Advancing Health Equity in Asthma Control through EXHALE Strategies

The Centers for Disease Control and Prevention (CDC), through its National Center for Environmental Health (NCEH), is offering funding under the program titled “Advancing Health Equity in Asthma Control through EXHALE Strategies.” This discretionary cooperative agreement supports a comprehensive and collaborative approach to improving asthma outcomes and reducing disparities through the implementation of the CDC’s EXHALE technical package. This initiative is grounded in a growing body of evidence suggesting that multi-component, coordinated strategies are more effective than single interventions in managing asthma, especially in underserved populations. Asthma remains one of the most prevalent and costly chronic conditions in the United States. Nearly 25 million people are affected, including 4.7 million children. Despite the availability of effective treatments, the burden of asthma remains high, with significant disparities by race, ethnicity, and income level. Non-Hispanic African American individuals are nearly three times as likely to die from asthma compared to white individuals, and people from Puerto Rico have the highest prevalence of asthma among all racial or ethnic groups. The EXHALE package consists of six strategies: education on asthma self-management; eliminating exposure to smoking and secondhand smoke; home visits for trigger reduction and education; achievement of guidelines-based medical management; linkages and coordination of care; and environmental best practices. Through this funding opportunity, CDC seeks to address not only clinical needs but also the environmental and social drivers that contribute to asthma disparities. Applicants are expected to build organizational capacity and form partnerships across sectors—including public health, education, housing, transportation, and community organizations—to expand the reach and sustainability of EXHALE-based interventions. Key activities include strengthening surveillance and evaluation systems, expanding communication strategies, and enhancing coordination with local stakeholders and community members. The award ceiling is $725,000 and the floor is $400,000 per budget period. A total of approximately $64 million is available to fund up to 28 recipients. This is a cooperative agreement, which implies substantial CDC involvement in project implementation, including guidance, technical assistance, and programmatic collaboration. There is no cost-sharing or matching requirement for this opportunity. Projects should aim to improve asthma outcomes and reduce disparities at the population level. This opportunity closed on April 19, 2024. Applicants were required to submit electronically by 11:59 PM ET on that date. Although this cycle is now archived as of May 19, 2024, the program builds on a recurring asthma control funding stream (CDC-RFA-EH19-1902) and is expected to continue in future fiscal years. Organizations involved in public health, education, housing, or social services may benefit from monitoring the CDC’s NCEH updates for the next iteration of this program. Eligible applicants included a broad range of entities such as state, county, and city governments, public and private higher education institutions, independent school districts, nonprofits (both 501(c)(3) and non-501(c)(3)), tribal governments and organizations, housing authorities, and special district governments. Applications were encouraged from organizations that could demonstrate existing capacity and partnerships to implement community-wide EXHALE strategies and sustainably reduce asthma disparities.