by Veronica Combs, Director of Community Engagement, AIR Louisville

Innovation doesn’t always mean improving the current way of doing something. Sometimes it means building an entirely new system. That’s what the Institute for Healthy Air Water and Soil and Propeller Health are doing with AIR Louisville. We want to do more than help people living with asthma identify triggers or remember to take daily maintenance meds. We want to test a new way of treating asthma, one that uses data and involves the entire community from doctors to employers to city leaders.

One way we’ll know we’ve succeeded with this work is by getting off a certain top 10 list. Each year the Allergy and Asthma Foundation of America compiles list of worst places to live if you have asthma. Louisville is often on this list.

To understand how we plan to accomplish this, you can join a live video conference on Tuesday, June 23 at noon Eastern. I will be speaking with four people who are working with AIR Louisville:

Dr. Meredith Barrett – Meredith is the vice president of science and research at Propeller Health. She has served in many different roles in both the health and environment fields, including: researcher, data analyst, project manager, grant writer, teacher, outreach coordinator, environmental educator, course designer, associate editor, board member and mentor. She wrote the grant that funded AIR Louisville and is leading the program with Veronica Combs.

Dr. Jim Sublett – Dr. Sublett is the co-founder and managing partner of Family Allergy and Asthma. He is also the current President of the American College of Allergy, Asthma & Immunology. Dr. Sublett sits on several other boards, including the University of Louisville Board of Overseers and Norton Healthcare Board of Trustees. He participated in the pilot project in 2013 and was one of the first partners in the 2015 expansion of that program. Patients at Family Allergy and Asthma can get a sensor and join AIR Louisville at no cost.

Mike Tringale – Mike is the senior vice president of external affairs for the Asthma and Allergy Foundation of America. He leads research efforts behind the Foundation’s annual reports on allergy and asthma capitals. During the video conference, he will explain how AAFA calculates the scores for the list as well as what Louisville can do make life easier for people living with asthma. He also recently appeared on The Daily Show with Jon Stewart to explain the annual pollen tsunami.

Christine Vaughan – Christine is the marketing and event coordinator at Insider Louisville and the owner of 502 Social. She was also one of the first people to join AIR Louisville. She has been using a Propeller sensor on her inhaler since February. In addition to planning events, Christine is a cyclist.

Join us on June 23 to learn more about AIR Louisville. You can RSVP to get the event on your calendar, or just bookmark the Hangout link and tune in at noon Eastern.

by Alonzo L. Plough, Ph.D., MPH

This post originally appeared on the Robert Wood Johnson Foundation’s Culture of Health blog.


Louisville, Kentucky ranks among the poorest in air quality and highest in asthma rates among U.S. cities. A new art installation from Propeller Health shows residents real-time changes in the city's air quality, equipping them with the data to reach their goal of becoming one of the healthiest cities by 2020.




















I stand in front of an intriguing art installation on a busy street corner in downtown Louisville, KY, and visualize the invisible. It’s a bright orange steel kiosk outfitted with an interactive touch screen that allows passersby to “see” how air pollution levels change around the city in real time while also learning how these pollutants impact the severity of asthma symptoms. Called AirBare, the installation project was funded by RWJF and represents a unique collaboration between visual artists, big data analysts and local health advocates. By “popping” virtual bubbles on the screen, users find out what causes air pollution and what it will take to reverse it. This is relevant information for residents of Louisville, a city that consistently ranks among the lowest in air quality in the nation and has one of the highest rates of asthma and other respiratory conditions.

My visit to the AirBare installation coincided with a conference held in Louisville in March that brought together economists, health policy folks, food experts and, remarkably, Charles, the Prince of Wales, to examine the issue of air quality and the larger concept of sustainability in this Ohio River Valley city. The Prince, a longtime advocate for environmental issues with connections in Louisville, added star power to the Harmony & Health conference, sponsored by the non-profit Institute of Health Air Water & Soil. But there is plenty else to be excited about in Louisville. Under the leadership of Mayor Greg Fischer, city agencies have collected reams of data on air quality, health outcomes, life expectancy, income inequality, and unemployment, among many other measures. What has emerged is a far better picture of the tough environmental and socioeconomic issues impacting the health and wellbeing of Louisville’s 600,000 residents, and a serious and concerted commitment to build a culture of health.

