AMA Resolutions

Resolution: (A-01)

Introduced by:  American Academy of Child and Adolescent Psychiatry
                           American College of Preventive Medicine

Subject:  Understanding and Reducing the Increase in Childhood Asthma

Referred to:

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Whereas, asthma is the most common chronic disease among children; and

Whereas, children with asthma may need to limit their daily activities to control or prevent asthma attacks; and

Whereas, extreme exacerbation of asthma can lead to emergency room visits, hospitalization and even death; and

Whereas, the tendency to develop asthma may be inherited, but not all children with asthma have a family history of the disease; and

Whereas, exposure to indoor and outdoor sources of biological and chemical environmental contaminants have been shown to cause asthma or exacerbate existing asthma; and

Whereas, children with asthma are particularly sensitive to outdoor air pollution such as ozone, particulate matter and sulfur dioxide; and

Whereas, between 1980 and 1994, the number of children with asthma in the United States increased by 75%; and

Whereas, between 1990 and 1995, the number of children with asthma increased by approximately 30%, from 5.8% to 7.5%; and

Whereas, children living in families with incomes below the poverty level have significantly higher rates of asthma than children living in families at or above the poverty level; and

Whereas, studies have indicated that air pollution during the summer is associated with approximately 6 to 24% of all hospital admissions for asthma; and

Whereas, hospitalizations for asthma accounted for 7% of all hospitalizations for children aged 0-14 in 1998; and

Whereas, asthma is the fourth leading cause of non-injury related hospitalizations for children; therefore be it

RESOLVED, That the AMA House of Delegates request the Council on Scientific Affairs to prepare a report reviewing the scientific literature concerning the increased incidence of childhood asthma, and the relationship between asthma and socioeconomic status, air pollution and exposure to environmental toxins; and be it further

RESOLVED, that the AMA House of Delegates request the Council on Scientific Affairs to develop recommendations, based on the scientific literature, for specific public policy, public education and/or legislation designed to reduce the incidence of childhood asthma.

Fiscal Note: staff assistance requested

RELEVANT AMA POLICY

H-160.932 Asthma Control

The AMA: (1) encourages physicians to make appropriate use of guidelines, including those contained in Expert Panel Report II: Guidelines for the Diagnosis and Management of Asthma released by the National Heart, Lung and Blood Institute. Furthermore, the AMA believes practice guidelines should be evidence-based and urges that all future guidelines for the diagnosis and management of chronic diseases such as asthma be evidence-based; (2) encourages physicians to provide education to patients about asthma and the principles of asthma self-management as follows: (a) The AMA insists that patient education be based on evaluated models using appropriate behavioral theory and emphasizing the core asthma information and skills associated with effective self-management; (b) The AMA encourages physicians to participate in training based on evaluated physician education models that can enhance their teaching and communication skills enabling them to provide patient education that engenders positive change in patients; (c) The AMA encourages physicians to augment their own patient education whenever possible by referring patients to comprehensive asthma education programs based on evaluated models; and (3) encourages physicians to monitor outcomes of their asthma treatment through instruments such as the Asthma Outcomes Monitoring System (AOMS) developed by the Joint Council of Allergy, Asthma and Immunology. (CSA Rep. 4, A-98)