for-funds","status":"publish","path":"/stateofhealth/22215/fresno-pilots-asthma-program-aimed-at-tapping-investors-for-funds","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22223\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A.jpg\">\u003cimg class=\"size-large wp-image-22223\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A-640x426.jpg\" alt=\"Maura Vasquez tells health educator Nunu Sixay during a home visit on Tuesday, September 9, 2014, that her son, Jovani Garcia-Vasquez, 6, has not visited the emergency room since learning that administering his medication more regularly could help alleviate his asthma symptoms (Heidi de Marco/KHN).\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During a home visit Maura Vasquez (R) tells health educator Nunu Sixay that her son, Jovani, 6, has not been to the E.R. since learning that administering his medication more regularly could help alleviate his asthma. (Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman\u003c/strong>, \u003ca title=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" href=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Inside her single-story home in the dry and dusty Central Valley, Dalia Mondragon scarcely sleeps. Several times a night, she tiptoes into her children’s rooms to make sure their chests are peacefully rising and falling.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Under the approach, investors fund a social impact bond; if a social program saves money -- investors make money.\u003c/aside>\n\u003cp>“I feel like any time they could stop breathing,” she says.\u003c/p>\n\u003cp>Mondragon and all four of her children have asthma -– a disease that has sent them to the hospital more times than she can count. So she is more than willing to open her home to Nunu Sixay, an asthma prevention worker trying to figure out what is triggering the attacks. On a recent visit, Sixay found some possible culprits: mold in the bathroom and aerosol furniture polish in the kitchen.\u003c/p>\n\u003cp>Sixay’s work visiting low-income families like the Mondragons is part of a public health experiment to help asthmatic children breathe easier and stay out of costly emergency rooms – with the aim of getting investors to pay for it.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The plan is to create a “social impact bond,” a contract in which Wall Street and other investors agree to support programs with goals such as taxpayer savings and improved health outcomes. If the programs can demonstrate with solid evidence that they have met those goals, the investors recoup their principal and get a return, typically from the government.\u003c/p>\n\u003cp>The asthma project is among the first to focus on improving health outcomes. But a rising number of “pay for success” projects are planned or underway around the nation, including in Ohio, Connecticut, South Carolina and Massachusetts. One seeks to expand early childhood education in Utah, for instance, and another to reduce homelessness in Colorado.\u003c/p>\n\u003cp>Typically, private investors or foundations provide at least a portion of the seed money. Bank of America Merrill Lynch, for instance, raised $13.5 million from its investors for a New York project aimed at reducing recidivism and increasing employment among former inmates. Depending on the outcomes, which must be evaluated by an independent third party, the government will repay the investors and provide a return. Generally, it is a slice of taxpayer savings, ranging from 5 to 12 percent of the original investment.\u003c/p>\n\u003cp>“We were all excited about the idea of a whole new form of impact investing,” said Kirstin Hill, a managing director in Merrill Lynch’s global wealth management business.\u003c/p>\n\u003cp>The bonds, which first were devised in England, appeal to investors who want to see part of their portfolio go toward what they see as a social good. “People with lots of money are anxious to invest at least a portion in things like this, especially if you give them a reasonable return,” said John Vogel, who teaches business administration at Dartmouth’s Tuck School of Business.\u003c/p>\n\u003cp>Critics, however, say it’s too early to see what impact the bonds will have, and question whether the effects can be accurately measured. Some are skeptical that many private firms will invest.\u003c/p>\n\u003cp>\u003cstrong>Growing The Pie\u003c/strong>\u003c/p>\n\u003cp>Organizations are looking for ways to “grow the pie of funding that is available to the social sector” rather than relying only on philanthropic and government funds, said Rick Brush, CEO of Collective Health. The Connecticut company is helping to organize the Fresno project with Social Finance, a Boston nonprofit that designs social impact bonds.\u003c/p>\n\u003cp>Nirav Shah, director of Social Finance, said numerous health programs have a significant impact on patients but are outside of clinical settings so aren’t typically reimbursed by insurers.\u003c/p>\n\u003cp>In the asthma program, for example, a social impact bond could pay for home renovations such as stripping out carpet or getting rid of mold.\u003c/p>\n\u003cp>The Fresno project is still in its pilot stage: Organizers won’t start reaching out to investors until late next year Funding from banks, individuals and foundations would enable the asthma prevention program to expand from about 200 children to 3,500, they said. In this case, the returns could come from either the state or insurers, Shah said.\u003c/p>\n\u003cp>The pilot program, which is funded by a grant of about $1 million from The California Endowment, is using claims data to track ER visits and measure the savings before turning to investors. The estimated savings per child is more than $7,700.\u003c/p>\n\u003cp>\u003cstrong>Taking It To Heart\u003c/strong>\u003c/p>\n\u003cp>In Fresno, asthma prevention workers ask parents to commit to three changes in the home to help prevent asthma attacks. Throughout the year, they follow up with in-person visits and phone calls. “The little knowledge we give them they really take it to heart,” Sixay said.