Reducing childhood asthma through community-based service delivery--New York City, 2001-2004.

Since 1980, asthma prevalence, hospitalization, and mortality have been increasing in the United States. Because of concern about asthma-related morbidity among children in Central Harlem, New York City (NYC), the Harlem Children's Zone Asthma Initiative (HCZAI) was established in 2001 to reduce asthma-related morbidity through improved surveillance, health-care use, and health-care service delivery for children aged < or =12 years living in a 60-block radius of Central Harlem known as the Harlem Children's Zone Project. Families of children with asthma or asthma-like signs or physical findings consistent with asthma are invited to participate in the program. This report summarizes preliminary data collected during 2001-2004 on the effectiveness of the program in reducing asthma-related morbidity; data indicate decreased parental/guardian reports of school absences among children enrolled in the program, both for any reason and because of asthma. In addition, emergency department and unscheduled physician office visits for treatment of asthma decreased from 35% to 8% after 18 months of the program, indicating improved asthma management and appropriate use of health-care services by program enrollees. The effectiveness of HCZAI underscores the utility of community-based public health programs in reducing asthma morbidity.