Action Against Asthma: A Strategic Plan for the Department of Health and Human Services . Notes


1. The term "minority" as used in the rest of this paper refers to "racial and ethnic minority."

2. Surveillance is the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation and evaluation of public health practice (1). A surveillance system includes the functional capacity for data collection and analysis as well as the timely dissemination of these data to persons who can undertake effective prevention and control activities (2). Public health officials use surveillance to understand changes in rates of disease in different locations or populations, to help evaluate medical care and public health programs, and to identify clues about risk factors.

3. Public health practice activities are those that facilitate the work of the medical community and others to prevent illness, reduce the severity of symptoms, and improve the quality of medical care. The role of government in public health includes: 1) the systematic collection and analysis of health information; 2) the development of goals and priorities based on scientific knowledge and measures to achieve them; 3) taking action through public education, advocacy, negotiation, and mobilization of resources; and 4) evaluation to determine whether policy goals are achieved (3) .

4. The term "minority" as used in the rest of this paper refers to "racial and ethnic minority."

5. Although national data do not provide the resolution necessary to identify particular geographic areas hardest hit by the asthma epidemic, surveys undertaken in a number of large cities in the United States indicate that the prevalence and severity of asthma are greatest in the medically underserved, inner city. A large proportion of inner-city families are insured through Medicaid .

6. Tolerance is an immune state that can be induced, and that results in long term blocking of immune responses. Tolerance induction has recently been shown to be very promising for blocking immune responses leading to rejection of organs after transplantation.

7. Coordinating Committee member organizations are listed in Appendix F.

8. Recurrent episodes of cough and wheezing are almost always due to asthma in both children and adults. However, children are often diagnosed with bronchitis , bronchiolitis, or pneumonia, even though the signs and symptoms are most compatible with asthma (58) .

9. Many of these surveys are carried out by CDC's National Center for Health Statistics (NCHS). State-based surveillance supported by the National Institute for Occupational Safety and Health has been used to identify high risk industries, occupations and substances .

10. A number of current activities and urgent needs related to the evaluation of asthma programs were described in Priority Area II and are not repeated here.

11. Elements of such evaluations might include: whether an intervention program has an impact on reducing the health burden of asthma and to what degree; whether the activities themselves work as planned, such as whether the intended audience is reached, whether they understand what was taught, and whether they modify behavior as a result; whether the processes used to implement the activity are effective and sustainable over the long-term; and whether the intervention or activity is cost-effective.

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