Topic: Improving asthma safety in schools
Pages: 7, Double spaced
Order type: Essay
Language: English (U.S.)
The aim of the assessment is to present current recommendations on your topic (Improving asthma safety in schools) and, utilising learning from part one of the assessment, provide recommendations for fellow public health practitioners to successfully address the issues.
Asthma is a leading chronic illness in Australia and ranked as having one of the highest rate across the globe. The prevalence is higher in school going children, especially aged below the age of fifteen years, than in adults. The impact of asthma is even reported to be adverse in children, often leading to hospitalization, and in worst cases it leads to death. Statistics show that “Children under 15 are more likely to be hospitalized with asthma (451 per 100,000 population) than those aged 15 and over” (Asthma Australia, n,d.a, para. 3). Seeing a need to improve this dire situation, Asthma Foundation has engaged in a community-based initiative and engaged in actions aimed at putting an end to the asthma problem. This paper is a critical analysis of asthma as a public issue that Asthma Foundation is working on. The analysis justifies and explains why this public health issue is important and describes the background to the issue including the historical, political, economic, and social context.
Justification of the Public Health IssueAsthma has been found to be a disease affecting many people not only here in Australia but all over the world. Symptoms that characterize the illness, include persistent cough, chest clogging, wheezing and inability to breath properly. In Australia, one in nine people, approximately 2.5 million people, are diagnosed with asthma (Asthma Australia, n.d.a). The prevalence of asthma, especially among children has reportedly been on the rise over the past decade. However, the main cause for this increase has not been established fully. Asthma attacks its victims early in life- within the first three years, where majority are said to show the main symptom, which is wheezing. At the age of six years, approximately 60 per cent of these children stop wheezing, while 40 per cent continue, which means they have contracted asthma. By the time they are in school, it is only about 10 to 15 per cent of the 40 per cent who report or complain about the symptoms, while the rest 25 to 30 percent either ignore or refrain from complaining hence foregoing treatment (Aalderen, 2012). Asthma as a public health concern needs to be prevented and treated for the following reasons. First, the burden of asthma is relatively high across the board, considering the cost of hospitalization and the long-term medication for treating the illness. Secondly, people suffering from asthma are said to live a poor-quality life (Asthma Australia, n.d.a). Thirdly, reports indicate that asthma negatively affects the day-to-day activities of 34 per cent of people (Aalderen, 2012). Majority of the affected are school going children whose school attendance is interfered with when they must visit the hospital when the symptoms heighten, or for regular check-ups. In Australia alone, an average of 400-500 deaths are registered annually in asthma related conditions, figures that heightens the need for an effective intervention for this illness. Asthma Foundation is one of the health organizations on the fore front in helping solve the problem of asthma. The organization’s main purpose of existence is built upon three main missions; to seek a cure to asthma, to improve the quality of life for people with asthma and to raise funds and utilizing funds for research and cure of asthma. Asthma Foundation’s main concern are the minority groups, including children for which is has established several programs targeting them. Such programs for children include; Australia’s Asthma First Aid for Schools, Asthma Friendly Schools Program, and Asthma Services for Schools. The First Aid program for schools aims at training staff on first aid techniques for children with asthma. The Asthma Friendly Schools Program is basically program that encourages schools to collaborate with the foundation and helps solve the asthma problem in several. Another program is the Asthma Services for children where parents and guardians are provided with asthma management skills and knowledge for helping their sick children have a quality life. The good part about these programs is that all of them are free to join and participate in and where there arises any problem or inquiries, the Asthma Foundation provides a helpline which is a free and confidential information and support telephone service for anyone with questions or concerns about asthma. Additionally, the foundation has an asthma action plan, which is a written plan that develops the community’s children with the child’s doctor to help control the children’s asthma. The goal of an asthma action plan is to reduce or prevent flare-ups and emergency department visits through day-to-day management. Thus, the program ensures students safety, in case of an asthma attack – staff will know what to do according to the action plan as everyone has different asthma condition.