\u003c/p>\n\u003cp>One recent day, Sixay stopped by the cramped house of 6-year-old Jovani Garcia-Vasquez. His mother, Maura Vasquez, said she used to rush her son to the hospital every time he had an asthma flare-up. She said that a doctor had advised her not to give the inhaler to her son because he could get addicted to Albuterol. “So I didn’t give it to him, hardly ever,” she said.\u003c/p>\n\u003cp>After learning from Sixay that the medication actually helps relieve the asthma symptoms, Vasquez began administering it more regularly. She said she hasn’t had to take him to the ER since.\u003c/p>\n\u003cp>“I didn’t know how to help him,” she said. “Now I know.”\u003c/p>\n\u003cp>Sixay sat down with Jovani and asked him to point to faces that showed how he felt. When she asked “How is your asthma today?” he pointed to a happy face.\u003c/p>\n\u003cp>Sixay, who works for the Central California Asthma Collaborative, said she is taking small steps toward solving a big problem. Fresno has one of the highest childhood asthma rates in California, with a fifth of children ages 5 to 17 affected. The county also has high rates of asthma-related pediatric emergency room visits and hospitalizations, paid for primarily by Medi-Cal, California’s public insurance program for poor people. All told, about $35 million is spent countywide per year for hospital costs for children with asthma, according to Collective Health and Social Finance.\u003c/p>\n\u003cp>The region has relatively poor air quality, said Vipul Jain, a professor at UC San Francisco and pulmonologist at Fresno’s Community Regional Medical Center. “It’s this recurrent, vicious glob [of bad air] that never lets them free,” he said. Poverty, lack of regular care and poor housing conditions also contribute to high hospitalization rates, he said.\u003c/p>\n\u003cp>Jain said home interventions can certainly help, but good self-management, disease education and clinical care also are needed. Otherwise, “it’s not realistic to expect a significant change,” he said.\u003c/p>\n\u003cp>The Fresno project is collaborating with Clinica Sierra Vista, a community health center in Fresno, which is providing ongoing medical care. Each day, the clinic’s doctors see asthmatic children like Jose Lomelli, 11.\u003c/p>\n\u003cp>On a recent September morning, Jose’s mother, Hopie Castro, took him to the doctor because he was coughing and using his inhaler every few hours and she worried he would have to go to the emergency room.\u003c/p>\n\u003cp>Jose missed about a fifth of the last school year because of asthma and has gone to the hospital more than 15 times in the past several years, Castro said.\u003c/p>\n\u003cp>Dr. Kami Jow listened to Jose breathe and confirmed that he was having an asthma attack. He prescribed steroids, and he corrected him on using his inhaler so the medicine would flow into his lungs.\u003c/p>\n\u003cp>“How do I know when to take him to the emergency room?” she asked.\u003c/p>\n\u003cp>“You’ll see him working really hard to breathe,” he said.\u003c/p>\n\u003cp>Jow said he often sees families who don’t know what leads to asthma attacks or how or when to use medication. Rarely, he said, does he have the time to educate them thoroughly about the disease.\u003c/p>\n\u003cp>That’s where workers like Sixay come in.\u003c/p>\n\u003cp>She sees a lot of progress but faces occasional setbacks. The Mondragons, for instance, had made improvements at home –- then recently got a kitten. It’s cute, she told the family, but not good for the airways.\u003c/p>\n\u003cp>“It’s a process,” she said. “They are not all going to change overnight.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/22215/fresno-pilots-asthma-program-aimed-at-tapping-investors-for-funds","authors":["8344"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_23"],"featImg":"stateofhealth_22223","label":"stateofhealth"},"stateofhealth_13334":{"type":"posts","id":"stateofhealth_13334","meta":{"index":"posts_1716263798","site":"stateofhealth","id":"13334","score":null,"sort":[1371831328000]},"parent":0,"labelTerm":{"site":"stateofhealth"},"blocks":[],"publishDate":1371831328,"format":"aside","disqusTitle":"Can Air Pollution Cause Asthma in Kids? How About Autism?","title":"Can Air Pollution Cause Asthma in Kids? How About Autism?","headTitle":"State of Health | KQED News","content":"\u003cfigure id=\"attachment_12294\" class=\"wp-caption aligncenter\" style=\"max-width: 491px\">\u003cimg class=\"size-full wp-image-12294\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/AutoPollution_GettyImages.jpg\" alt=\"(Getty Images/Thinkstock)\" width=\"491\" height=\"349\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/04/AutoPollution_GettyImages.jpg 491w, https://ww2.kqed.org/app/uploads/sites/27/2013/04/AutoPollution_GettyImages-400x284.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/04/AutoPollution_GettyImages-320x227.jpg 320w\" sizes=\"(max-width: 491px) 100vw, 491px\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images/Thinkstock)\u003c/figcaption>\u003c/figure>\n\u003cp>We all know air pollution is not great for your health, but two new studies this week stressed just how bad it can be for children, infants and the developing fetus. Exposure to air pollution at a young age, these studies showed, can lead to an array of long-lasting health problems, including asthma and autism.\u003c/p>\n\u003cp>It's not just that polluted air can, say, trigger asthma attacks. Now, researchers are finding that exposure to air pollution may actually cause some diseases.\u003c/p>\n\u003cp>“We’re discovering some of the long-term effects of this air pollution: things like lung development in kids,” said Georges Benjamin, executive director of the American Public Health Association.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Communities should be informed of what they’re breathing.” -- Paul Cort, Earthjustice \u003c/aside>\n\u003cp>A \u003ca href=\"http://europepmc.org/abstract/MED/23750510/reload=0;jsessionid=1gzFXIEMY9Op4KHZiWa1.6\">study\u003c/a> led by UCSF found that African American and Latino infants living in communities with high automobile exhaust are more likely to develop childhood asthma than those living with less pollution. This is significant because minority communities are more likely to live near congested roadways.