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Gasping for air. Tightness and pain in the chest. Anxiety and panic. This is what an acute asthma episode can feel like.
Roughly 150,000 such episodes each year lead to inpatient admissions for children nationwide, including more than 1,200 a year in our region.
But something different happens when children with asthma come to Cincinnati Children’s. Beyond treating the asthma attack, physicians here dig deeper to find potential causes.
Doctors know that thousands of Hamilton County children live in old, poorly maintained apartments.
Science has shown that factors related to poor housing can make asthma worse.
So when children with asthma need to be admitted to the hospital, physicians at Cincinnati Children’s ask some extra questions to assess environmental risks. Does their building have water damage? Is there mold on the walls?
And when doctors hear about potential asthma risks, they take action.
In partnership with the Cincinnati Health Department, Cincinnati Children’s launched the Collaboration to Lessen Environmental Asthma Risks (CLEAR) in 2011 to help find and fix housing problems that contribute to triggering asthma attacks.
When families raise concerns, physicians alert health department sanitarians who have the authority to inspect properties and order repairs. So far, dozens of families have reported housing concerns. More than 50 properties have been inspected and more than 30 buildings have been repaired through the CLEAR program.
“It’s not about what’s your job, what’s my job. It’s about the child and the child’s health,” says Andrew Beck, MD, MPH, assistant professor, General and Community Pediatrics and Hospital Medicine. “The depth of the partnership here is unique. This level of intervention is rarely available from the inpatient wards in other cities.”
Cincinnati Children’s also partners with the Legal Aid Society of Cincinnati to help families address health and housing issues that extend beyond the hospital walls.
When children come into the medical center’s three pediatric primary care clinics, pediatricians who learn about families facing problems can refer them directly to Legal Aid for further assistance. In fact, a Legal Aid paralegal or attorney works inside Cincinnati Children’s largest clinic five days a week.
Since its inception in 2008, the Child HeLP program has received more than 2,450 referrals seeking assistance with enrolling in Medicaid, securing food stamps, obtaining special school services and more. More than 700 new referrals occur each year.
Some of the program’s biggest successes have involved addressing unhealthy housing. In 2009, a single referral to the Child HeLP program ultimately led to improvements made at 19 apartment buildings owned by a single absentee landlord.
“In the end, 677 apartment units were helped,” says Rob Kahn, MD, MPH, associate director of General and Community Pediatrics. “Not so long ago, asking a question about housing was something a doctor would never ask. Now we make it standard practice. We know bad housing is bad for asthma. So if we can partner with great community agencies to improve housing we know we can make a difference.”
Frustrated at treating children with severe asthma caused by poor housing conditions, Drs. Rob Kahn (left) and Andrew Beck work with the Cincinnati Legal Aid Society to get buildings repaired.
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