The numbers, contained in the Louisville Metro Health Equity Report, paint a clear picture of the city’s challenges. More than 63 percent of Louisville residents live in neighborhoods with a life expectancy below the national average, and people can experience an 18-year gap from one neighborhood to the next. Almost 32 percent of African-American residents are in fair or poor health, and one in five residents lives in poverty; unemployment is high. And then there is the air quality problem. Louisville sits in a valley where toxic pollutants generated by nearby coal and oil-burning power plants and other industrial facilities collect in the stagnant air. As a result, asthma is the third leading cause of hospitalization in Jefferson County—which includes Louisville.

Still, this is a community that is fully committed to taking the steps necessary to bring about sustainable change. Air Louisville, the city’s multi-stakeholder clean air initiative, is a great example of what it takes for a community to really move toward building a healthier culture. It all begins with documenting the problem. The city had air quality sensors placed around various Louisville neighborhoods to collect and record real time data on levels of particulates and other toxic chemicals. At the same time, some 350 asthma sufferers were given high-tech inhalers that used GPS to relay the time and geographic location of asthma symptoms. The tracking device—which can sit on top of any inhaler, was developed by a former RWJF Health and Society Scholar, who also started Propeller Health. The devices are being made available at no cost to members of the community who participate in the research. Interestingly, the AirBare installation utilizes data from both the neighborhood sensors and the high-tech inhalers to raise awareness about the connection between air quality and asthma in community members.

This month the Air Louisville initiative is expanding. In a collaboration between the Institute for Healthy Air, Water and Soil, Propeller Health, local health plans, and other groups, 1,000 more Louisville citizens are being equipped with sensors for their asthma inhalers to track when, where, and how often they use their devices. This data-driven initiative uniting public, private and philanthropic organizations is designed to use digital health technology to help patients better manage their asthma symptoms, and aid city leaders in making smarter policy decisions about how to keep the air clean.

Louisville has as its goal to be one of the country’s healthiest cities by 2020. That’s an ambitious aim, but my recent visit convinced me that this city is up for the challenge. The key factor is collaboration: Louisville has enlisted a broad range of partners working in community development, health care, transportation and business—to name just a few—in executing its strategic plan. Along with the Air Louisville program, there are initiatives under way to improve health care delivery, reduce obesity and increase residents’ access to fresh, healthy foods. It’s exciting to see a community resonating so closely with RWJF’s framework for building a Culture of Health.


Alonzo Plough, PhD, MPH, is vice president, Research-Evaluation-Learning and chief science officer for the Robert Wood Johnson Foundation. Read more from his blog series.

by Veronica Combs, Director of Community Engagement, AIR Louisville

AIR Louisville is thrilled to announce a $25,000 donation from the American Lung Association in Kentucky. This gift from the local chapter of the national organization will allow us to expand our community asthma program by adding 125 more people.

“This gift will allow us to reach many more people living with asthma in Jefferson County,” said Veronica Combs, director of community engagement for AIR Louisville.

AIR Louisville is distributing sensors to people in Jefferson County who have asthma. Propeller Health's FDA-approved sensor fits on top of an inhaler and tracks when, where and how often a person takes a dose of medicine. Having an electronic record of this data helps individuals and their doctors better understand asthma triggers.

AIR Louisville is a collaboration between the Institute of Healthy Air Water and Soil, Propeller Health and the City of Louisville. Kentucky has the fourth highest rate of adult asthma in the US, and Louisville consistently ranks among the top 20 "most challenging" cities to live in with asthma.
This grant marks a new partnership between the American Lung Association in Kentucky and the Institute for Healthy Air Water and Soil. The two groups will work together to track air quality and help citizens – especially people living with asthma and COPD - understand the link between health and air quality.

The Community Foundation of Louisville is the fiscal sponsor of the Institute and helped to connect Barry Gottschalk, the CEO and President of the American Lung Association in Kentucky, and Ted Smith, the executive director of the Institute.

