Luc Joseph, MD, PhD, MPH

Luc Joseph, MD, PhD, MPH

1999-2000

Pediatrician and Instructor in Pediatrics, Children's Hospital Boston, Boston, MA

Dr. Joseph’s principal interests are public health policy issues related to minority and vulnerable populations as well as community-based approaches to HIV and asthma prevention in disadvantaged groups.

Dr. Joseph received his doctorate and medical degrees from the University of Rochester School of Medicine and Dentistry in 1994 and 1996 respectively, and completed residency training in pediatrics at Children’s Hospital Boston in Boston, MA in 1999. He completed the CFHU Fellowship and received an M.P.H. from the Harvard School of Public Health in 2000.

Pediatric Asthma: Promoting Best Practice in Schools- Bringing State and Federal Agencies into Partnership with Various National and Local School Associations/ Boards to Tackle the Rising Rate of Asthma Rate and Morbidity in School Children in New England

Abstract:

Asthma is a serious chronic condition affecting nearly five million children in the U.S. Asthma is major public health problem in children, especially children living in poverty. In the 1990s, dramatic increase in the prevalence and mortality from asthma has helped focus public attention on this disease. Data from the National Health Interview Survey indicate that the prevalence of the disease almost doubled in the less than 18 age group from 1982 to 1995. Also, the number of deaths due to asthma in the less than 15 age group has increased almost 3 fold from 1979 to 1997.  In 1997, the economic costs and negative educational impact of childhood asthma were enormous, with an estimated cost for treatment of $1.9 billion and with more than 10 million school absences per year.

The Regional Directors of the U.S. Environmental Protection Agency, the Department of Health and Human Services, and the Department of Housing and Urban Development will host a summit of Commissioner-level officials from state agencies along with school officials and various state associations to tackle the asthma epidemic in New England.

Recommendations:

As members of the school asthma working group, we recommend that:

1) Every school child with asthma should have at school a written asthma management plan that is readily accessible. This management plan should be reviewed at least bi-annualy with parents for regular updates and to encourage compliance with the plan.

2) School nurses should be given more opportunities for asthma training, including learning about latest recommendations on best practice guidelines on asthma. In addition, all school personnel including coaches and teachers should become familiar with the basics of asthma care as well as the recognition of asthma symptoms.

3) States pass new laws or clarify existing laws that permit students with asthma to self-medicate on school grounds as long as parents, physicians, and school nurses agree thus allowing school nurses to dedicate more time in a proactive rather than reactive mode.

4) New England schools adopt the “How asthma friendly is your school?” checklist of the National Asthma Education and Prevention Program of the National Heart, Lung, and Blood Institute.

5) Students identified with asthma, especially those with moderately severe and severe asthma, should be encouraged to join existing local support network for children with asthma.

6) Disadvantaged schools should be provided with the resources to buy asthma equipment and supplies.

Faculty Preceptors:

Polly Hoppin, Assistant to Region I Director, U.S. Department of Health and Human Services