Racial disparities in asthma can be explained by socioeconomic and environmental factors
In the United States, racial disparities exist in the prevalence of asthma, morbidity and even mortality, largely explained by looking at socioeconomic and environmental factors, such as access to healthcare, a nationwide analysis shows. The findings highlight the potential of targeted interventions, such as mobile asthma clinic programs and joint programs with schools where asthma prevalence is high. Asthma is a leading cause of school absence.
The analysis was published January 2019 in the Journal of Allergy and Clinical Immunology.
Per reports about the study, public health researchers said they’ve observed that African Americans have a substantially higher rate of emergency hospital visits for asthma and a higher rate of asthma-related death, compared with Caucasians.
“t isn't clear why asthma outcomes are worse in African American patients. The findings from our study suggest that poorer asthma outcomes are not genetic or biological in nature, but are instead (because of) a number of socioeconomic and environmental factors that impact asthma care,” said Anne Fitzpatrick, PhD., associate professor of pediatrics and director of the Asthma Clinical Research Program in the Department of Pediatrics at Emory University School of Medicine. “These factors can be modified and improved with the right interventions.”
Fitzpatrick’s team analyzed data from the National Heart Lung and Blood Institute's Severe Asthma Research Program, which includes academic medical centers in California, Missouri, Wisconsin, Ohio, Georgia, North Carolina, Virginia, Pennsylvania and Massachusetts. This study included 579 participants six years and older, each observed for one year.
African American patients were more than twice as likely to visit the emergency department for asthma, data showed. When the statistics were weighted – based on community and family socioeconomic factors and environmental exposure – the racial differences evened out.
What remained, though, after the statistical weighting was that African American patients were 43 percent less likely to see a doctor in an outpatient setting for asthma.
Allergenic housing conditions are another concern, Fitzpatrick says. Asthma medications won't work well if triggers of asthma, such as dust mites and mold, aren't eliminated from the home.
Types of intervention that can make a difference are mobile asthma programs, often in coordination with schools, and employer-endorsed health initiatives that incentivize wellness and preventive care.
