Community Action to Fight Asthma (CAFA) is a network of asthma coalitions in California shaping local, regional, and state policies to reduce the environmental triggers of asthma for school-aged children where they live, learn, and play.

CAFA began as an initiative of The California Endowment (TCE) in 2002, in which they funded twelve local coalitions across the state and various technical assistance providers and state level coordinators. The exact structure, number, and type of funded partners has changed at various points throughout the last seven years. But, a couple of things have remained unchanged—1) CAFA’s mission to reduce environmental triggers of asthma through policy change; 2) the role and importance of local asthma coalitions.

CAFA is comprised of local asthma coalitions that bring together diverse constituents, including health care providers, schools, public health organizations, environmental health and justice groups, and community residents to collectively address the problem of asthma in their communities. Collectively, the coalitions constitute the CAFA Network, which mobilizes the voice and experience of the local communities to shape asthma policies at all levels.

In recent years, the CAFA Network has had many policy successes at local and state levels. With these successes under our belts, as well as the wisdom, experience and strength gained over time, CAFA has evolved into an entity of its own – a true leader in reducing the burden of asthma, moving beyond a TCE Initiative to become a large and powerful Network.

We just completed the 8th Annual CAFA Meeting, bringing together coalitions from across the state to work collectively on our state policy agenda and to provide support for the great local work being conducted in communities across the state. This year was particularly exciting because there was a large emphasis placed on broadening the network. In addition to the 10 funded coalitions, 4 new coalitions (or, new to CAFA) participated in the conference and will likely become formal members of the CAFA Network. Additionally, many partner organizations participated, largely as allies in our policy work, such as the California Pan Ethnic Health Network (CPEHN), the California School Boards Association (CSBA), the Ethnic Health Institute, the Sacramento Mutual Housing Association, California Teachers Association (CTA), and both asthma programs within the California Department of Public Health, to name a few.

As we grow in size, our ability to influence policy change also grows. During the Annual Meeting, we spent time refining our policy priorities and then meeting with legislators and their staff to share information about these priorities. In focusing CAFA’s state level policy work, the following are priority areas:

Outdoor Air Quality
The quality of the air we breathe is a major determinant of lung health. The more pollutants and particles in the air, the more likely we are to develop respiratory conditions such as asthma. As a result, improving outdoor air quality (OAQ) is a significant part of the strategy to reduce asthma, especially in California, home to 9 of the 10 most ozone polluted counties in the country.

Most of the asthma triggers in our outdoor air comes from emissions from human industry, including factories, cars, trucks, and other forms of transportation. As such, considerable focus has been placed on smokestacks and tailpipes for reducing harmful emissions. While this is an essential approach, cleaning emissions alone will not result in significantly cleaner air when the number of vehicles and factories continue to grow. As a result, asthma and other air quality advocates have turned their focus to many of the broader decisions that determine the need for more vehicles and factories in the first place. Influencing where highways are placed, how goods are transported, where housing is built, where public transit travels, and where industry is located are fruitful new approaches to combat dirty air.

Schools
Asthma is a major problem for school-aged children. One in every six children in California has been diagnosed with asthma. It is the leading cause of school absences due to chronic disease in the country, costing children their education and schools resources in lost attendance-based funding. All too often, students and school staff with asthma are confronted with poor air quality from malfunctioning or from under maintained ventilation systems, air pollutants, nearby freeways or railyards, dust, mold, pests, and chemical fumes and residues from cleaning products, pesticides, furnishings, and building materials that trigger and exacerbate their asthma while at school. Studies have demonstrated that the reduction of asthma triggers in school facilities has a positive impact on student achievement and staff well-being. Leadership in addressing school health problems is clearly needed.

Creating healthier school environments starts by recognizing that every child and school employee has the right to a safe, clean school environment that does not make them ill. Schools around the country have successfully incorporated comprehensive asthma management into their Coordinated School Health Program, prohibited bus and vehicle idling on or near school grounds, implemented integrated pest management practices, and switched to less toxic cleaning products to help reduce environmental triggers to asthma on their campuses. Creating healthy schools requires strong leadership with commitment, flexibility, and resourcefulness from a variety of school stakeholders. Most importantly, working together, education and health advocates can demonstrate their leadership in creating State policies that encourage the creation of healthy schools so that students can learn and teachers can teach without being distracted or debilitated by health conditions like asthma.

Housing
Far too often the homes people live in contribute to the problem of asthma. Pet dander, cleaning products, infestations, mold and even the materials used to build the house are common asthma triggers that can be addressed through repairs and improved cleaning and maintenance practices. In many of our communities across the state, however, renters have the added challenge of uncooperative landlords. Because of this reality, CAFA is focused on state policies that improve the quality of housing and increase the rights of renters to live in safe, healthy housing. Recognizing that the chronic lack of affordable housing in communities across the state is a significant factor that “pushes” people into substandard housing, CAFA also supports policies that expand access to quality affordable housing.

What’s Next?
CAFA is led by the Regional Asthma Management & Prevention (RAMP) Initiative, in partnership with the National Latino Research Center (NLRC), and we are at a very important point in our history. We currently have a wonderful opportunity to expand CAFA’s membership, its reach, and its impact on reducing the burden of asthma in the coming years.

We are placing a strong emphasis on expanding the Network to include those coalitions across the state who share CAFA’s mission, but have not yet been formally involved. Information on membership can be found at //calasthma.org/about_cafa/membership/.

As the CAFA Network grows, our ability to influence policy change will also grow. In the coming year, the CAFA Network, and its partners, will be working on specific policy objectives related to the priorities described above. Brandon Kitagawa, RAMP’s Policy Associate, is the contact person for any policy-related questions and can be reached at brandon(at)rampasthma(dot)org.

Finally, RAMP, in partnership with NLRC, will continue to provide coordination for this Network, which includes convenings, the website, the e-newsletter, enhanced communications, and sustainability efforts. Any additional questions about CAFA can be directed to Kate Lorenzen, RAMP’s Senior Program Associate, at kate(at)rampasthma(dot)org.

We look forward to working with all of you in pursuing the mission of CAFA!