\u003c/p>\n\u003cp>In California, African Americans and multi-racial people have some of the highest rates of asthma, according to the \u003ca href=\"http://www.cdc.gov/asthma/stateprofiles/Asthma_in_CA.pdf\">CDC\u003c/a>. But rigorous scientific studies that examine just how the lungs of minority children develop when swamped with car exhaust have been rare.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In this new study, researchers followed more than 4,000 African American and Latino children in the Bay Area and other cities in the United States and Puerto Rico. It’s one of the largest studies of its kind.\u003c/p>\n\u003cp>They found that exposure to higher levels of nitrogen dioxide -- a pollutant found in automobile exhaust -- put healthy infants at a greater risk of developing asthma later in life.\u003c/p>\n\u003cp>This was despite the fact that the average amount of nitrogen dioxide infants were exposed to was almost 3 times lower than the limit set by the Environmental Protection Agency.\u003c/p>\n\u003cp>“We found an association even though all of these children were exposed to what the EPA would consider to be an acceptable level of air pollution,” said Katherine Nishimura, a UCSF researcher and lead author on the study.\u003c/p>\n\u003cp>Nishimura tracked pollution exposure for infants within their first years of life. This is a time when children’s lungs and immune system are developing, she said.\u003c/p>\n\u003cp>Even though factors other than pollution may also increase the risk of developing asthma -- like obesity, stress, and a family history -- the team’s results raise questions about whether the national standards for nitrogen dioxide are strong enough.\u003c/p>\n\u003cp>The problem hits home in California. This year, California cities dominated the top ten most air polluted cities in the nation, according to the American Lung Association's \u003ca href=\"http://www.stateoftheair.org/2013/city-rankings/most-polluted-cities.html\">State of the Air\u003c/a> report.\u003c/p>\n\u003cp>“The state has this golden reputation of being so far out in front in everything,” said Paul Cort, attorney at Earthjustice, a San Francisco-based environmental advocacy group that has pushed for tighter air pollution standards. “And yet we still have two of the most polluted air basins in the country.”\u003c/p>\n\u003cp>\u003cstrong>Stronger evidence that pollutants increase risk of autism\u003c/strong>\u003c/p>\n\u003cp>Other research out this week links air pollution to autism. Those findings suggest that public health officials might want to look at strengthening regulations for more than just nitrogen dioxide.\u003c/p>\n\u003cp>Diesel particulates and metals like lead, manganese, and mercury that are found in polluted air have been shown to disrupt brain development in babies in the womb.\u003c/p>\n\u003cp>Scientists from Harvard's School of Public Health \u003ca href=\"http://ehp.niehs.nih.gov/wp-content/uploads/121/6/ehp.1206187.pdf\">found\u003c/a> that pregnant women who were exposed to high levels of air pollution were up to two times more likely to have a child with autism when compared to pregnant women who lived in low pollution areas.\u003c/p>\n\u003cp>In the study, air pollution came from a variety of sources including automobiles, power plants, factories, incinerators and businesses. And greater levels of diesel, mercury, lead, manganese, methylene chloride, and a combination of metals found in the air were linked to higher rates of autism.\u003c/p>\n\u003cp>“New studies should begin the process of measuring metals and other pollutants in the blood of pregnant women or newborn children to provide stronger evidence that specific pollutants increase risk of autism,” Marc Weisskopf, a public health professor at Harvard and an author of the study said in a \u003ca href=\"http://www.hsph.harvard.edu/news/press-releases/exposure-to-high-pollution-levels-during-pregnancy-may-increase-risk-of-having-child-with-autism/\">press release\u003c/a>. “A better understanding of this can help to develop interventions to reduce pregnant women’s exposure.”\u003c/p>\n\u003cp>The researchers looked at more than 22,000 women who had children with and without autism. This was the first large national study to examine the effects of air pollution on pregnancy and autism, the authors said.\u003c/p>\n\u003cp>“Clearly the underserved communities are very affected,” said Benjamin. “Many times these [factories and] plants are put into communities where the land is fundamentally cheap.”\u003c/p>\n\u003cp>But air pollution has rarely been monitored in these communities, hindering advocates’ abilities to fully grasp and tackle the issue, said Cort. “These communities should be informed of what they’re breathing,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Advocates hope that the flood of research on the effects of air pollution on children will bolster a case for tighter air pollution and car emission standards in the future.\u003c/p>\n\n","disqusIdentifier":"13334 http://blogs.kqed.org/stateofhealth/?p=13334","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/06/21/can-air-pollution-cause-asthma-in-kids-how-about-autism/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":878,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":25},"modified":1371831336,"excerpt":"We all know air pollution is not great for your health, but two new studies this week stressed just how bad it can be for children, infants and the developing fetus. Exposure to air pollution at a young age, these studies showed, can lead to an array of long-lasting health problems, including asthma and autism.\r\n\r\nIt's not just that polluted air can, say, trigger asthma attacks. Now, researchers are finding that exposure to air pollution may actually cause some diseases.\r\n\r\n“We’re discovering some of the long-term effects of this air pollution: things like lung development in kids,” said Georges Benjamin, executive director of the American Public Health Association.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"We all know air pollution is not great for your health, but two new studies this week stressed just how bad it can be for children, infants and the developing fetus. Exposure to air pollution at a young age, these studies showed, can lead to an array of long-lasting health problems, including asthma and autism.