Asthma and food allergies remain major health concerns, especially as students head back to school. Chris Martinez, President and CEO, Asthma and Allergy Impact and Rescue (AAIR), joins us to share life-saving, practical solutions that keep kids healthy and learning. From stocking albuterol in schools to equipping families with diagnostic kits and advancing key policy initiatives, AAIR is transforming how communities respond to these chronic conditions.
Guest: Chris Martinez, President and CEO, Asthma and Allergy Impact and Rescue (AAIR)
Host/Producer: Carol Vassar
TRANSCRIPT:
Announcer:
Welcome to Well Beyond Medicine, the world’s top-ranked children’s health podcast produced by Nemours Children’s Health. Subscribe on any platform at NemoursWellBeyond.org or find us on YouTube.
Carol Vassar, podcast host/producer:
Each week, we’ll be joined by innovators and experts from around the world, exploring anything and everything related to the 85% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar, and now that you are here, let’s go.
Kids are back in school across the nation, and we’re talking in this episode about some of the most common chronic conditions affecting kids: asthma and food allergies. Whether it’s at home, in school, or anywhere else in the community, having quick access to the right tools, medications and training when a child has a medical incident related to these conditions, well that can mean the difference between a close call and a tragedy.
To discuss all of this, I’m joined by Chris Martinez, President and CEO for The Foundation for AAIR – that’s Asthma and Allergy Impact & Rescue. AAIR began over 40 years ago in St. Louis as a local organization and has blossomed into a nationwide force advocating for practical solutions and education on these issues for families and for schools, and, really, for all of us.
Chris joined AAIR in 2020, and it turns out he has a personal connection to the work. Here’s Chris Martinez:
Chris Martinez, President and CEO, AAIR:
I don’t think about this a great deal, but again, certainly it has informed my feelings around the work, whether I care to admit it or not.
So I was diagnosed with asthma in high school. I went to a doctor who wasn’t my primary care physician. It was just whoever I could get into to get that physical for sports. And I remember the doctor saying to me, “Have you ever been diagnosed with asthma?” And I said, “Oh, no. No, I don’t have asthma.” And he’s like, “Hmm, okay.” And that was my first conversation, and that’s where it ended. So he heard something, he heard some wheezing, and he signed my physical and sent me on my way. And I don’t even remember his name, so it’s not like he could throw this, that young doctor at the time, under the bus.
But a couple weeks later, I was wheezing in soccer tryouts, and then I went back to my doctor and got the full diagnosis. And I sort of chuckle at that because fine, and I’m very well managed now and all of that. But the reality is that story’s probably all too common, where there’s some indication of a condition, whatever it may be, and there isn’t a ton of seriousness or follow-up. And for kids who and who are in certain situations, that can be really dangerous.
Carol Vassar, podcast host/producer:
Well, thank you for sharing that. We’ll definitely try and get information out about how parents can become more involved, maybe earlier in the process, before they get to that high school physical or their child does. Tell me about AAIR. I mentioned in the intro that it started as a regional chapter about 40 years ago. It’s now expanded nationwide. You really rebranded at the beginning of 2025. Talk about the history of the growth and how that shapes your nationwide efforts right now.
Chris Martinez, President and CEO, AAIR:
Yeah, happy to. So such a great legacy. The organization was founded as a nonprofit back in 1981 by two physicians and a social worker, all of whom are still with us and still supportive of the cause, which is just amazing. But the reality was that they started the organization with sort of the same core driving mission, if you will, that we have today, which is to help kids breathe. They saw way too many kids struggling in the city of St. Louis with asthma. And not just struggling, but often having much, much worse outcomes than that. And so, they launched the very first program, which was an individual prescription assistance program, making sure that kids were getting inhalers and various components support, primarily in the home at first. And so, that was our first program, and it’s a program actually that still lives on today.
Carol Vassar, podcast host/producer:
Give us a sense, Chris, of how big this issue is. The size, the scope of both asthma and food allergies as we look at the population of kids and youth today.
Chris Martinez, President and CEO, AAIR:
Absolutely. Yeah. For a general sense of context or scope, depending on your area, anywhere from 5 to 10% of the kids around you may have asthma. So with a national average hovering around 7%, if you’re looking at a football game for context, and there are 22 players on the field at any given time, three or four of those kids probably have asthma. Some of them have probably not been diagnosed. And for some further just numbers, to put some context to it, asthma is in most situations the number one chronic disease in children, and the biggest reason why kids miss school chronically.
