While asthma is common in the United States, its frequency and impact vary greatly. Black Americans are two to five times more likely than other groups to be hospitalized due to asthma. Meanwhile, Puerto Ricans have the highest rate of asthma prevalence of any racial or ethnic group in the United States.
To help address these stark inequities, one year ago the Asthma and Allergy Foundation of America (AAFA) announced the Health Equity Advancement and Leadership (HEAL) Innovation Program, funded by Amgen as the exclusive pilot year sponsor. The community-based program launched in four cities in its first year: Chicago, Detroit, Los Angeles and St. Louis.
As the program expands to two new communities with a high burden of asthma, it is guided by learnings from the pilot year. One of these key learnings is the critical role that local community health workers have in reaching these communities and sparking change.
Recognizing the Power of Localized Healthcare and Community Health Workers
Community health workers (CHWs) were integral to year one of HEAL Innovation. They have the unique ability to meet people where they are, reducing many barriers that patients may face.
Before the program started, 42% of HEAL Innovation program participants reported a lack of reliable transportation that kept them from medical appointments, meetings, work or from getting necessities. In addition to the lack of reliable transportation, program participants experienced other barriers including food insecurity, the risk of losing utilities and exposure to pollution.
CHWs across each of the original four cities have been conducting at-home and virtual visits with program participants to customize each person's asthma management plan. Home visits have offered an opportunity to educate patients and their entire households on topics like hidden asthma triggers. CHWs have sometimes even provided households with donated products from AAFA's CERTIFIED asthma & allergy friendly® program. Items like asthma-friendly pillows, laundry detergent or air purifiers were provided at no cost.
Through their understanding of the complex barriers to asthma care facing their communities, CHWs can offer tailored solutions, education and access to resources to help people living with asthma achieve better health outcomes. Additionally, CHWs often act as both trusted voices to amplify individual participant needs and sources of encouragement to help them better advocate for themselves.
"Being in the local community and having home-based interventions is the best way to get better outcomes for asthma disparities," said Kenneth Mendez, president and CEO of AAFA. "Community health workers play a critical role because they have a deep understanding of their communities and act as caring liaisons for patients as they navigate the healthcare system."
As the program expands into Year Two, HEAL Innovation will increase the number of CHWs at each program site and provide additional education to CHWs so they are even better equipped to support their communities.
Looking Ahead: Collaborating for A Healthier Future
As part of Amgen's commitment to improving health equity, the organization will continue supporting AAFA as HEAL Innovation expands into two new communities: Bronx, N.Y. and the Black Belt Region around Montgomery, Ala. The Bronx initiative will implement a unique asthma care intervention program with the organization AIRnyc and will support the Hispanic and Latinx population. The Alabama program will support patients in rural communities with a virtual patient education and home visiting program. As Year Two reaches new communities, AAFA and Amgen are committed to a sustainable expansion so each local organization participating in the program is set up for long-lasting success.
"Amgen's mission is to serve patients, and we believe everyone – no matter where they live – should have the best opportunity for good health outcomes. But when we look at chronic conditions, like asthma, there are communities that are more vulnerable," said Ponda Motsepe-Ditshego, vice president and therapeutic area head of Global Medical, Inflammation & Representation in Clinical Research at Amgen. "Together with AAFA, we're aiming to close the gap in equity for asthma patients."