The voices of Urban Institute's researchers and staff
April 18, 2014

Many DC children are struggling to breathe. Is bad communication to blame?

April 18, 2014

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Could simply fixing gaps in communication between doctors and schools be a key to reducing the impact of asthma on poor kids?

A lot of research shows that not getting the right—or consistent—care causes conspicuous health disparities that fall neatly along racial, ethnic, and economic lines. For many kids with asthma, their condition is managed not by routine care, but by regular emergency trips to the hospital while struggling to breathe.  Unfortunately, if you’re a low-income African American or Latino child with asthma in DC, your asthma experiences are more likely to include one of those terrifying trips.

Access, quality of care, and poverty are part of the story, which my colleagues and I highlight in a series of blog posts and our new report. But our report also highlights the problems created by miscommunication—or worse, no communication—between the professionals and caregivers children need most to manage this chronic and life-threatening illness. Could focusing on communication make things much better for kids? It takes a team to manage children’s asthma.

It takes medical professionals, parents, schools, and the patients themselves.  But our report finds several places where communication lapses routinely occur.

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Doctors need the time to educate parents and patients about the different kinds of medications and make sure they understand that some need to be taken every day indefinitely, no matter how the child is feeling. IMPACT DC , the Children’s National Health System program that sees patients who come to the emergency department for asthma-related issues tries to tackle this problem.AC_dots-04

But to keep children well, IMPACT DC needs to be able to hand off the care to community providers who can take the time to follow up with parents and patients to make sure that they are following these instructions. And parents need to understand and help their kids stick with the medications and care plan—and to speak up when they are confused.AC_dots-05

Finally, doctors and parents need to make sure that the adults at school—where kids spend most of their daytime hours—know about each child’s asthma diagnosis and individual plan. School nurses can help kids remember to take their daily medications and use their emergency inhalers before exercise—and when they feel symptoms coming on.

We know how to manage children’s asthma, and we know everyone we need on the team. Now we need to make sure the team works together.

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Illustration by Daniel Wolfe, Urban Institute. 

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