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Testimony on S.B. 172 and H.B. 5672-- Acts Concerning an Asthma Tracking System

March 6, 2001, Hartford, Connecticut

Ladies and Gentlemen of the Public Health Committee,

My name is Nancy Alderman and I am president of Environment and Human Health, Inc., a nonprofit organization made up of doctors, public health professionals and policy experts dedicated to the purpose of protecting public health from environmental harms through research, education and the promotion of sound public policy.

Last year we conducted an asthma prevalence survey that included 85% of all the school children in Connecticut. That percentage number represents 513,688 school children. This was the first time such a broad scale study of asthma prevalence was done in Connecticut and it showed that, on average, 9% of Connecticut’s school children have doctor diagnosed asthma. That translates into one in 11 school children in Connecticut have asthma. Any disease that affects one in 11 children can be considered an epidemic. Because asthma is a chronic disease these numbers are not likely to go down in the short term.

The importance of EHHI’s Asthma Prevalence Study is not just that it shows how many and where the asthma cases are among our school age populations, but also that it sets up a model for tracking asthma that uses already existing infrastructures, and thus can be implemented by the State for a modest amount of money.

Asthma is presently not a reportable disease in this State. It is important to understand how the asthma data that we do have is collected. Asthma cases are now only counted by looking at hospital admissions and emergency room visits. This fact means that inner city populations who use the hospitals as their primary care facilities are counted while people with asthma who use doctors in other than hospital settings are not counted. This system of only using hospital admissions and emergency room visits for the collection of asthma data not only completely skews the data but is also not adequate to understand the disease which is now in epidemic proportions among our children.

By having school nurses collect the asthma prevalence data on their students, the State will be able to get the asthma prevalence data for its school age population. We will then be able to look at urban, suburban and rural numbers, socioeconomic differentials, grammar, middle and high school ages and specific geographic areas by individual schools and by school districts.

EHHI collected this kind of data, but because it is a non-profit, it had to promise confidentiality to the schools, and thus it had to analyze and distributed its data in the aggregate. The limitations of this are enormous. For instance, in the aggregate, the highest asthma rate in any school district was 14%. However, if one goes down to the smaller unit of analysis, the individual school, there were 19 individual schools with asthma rates above 14%, with the highest of those at 25%. There were 5 individual schools with asthma rates above 20% and these figures do not include Connecticut’s larger school districts of which the urban schools belong, because our data for those districts came in in the aggregate.

We must be able to get open and accurate data for our school children if we are to better understand this disease. This kind of data can easily be attained from our school nurses. When and if the State collects the asthma data the information will be made available for everyone and researchers and health professionals will be better able to understand what is going on with the disease. As well, resources can get distributed to those areas that show the greatest need.

EHHI’s study shows that asthma prevalence is high among all populations: urban suburban and rural. No group or town has escaped this epidemic. Connecticut must begin to track asthma now. We cannot wait any longer to begin to make serious impacts on this disease. By using the model set up in EHHI’s study, and by having school nurses report their asthma prevalence data annually to their local health departments and the State Health Department, Connecticut can start tracking asthma immediately and it can be done for the modest estimated cost of $ 250,000. Surely an epidemic deserves no less.

Nancy Alderman, President Environment and Human Health, Inc.

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