Vijay Naraparaju MD, associate program director in Hurley Medical Center’s Combined Internal Medicine/ Pediatrics Residency Program, soon may have even more to offer as he teaches resident physicians and medical students about asthma care and other topics.

Naraparaju, a Michigan State University College of Human Medicine faculty member on the Flint campus, was one of 25 pediatricians in the United States selected to participate in the Asthma Champions Leadership Training Program, funded in part by the National Institutes for Health and the National Asthma Control Initiative of the National Heart, Lung, and Blood Institute. The $4000 workshop is free to Naraparaju, who is expected to generate improvement plans for asthma care throughout the 6-month program.

The professional development program is led by the South Bronx Asthma Partnership and the National Asthma Control Initiative. It targets early-career pediatricians who:

• Have served as an attending pediatrician in any ACGME*-accredited residency training program with an academic appointment <7 years.
• Plan to continue as a faculty member in a residency training program for at least two more years
• Have demonstrated leadership potential in promoting quality patient care.
• Want to actively help the future health care system to succeed

The development program is especially designed to help those who serve geographical locations with the greatest need, such as the Flint area with its high prevalence of childhood asthma and Hurley as a community safety-net hospital. While Hurley provides excellent care to residents in many surrounding counties, disparate asthma outcomes still exist, primarily distinguished by geographical location and socioeconomic status. So, for example, children in neighborhoods around the hospital may fare worse than children in more affluent locations.

According to an Aug. 10, 2011, eMedicine.com summary article about asthma, about 34.1 million people in the United States have been diagnosed with asthma in their lifetime. The most recent US Centers for Disease Control and Prevention (CDC) Asthma Surveillance Survey estimates the prevalence of current asthma during 2001-2003 at 6.7% in adults and 8.5% in children, with the burden of asthma increasing more than 75% from 1980 to1999.

The eMedicine authors also stated that asthma accounts for more school absences and more hospitalizations than any other chronic illness. In most children's hospitals in the United States, it is the most common diagnosis at admission.

Worldwide, 130 million people have asthma. The prevalence is 8-10 times higher in developed countries (eg, United States, Great Britain, Australia, New Zealand) than in developing countries. In developed countries, the prevalence is higher in low-income groups in urban areas and inner cities than in other groups.

Locally, Genesee County’s pediatric asthma numbers are better than the state as a whole, except when comparing by insurance status. Children with Medicaid in Genesee County fare worse, according to the Asthma Initiative of Michigan’s data for Genesee County from 2005-2006, available online. It lists the following rates for asthma, which costs ~$18,000 per person per year in direct and indirect costs:

Table 1. Average Number and Rates of Hospitalization due to Asthma, Genesee County and Michigan, All Ages, 2004-2006 (Source: Asthma Initiative of Michigan)

Table 2. Characteristics of Asthma Management for Children Enrolled in Medicaid¹ with Persistent Asthma², Genesee County and Michigan, Age ≤18 Years, 2005 (Source: Asthma Initiative of Michigan)

For more information, visit the AIM website at: http://www.getasthmahelp.org/county-asthma-statistics.aspx.