Advancing Health Equity in Asthma Control through EXHALE Strategies

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The CDC National Asthma Control Program is announcing a new, FY24 non-research notice of funding opportunity (NOFO) designed to improve the health and quality of life for people living with asthma.  This NOFO builds upon the work of state, local and territorial public health departments and their strategic partners supported by CDC through funding opportunity announcement CDC-RFA-EH19-1902.Asthma is a complex, highly prevalent chronic disease and is consistently one of the top five most costly health conditions. According to 2020 current asthma prevalence data, more than 25 million Americans have asthma, including 4.2 million children and 21 million adults.  The cost of asthma places a significant economic burden on the United States (U.S.). In 2013 alone, asthma cost the U.S. economy an estimated $81.9 billion in medical expenses, missed school and work days, and deaths.There are significant disparities in asthma outcomes by race, ethnicity, and socioeconomic status.  In the U.S., the burden of asthma falls disproportionately on Black, Hispanic, and American Indian and Alaska Native populations. Black individuals are nearly three times as likely to die from asthma than white individuals. Puerto Ricans have the highest rate of asthma prevalence compared to any other racial or ethnic group in the U.S.Given evidence that a multi-component approach to controlling asthma is more effective than individual strategies applied in isolation, this NOFO is based on a technical package known as EXHALE (https://www.cdc.gov/asthma/pdfs/exhale_technical_package-508.pdf).  EXHALE represents six evidence-based strategies selected for their potential of having the greatest collective impact on controlling asthma.  These strategies include: Education on asthma self-management, eXtinguishing smoking and exposure to second-hand smoke; Home visits for trigger reduction and asthma self-management education (AS-ME); Achievement of guidelines-based medical management; Linkages and coordination of care; and Environmental policies or best practices to reduce indoor and outdoor asthma triggers.      This NOFO aims to address the systems-level, environmental, and social drivers of disparities by leveraging and expanding strategic partnerships to implement EXHALE strategies.  Recipients will strengthen existing organizational infrastructure (i.e., leadership and program management, strategic partnerships, surveillance, communication, and evaluation) and leverage existing partnerships with different sectors (e.g., community- and faith-based organizations, racial and ethnic minority-serving organizations, tribal communities, school and transportation systems, housing and healthcare systems, nongovernmental organizations) and community members to expand the reach and sustainability of asthma control services through implementation of EXHALE.

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