And while it is a manageable disease, Americans spend well over $80 billion every year on asthma care, and more than 10 Americans every day die from an asthma attack. So while it is manageable, there’s still some work to be done to be managing it. And similarly with food allergies, this can be a thing that can often go undiagnosed for quite some time, and it takes some real awareness and some vigilance to first understand your condition. Because, as we know, some tasty foods often contain a lot of different ingredients. And so, it’s sometimes tough to tease out exactly what you may be allergic to. And oftentimes those come in multiple diagnoses. So you may be allergic to a number of things all at the same time. And so, that becomes really, really difficult.
And 10% of American adults, so one out of every 10 American adults have at least one food allergy. And so, it’s a really significant piece. And anaphylaxis, which can come on from various food allergies, can be extremely dangerous if not properly managed.
Carol Vassar, podcast host/producer:
And we’ll talk about some of the interventions that could be brought to bear there. I mentioned that kids are back in the school all the way across the nation. I’m in Connecticut. They finally went back to school this past week. I want to talk about Rescue. That seems to be your marquee program right now. What is Rescue? How is it involved in the schools? How many schools or how many states are participating in this program?
Chris Martinez, President and CEO, AAIR:
Absolutely. Yeah. So when you think about keeping anyone healthy, you really think about doing that in every place that they are. So many, many asthma attacks happen in the school setting. And so, in 2012, the state of Missouri actually became the very first state in the country to pass what’s known as a stock albuterol law or an undesignated albuterol law. And that means that schools can stock asthma, rescue medication, and all of the accoutrements that go with that, the spacers and nebulizers and various things, and they can intervene and help a child, or that matter, or even a staff person when they have an asthma exacerbation. So that was 2012, the law passed on the heels of that legislation. Our organization, under its previous name, started a program called Rescue.
And that was recognizing that it’s one thing to have a law, it’s another thing to implement the good intention of that law. Or as we sometimes jokingly say, it’s one thing to have a gym membership, it’s another thing to sort of show up and lift heavy things.
And so, we started this program with a few dozen schools at first, making sure that they had this stuff and they were trained and understood how to use it. And then in 2020, we began really scaling the program, understanding essentially after about an eight-year pilot. And so, we were able to expand that program into every public school in the state of Illinois, every public school in the state of Missouri, a number of other schools on the private side. And now we’re currently working on some pilots in Arkansas, Wisconsin, California, and looking at a number of other states. So right now it’s in just about seven schools, and the program would be legal. That same law that I mentioned that started in Missouri, is legal in just about half the country. It’s now, I believe, 24 states and the District of Columbia where that would be allowed. And so, we continue to do our best to expand.
Carol Vassar, podcast host/producer:
Now, albuterol, of course, is the medication that’s in the inhaler that’s applied to the child or the staff member who might be having that asthma incident at that moment. What kind of impact? You had an eight or nine-year pilot program, and now you’re really expanding this nationwide. Have you seen some impact from this initiative? Any evidence-based information you can share with us there?
Chris Martinez, President and CEO, AAIR:
Yeah, absolutely. So, currently, about 76 – 77% of the time when a school nurse or another school official intervenes on behalf of a child having an asthma exacerbation, they go right back to class. Alternatively, school nurses will tell us that, in their opinion, kids go back to class if those resources are not available about 25% of the time. So when you think about that from a health standpoint, that’s obviously really significant. And even if a child has to leave because their asthma attack is serious enough, if they have to go home or what have you, having that medication right there and getting that initial dose will at least start them on the path of recovery. And so, we know that that’s really important. It’s also true that you mentioned that we want to really look at practical solutions, and it’s a very practical thing that money matters.
And so, we really try to focus on both saving kids and cash. And so, oftentimes we’re talking to our partners and stakeholders about the fact that if a child leaves a school for an asthma attack, gets in an ambulance, heads to the emergency department, even on an outpatient basis, that will easily cost 3,000 or more dollars. We outfit an entire school, get them all of the medication, all of the equipment they need, training, collect anything that’s expired at the end of the school year, etc, for just about $1,000 per school.