\r\n\r\nIt's not just that polluted air can, say, trigger asthma attacks. Now, researchers are finding that exposure to air pollution may actually cause some diseases.\r\n\r\n“We’re discovering some of the long-term effects of this air pollution: things like lung development in kids,” said Georges Benjamin, executive director of the American Public Health Association.","title":"Can Air Pollution Cause Asthma in Kids? How About Autism? | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Can Air Pollution Cause Asthma in Kids? How About Autism?","datePublished":"2013-06-21T09:15:28-07:00","dateModified":"2013-06-21T09:15:36-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"can-air-pollution-cause-asthma-in-kids-how-about-autism","status":"publish","path":"/stateofhealth/13334/can-air-pollution-cause-asthma-in-kids-how-about-autism","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12294\" class=\"wp-caption aligncenter\" style=\"max-width: 491px\">\u003cimg class=\"size-full wp-image-12294\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/04/AutoPollution_GettyImages.jpg\" alt=\"(Getty Images/Thinkstock)\" width=\"491\" height=\"349\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/04/AutoPollution_GettyImages.jpg 491w, https://ww2.kqed.org/app/uploads/sites/27/2013/04/AutoPollution_GettyImages-400x284.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/04/AutoPollution_GettyImages-320x227.jpg 320w\" sizes=\"(max-width: 491px) 100vw, 491px\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images/Thinkstock)\u003c/figcaption>\u003c/figure>\n\u003cp>We all know air pollution is not great for your health, but two new studies this week stressed just how bad it can be for children, infants and the developing fetus. Exposure to air pollution at a young age, these studies showed, can lead to an array of long-lasting health problems, including asthma and autism.\u003c/p>\n\u003cp>It's not just that polluted air can, say, trigger asthma attacks. Now, researchers are finding that exposure to air pollution may actually cause some diseases.\u003c/p>\n\u003cp>“We’re discovering some of the long-term effects of this air pollution: things like lung development in kids,” said Georges Benjamin, executive director of the American Public Health Association.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Communities should be informed of what they’re breathing.” -- Paul Cort, Earthjustice \u003c/aside>\n\u003cp>A \u003ca href=\"http://europepmc.org/abstract/MED/23750510/reload=0;jsessionid=1gzFXIEMY9Op4KHZiWa1.6\">study\u003c/a> led by UCSF found that African American and Latino infants living in communities with high automobile exhaust are more likely to develop childhood asthma than those living with less pollution. This is significant because minority communities are more likely to live near congested roadways.\u003c/p>\n\u003cp>In California, African Americans and multi-racial people have some of the highest rates of asthma, according to the \u003ca href=\"http://www.cdc.gov/asthma/stateprofiles/Asthma_in_CA.pdf\">CDC\u003c/a>. But rigorous scientific studies that examine just how the lungs of minority children develop when swamped with car exhaust have been rare.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In this new study, researchers followed more than 4,000 African American and Latino children in the Bay Area and other cities in the United States and Puerto Rico. It’s one of the largest studies of its kind.\u003c/p>\n\u003cp>They found that exposure to higher levels of nitrogen dioxide -- a pollutant found in automobile exhaust -- put healthy infants at a greater risk of developing asthma later in life.\u003c/p>\n\u003cp>This was despite the fact that the average amount of nitrogen dioxide infants were exposed to was almost 3 times lower than the limit set by the Environmental Protection Agency.\u003c/p>\n\u003cp>“We found an association even though all of these children were exposed to what the EPA would consider to be an acceptable level of air pollution,” said Katherine Nishimura, a UCSF researcher and lead author on the study.\u003c/p>\n\u003cp>Nishimura tracked pollution exposure for infants within their first years of life. This is a time when children’s lungs and immune system are developing, she said.\u003c/p>\n\u003cp>Even though factors other than pollution may also increase the risk of developing asthma -- like obesity, stress, and a family history -- the team’s results raise questions about whether the national standards for nitrogen dioxide are strong enough.\u003c/p>\n\u003cp>The problem hits home in California. This year, California cities dominated the top ten most air polluted cities in the nation, according to the American Lung Association's \u003ca href=\"http://www.stateoftheair.org/2013/city-rankings/most-polluted-cities.html\">State of the Air\u003c/a> report.\u003c/p>\n\u003cp>“The state has this golden reputation of being so far out in front in everything,” said Paul Cort, attorney at Earthjustice, a San Francisco-based environmental advocacy group that has pushed for tighter air pollution standards. “And yet we still have two of the most polluted air basins in the country.”\u003c/p>\n\u003cp>\u003cstrong>Stronger evidence that pollutants increase risk of autism\u003c/strong>\u003c/p>\n\u003cp>Other research out this week links air pollution to autism. Those findings suggest that public health officials might want to look at strengthening regulations for more than just nitrogen dioxide.\u003c/p>\n\u003cp>Diesel particulates and metals like lead, manganese, and mercury that are found in polluted air have been shown to disrupt brain development in babies in the womb.\u003c/p>\n\u003cp>Scientists from Harvard's School of Public Health \u003ca href=\"http://ehp.niehs.nih.gov/wp-content/uploads/121/6/ehp.1206187.pdf\">found\u003c/a> that pregnant women who were exposed to high levels of air pollution were up to two times more likely to have a child with autism when compared to pregnant women who lived in low pollution areas.