Racial differences in asthma are shocking

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Asthma is a lifelong disease that causes wheezing, breathlessness, chest tightness and often causes coughing during the nighttime or early-morning. Today, more than 12 million people in the U.S. have asthma. According to the Centers for Disease Control and Prevention, the number of people with asthma continues to rise.

Asthma
Cathy Vitari, nurse practitioner with the Asthma Institute, performs a breathing test called spirometry at a community event.

Asthma affects people from all backgrounds and communities. It is more common and often more severe among children, women, African Americans and Puerto Ricans. Asthma is also more common and severe among people living in lower income and urban communities.

The racial differences in asthma are shocking. For example, according to the National Heart, Lung and Blood Institute, African American children are more than one and a half times more likely to have asthma than White children. African American children with asthma are twice as likely to be hospitalized and four times as likely to die as White children. In Allegheny County, 16.6 percent of African Americans were diagnosed with asthma, compared with 8.9 percent of Whites locally (see Figure 1).

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The reasons for racial disparities are complex and cannot be explained by genetic differences alone. Research has shown that factors associated with poverty, such as lack of resources and specialized health care, exposure to violence and stress may contribute to asthma. Adults and children living in urban communities are often exposed to poor housing and work conditions that place them at greater risk for exposure to environmental factors, such as allergens, irritants and stressors that can make asthma worse.

Unfortunately, we still do not know what actually causes asthma. Research has shown that if someone in your family has asthma, you are more likely to have the disease as well. While asthma cannot be cured, it can be controlled by taking medicine and avoiding the things that can cause an asthma attack. These things are called triggers. The triggers for one person’s asthma can be very different from those of another. It is important that people with asthma work with their doctor to learn about their own asthma triggers and find ways to avoid them. Some of the most common triggers for asthma in children and adults include tobacco smoke, pollution and smoke in the air we breathe, cockroaches, mold and pets. For some people, exercise can cause an asthma attack. Breathing in chemicals from household cleaning supplies or perfumes and even breathing in cold air also can lead to an attack. Asthma attacks are more likely to occur when someone is upset, scared or excited.

Researchers have found that having stressful things happen, such as changes in where you live or being exposed to family or community violence, may also have an impact on asthma. Research also shows that stress can make it more difficult to properly take asthma medications and possibly increase the harmful effects of pollutants, such as tobacco smoke and exhaust from cars.* Knowing this information raises the possibility that efforts to decrease stress may result in improving asthma outcomes for all those with asthma and potentially reduce disparities.

Remember, regardless of age, race, ethnicity, gender, income or personal history, most people with asthma can find ways to control it. It is important to use medications properly, know your triggers and work closely with your health care provider, family and friends for help in avoiding them.

*This information was taken from articles “Asthma risk factor assessment: what are the needs of inner-city families?” published in Annals of Allergy, Asthma & Immunology(2006), 97(1):S11-5 and “Traffic-related air pollution and stress: effects on asthma” published in ­Environmental Health Perspectives (2008),116(9):A376-A377.

Resources

It’s important to talk to an asthma specialist to be sure you receive a proper diagnosis. Some people who think they have asthma do not have it. Many people with asthma have not been properly diagnosed and treated. If you have been told that you have asthma, here are some things you need to know: There are different types of asthma. People who are diagnosed with asthma as children tend to experience different symptoms than those who are diagnosed as adults. Because asthma is a chronic disease, it does not disappear when symptoms go away. It’s important to learn about asthma, know your medications and watch your symptoms. See the resources listed below for more information about how to get in touch with an asthma specialist:

Healthy Lungs Pennsylvania helps people achieve and maintain good lung health through education, prevention, awareness and direct services. For more information about services, including Camp Huff-n-Puff, an overnight camp for children with asthma, please visit http://www.healthylungs.org or call 1-800-220-1990.

The University of Pittsburgh Asthma Institute’s mission is to increase the scientific understanding of asthma/allergic diseases across all ages, to translate these findings into innovative approaches and to implement these approaches through an integrated partnership of scientists, clinicians, educators, patients and the community, thereby improving the health of asthma patients. For more information, visit http://www.AsthmaInstitute.pitt.edu.

The Asthma Center at Children’s Hospital of Pittsburgh of UPMC brings together experts on lung function, breathing sensitivities and the immune system to provide the highest level of care for their patients. Asthma testing is available at all Children’s Hospital locations. To find out more, or to make an appointment with a pediatric asthma specialist in the location nearest you, please call 412-692-LUNG (5864).

If you or someone you know does not have adequate health care, more resources can be found in the “Allegheny County Health Care Guide for the ­Underinsured and Uninsured.” Visit http://www.Achd.net or call 412-687-ACHD to request a copy of the guide.

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