Program uses home visits to help asthmatic kids breathe easier
The Gonzalez family in SeaTac is among many now benefiting from targeted home visits, in which community-health workers inspect residences for triggers like dust, poor ventilation and mold that can aggravate asthma. Then, they offer solutions.
Seattle Times staff reporter
In an abnormally tidy bedroom for a boy his age, Abraham Gonzalez, 12, plays with his Pokémon toys and dinosaur figurines with his 8-year-old sister, Hillary, on a Spider-Man comforter.
Two years ago, Abraham's room had carpeting and a filthy furnace collecting dust, which sometimes riled up his asthma. Now, without the carpet and outdated furnace, the soon-to-be seventh-grader at Chinook Middle School in SeaTac doesn't say he has asthma, because it hasn't bothered him in a year.
"It was pretty nice. That program really helped our house. My kid doesn't have problems anymore," said his father, who is also named Abraham Gonzalez.
The Gonzalezes are among thousands of families who have benefited from a home visit, in which community-health workers inspect residences for triggers like dust, poor ventilation and mold that can aggravate asthma. Then, they suggest solutions.
"Fifteen years ago is when we saw asthma was increasing steadily over the years. We had an emerging epidemic on our hands," said Dr. Jim Krieger, director of the King County Asthma Program, or KCAP, which helps Medicaid-eligible families with asthmatic children ages 3 to 17. "There were no programs in place that, by changing the home environment, you could improve asthma outcomes. We focused on the home because that's where most of the triggers were happening."
Improper food storage, cockroaches, water leaks and dust mites, he said, are a few conditions that can provoke asthma. Since its start in 1997, KCAP has helped 2,500 families.
According to the U.S. Centers for Disease Control and Prevention, asthma is on the rise again, after a slight decline in the late 1990s and early 2000s. Nationwide, 7 million children have asthma, including 28,000 children in King County.
In SeaTac, the almost 60-year-old house the Gonzalezes live in didn't seem like a trigger hot spot until they received a letter about the program from Highline Public Schools. The letter was sent to students whose school medical records showed they suffered from asthma.
Warm temperatures can disturb asthma with trees producing pollen; inhaling cold air in the wintertime can worsen breathing. Both problems affected Abraham. "When the weather changed, I was always scared. I would look at him and say, 'What if it bothers him today?' or 'What if it doesn't?' It was really scary," said Abraham's mother, Patricia Gonzalez.
"Usually, once a week, we had to go to the doctor or the hospital, but after we moved here, it was different, and it was better when they fixed it."
In April 2009, KCAP and the King County Housing Authority partnered to improve the home environment of children with chronic asthma in low-income households in ethnically diverse southwest King County. The Highline Communities Healthy Homes project received $875,000 from the American Recovery and Reinvestment Act, also known as the stimulus plan, to make repairs to homes. .
The Gonzalez family received new fans and doors to better circulate air flow, a new heating system, carpet removal and hardwood-floor refinishing, insulation on the roof and in the crawl space, a fireplace cover, a high-efficiency vacuum cleaner, hypoallergenic bedding and eco-friendly cleaning products. The family paid nothing — the improvements were arranged by the Highline project.
Poor ventilation is one of the main issues community-health workers notice in the homes, said KCAP administrative specialist Maria Skowron-Zayas, and it contributes to the collection of moisture and mold.
During the eight months of repairs, KCAP community-health workers visited the Gonzalez family several times, continuing to educate them on how to reduce asthma triggers. The Highline project ended this April.
KCAP currently conducts four home visits a week around the county, compared with 10 a week in earlier years, due to dwindling funds.
While KCAP focuses on the county, the city of Seattle has a similar program. The city funds the American Lung Association's Master Home Environmentalist program to conduct home visits, primarily in minority communities with high asthma rates. The program makes 200 visits a year.
Casey Coulombe, program coordinator for the association, said a doctor's first inclination is to medicate. But a closer look at the patient's environment is often warranted. "There are things in people's environment," he said. "If you can limit the source of the asthma attack, then it becomes even more under control. That's empowering for people."
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