The Health Department and Montefiore Medical Center, with support from New York’s Robin Hood Foundation, the New York State Health Foundation, and the Fund for Public Health of New York, are collaborating on a new study to help improve children’s health by evaluating how their asthma improves when cockroaches and mice are reduced through safe pest control in homes. Pests are a known asthma trigger, so this study is seeking low-income children in the Bronx ages 5 to 12 who suffer from persistent asthma and are living in homes with pests. Healthfirst and Affinity, among the largest pediatric health insurers in the Bronx, are partnering with the research team, providing recruitment support and healthcare utilization data as part of the evaluation. 

“This study is the first of its kind to look at how health outcomes can be improved by providing a one- or two-visit, safe, and effective pest control for children with asthma,” said Dr. Mary Bassett, New York City Health Commissioner. “We urge families with young children that have chronic asthma and live in a home with cockroaches and mice to participate. They will help with an innovative and important study, and they will receive free, safe and professional pest control services for their home.” 

This study is intended to build a health and economic case for safe pest control as a health intervention. The research aims to demonstrate to health insurers how basic and inexpensive safe pest control can reduce costly and traumatic hospitalizations and emergency department visits for children with asthma. 

“Our collaboration with the Health Department builds on a series of studies we have carried out at Montefiore to address the epidemic of asthma that is disproportionately occurring in the community we serve,” said Marina Reznik, M.D., M.S., attending physician, Division of General Pediatrics Department of Pediatrics, The Children’s Hospital at Montefiore, associate professor of Pediatrics, Albert Einstein College of Medicine and co-principal investigator on the study. “Through this research, we hope to learn how we can improve the asthma care and outcomes for the Bronx children, and extend our findings to integrate a safe and effective pest control intervention into clinical treatment plans for high-risk asthma patients.” 

Asthma is the most common chronic childhood disease, affecting more than 177,000 NYC children younger than 12. While asthma hospitalizations are decreasing overall in New York City, some of the highest rates of asthma-related emergency department visits and hospitalizations are among children in the Bronx. In 2009, 8.3% of children aged 0 to 12 in the Bronx suffered an asthma attack in the past year, according to parent reports – a rate 38% higher than the citywide average. In 2012, three South Bronx neighborhoods had the highest rates of asthma hospitalization among 5- to 14-year-olds. 

The Bronx also has high rates of the top three home environmental asthma triggers, which are mice, cockroaches, and secondhand smoke. This study will help address these disparities through pest control in the homes of children with persistent asthma. It will assess the cost of implementing pest control services and aims to contribute to a best-practice model for preventive pest control services that not only effectively reduce asthma triggers, but also replace the current pesticides-only approach. 

This new study will build on the work the Health Department currently does to reduce asthma in low-income neighborhoods. Through its East Harlem Asthma Center of Excellence, the Health Department has taken a comprehensive team approach to controlling asthma and has an alignment of services to help kids get their asthma under control. The numbers show that the Health Department’s efforts and those of its partners are having an impact, contributing to decreasing asthma hospitalization rates in East Harlem by more than 27% between 2000 and 2011.

“Asthma is the number one cause for kids missing school in New York City,” said Sarah Oltmans, Senior Program Officer for Robin Hood.  “By missing fewer classes, their parents will miss fewer days of work – the deceptively simple program has the potential to dramatically improve the health and livelihoods for both asthmatic children and their families. We hope the study will inform the current public policy debate on health care costs so the most effective and beneficial services are made available to families in need.” 

"The human and financial costs associated with asthma are significant," said James R. Knickman, President and CEO of the New York State Health Foundation. "Prevention efforts to reduce household triggers affecting families in the Bronx could result in better health outcomes and significant cost savings." 

“We are proud to partner with the New York City Department of Health and Montefiore Medical Center in an effort to improve outcomes for our members living with pediatric asthma in the Bronx, by control of common pests in the home that make asthma worse and in an environmentally safe way,” said Susan Beane, MD, Healthfirst VP and Medical Director. “Healthfirst is dedicated to improving the health outcomes of children in areas like this with high incidences of asthma to effect an overall change in asthma triggers and educate parents on best practices for reducing those triggers.” 

“This study is valuable for our members with asthma,” said Camille L. Kurtz, Vice President, Medical Management of Affinity Health Plan. “Based on the success of this study, we would be interested in considering similar services for our members to help them manage their asthma.” 

Recruitment is currently ongoing, and all families that participate will receive free pest control services in their home.  Parents and caregivers of children with chronic asthma who are interested in participating in the study should call 646-632-6304, email info_asthmastudy@health.nyc.gov, or visit bit.ly/asthmapest.