ASTHMA

在美国，哮喘是一个重要的健康问题， 对于儿科人群来说尤其如此。疾病的流行 哮喘、哮喘死亡率和发病率以及死亡率和死亡率的增加 低收入市中心黑人儿童的发病率明显更高 而不是其他儿科社会经济群体。这一分两个阶段的提案是 旨在比较市中心黑人哮喘患者和市中心白人哮喘患者 哮喘患者，非市中心的黑人和白人哮喘患者和市中心 非哮喘患者识别社会经济，心理，家庭， 影响黑人城区的环境和临床因素 4至11岁的哮喘患者，并导致哮喘发病率和 死亡率(第一阶段)。根据第一阶段的数据，我们将设计和 实施全面的哮喘管理方案，包括：a)国家 临床环境中的艺术医疗护理，b)专业外展至 患者及其家属和c)促进哮喘的社区组织 自我管理。市中心的黑人哮喘患者接受最先进的治疗 医疗保健和专业外展或最先进的医疗保健， 专业外展和社区组织将在 以及市中心和郊区的哮喘患者，他们没有 参与哮喘管理项目。这一独特的合作 两大医疗中心作为平等的合作伙伴，包括5个 临床环境应有助于确定导致 中心城区哮喘发病率和死亡率及防治方法建议 哮喘管理，以克服哮喘护理的障碍。

Bronchial asthma is a significant health problem in the United States and this is particularly true for the pediatric population. The prevalence of asthma, asthma mortality and morbidity and the increase in mortality and morbidity are significantly higher in low income inner-city Black children than in other pediatric socioeconomic groups. This two phase proposal is designed to compare inner-city Black asthmatics with inner-city White asthmatics, noninner-city Black and White asthmatics and inner-city nonasthmatics to identify socioeconomic, psychological, familial, environmental and clinical factors which impact upon Black inner-city asthmatics aged 4 to 11 and contribute to increased asthma morbidity and mortality (Phase I). Based upon the Phase I data, we will design and implement a comprehensive asthma management program including: a) State of the Art Medical Care in clinical settings, b) Professional Outreach to patients and their families and c) Community Organization to promote asthma self management. Inner-city Black asthmatics receiving State of the Art Medical Care and Professional Outreach or State of the Art Medical Care, Professional Outreach and Community Organization will be compared among themselves and with inner-city and suburban asthmatics who do not participate in the asthma management program. This unique collaboration of two major medical centers acting as equal partners and encompassing 5 clinical settings should help to identify the major factors contributing to asthma morbidity and mortality in the inner-city and suggest methods for asthma management to overcome the impediment to asthma care.