Asthma is a pervasive affliction, but it may be one that is often preventable. So goes the rationale behind a large-scale public health initiative that just launched in Louisville. The goal is to track asthma-inhaler use across the city and use that information to address the city’s asthma problem, saving money and maybe even lives.
Certainly Kentucky, and Louisville in particular, has conditions that are ripe for asthma. In 2014, the Asthma and Allergy Foundation ranked Louisville the 16th most challenging city for people with asthma. The city was also the No. 1 spring allergy capital in the U.S. in 2014. This is actually worse than 2013’s ranking, where the city came in fifth.
To get a read on where in the city asthma flare-ups are most prevalent, the Institute for Healthy Air, Water and Soil is distributing 1,000 asthma inhaler-attachments throughout Jefferson County. The special sensors will electronically track where and when the inhalers are being used, creating a database of the city’s asthma hotspots.
The electronic monitors attach directly onto asthma inhalers and are made by Madison, Wisc.-based firm Propeller Health. The program — funded via a $750,000 grant from the Robert Wood Johnson Foundation — is a collaboration between the aforementioned institute, Louisville Metro Public Health and Wellness, and others.
Veronica Combs, director of community engagement for the institute, says the project officially kicked off Jan. 1. The goal is to distribute the inhaler sensors across a wide spectrum of the city’s geographic and demographic profiles.
Why is this needed?
“We always make the list of the worst places to live with asthma,” she says. The city also has a lot of smokers, which adds yet another contributing factor to the city’s poor respiratory history.
Combs says the project is scheduled to last two years. This will break out into a year to gather data on where the inhalers were used, and a year to dissect the data collected.
This is the second round of inhaler monitors distributed in Louisville. The first round was in 2012, with 350 Propeller inhalers distributed. The inhalers were used throughout 13 months, and data was collected for what Propeller called “over 5,400 rescue inhaler use events.”
The Propeller sensor wirelessly syncs with the user’s smartphone using the phone’s built-in Bluetooth technology. Once the sensor is paired, the phone automatically captures the data from the sensor whenever it is nearby. It can be used both for individuals and to track community use.
Propeller CEO David Van Sickle says the first round of data yielded some surprises. One surprise was that people were experiencing asthma-related problems when they were out in the community. “Historically, people thought the majority of asthma symptoms were at home,” he says.
Which parts of the city had the worst asthma? He says there was a defined pattern of more use in the downtown area and in the West End. He added there was a second cluster in the eastern part of the city, which was linked to wind, with the implication that it blew asthma-causing irritants in that direction.
“It just goes to underscore that air quality is not a local issue,” he says. “It can cross borders with abandon and needs a collective effort.”
A Propeller-supplied graphic of hospitalization visits for asthma in 2010 clearly shows the most asthma occurred in the west side of the city. This area included the 40213, 40212 and 40215 ZIP codes, among others.
Ted Smith, the city of Louisville’s chief of civic innovation, says the data from the 2012 study is currently being prepared for scientific publication. Slides are available to see some of Propeller’s findings.
The original version of this story misstated the last name of Veronica Combs, director of community engagement for the Institute for Healthy Air, Water and Soil, which is spearheading the distribution of asthma-inhaler sensors.