Historical, Economic, Political and Social Context of AsthmaHistorical Asthma has been a significant cause of mortality and morbidity globally (Braman, 2006; Bahandori, et al., 2009; Van & Oliver, 2015). Over the years, thousands of people have died annually in asthma related illnesses (Gillepsie-Bennet, 2006). Surprisingly, during the 1950s, asthma was never identified as a serious medical condition. However, due to little awareness and sensitization, asthma prevalence grew to alarming levels and thus regarded as one of the leading and serious chronic diseases that is causing the hospitalization and deaths of many. Nonetheless, due to the improved awareness over the years, reports indicate that through the recent years, there has been a constant trend of asthma patients, and where the death rate is on a decline (Thomas, 2016). However, while these rates have improved for young adults and older adults, the rates among children is still wanting. Children, unlike adults, have been found to ignore the symptoms of asthma or even to hide them, perhaps contributing to the problematic situation among them. EconomicAmong chronic illnesses, asthma ranking is at the top in terms of economic cost. This is due to the significant healthcare utilizations that come with managing the disease. A decade ago, the average cost on an asthma patient was $89. In addition, over 80% percent report having problems taking care of asthma medication cost with 49% admitting to taking less medication or not taking it at all due to its high cost (Nauspiel, 2013; Loch, 2014). In the financial year of 2008-09, approximately $655 million was disbursed in asthma treatment, while the figure was expected to grow over the years (Asthma Australia, n.d.a). Today, the cost of managing asthma is even higher considering the increased input in research and programs that are targeted towards ending the disease. According to Asthma Foundation, 50% of the personal costs go to pharmaceutical prescriptions, 30% go to out-patient services, and 20% are spent on in-patient services (Asthma Australia, n.d.a). Moreover, the economic burden also impacts the general population at large considering that the government, and the private sector, despite losing workforce to deaths, they must invest more funds in health coverage. Political As aforementioned, besides affecting individuals and their families, the asthma illness influences the political framework. The government is spending a lot on the disease, in terms of grants to support research and medical insurances to cover its labor force. For instance, in 2015 the government spent over 25 billion of its revenue on asthma (Braman, 2006). The funds were spent on asthma regulating programs and formal care, money that would have been used in improving infrastructure and such. The political sphere is also affected in the sense that instead of spending time in political circles discussing more developmental issues, the time is spent discussing how to invest more funds to mitigate the problem, or how to protect the population from its adverse effects (Brown et al. 2004). For example, since it is the responsibility of the government to provide quality health for its citizens, members of parliament end up taking time in the parliament drafting and passing environmental laws to manage the situation. When such laws fail, the government in turn receives all the blame and sometimes causing some politicians to lose their positions for failure (Brown et al. 2013). Social Socially, asthma has been recognized as one of the major influencers of an individual social life, particularly on children. Globally the disease accounts for over 10 million of school days lost every academic year. In Australia, 92% of asthma-related deaths occur in patients of at least 35 years, who might be important members of a family. Further, the illness causes physiological issues such as anxiety and depression (Loch, 2014). Additionally, studies show that asthma leads to the decline of people’s happiness and quality of life, especially with the increase of severity of the illness. In fact, 34% of the people complain that asthma affects their lives in one way or another. This includes taking care of the asthma patients at the expense of attending their daily activities, budgeting for medication instead of budgeting for other things, and in the case of the patients, skipping school or work when going to the hospital or when admitted for serious cases of asthma. The social impact is greater among school going children than in other age brackets, mainly related to issues of discrimination of ailing kids, bullying and harassment of the patients, say, for their use of asthma inhalers, and for declining in grades simply because they skipped some classes or because they developed negative attitude towards school.
Asthma Foundation’s Community-Based Initiative – The fairbridge project The Asthma Foundation’s Fairbridge project was launched in 2001. It was assigned to me for my 200 hrs placement this year 2017. The mission of the project is to reach out to the whole community by encouraging schools to develop safe, fit, and all-encompassing environments for students with asthma. Beneficiaries receives a lot of benefits, including free asthma kits, and free asthma training, among others. A grant of $75,000 from Fairbridge was given the Asthma Foundation to support that course. In so doing, the initiative has managed to supply an estimated 1,500 kits to more than 750 schools. The initiative’s objective is to enhance the safety of school environments for students in regional, remote, and low socio economic areas in NSW. To achieve that objective the project ensures it has the asthma emergency kits available in schools, to treat children in case of asthma symptoms or emergency flare ups. Previously, the community was grappling with a shortage of those resources and as a result, the prevalence of asthma kept increasing. The kits provide the community with the much-needed information about asthma and thereby helps in prevention of the disease. Additionally, the project helps the community in emergency situations by ensuring that schools are well equipped to cope in asthma emergencies as asthma kits are not mandatory in school first aid equipment. To make its mission effective, the project sees to it that the community adequately trained and that only the trained receive the emergency kits. Moreover, the training provided is free of charge to reach as many people as possible and the project makes it easier for the community such that those who are not able to access the service face-to-face, are able to access it online.
StrengthsThe program can live its objective of maintaining a safe environment for the community. It can disseminate up to 1,500 emergency kits which are sent out to the needy community. Through its specific and measurable goals, the farebridge project can focus its efforts fully and to track its progress and keep moving. It does this first through a study of the environment and the community, then its target- the schools, then determine how to impact positively, such as through one of its initiative of providing free training to school’s staff and the number of kits to disseminate per school. To measure the goals is also easy as later one can look at the prevalence of asthma hospitalization/attack in that area to see if there’s any improvements. Additionally, the project’s initiatives are realistic and achievable, which makes it stand out and impactful to the community. Management of asthma being a problematic issue, farebridge project is stretched out to its limits, but still believes that its objectives are possible to meet. It is at least able to raise awareness of asthma in the targeted areas, provide training to staff and provide emergency kits, hence helping in reducing asthma prevalence. As a result, many would-be serious cases have been detected early and treated. The effectiveness of the initiatives also a plus for the project. For example, training is also made available online if they do not have time to organize a training at schools. Moreover, the initiatives are not only relevant to the organization, they are also relevant to the community. Based on statistics, asthma is a leading chronic disease and therefore needs as effective initiatives as those implemented by farebridge project. Finally, the initiatives are time-bound, meaning that their achievements are implemented and tracked stage by stage, such as the training which is done first, then the provision of emergency kits which is done later and only to the trained staff. This not only makes the project run systematically, but also on less costs.