\u003c/p>\n\u003cp>In the study, air pollution came from a variety of sources including automobiles, power plants, factories, incinerators and businesses. And greater levels of diesel, mercury, lead, manganese, methylene chloride, and a combination of metals found in the air were linked to higher rates of autism.\u003c/p>\n\u003cp>“New studies should begin the process of measuring metals and other pollutants in the blood of pregnant women or newborn children to provide stronger evidence that specific pollutants increase risk of autism,” Marc Weisskopf, a public health professor at Harvard and an author of the study said in a \u003ca href=\"http://www.hsph.harvard.edu/news/press-releases/exposure-to-high-pollution-levels-during-pregnancy-may-increase-risk-of-having-child-with-autism/\">press release\u003c/a>. “A better understanding of this can help to develop interventions to reduce pregnant women’s exposure.”\u003c/p>\n\u003cp>The researchers looked at more than 22,000 women who had children with and without autism. This was the first large national study to examine the effects of air pollution on pregnancy and autism, the authors said.\u003c/p>\n\u003cp>“Clearly the underserved communities are very affected,” said Benjamin. “Many times these [factories and] plants are put into communities where the land is fundamentally cheap.”\u003c/p>\n\u003cp>But air pollution has rarely been monitored in these communities, hindering advocates’ abilities to fully grasp and tackle the issue, said Cort. “These communities should be informed of what they’re breathing,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Advocates hope that the flood of research on the effects of air pollution on children will bolster a case for tighter air pollution and car emission standards in the future.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/13334/can-air-pollution-cause-asthma-in-kids-how-about-autism","authors":["1462"],"categories":["stateofhealth_11"],"tags":["stateofhealth_21","stateofhealth_23","stateofhealth_155","stateofhealth_96","stateofhealth_461"],"featImg":"stateofhealth_12294","label":"stateofhealth"},"stateofhealth_686":{"type":"posts","id":"stateofhealth_686","meta":{"index":"posts_1716263798","site":"stateofhealth","id":"686","score":null,"sort":[1322091785000]},"parent":0,"labelTerm":{"site":"stateofhealth"},"blocks":[],"publishDate":1322091785,"format":"aside","disqusTitle":"Could Acetaminophen Worsen Asthma?","title":"Could Acetaminophen Worsen Asthma?","headTitle":"State of Health | KQED News","content":"\u003cfigure id=\"attachment_701\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/TylenolBox_FLickr_Allen1.jpg\">\u003cimg class=\"size-medium wp-image-701\" title=\"Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/TylenolBox_FLickr_Allen1-300x217.jpg\" alt=\"Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\" width=\"300\" height=\"217\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\u003c/figcaption>\u003c/figure>\n\u003cp>A study published earlier this month in \u003ca title=\"http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract\" href=\"http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract\" target=\"_blank\">Pediatrics \u003c/a>finds a strong association between the use of acetaminophen and asthma, both in symptoms and number of cases, for children and adults.\u003c/p>\n\u003cp>\u003ca title=\"https://www.akronchildrens.org/cms/doctors/john_mcbride/index.html\" href=\"https://www.akronchildrens.org/cms/doctors/john_mcbride/index.html\" target=\"_blank\">John McBride\u003c/a>, Director of the Respiratory Center at Akron Children's Hospital, reviewed studies going back more than a decade, one of which looked at 300,000 children around the world. \"Looking at the data,\" he said, \"it's quite likely that acetaminophen is a problem for patients that have asthma.\"\u003c/p>\n\u003cp>The association between asthma and acetaminophen, which many people know by the brand name, Tylenol, caught him by surprise, he says. \"I read the literature and was stunned. I decided the people who really needed to know were primary are physicians and patients.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">“The children who took acetaminophen were twice as likely to be seen for an asthma attack.\"\u003c/aside>\n\u003cp> Among the most compelling studies was one done in 2000 at Boston University. Ironically, it was a follow up to research that had established the safety of ibuprofen.\u003c/p>\n\u003cp>The ibuprofen study followed 84,000 children with a fever who were randomly treated with either ibuprofen or acetaminophen. In 2000, researchers looked at the 1800 children who had previously been diagnosed with asthma. \"The children who took acetaminophen were twice as likely to be seen for an asthma attack than kids who got ibuprofen, and the more acetaminophen they took, the more likely they were to be seen for an asthma attack,\" McBride learned.\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But an association between acetaminophen and asthma is different from showing that acetaminophen causes an asthma episode. \u003ca title=\"http://www.lpch.org/findADoctor/search/doc.pl?doc=25243&resultSet=25243\" href=\"http://www.lpch.org/findADoctor/search/doc.pl?doc=25243&resultSet=25243\" target=\"_blank\">Dr. David Cornfield\u003c/a>, Chief of Pediatric Pulmonary Medicine at Stanford's Lucile Packard Children's Hospital agrees that an association exists. \"What's really needed now,\" he says, \"is a trial that would establish causation. To do that, you have to have a well-powered placebo controlled trial, several years long.\"\u003c/p>\n\u003cp>The Boston University study was a great starting point, says \u003ca title=\"http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=17885\" href=\"http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=17885\" target=\"_blank\">Dr. Maria Garcia-Lloret\u003c/a>, Professor of Pediatric Allergy at Mattel Children's Hospital at UCLA. But the majority of the children in the study were caucasian. In addition, she says, a new study should include a control group, that receives placebo. \"This is a study that could be repeated as a prospective, randomized study, with a broader population, with a different genetic makeup. The kids in this study were 77% white. Blacks, in particular, are more prone to more severe asthma, more severe allergies.