So if we keep one kid out of the emergency department from every school that we’re in, we have the opportunity to save dollars at a factor of about three to one. And so, that’s been a really important component to help people understand that yes, this is a good thing, but even if it doesn’t feel good enough for you, it’s a practical thing economically as well.
Carol Vassar, podcast host/producer:
You talked about spacers. Now, we talked to a woman whose son is in a school does have an albuterol inhaler. Spacers are part of the kits that you provide, do people understand what the mechanism is there? Most people just think, oh, put the inhaler in their mouth and it’s done. How do you go about teaching that proper? That was actually a question that came from somebody who is in the know on this.
Chris Martinez, President and CEO, AAIR:
Yeah, no, absolutely. Absolutely. So it’s a great question and I would suggest that a lot of nurses, respiratory therapists, physicians probably feel it’s like the question. So many times, all of us, children, adults are prescribed an inhaler with maybe a quick explanation, but oftentimes without any kind of holding chamber or quote-unquote, spacer. And there are a number of them out there that are good, and some of them are reusable and last for a long, long time made of plastic and washable and all that, and others are disposable. So there are a lot of great resources.
The reality is, particularly for a young child who it can sometimes have a challenge, getting that timing just right on the actuation of the inhaler, having that holding chamber is a massive difference in the amount of the medication that actually gets to the appropriate place in their lungs. For anyone who’s ever used an inhaler and accidentally sprayed it to the back of your throat at the wrong time, you’ll know what I’m talking about.
And so, it just makes the dose so much more effective. So to your point or to your question of how do we educate that, so we work with physicians, respiratory therapists and nurses to set up our training. We provide our training to, of course school nurses, but really any school official who is willing to join the training. So that may be coaches or secretaries or music teachers, whatever it may be, so that they feel comfortable. And so, then we walk through and that training has a demonstration where we show folks how to use all of the resources. It’s a really important component, and there’s a lot of learning, I think, to still take place. Because you see a lot of kids with inhalers from time to time, but not nearly as many with the spacer as well.
Carol Vassar, podcast host/producer:
It sounds like that’s an important component. So Chris, as we talk about asthma, how does AAIR address things like exercise-induced asthma and other preventable triggers through either education or outreach?
Chris Martinez, President and CEO, AAIR:
Yeah. Well, let me first say that there’s no replacement for having a doctor who knows you. And so, you should work closely with your physician to come up with a very customized plan. But that being said, we want to encourage folks to have an asthma action plan, or for that matter, a food allergy action plan, so that customized program can be shared with coaches and teachers and grandparents and babysitters, and so on.
And so, that may very well include you taking a couple four puffs of your inhaler before a strenuous activity, which helps preempt any serious asthma exacerbations. It’s also true that a lot of kids are carrying rescue inhalers, but maybe not daily management drugs. And so, again, we want to encourage people to look at all of the possibilities with their physician and make sure that that’s something that they’re managing on a very customized, personalized basis. And we know when, if you go look at the US Olympic team, there are a number of young men and ladies as sprinters who suffer from asthma. And so, you can absolutely live active lives with these conditions, but it does take some awareness and some management.
Carol Vassar, podcast host/producer:
I think this is a good time to dovetail into AAIR’s pediatric asthma and food allergy diagnosis kits. What are those, how is it different from rescue, who receives them, and how are they going about helping to help families in the schools with this?
Chris Martinez, President and CEO, AAIR:
Yeah. Happy to touch on that. So I think a good way to segue into that is to just remind folks of our mission, which is to make sure that every child is rescued at school, healthy at home, and connected to care. So if we’re taking care of kids in school, that’s fantastic, but not every waking hour is in school and there’s still summers and things happening at home and pets and all kinds of stuff. And so, we have to really think about what is that holistic sort of wrap around approach. And so, we developed a new resource just a few years back, our new diagnosis kits, which essentially are backpacks full of resources. One for food allergies, one for asthma.
And they’re full of great educational resources, some fun stuff, some interactive stuff. There’s a hypoallergenic, washable teddy bear in each backpack for the young kiddos. And the goal is really just to help them know better and then do better and get a little bit faster from diagnosis to control. And even if the child or family hasn’t been diagnosed super recently, but if they’re challenged by that diagnosis still, this is a great resource. And so, those go out to kids all over the country, and we’re eager to keep growing that program.