WeaknessesThe objectives of the project, although are time-bound, balancing between short-term and long-term goals is quite challenging. For example, then it is training is complete and the emergency kits need to be dispatched, successful dissemination to all target schools could be hampered by many factors, such as limited resources and therefore fail to meet the period. Talking of limited resources, the project is facing inadequate workforce as in some rural areas – no trainer is available because of different factors, such as long distances and hard living conditions, among others. Limited funds also affect the attainability of the project’s objectives. Further, the specificity and relevance of the project is disadvantaged by a confusion in sampling the needy schools. For example, target schools are analyzed against their (Asthma Foundation) database but SEFIA code is sorted by the postcodes – therefore if a wealthy school is located at a poor suburb – they will be included in the list and be asked to accept the kits. Conversely, if a poor school is located at a rich suburb – they will not be included in the target list. Moreover, some schools discard the kits even when they are considered as low SEIFIA with HIGH prevalence of asthma admission. This makes it harder for the project to meet its objectives. OutcomeThe Project can treat asthma attacks and decrease hospital admissions and death rates. Statistics indicate a significant change in both attacks and hospitalizations, hence more is expected to improve even in the future. By providing free training to the targeted group and offering at least 2 asthma emergency kits to 750 schools in regional, remote, and low socio economic areas in NSW, the community is improving as a result of more knowledge of the disease and preparedness whenever any case is noted. Through such an initiative, the future is brighter at least in NSW. Furthermore, School staffs who are well trained will be more confident to provide a safe asthma environment for their students and staff. ConclusionWith an aim of improving asthma safety in schools, the Asthma Foundation’s community based initiative- the Fairbride project, has done a lot towards that course. It has been determined that the initiative has not only sought to reduce the rate of asthma, create awareness, and improve the health of the community, it has also implemented its actions, thereby helping manage the illness in one way or the other. Although at this point it the effectiveness of the project cannot be determines, considering that recent statistics, such as hospitalization numbers and death tolls have not been taken, it is hoped that the fairbridge project has achieved most of its specific objectives. Future outcomes are also expected to improve considering the current implementations. ReferencesAsthma Australia, (n.d. a). Statistics. Retrieved May 31, 2017 from https://www.asthmaaustralia.org.au/vic/about-asthma/what-is-asthma-/statisticsAsthma Australia, (n.d. b). Asthma Friendly Schools Program. Retrieved May 31, 2017 from https://www.asthmaaustralia.org.au/vic/education-and-training/i-work-in-an-education-setting/school/school-programs/asthma-friendlyBahadori, K., Doyle-Waters, M. M., Marra, C., Lynd, L., Alasaly, K., Swiston, J., & FitzGerald, J. M. (2009). Economic burden of asthma: a systematic review. BMC pulmonary medicine, 9(1), 24.Braman, S. S. (2006). The global burden of asthma. Chest Journal, 130(1_suppl), 4S-12S.Brown, P., Mayer, B., Zavestoski, S., Luebke, T., Mandelbaum, J., & McCormick, S. (2003). The health politics of asthma: environmental justice and collective illness experience in the United States. Social science & medicine, 57(3), 453-464.Brown, P., Mayer, B., Zavestoski, S., Luebke, T., Mandelbaum, J., & McCormick, S. (2004). Clearing the air and breathing freely: the health politics of air pollution and asthma. International Journal of Health Services, 34(1), 39-63.Gillespie-Bennett, J., Keall, M., Howden-Chapman, P., & Baker, M. G. (2013). Improving health, safety and energy efficiency in New Zealand through measuring and applying basic housing standards. The New Zealand Medical Journal (Online), 126(1379).Loch, A. A. (2014). Discharged from a mental health admission ward: is it safe to go home? A review on the negative outcomes of psychiatric hospitalization. Psychol Res Behav Manag, 7, 137-145.Neuspiel, D. R., & Taylor, M. M. (2013). Reducing the risk of harm from medication errors in children. Health Services Insights, 6, 47.Thomas, N. J. (2014). Asthma Management Practices In Two Ontario School Districts: Applying Knowledge To Action. Queen’s University (Canada).van Aalderen, W. M. (2012). Childhood asthma: diagnosis and treatment. Scientifica, 2012.Van Ly, D., & GG Oliver, B. (2015). Do we really need to keep redesigning β2-agonists for the management of asthma?. Current drug delivery, 12(1), 9-15.