Advancing Health Equity in Asthma Control through EXHALE Strategies - The Wisconsin Department of Health Services’ Asthma Program works to improve the health and quality of life for people living with asthma. The Asthma Program and the Wisconsin Asthma Coalition have implemented strategies in the Wisconsin Asthma Plan 2021-2025 related to infrastructure, community, home- and school-based interventions, and health systems coordination. Successfully implemented strategies include the Asthma-Safe Homes Program, Medication Therapy Management Program, the School Walkthrough Program, collaborations with statewide healthcare organizations to support guidelines-based medical care, and a strong partnership with Medicaid to improve coverage of asthma services. Our program has been nationally recognized for its leadership in environmental asthma management and healthy homes initiatives. While we have made considerable strides toward reducing asthma morbidity and mortality, significant socioeconomic and racial and ethnic inequities persist, particularly among Black, Indigenous, and Hispanic populations, people with low incomes, and children. These disparities are most prevalent within Wisconsin’s urban southeastern counties, and within rural counties with high poverty rates and large tribal populations. Our program has identified several key issues that must be addressed to improve asthma outcomes among priority populations in Wisconsin. Adherence to guidelines-based care among primary care providers, provision of asthma resources within schools, and coverage of in-home asthma education and environmental services need to be enhanced within high asthma burden communities. Our program seeks to achieve the following outcomes: implementation of EXHALE strategies across settings; linkages to community resources to address health inequity; use of surveillance and evaluation data to drive program improvement; enhanced and new strategic partnerships; increased access to EXHALE interventions for people with uncontrolled asthma; reduced impact on the identified driver of health inequity for asthma control; coordination of care across settings; reduced exposure to environmental asthma triggers; sustainability of results-based health equity partnerships; policies enacted and evaluated to address drivers of asthma control; reduced asthma-related emergency department visit and hospitalizations; and reduced asthma-related mortality and disparities. To accomplish these outcomes, we will implement a comprehensive and coordinated approach spanning public health, schools, community organizations, and healthcare. Our program aims to reduce asthma-related emergency department visits, hospitalizations, mortality, and disparities by enhancing strategic partnerships to help implement EXHALE strategies and strengthening our existing organizational infrastructure to advance health equity and sustainability. We will build upon successes from the CDC-RFA-EH19-1902 opportunity to leverage existing partnerships and develop new strategic partnerships to advance health equity, focusing in urban southeastern Wisconsin counties of Milwaukee, Kenosha, and Racine, with further expansion to additional high-burden counties in southern (Rock) and northeastern (Brown and Menominee) Wisconsin. Our new health equity partnerships with the Wisconsin Primary Health Care Association and regional Cooperative Education School Associations will contribute significantly to establishing new partnerships with FQHCs and school districts, respectively. In addition, we will engage community navigators, health plans, and other healthcare organizations to reach high-burden communities. We will work with Medicaid and HMOs to expand coverage of in-home asthma education and environmental assessment through alternate payment models. This grant will strengthen our existing infrastructure, enhance our ability to address drivers of asthma disparities, and expand our collaborations with partners to ensure the sustainability of asthma control services in Wisconsin.