\"\u003c/p>\n\u003cp>Doctors point to a couple theories as to why acetaminophen may be problematic for people with asthma. Acetaminophen has \"long been shown to diminish the response of the immune system to viruses,\" Dr. Cornfield explained, specifically two molecules which help the lungs defend against viruses.\u003c/p>\n\u003cp>Johnson & Johnson, maker of Tylenol, provided a statement today stating, \"Tylenol (acetaminophen) has over 50 years of clinical history to support its safety and efficacy and, when used as directed, Tylenol, has a superior safety profile, compared with other OTC [over the counter] pain relievers.\"\u003c/p>\n\u003cp>But Dr. McBride questions the safety of acetaminophen for people with asthma. He agrees more thorough research is needed, but for a different reason. He closes his study:\u003c/p>\n\u003cblockquote>\u003cp>At present, however, I need further studies not to prove that acetaminophen is dangerous but, rather, to prove that it is safe. Until such evidence is forthcoming, I will recommend avoidance of acetaminophen by all children with asthma or those at risk for asthma and will work to make patients, parents, and primary care providers aware of the possibility that acetaminophen is detrimental to children with asthma.\u003c/p>\u003c/blockquote>\n\u003cp>In the meantime, every doctor we contacted reminded us that over-the-counter medicines are still medicines, with side effects. \"You have to think twice before you give yourself or your child a medicine,\" says Dr. Garcia-Lloret. \"Do they really need it? Or will they get better on their own? You have to balance whether it’s necessary or whether you can wait a bit and it will resolve by itself.\"\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","disqusIdentifier":"686 http://blogs.kqed.org/stateofhealth/?p=686","disqusUrl":"https://ww2.kqed.org/stateofhealth/2011/11/23/could-acetaminophen-worsen-asthma/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":684,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":14},"modified":1322519982,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"A study published earlier this month in Pediatrics finds a strong association between the use of acetaminophen and asthma, both in symptoms and number of cases, for children and adults. John McBride, Director of the Respiratory Center at Akron Children's Hospital, reviewed studies going back more than a decade, one of which looked at 300,000","title":"Could Acetaminophen Worsen Asthma? | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Could Acetaminophen Worsen Asthma?","datePublished":"2011-11-23T15:43:05-08:00","dateModified":"2011-11-28T14:39:42-08:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"could-acetaminophen-worsen-asthma","status":"publish","path":"/stateofhealth/686/could-acetaminophen-worsen-asthma","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_701\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/TylenolBox_FLickr_Allen1.jpg\">\u003cimg class=\"size-medium wp-image-701\" title=\"Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/TylenolBox_FLickr_Allen1-300x217.jpg\" alt=\"Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\" width=\"300\" height=\"217\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tylenol is a brand name of the drug acetaminophen. (Flickr/ Allen)\u003c/figcaption>\u003c/figure>\n\u003cp>A study published earlier this month in \u003ca title=\"http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract\" href=\"http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract\" target=\"_blank\">Pediatrics \u003c/a>finds a strong association between the use of acetaminophen and asthma, both in symptoms and number of cases, for children and adults.\u003c/p>\n\u003cp>\u003ca title=\"https://www.akronchildrens.org/cms/doctors/john_mcbride/index.html\" href=\"https://www.akronchildrens.org/cms/doctors/john_mcbride/index.html\" target=\"_blank\">John McBride\u003c/a>, Director of the Respiratory Center at Akron Children's Hospital, reviewed studies going back more than a decade, one of which looked at 300,000 children around the world. \"Looking at the data,\" he said, \"it's quite likely that acetaminophen is a problem for patients that have asthma.\"\u003c/p>\n\u003cp>The association between asthma and acetaminophen, which many people know by the brand name, Tylenol, caught him by surprise, he says. \"I read the literature and was stunned. I decided the people who really needed to know were primary are physicians and patients.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">“The children who took acetaminophen were twice as likely to be seen for an asthma attack.\"\u003c/aside>\n\u003cp> Among the most compelling studies was one done in 2000 at Boston University. Ironically, it was a follow up to research that had established the safety of ibuprofen.\u003c/p>\n\u003cp>The ibuprofen study followed 84,000 children with a fever who were randomly treated with either ibuprofen or acetaminophen. In 2000, researchers looked at the 1800 children who had previously been diagnosed with asthma. \"The children who took acetaminophen were twice as likely to be seen for an asthma attack than kids who got ibuprofen, and the more acetaminophen they took, the more likely they were to be seen for an asthma attack,\" McBride learned.\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But an association between acetaminophen and asthma is different from showing that acetaminophen causes an asthma episode. \u003ca title=\"http://www.lpch.org/findADoctor/search/doc.pl?doc=25243&resultSet=25243\" href=\"http://www.lpch.org/findADoctor/search/doc.pl?doc=25243&resultSet=25243\" target=\"_blank\">Dr. David Cornfield\u003c/a>, Chief of Pediatric Pulmonary Medicine at Stanford's Lucile Packard Children's Hospital agrees that an association exists. \"What's really needed now,\" he says, \"is a trial that would establish causation. To do that, you have to have a well-powered placebo controlled trial, several years long.