And as I mentioned, that third part of our mission is connected to care. So when we get these backpacks to a child in their home, they’re able to register it, connect with us, and then interact with us a little bit so that we can get them additional resources, and not the least of which is a possible connection to a new doctor or to a primary care physician, particularly if they’re not already seeing one or even a specialist. And we know that whether it’s their asthma, whether any other condition that they’re challenged by, their ability to see a provider on a regular basis almost always improves their outcomes.
Carol Vassar, podcast host/producer:
We’ve talked a lot about the asthma side of the house. Let’s talk a little bit about food allergies. Now, I know people know the EpiPen, which is epinephrine. Those are the injectors that if somebody is having an allergic reaction, boom, hopefully that resolves it. Do you do anything with regard to helping schools prepare to use them? Do kids come with those already in their backpacks or how does that work?
Chris Martinez, President and CEO, AAIR:
Yeah, absolutely. So we do provide epinephrine to some schools, and it’s a really important priority for us to get more resources, but frankly, just get more funding to be able to make epinephrine more readily available. There are some good programs, some other good programs in the country, but what we’ve learned from school nurses is that oftentimes the expense can be really challenging for them or the availability, and some of the programs even that are free for schools are not often quite as consistent as we’d all like them to be. And so, we’re always trying to figure out ways to get epinephrine into the hands of schools and school officials.
I think the other thing to recognize too is that there are continuing developments around epinephrine. And so, that’s another place where we want to assist, particularly in state by state policy, making sure that states and schools can utilize the most up-to-date resources for kids.
Carol Vassar, podcast host/producer:
Let’s talk about policy. That was a beautiful segue. You’ve done some really great work getting Albuterol into 24 states and the District of Columbia. I’m assuming that’s going to continue. What other policy are you working on a nationwide basis that can help with-
Chris Martinez, President and CEO, AAIR:
Sure. Yeah. Well, just to touch on the food allergy piece that’s so important. So recently, there’s a US-based company that developed a fast-acting epinephrine that is a nasal inhalant. And so, for that to be available in schools, it means that the laws have to change, because most of the laws refer to something like auto-injector. So shifting that language from auto-injector, a very specific term to something that either includes additional delivery devices or even just says FDA-approved device is a really critical component. And it’s very logical, but it takes time and it takes time in state, by state, by state. And so, when we started this endeavor, and we are not alone for sure, there were only a couple of states that allowed this nasal inhalant drug, but now that number is around 20, or in the low twenties of states that now allow this newer drug.
And any sort can be argued that it’s a little less intrusive than a needle, even though the needles for this application are pretty small and largely painless. Still, if you’re a young school teacher who has to deliver this, probably feels a little simpler to help someone spray something up their nose than to put a needle in the thigh of a 6-year-old. So just giving schools options and choices and making that legal, so that’s another really critical policy.
And then I’ll touch on just one other one, which is a little more aspirational, just to give you a sense of the pipeline of policies that we’re always thinking about. If you or I were to put energy efficient windows in our home, we would probably get some kind of energy tax rebate or what have you. But if you were to own, say, several apartment buildings in Harlem or south side of Chicago or what have you, and you made sure that none of those buildings had triggers for asthma, which would be mold or pest dander, cockroach dander is a tremendous trigger for asthma, there’s really nothing for you to incentivize you to do that or to reward you for doing that.
So one of the things that we’d like to do with a focus on this pull-through method and appreciation for small business owners is to consider with lawmakers creating some incentives, where folks could maybe have their building periodically inspected to make sure that these things aren’t there, and there would be a bit of a reward to do that. Because it’s very difficult for someone, a well-intentioned mom or what have you to positively affect their child’s living environment if they don’t own it, to mitigate mold in an apartment building basement or to remove pests, that’s not really a role that you can play as a renter. And so, we’re just always trying to find ways that are truly win-win for all parties involved.
Carol Vassar, podcast host/producer:
As we look beyond the programs and beyond the statistics, you told us a story at the beginning about yourself and your own experience. Is there a family or a child that you’ve worked with whose life has been directly improved by the work that AAIR has done?
Chris Martinez, President and CEO, AAIR:
One of the most interesting stories, I think, it was actually very early in my tenure with the organization. I mean, it was day three or four, and there was a father who was actually in our office in St. Louis, and he was becoming part of the Breath program for his young son. So that means that we would help them get medication, and some education, and some equipment. And he was kind of upset, and I was excited. I think he was one of the first couple clients that I met, so I was glad to interact with him, but I could tell he was kind of getting emotional and I said, “Hey, it’s fine. This is what we do. We’re happy to do it,” that sort of thing. He’s like, “No, no, you don’t understand. 20 years ago, you all gave me medication for this same program.”
