The burden of asthma in Maryland is immense. 6.8% of Maryland children and 10.8% of Maryland adults have asthma— leading to 21,852 asthma-related emergency department visits in Maryland and 1,866 asthma-related hospitalizations in 2022.[1] Asthma is also a health equity issue in the state, as Black Marylanders are almost three times as likely to visit the emergency department for asthma than the next most affected group (Latinos).[2] This burden is especially pronounced in Baltimore City, where nearly 14% of adults have asthma.[3] The University of Maryland Medical Center has found that asthma is the leading cause of school absenteeism in the city.[4]
Uncontrolled asthma leads to missed work or school days, poor sleep, less exercise, and frequent attacks that are both uncomfortable and dangerous. In severe cases it can lead to emergency department visits or hospitalization.[5] Both local health departments and family physicians have a role to play in helping Marylanders manage their asthma, ensuring that people with the condition can feel good and stay active without worrying about an attack.
[1] Maryland Department of Health, “Environmental Health: Asthma,” State of Maryland
[2] Ibid.
[3] Baltimore City Health Department, “Asthma in Baltimore,” City of Baltimore
[4] “Asthma FAQs,” University of Maryland Medical System
[5] “Asthma in Baltimore.”
Asthma Action Plans
One tool that is instrumental in controlling a child’s asthma is the Asthma Action Plan.[1] An Asthma Action Plan is prepared jointly by a patient and their physician to document personalized strategies to inform, identify, and treat attacks whenever they occur. AAPs include zone-based (green for long-term control, yellow for limited symptoms, red for emergencies) identification techniques for asthma attacks, including measurement of peak flow, and the medicine that should be administered for each zone a child is experiencing. Some action plans also include a medication log to track a child’s history across institutions. The Maryland State Department of Education has Asthma Action Plan forms, as do most local school districts.[2] Action plans should be shared with everyone who cares for a child with asthma.
[1] “Asthma Action Plan and Medication Administration Authorization Form,” Maryland State Department of Education
[2] “Asthma Action Plan,” Asthma and Allergy Foundation of America
How Do Local Health Departments Help?
Many counties in Maryland offer home visiting services for families with children with asthma.[1] Medicaid-eligible households can receive home visits with a local health worker to receive resources, case management, and education on how to control a child’s asthma. These home visits also include supplies that help eliminate common asthma triggers, including HEPA filters, pillowcase and mattress covers, pest control kits, medicine containers, cleaning supplies, and more. Enrollment in this program can also connect families further to community resources to help control their child’s asthma.
The following local health departments offer asthma home visitation services:
Please see MDAFP’s Local Health Department Resource page under Members for links to these local health department websites for more information.
How Can Physicians Coordinate with LHDs?
Not all families facing an asthma diagnosis are aware of these services offered in their community. Family physicians can help their patients with asthma by referring them to the home visitation program in their county and informing them of the offered services, including free supplies and environmental assessment to limit triggers. In turn, physicians should be prepared for families engaged with these home visitation programs to ask for assistance in filling out an Asthma Action Plan for their child.
Both medication and social supports are essential parts of the asthma
care continuum. Partnerships and coordination between physicians, who
can supply the former, and local health workers, who can address the
latter, can ensure that those who face the condition can keep it under
control and lead safe, active, and healthy lives.
[1] Maryland Department of Health, “Home Visiting Services for Children with Asthma,” State of Maryland
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