“We are proud to bring together two Louisville organizations doing important work to make everyone healthier,” said Susan A. Barry, president and CEO of the Community Foundation of Louisville. “This is a great example of how we connect donors who want to support innovative work, with non-profits who want to reach as many people as possible.”

Gottschalk said that he decided to make this generous contribution to AIR Louisville because the program supports the ALA’s goal of improving air quality and helping people living with asthma and other breathing problems. In the ALA’s annual State of the Air Report released just last week, Louisville was ranked as the 28th most polluted city in the nation.

“Although we have made steady improvements in cleaning up our air since the first State of the Air Report 16 years ago, there is still a lot of work to be done,” Gottschalk said. “The American Lung Association in Kentucky looks to support new approaches such as AIR Louisville to improve our air quality and help people living with asthma and other breathing problems.”

The effort also will help the city gather data about air quality and make smarter decisions about how to improve our environment. The AIR Louisville program will collect data for a year from sensors attached to asthma inhalers. Analyzing this data will help the city create a map of asthma hotspots in Jefferson County.

The program is funded by a grant by the Robert Wood Johnson Foundation.

Today we are pleased to announce we will build the first-ever national Asthma Risk Map for the United States, where citizens can track how climate change affects the frequency and severity of asthma attacks and chronic obstructive pulmonary disease (COPD). To accomplish this, Propeller plans to expand its current municipal public health asthma initiatives to five cities around the US in the next two years as part of President Obama’s Climate Data Initiative.

Propeller will collect in near real-time inhaler usage across the US.  By pinpointing the time and location of rescue inhaler usage, Propeller will be able notify the community and nation of potential asthma risk hot spots, or The Asthma Risk map. This map is the first piece of the puzzle in helping us provide in-depth models on the impact climate change will have on public health. In addition to this, our big data analytics will collect an additional 40 data points, such as weather conditions, wind direction, air pollution, pollen counts, land use and traffic patterns at the time and location an inhaler is used.

The first of such cross-sectoral programs, AIR Louisville – a partnership with the Institute for Healthy Air Water and Soil, funded by the Robert Wood Johnson Foundation – is already using Propeller’s FDA-cleared sensors to collect these necessary data. As we expand to more cities the additional data will help build richer model sets.

Using predictive spatial modeling techniques, and open government data resources from ClimateData.gov, the Environmental Protection Agency and National Oceanic and Atmospheric Administration global climate models, Propeller will identify areas in US cities where the impacts of climate change will be felt most acutely by people with chronic respiratory disease over the next 10 to 100 years and beyond.

These models will consider modifiable predictors such as air pollution and transportation in addition to climate conditions to help local municipalities plan collaboratively for the impacts of climate change on health and to identify the most promising interventions that could be implemented now to reduce this burden. This initiative will also raise public awareness and help to build resilient communities that can withstand the impacts of climate change now and into the future.

LOUISVILLE, Ky., March 20, 2015 /PRNewswire/ -- Today marks the start of AIR Louisville, the first-of-its-kind data-driven collaboration among public, private and philanthropic organizations to use digital health technology to improve asthma. Kentucky has the fourth highest adult asthma prevalence in the US and Louisville consistently ranks among the top 20 "most challenging" cities to live in with asthma. Leveraging Propeller Health's FDA-approved medication inhaler sensors, the program will track when, where and how often residents of Louisville experience asthma symptoms. These data, along with Propeller Health's personalized asthma management system, will help patients to better manage their asthma symptoms, and aid city leaders in making smarter decisions about how to keep the air clean.

"The goal of the AIR Louisville program is to use data from Propeller's connected medication sensors to make smarter choices about how we improve the quality of life for our residents," said Ted Smith, Chief of Civic Innovation at Louisville Metro Government and Executive Director of the Institute for Healthy Air Water and Soil. "By collecting data about where and when residents have asthma attacks, we can help inform public policy that will reduce the burden of asthma city-wide.  The program will also help physicians, patients and employers understand asthma triggers and do a better job managing this health problem in our city."