In February 2001, The California Endowment initiated a series of programs focused on improving the quality of life for school-aged children with asthma. One initiative, begun in 2002, is Community Action to Fight Asthma (CAFA). Initially funded for three years, this insightful program aims to reduce environmental triggers of asthma among school-aged children where they live, learn, and play through policy change at the local, regional, and state level.

The structure of CAFA included twelve community-based asthma coalitions across California that brought together diverse constituents—public health, managed care, hospitals and clinics, providers, schools, environmental health and justice organizations, housing rights groups, community advocates, and parents of children with asthma—to collectively reduce the burden of asthma. The twelve coalitions were supported by four regional centers: the Regional Asthma Management & Prevention (RAMP) Initiative, a project of the Public Health Institute, supported coalitions in Northern California; the Central California Asthma Project (CCAP), a partnership of the San Joaquin Valley Health Consortium and the American Lung Association of Central California, supported coalitions in the Central Valley; the National Latino Research Center (NLRC), a project of California State San Marcos, supported coalitions in the San Diego and Imperial Valley area; and Physicians for Social Responsibility (PSR) supported coalitions in the Los Angeles Area. The overall initiative was coordinated by Community Health Works of San Francisco, a partnership of San Francisco State University and City College of San Francisco. The Initiative was further supported by Technical Assistance Partners including: PolicyLink, the Public Media Center, and the Evaluation Team, a partnership of the University of California San Francisco’s Institute for Health Policy Studies and Philliber Research Associates.

There were many successes during the three-year period, including:

• Transforming local coalitions from organizations that are primarily focused on improving asthma clinical care and self-management to ones that also address environmental triggers of asthma. For example, the Solano Asthma Coalition developed policies to reduce harmful particulate matter from wood burning.
• Raising public and policymaker awareness about environmental triggers of asthma through outreach and education. For example, the coalitions in Merced/Mariposa, Kern, and Tulare worked with schools to be first in the country to conduct an Air Quality Flag Program which monitors and informs students, parents and community members about daily air quality that may affect health.
• Developing and applying data to interventions and policy. For example, the Los Angeles Asthma Collaborative used data on pollution caused by exposure to freeways in efforts to reroute the 710 freeway.
• Identifying, developing and implementing new and creative programs and policies to reduce environmental triggers for asthma.  For example, the San Francisco Asthma Task Force developed a policy to institutionalize use of the EPA’s Tools for Schools Program that assesses school air quality and provides tools for improving it.
• Increasing leadership and local coalition capacity and confidence to affect policy change. For example, the San Diego Regional Asthma Coalition took a problem of trash collection in local neighborhoods and successfully increased trash pick up days.
• Creating and using a statewide network. For example, CAFA actively participated in and helped organize a policy briefing that brought together three legislative committees (health, education, and environment), resulting in a package of asthma bills.
• Leveraging resources and recognition for asthma prevention. By increasing the visibility and understanding of links between asthma and the environment, local groups have leveraged state and local resources toward sustainability in many ways.

In 2005, The California Endowment committed three additional years of funding for key components of the CAFA Network. As explained on this website, the twelve coalitions, RAMP, NLRC, PolicyLink, the Public Media Center, and the Evaluation Team continue to be involved. Additionally, alliances have been formed with numerous other asthma coalitions and environmental and public health groups across the state. The CAFA Network will build upon the multiple successes of the initial years of funding to further advance asthma policy in California.