New York's asthma-related Medicaid expenditures rose more than 26 percent in the last five years, as the state's overall annual asthma bill topped $1.3 billion for medical costs and lost productivity, according to a report released today by State Comptroller Thomas P. DiNapoli.
"Asthma isn't just costly, it can be lethal," DiNapoli said. "For the New Yorkers fighting this chronic disease, a flare-up can mean missing work or school and too many late night emergency room visits. The Medicaid cost to taxpayers for treating asthma has jumped and the prevalence of asthma among older Medicaid recipients is especially high. The state needs to better understand asthma trends and better target publicly funded initiatives, particularly for Hispanic, African-American and the poorest New Yorkers struggling with this disease."
Roughly 1.7 million people in New York suffer from asthma, according to estimates by the Centers for Disease Control and Prevention (CDC). New York's $55 billion Medicaid program enrolls approximately one in four New York state residents, including 559,000 diagnosed with asthma, and spent $532 million on asthma care in 2013.
For Medicaid recipients, New York's highest asthma rates were in the Bronx and four upstate counties, according to DiNapoli's report.
In New York City, asthma rates among Medicaid recipients were particularly high in the Hunts Point and Longwood-Morrisania neighborhoods in the Bronx; East Harlem in Manhattan; Carroll Gardens-Red Hook in Brooklyn; and Arverne in Queens.
Asthma-related death rates dropped 24 percent from 2002 to 2011 statewide and by 17 percent in New York City, according to the state Department of Health (DOH). Hispanics and non-Hispanic blacks had significantly higher mortality rates than whites, with nearly 32 deaths per million residents for non-Hispanic blacks and 22 deaths per million residents for Hispanics versus less than seven deaths per million residents for non-Hispanic whites, according to DOH.
The financial consequences of asthma remain significant. Hospitalizations accounted for $660 million in asthma-related costs in 2011, a 61 percent rise since 2002, according to DOH. The dramatic variation in Medicaid asthma rates across communities demonstrates the need to target public asthma programs to those most in need, DiNapoli's report concludes.
Declines in asthma-related deaths and hospitalizations in New York, and in asthma rates among children enrolled in the Medicaid program, demonstrate progress against the disease, DiNapoli's report states.
New York has increased asthma care for children at school-based health centers, home interventions and Medicaid access to medications, education and hospital care.
DOH is also proposing to expand its home-based asthma education program to reduce childhood exposure by abating household triggers from second-hand smoke to mold and dust mites, and to follow up on hospital visits to help Medicaid recipients and their families avoid future visits.
But further advancement is essential. Health advocates and policymakers recommend additional steps, including school programs to boost awareness of asthma triggers, remediation of mold in public and private housing and increased asthma self-management education.
New York City Comptroller Scott Stringer: "Despite progress made in cleaning up New York City's notoriously polluted air, children living in poverty are nearly twice as likely to suffer from asthma. Children in Hunts Point, Mott Haven, and East Harlem are hospitalized for asthma at more than twice the rate of other kids in the city. I commend Comptroller DiNapoli's effort to highlight this public health crisis and I join him in seeking solutions that will let all New Yorkers breathe a little easier."
New York City Council Speaker Melissa Mark-Viverito: "The findings of State Comptroller DiNapoli's study are a clear indication that asthma remains a major public health issue in New York. It's particularly alarming that Latino and African-American communities show disproportionately high rates of asthma. There is a real need for continued funding to treat asthma symptoms, as well as proactive steps to prevent the problem from growing in the future."
Senator José M. Serrano (D, WF- Manhattan/Bronx): "The communities I represent in the South Bronx and East Harlem have unfortunately been facing a full-blown asthma epidemic for far too long. The residents of these neighborhoods - especially our youth - report some of the highest asthma rates in the entire state, so it's critical that we find new ways to attack this growing problem. My sincere thanks to State Comptroller Tom DiNapoli for his ongoing efforts, along with this much needed report, which will supply new data and bring additional attention to this problem. Knowledge, awareness and prevention are key components to fighting and winning the war on asthma."
Assemblyman Robert Rodriguez (D- Manhattan/Bronx): "We commend the efforts undertaken by the CDC and state Department of Health in the last 10 to15 years to combat asthma and help to reduce asthma-related deaths by 22 percent in New York state. In communities like Hunts Point in the Bronx, and my district of East Harlem in Manhattan, however, we are not seeing improvement, particularly for non-Hispanic blacks and Hispanics. We are encouraged by the expansion of the state's Medicaid home-based asthma assessment and education program, and will be closely monitoring the results. But it is also our responsibility to look at this problem holistically, by working towards improved emission standards and providing safe, mold-free housing. Comptroller DiNapoli's report helps in this effort."
Manhattan Borough President Gale Brewer: "Asthma can be prevented with better public health. By working together, state and city governments can ensure resources are concentrated where they can be most effective. This report by Comptroller DiNapoli is a great step."
NYC Health Commissioner Dr. Mary Bassett: "I want to thank Comptroller Tom DiNapoli for shining a light on the prevalence and cost of asthma in New York state. Despite declines in overall deaths from asthma and asthma-related hospitalizations, asthma prevalence rates among Medicaid recipients remain significantly higher for children up to age17 and adults aged 55 and over, reinforcing the need in communities such as East Harlem to continue working collaboratively with all stakeholders to address and manage this chronic health condition."
Jeff Seyler, president and CEO, American Lung Association of the Northeast: "We applaud Comptroller DiNapoli for his efforts to illustrate the very real human toll that asthma continues to have on New Yorkers. This report demonstrates that we still have a lot of work to do to reduce the burden of asthma across the state."
For a copy of the report, visit: http://www.osc.state.ny.us/reports/economic/asthma_2014.pdf
The report contains a full breakdown of Medicaid asthma rates in the five boroughs of New York City by county and by selected zip codes.