Overview. Although Minnesota has lower asthma prevalence relative to other states, population groups identifiable by race, income, and geography are subject we have stark disparities in asthma prevalence, uncontrolled asthma, and asthma deaths. Since 2011, the first year BRSSS data are available, prevalence among Blacks has been higher than among whites, much as 89% higher in 2018 (1). Since 2015, the first year BRFSS data are available for American Indians in Minnesota, prevalence among American Indians has been as much as 172% higher. In certain metropolitan zip codes, uncontrolled asthma, as represented by asthma-related emergency visits, is multiples of times higher than the state average (2). These zip codes are generally lower income, with older housing, often less well-maintained housing, are near or encompass busy thoroughfares, and encompass numerous industrial sources of pollution (3,4). In addition, populations in these zip codes include higher proportions of BIPOC than the metropolitan area generally. Rural areas do not fare well either. More than ten percent of people in rural Minnesota live below the poverty level (5). Data collected by Minnesota Community Measurement show that rates of optimal asthma care are lowest in the most remote corners of the state (6). Data collected by MDH’s Rural Health Program show provider shortages in the entire northern half and western half of the state. Thirty counties have no areas that are not shortage areas (7).
Applicant. To address asthma disparities, the Minnesota Department of Health (MDH) is applying for CDC-RFA-EH-24-0016: Advancing Health Equity in Asthma Control through EXHALE Strategies. MDH has the capacity and intends to serve 87 counties and 11 Tribes but will focus on subpopulations and areas disproportionately impacted by asthma. MDH has the capacity to serve all populations and communities within the state. The department is physically located at 625 Robert Street North in St. Paul, Minnesota.
Purpose. With partners and in consultation with communities served, MDH will work to increase guidelines-based asthma care, patient self-management of asthma, and patient access to social determinants of health with the goal of improving asthma control, and thereby decreasing the burden of asthma and mortality attributed to asthma.
Strategies and Priority Populations. MDH will work to implement EXHALE strategies and to link people with asthma, health care, and community resources so that all people with asthma have access to health care and to resources that can help provide or supplement social determinants of health. MDH will work across the state, but is designating urban Black populations, American Indians, and low-income areas with high rates of asthma emergency visits as focus populations.
Outcomes. The long-term outcomes for this proposal are: (1) Increased coordination of care across settings. (2) Reduced exposure to environmental asthma triggers. (3) Improved sustainability of results-based health equity partnerships. (4) Increased policies and plans enacted and evaluated to address drivers of asthma control. (5) Reduced asthmarelated emergency department visits and hospitalizations. (6) Reduced asthma-related mortality and disparities.
References:
(1) BRFSS, 2011-2022
(2) Minnesota Public Health Data Access. Asthma. Viewed 4/6/2024.
(3) CDC. Social Vulnerability Index. Viewed 4/6/2024.
(4) US Zip codes. Viewed 4/6/2024.
(5) Rural Health Care in Minnesota: Data Highlights. Viewed 4/6/2024.
(6) Minnesota Community Measurement. Issue Brief: Optimal Asthma Control in 2020. Adults and Children.
(7) Rural Health Care in Minnesota: Data Highlights. Viewed 4/6/2024.