Carol Vassar, podcast host/producer:
Oh my goodness.
Chris Martinez, President and CEO, AAIR:
And so, I was struck. I was like, oh, wow, that’s really moving, and that’s really telling. And at the onset, it’s like a really, really, really beautiful story of consistency and providing. But at the same time, as I reflected on it later, I recognize that it’s actually, it’s a tremendous failure, because we have not created a system change enough to where that family can get the same kind of support and healthcare that the family across town in a more affluent neighborhood can. So it’s really become a bit of a battle cry for us in that we want to really be systems focused. And now that young man is doing really well. His school is part of the Rescue program. His stuff has actually gotten into other healthcare that we kind of worked with a legal partner to shepherd them onto. So it was no longer part of the Breath program, but supported through rescue and support it through another healthcare situation. So individually, it’s a pretty successful story, but when you think about it more broadly, it’s actually a story of opportunity.
Carol Vassar, podcast host/producer:
Lots more work to be done. What’s ahead for AAIR? What’s the big bold goal that you’re moving toward?
Chris Martinez, President and CEO, AAIR:
Yeah, so I think there’s probably three things. One is certainly the expansion of the Rescue program and getting more and more states to understand the value. And when I say value, again, there’s a real economic value. So in the state of Illinois, let’s say, the state put about $2 billion towards running the program in this past school year. But the most recent calculations based on mitigating emergency room visits, etc, etc, would suggest that we actually saved about $5.9 million in total healthcare savings. So once again, this is a saving kids and cash proposition.
So I think continuing to sort of echo that message around the country and helping lawmakers understand that you can do well while doing good, that is certainly a critical component of our growth. And then the second piece is really enhancing our food allergy work. We want to work with venues, with sports venues, with entertainment venues, and create safer spaces, so more and more kids and families can be at these events and potentially even safely eat at concession stands and those types of things. So that’s definitely an important part of our growth.
And then lastly, as I mentioned that third piece of our mission statement, which is that connected to care, we are never going to build our own individual pipeline of physicians or what have you. So it’s us partnering with all the right communities, all the right associations and networks, and making sure that they’re ready to see our kids in the neighborhoods where they need to be seen. So growing that network in a way that allows us to keep kids protected everywhere they are is a really important component of our future. And so, hopefully one day where we have stock medication, epinephrine and albuterol, or whatever the best practice medication is in schools at the moment, keeping them protected, and then we can shepherd them to what keeps them protected in the home and in the community at large as well.
Carol Vassar, podcast host/producer:
Chris, it sounds like under your leadership, AAIR has big work to do, but is on the right track, has already grown so much and continues to grow. We thank you for sharing and hopefully you’ll come back to the podcast in the future with an update and more information about what AAIR is doing out there in the community. Thanks so much for being with us.
Chris Martinez, President and CEO, AAIR:
Oh, you’re quite welcome. Our pleasure, Carol. Love the work that you do.
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Well Beyond Medicine.
Carol Vassar, podcast host/producer:
Thanks, Chris. We love the work you’re doing too. Whether it’s the air our children breathe, the food they eat, or some other factor, if it affects their health and well-being, the Nemours Well Beyond Medicine podcast is ready to talk with the leaders and experts you trust and then share it with you.
Have an idea on what we should cover in the future? Leave a voicemail on our website, NemoursWellBeyond.org, or send an email to [email protected]. Visit the website to catch up on past episodes. Sign up for our monthly newsletter, leave a podcast review or subscribe to the podcast, which you can also do on your favorite podcast app. Now that website, again, is NemoursWellBeyond.org, and the video version of the podcast is also available on the Nemours YouTube channel. Thanks to the production team for this episode, Cheryl Munn, Susan Masucci, Lauren Teta, and Alex Wall. Video production by Britt Moore, audio production by yours truly.
Join us next time. As one man’s tremendous loss has him pursuing better maternal outcomes for all. I’m Carol Vassar. Until then, remember, we can change children’s health for good. Well Beyond Medicine.
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Well Beyond Medicine.
