Background on Environment & Policy
What are environment and policy strategies?
- Interventions that help to create healthy places and practices to support healthy community members.
- Environmental interventions are designed to modify structures and physical surroundings in order to influence an individual’s capacity to make healthy choices that can impact their own health or the health of those around them.
- Policy interventions are laws or regulations that are put in place to achieve a goal, including organizational policies or public policies at the local, state or national levels. Policies are an important way to focus on the economic, environmental, and social factors that serve to create or enable health problems relating to asthma.
- Environment and policy interventions are intended to improve behaviors and environments in order to address asthma. They can enhance access to medication or other tools and resources to assist in asthma management, reduce exposure to environmental triggers, and improve asthma health care.
Why are environment and policy strategies useful?
- They have the potential to reach all community members and create community changes that last much longer than most other types of interventions.
- Changes in environments and policies may be critical to creating broad based changes in triggers for asthma (e.g., allergens, environmental tobacco smoke, pollutants) as well as asthma management (e.g., compliance with medications, use of inhalers or peak flow meters).
- These policies and associated changes to the environment are designed to increase individual access to needed products and services, reduce the frequency of asthma episodes, and promote healthy lung capacity.
How can I use environments and policy strategies in my asthma intervention?
- Enhanced access interventions work to address policy and environmental barriers to managing asthma symptoms. For example, these interventions include those that act to ensure that all community members have needed medications, inhalers and peak flow meters; materials needed to reduce exposure to things in the environment that trigger asthma (e.g., bedding, vacuum cleaners); or transportation to and from health care providers.
- Reducing exposure to environmental triggers includes indoor environmental allergens or irritants such as dust mites, cockroaches, tobacco smoke, molds, and animals (e.g., cats, dogs and rodents) that are associated with asthma. Reducing exposure to these allergens at home, in schools or in the workplace may be the most significant way to reduce and manage asthma symptoms. Interventions to reduce exposure to triggers often involves educating families or individuals about these potential triggers, identifying triggers present in the individual’s immediate environment, or developing good habits to clean or remove triggers (e.g., removing pets from the home or eliminating smoking from the worksite). Most interventions have been conducted with families of children with asthma or working with organizations where adults and children spend most of their time (e.g., worksites and schools). To date, most programs have focused reducing environmental triggers as way to reduce severity of the disease after asthma has been diagnosed (secondary prevention) rather than on preventing the onset of asthma (primary prevention).
- Policies to improve asthma care and reduce exposure to environmental triggers include those to create community structures to improve diagnosis and quality of care, improve the ability of community organizations, schools and workplaces to meet the needs of individuals with asthma, and generally reduce exposure to environmental triggers that increase asthma symptoms. This may also incorporate advocacy for improved housing conditions and increased access to resources (e.g., reduced cost of medications, insurance coverage).
With whom should I work to develop and implement environment and policy strategies in my asthma intervention?
- In order to create policies and environments that support individuals with asthma or to prevent increases in the number of individuals with asthma in your organization, you may need to work with management and decision-makers to decide what makes sense for the organization.
- In the community, you may want to meet with local organizations (e.g., educational institutions, community organizations) to decide what can be implemented as well as policy- and decision-makers to develop, enforce, and evaluate these policies and changes to the environment.
- It is also critical to work with local businesses that can help to implement these interventions (e.g., pharmacies, pest control).
- You might consider working with experts in public policy, law, advocacy, law enforcement, community organizing, insurance or other partners to decide what changes can be made to improve the community as well as how these changes can be promoted.
How can I enhance environment and policy strategies in my asthma intervention?
- To further reduce asthma symptoms or increase asthma management, consider involving education through written materials or videos (individual education interventions) to complement efforts to enhance access, remove environmental triggers, or create policies. Some may follow-up with a telephone call (supportive relationships) to address any barriers to implementing the changes recommended.