\"\u003c/p>\n\u003cp>The Boston University study was a great starting point, says \u003ca title=\"http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=17885\" href=\"http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=17885\" target=\"_blank\">Dr. Maria Garcia-Lloret\u003c/a>, Professor of Pediatric Allergy at Mattel Children's Hospital at UCLA. But the majority of the children in the study were caucasian. In addition, she says, a new study should include a control group, that receives placebo. \"This is a study that could be repeated as a prospective, randomized study, with a broader population, with a different genetic makeup. The kids in this study were 77% white. Blacks, in particular, are more prone to more severe asthma, more severe allergies.\"\u003c/p>\n\u003cp>Doctors point to a couple theories as to why acetaminophen may be problematic for people with asthma. Acetaminophen has \"long been shown to diminish the response of the immune system to viruses,\" Dr. Cornfield explained, specifically two molecules which help the lungs defend against viruses.\u003c/p>\n\u003cp>Johnson & Johnson, maker of Tylenol, provided a statement today stating, \"Tylenol (acetaminophen) has over 50 years of clinical history to support its safety and efficacy and, when used as directed, Tylenol, has a superior safety profile, compared with other OTC [over the counter] pain relievers.\"\u003c/p>\n\u003cp>But Dr. McBride questions the safety of acetaminophen for people with asthma. He agrees more thorough research is needed, but for a different reason. He closes his study:\u003c/p>\n\u003cblockquote>\u003cp>At present, however, I need further studies not to prove that acetaminophen is dangerous but, rather, to prove that it is safe. Until such evidence is forthcoming, I will recommend avoidance of acetaminophen by all children with asthma or those at risk for asthma and will work to make patients, parents, and primary care providers aware of the possibility that acetaminophen is detrimental to children with asthma.\u003c/p>\u003c/blockquote>\n\u003cp>In the meantime, every doctor we contacted reminded us that over-the-counter medicines are still medicines, with side effects. \"You have to think twice before you give yourself or your child a medicine,\" says Dr. Garcia-Lloret. \"Do they really need it? Or will they get better on their own? You have to balance whether it’s necessary or whether you can wait a bit and it will resolve by itself.\"\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/686/could-acetaminophen-worsen-asthma","authors":["240"],"categories":["stateofhealth_12"],"tags":["stateofhealth_23"],"featImg":"stateofhealth_701","label":"stateofhealth"},"stateofhealth_566":{"type":"posts","id":"stateofhealth_566","meta":{"index":"posts_1716263798","site":"stateofhealth","id":"566","score":null,"sort":[1321924377000]},"parent":0,"labelTerm":{"site":"stateofhealth"},"blocks":[],"publishDate":1321924377,"format":"aside","disqusTitle":"Breath of Fresh Air on San Joaquin Valley Air District Board","title":"Breath of Fresh Air on San Joaquin Valley Air District Board","headTitle":"State of Health | KQED News","content":"\u003cfigure id=\"attachment_576\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/BakersfieldPollutedSunset_AndyCastro_Flickr_20111121.jpg\">\u003cimg class=\"size-medium wp-image-576\" title=\"Sunset through a Polluted Bakersfield Sky. (Andy Castro: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/BakersfieldPollutedSunset_AndyCastro_Flickr_20111121-300x168.jpg\" alt=\"Sunset through a Polluted Bakersfield Sky. (Andy Castro: Flickr)\" width=\"300\" height=\"168\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sunset through a Polluted Bakersfield Sky. (Andy Castro: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this month, KQED's Sasha Khokha reported \u003ca title=\"http://www.californiareport.org/archive/R201111010850/a\" href=\"http://www.californiareport.org/archive/R201111010850/a\" target=\"_blank\">Central Valley residents' concerns\u003c/a> that the San Joaquin Valley Air Pollution Control District was not effectively communicating public health warnings on poor air quality days.\u003c/p>\n\u003cp>Just hours after that report aired, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/11/02/kqed-story-prompts-improved-public-health-alerts/\" href=\"http://ww2.kqed.org/stateofhealth/2011/11/02/kqed-story-prompts-improved-public-health-alerts/\" target=\"_blank\">State of Health brought news\u003c/a> that the Valley Air District had issued an air quality alert using significantly stronger language than it had used before. Air quality activists were pleased with the new tone.\u003c/p>\n\u003cp>Today, air quality activists are cheering again. California Governor Jerry Brown appointed a new member to the Valley Air District board. And not just anyone, but a physician with a long background in public health. The new appointee, Dr. Alex Sherriffs, is a professor at UCSF-Fresno in the Department of Family and Community Medicine. He also has been in private practice in Fowler since 1983.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>In other parts of California, the appointment of a doctor to an air district board is not overly significant. But, in the case of the Valley Air District, activists fought for a physician-dedicated position on the board for over five years. The first doctor appointed to the Valley Air District board joined in 2008 and resigned earlier this year. Now, the seat is filled again.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Governor also selected Sherriffs as the Valley Air District board's representative to the statewide California Air Resources Board. Reached by phone this afternoon, Kevin Hall, Director of the \u003ca title=\"http://www.calcleanair.org/\" href=\"http://www.calcleanair.org/\" target=\"_blank\">Central Valley Air Quality Coalition\u003c/a>, was enthusiastic. \"We have come to know Dr. Sherriffs through his work at the medical society and his willingness to take time out of his schedule to speak up on behalf of his patients in an informed manner,\" Hall said. \"That’s why we worked so hard for five years to create a seat for a doctor, so the voice of public health would be right there at the policy level, like the other major air districts in the state.”