CDC's National Asthma Control Program: Twenty Years of America Breathing Easier
1998-1999: CDC Creates the National Asthma Control Program
National Surveillance Summary
“Surveillance for Asthma — United States, 1960-1995,” the first such national summary, reviews existing databases of self-reported asthma prevalence, asthma office visits, asthma emergency room visits, asthma hospitalizations, and asthma mortality. It also finds a need for a “national strategy for asthma control and surveillance.”
State Surveillance begins
CDC assists state health departments to begin gathering and analyzing data on hospitalizations and deaths due to asthma.
First Cooperative Agreements with state health departments
In 1999 CDC begins developing the National Asthma Control Program (NACP), funding cooperative agreements with Illinois, Minnesota, Oregon, and Rhode Island. The goals of the program were to reduce the number of deaths, hospitalizations, emergency department visits, school or work days missed, and limitations on activity due to asthma. The program supported the goals and objectives of Healthy People 2010 for asthma and was based on three principles:
- Tracking: collecting and analyzing data to understand when, where, and in whom asthma occurs
- Interventions: translating scientific information into public health practices and programs
- Partnerships: engaging all stakeholders in developing, implementing, and evaluating local asthma programs
Partnership work expands
The NACP funds 13 asthma tracking projects, 45 asthma interventions, and 30 asthma partnership projects along with six urban school districts and six national nongovernmental organizations (NGOs) funded to support and address asthma control within a coordinated school health program.
Replication and implementation of scientifically proven asthma interventions
The NACP funds 12 sites to implement asthma self-management educational programs for children in schools or health clinics.
National Surveillance Summary
The NACP publishes “Surveillance for Asthma — United States, 1980—1999,” updating the 1998 report.
Controlling Asthma in American Cities Project
The NACP begins funding grantees in seven states for seven years, under the Controlling Asthma in American Cities Project, to examine the effects of interventions in health care settings, school-based interventions, creating community linkages, and complex community-based interventions. This work informed subsequent efforts with state, territorial, and other partners nationwide.
Inner-city asthma intervention
In the Inner-City Asthma Intervention, the NACP funds 23 sites in 15 states to provide inner-city families with asthma education and individualized asthma control plans.
The NACP begins partnering with the Allergy and Asthma Foundation of American, the Allergy and Asthma Network/Mothers of Asthmatics (now the Allergy and Asthma Network), and the American Lung Association to provide educational tools for the NACP, our state partners, and others to use in promoting and enabling asthma self-management.
Enabling the nation’s schools to prevent asthma attacks and absences
The NACP funds 11 asthma tracking projects, 48 asthma interventions, and 33 asthma partnership projects as well as six urban school districts, one state education agency, and six national nongovernment organizations funded to support and address asthma control within a coordinated school health program.
In addition, the NACP funds 10 state and territorial health departments to develop asthma control plans that included tracking, intervention, partnerships, and occupational components. The NACP further funded an additional 25 state and territorial health departments to implement their state comprehensive asthma control plans. Three NGO partners were also funded to expand the reach of the NACP nationally.
By 2003, the NACP funded 33 states, the District of Columbia and Puerto Rico to develop asthma control plans that included tracking, interventions, partnerships, and to implement their comprehensive asthma control plans.
Asthma-Call back Survey
To provide in-depth state and local data to support various programs and policy needs, the NACP developed and tested an asthma survey module in the Behavioral Risk Factor Surveillance Survey (BRFSS) beginning in 2003. By 2005 the Asthma-Call-back Survey was implemented in conjunction with BRFSS, expanding quickly to 25 states in 2006 and 35 states in 2007.
National Surveillance Summary
The NACP publishes “National Surveillance for Asthma — United States, 1980—2004.” This report presented national data on asthma for self-reported prevalence; self-reported attacks; visits to physicians’ offices, hospital outpatient departments, and emergency departments; hospitalizations; and deaths.
Program expands to 36 states and territories
From 2009 through 2014, the NACP funds 34 states and two territories to conduct asthma surveillance, maintain and expand partnerships, implement statewide comprehensive asthma plans with their partners, implement interventions to reduce the burden of asthma, and develop and implement an evaluation plan. CDC also funds nine state health departments to conduct in-depth surveillance projects, disparities assessments, and interventions, implementation and evaluation and, starting in 2010, 40 states and territories to conduct the Asthma Call-back Survey. In addition, stating in 2010 the NACP funds four national NGOs to conduct educational activities related to the impact of poor air quality on individuals with asthma.
Learning and Growing through Evaluation
The NACP publishes the first of several modules of “Learning and Growing through Evaluation,” an award-winning program evaluation guide for state and other partners. This guide covers implementing evaluation, evaluating partnerships, evaluating asthma surveillance, evaluating services and health systems interventions, and performing economic evaluation of asthma programs. A series of webinars reinforced the Guide’s tools, enhancing their use by our partners.
Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities
CDC and other agencies release the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities, as part of the President’s Task Force on Environmental Health Risks and Safety Risks to Children to identify priority issues of environmental health and safety risks to children that could best be addressed through interagency efforts, recommend and implement interagency actions, and communicate to federal, state, and local decision makers information to protect children with asthma from risks.
National Surveillance Summary
The NACP publishes “National Surveillance of Asthma: United States, 2001-2010” in partnership with the National Center for Health Statistics. This report details trends in asthma prevalence, health care use, and mortality since 2001 and presents an overview of trends since 1980.
The NACP publishes the first “AsthmaStats” fact sheet. Asthma Stats are brief summaries of different surveillance topics, ranging from flu vaccination rates to insurance coverage and barriers to care.
2014 & 2016
Public Health – Healthcare Collaboration Focus
The NACP begins cooperative agreements “Comprehensive Asthma Control through Evidence-based Strategies and Public Health – Healthcare Collaboration” with 25 states. This five-year agreement helps our partners maximize the reach, impact, efficiency, and sustainability of comprehensive asthma control services across the public health and healthcare sectors, using a stepwise approach to ensure the availability of and access to guidelines-based medical management and pharmacotherapy. For people with poorly controlled asthma, it provides or link to more individualized services.
The NACP publishes the second edition of “Learning and Growing through Evaluation” published with updates corresponding to the new cooperative agreement, new evaluation standards and additional material on current trends in evaluation.
Asthma Call-back Survey Expands
By 2016, 26 states and territories were conducting the child Asthma Call-back survey, with 31 conducting the adult ACBS.
EXHALE Technical Package
The NACP publishes the EXHALE Technical Package, which presents a group of evidence-based strategies to improve asthma control and reduce health care costs. These strategies are complementary and intended to work in combination to reinforce each other. This resource is intended to inform decision-making in multiple sectors, and served as a guide for out latest Notice of Funding Opportunity, “A Comprehensive Public Health Approach to Asthma Control Through Evidence-Based Interventions,” issued in March 2019, which focuses on to improving the reach, quality, effectiveness, and sustainability of asthma control services.