\u003c/p>\n\u003cp>The San Joaquin Valley is home to some of the most polluted air in the country, fueling a rise in asthma cases across the region. Hall says one in six children will be diagnosed with asthma by age eighteen.\u003c/p>\n\u003cp>In a release, Ray Leon, director of the San Joaquin Valley Latino Environmental Advancement Project echoed Hall's comments. “An expert voice on the deadly impacts of air pollution has been sorely missing from the San Joaquin Valley air board, and the lack of Valley representation on the state air board has been a detriment, too,” he said. “We are pleased that our voices will once again be represented in Sacramento.\"\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","disqusIdentifier":"566 http://blogs.kqed.org/stateofhealth/?p=566","disqusUrl":"https://ww2.kqed.org/stateofhealth/2011/11/21/breath-of-fresh-air-on-san-joaquin-valley-air-district-board/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":459,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":10},"modified":1321924377,"excerpt":null,"headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Earlier this month, KQED's Sasha Khokha reported Central Valley residents' concerns that the San Joaquin Valley Air Pollution Control District was not effectively communicating public health warnings on poor air quality days. Just hours after that report aired, State of Health brought news that the Valley Air District had issued an air quality alert using significantly stronger language than","title":"Breath of Fresh Air on San Joaquin Valley Air District Board | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Breath of Fresh Air on San Joaquin Valley Air District Board","datePublished":"2011-11-21T17:12:57-08:00","dateModified":"2011-11-21T17:12:57-08:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"breath-of-fresh-air-on-san-joaquin-valley-air-district-board","status":"publish","path":"/stateofhealth/566/breath-of-fresh-air-on-san-joaquin-valley-air-district-board","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_576\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/BakersfieldPollutedSunset_AndyCastro_Flickr_20111121.jpg\">\u003cimg class=\"size-medium wp-image-576\" title=\"Sunset through a Polluted Bakersfield Sky. (Andy Castro: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/11/BakersfieldPollutedSunset_AndyCastro_Flickr_20111121-300x168.jpg\" alt=\"Sunset through a Polluted Bakersfield Sky. (Andy Castro: Flickr)\" width=\"300\" height=\"168\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sunset through a Polluted Bakersfield Sky. (Andy Castro: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this month, KQED's Sasha Khokha reported \u003ca title=\"http://www.californiareport.org/archive/R201111010850/a\" href=\"http://www.californiareport.org/archive/R201111010850/a\" target=\"_blank\">Central Valley residents' concerns\u003c/a> that the San Joaquin Valley Air Pollution Control District was not effectively communicating public health warnings on poor air quality days.\u003c/p>\n\u003cp>Just hours after that report aired, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/11/02/kqed-story-prompts-improved-public-health-alerts/\" href=\"http://ww2.kqed.org/stateofhealth/2011/11/02/kqed-story-prompts-improved-public-health-alerts/\" target=\"_blank\">State of Health brought news\u003c/a> that the Valley Air District had issued an air quality alert using significantly stronger language than it had used before. Air quality activists were pleased with the new tone.\u003c/p>\n\u003cp>Today, air quality activists are cheering again. California Governor Jerry Brown appointed a new member to the Valley Air District board. And not just anyone, but a physician with a long background in public health. The new appointee, Dr. Alex Sherriffs, is a professor at UCSF-Fresno in the Department of Family and Community Medicine. He also has been in private practice in Fowler since 1983.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>In other parts of California, the appointment of a doctor to an air district board is not overly significant. But, in the case of the Valley Air District, activists fought for a physician-dedicated position on the board for over five years. The first doctor appointed to the Valley Air District board joined in 2008 and resigned earlier this year. Now, the seat is filled again.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Governor also selected Sherriffs as the Valley Air District board's representative to the statewide California Air Resources Board. Reached by phone this afternoon, Kevin Hall, Director of the \u003ca title=\"http://www.calcleanair.org/\" href=\"http://www.calcleanair.org/\" target=\"_blank\">Central Valley Air Quality Coalition\u003c/a>, was enthusiastic. \"We have come to know Dr. Sherriffs through his work at the medical society and his willingness to take time out of his schedule to speak up on behalf of his patients in an informed manner,\" Hall said. \"That’s why we worked so hard for five years to create a seat for a doctor, so the voice of public health would be right there at the policy level, like the other major air districts in the state.”\u003c/p>\n\u003cp>The San Joaquin Valley is home to some of the most polluted air in the country, fueling a rise in asthma cases across the region. Hall says one in six children will be diagnosed with asthma by age eighteen.\u003c/p>\n\u003cp>In a release, Ray Leon, director of the San Joaquin Valley Latino Environmental Advancement Project echoed Hall's comments. “An expert voice on the deadly impacts of air pollution has been sorely missing from the San Joaquin Valley air board, and the lack of Valley representation on the state air board has been a detriment, too,” he said. “We are pleased that our voices will once again be represented in Sacramento.\"\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/566/breath-of-fresh-air-on-san-joaquin-valley-air-district-board","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_23"],"label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. 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