How Do Asthma Disparities

Asthma is a serious problem nationwide. It is also a significant problem in the state of Massachusetts, especially in communities in Boston. However, according to Harvard School of Public Health and NIEHS Center for Environmental Health, Roxbury and North Dorchester are highly noticeable hotspots (Backus, Terrell, Wool, & Straubel, 2012, p. 23). For the purpose of this paper, the main focus will be on asthma cases in

It is important to research environmental risk factors that influence asthma in low income neighborhoods to find possible ways to prevent asthma. The study “Urban Asthma and the Neighborhood Environment in New York City” proves that there is a positive correlation between neighborhoods and asthma hospitalizations.2 Children in lower income neighborhoods are more likely to be hospitalized due to asthma. Those living in lower income neighborhoods also tend to be minorities, which implies that African Americans and Latinos are more susceptible to asthma.2 Moreover, minorities are more likely to be living in public housing. The study explains that 11% of all housing units in Harlem is broken down and not suitable for living which proves that there is a positive correlation between the population of minorities and living in run-down housing and asthma related hospitalization.2

R.J. is a 15-year-old boy with a history of asthma diagnosed at age 8. His asthma episodes are triggered by exposure to cats and various plant pollens. He has been using his albuterol inhaler 10 to 12 times per day over the last 3 days and is continuing to wheeze. He normally needs his inhaler only occasionally (2 or 3 times per week). He takes no other medications and has no other known medical conditions. Physical examination reveals moderate respiratory distress with a respiratory rate of 32, oximetry 90%, peak expiratory flow rate (PEFR) 60% of predicted, and expiratory wheezing.

To better understand the impact of asthma, a brief overview of the causes (aetiology) and disease progression (pathophysiology) must be shown. As common as asthma is, not much is known about its aetiology, according to findings presented by Subbaroa, Mandhane and Sears (2009, pg. 181-187) in a review from the Canadian

Since asthma exacerbations in adolescence can lead to emergency room visits, hospitalizations, missed school and diminished health status, there was an evident need for effective asthma management for this population (Quaranta et al., 2014). Unfortunately, these rural adolescents with asthma, and their families, had difficulty determining when their asthma was poorly controlled; and unless the asthma symptoms were disruptive to family life, there was often little motivation for these individuals to seek medical care, thus increasing the risk of poor outcomes (Quaranta et al., 2014, p. 99). According

This results in Hispanics Americans living in very tightly-knit segregated urban communities, in older housing, and lack access to healthcare that can contribute to asthma exacerbation (Bhan et al., 2015). In the State of Connecticut there is a program called, Putting on AIRS or Asthma Indoor Risk Strategies. This program designed to assess environmental risk in the homes for asthmatic children and families. The hope is to reduce the frequency of asthma-related events by identifying environmental triggers. A public health nurse experienced in asthma management, conducts asthma education in the home. There is also an assessment for environmental asthma triggers in the home such as roach infestation or mold. The program follows participants over a six-month time frame, and has been shown to significantly improve outcomes for asthmatics (Nepaul et al.,

The impacts of climate on Hispanic health are further inflamed by challenges to better healthcare and medical resources. According to the US Department of Health and Human Services of Minority Health, Hispanic adults are 30% more likely to be admitted to the hospital for asthma than non-white Hispanics. Additionally, minority children are less likely than white children to be prescribed or take recommended treatments to control their asthma, and are less likely to attend outpatient appointments. Among racial and ethnic groups, Hispanics account for the largest share of the uninsured, including 12.6 million adults and nearly 3 million children as of 2011, according to The Henry J. Kaiser Family Foundation.

The choice of the qualitative research as the domain of the study and of IDI and FGDs as its methods are considered appropriate, as the authors set out to explore the dimension surrounding the quantitative finding that more Puerto Rican children experience asthma than any other major ethnic groups in the country. One of the reasons for choosing qualitative research is because it will provide not only authentic and valid information, but also insights and ideas into asthma management, as experienced by the children, parents, and the families as a whole. It is through the

Asthma is a respiratory disease that many people deal with every single day. “According to World Health Organization, approximately 180,000 people die from asthma each year.” (Jardins and Burton 187) Most people never think of asthma as a life threatening disease, but it can be crucial. As the number of people with asthma increases, the more likely you are to come in contact with someone who has been diagnosed with this disease. Asthma is a severe breathing problem that has many complications that is dealt with daily like shortness of breath, chronic cough, tightness of the chest and shortness of breath, my main focus is childhood asthma, allergic asthma, and medication to treat asthma.

Nicholas and his colleagues found in their study that the children asthma prevalence in East Harlem was about 4 times that of the national prevalence. Specifically, African American children had 3 times higher asthma prevalence. (Nicholas, 2005) Asthma is the leading cause of emergency room evaluations, pediatric hospitalizations, and school absenteeism in New York City (Corburn, Osleeb, & Porter, 2006)

As of 2009, studies conducted by the CDC have shown that asthma impacts approximately one in every twelve people, and the numbers only continue to grow (CDC, 2011). Some of the most common symptoms can range anywhere from coughing (especially at night or during exercise), wheezing and chest tightness, to shortness of breath. Asthma is often a chronic condition and while many times it can present itself as being mild, it can also sometimes lead to death if a person suffers an asthma attack. Asthma can be genetic, but it can also be caused, as well as exacerbated by, environmental factors such as air pollution. Studies have shown that children living in the Bronx are experiencing asthma at levels eight times higher than the national average. In addition, rates of death from asthma are a whopping three times higher than the national average, and hospitalization rates at about five times higher.” (Ruppell, 2000). Asthma is not a disease that targets only one group of people, yet the Bronx still exhibits disproportionately high levels of asthma especially in neighborhoods that are poorer areas of the city. In fact, people from these poor areas are 21 times more likely to be hospitalized due to asthmatic conditions compared to people from more affluent parts of the city (Ruppell,

By age group (in years), those of the ages 18-24 have the highest prevalence of asthma which is 13.3% and ages 45-54 have the second highest prevalence of asthma that is 11.3%. Those of the ages 25-34 have a 9.8% prevalence of asthma. The ages 35-44 have a 9.7%, the ages 65-74 have a 9.6%, the ages 55-64 have a 9.4%, and lastly the ages 75 and older have an 8.2% prevalence of asthma. For gender, females have a higher prevalence of asthma (12.5%) than males (7.7%). By race/ethnicity, those who are black have the highest prevalence of asthma which is 11.8%, individuals that are defined as other than white, black, or Hispanic have the second highest prevalence which is 11.6%, Hispanics have a 11.5% prevalence, and white individuals have a 9.9% prevalence of asthma. Based on household income, those who make less than $20K per year have the highest prevalence of asthma, however; there is no trend of high to low asthma prevalence based on income. With an income of $20K per year, the asthma prevalence is 11.3%, and with an income of $35K it is a 6.6%. However, after $35K the asthma prevalence percentage begins to ride. A household income making $50K per year has a 7.4% asthma prevalence, and an income of >$75K has an 8.8%. After the >$75K there is no further information on higher incomes. Additionally, individuals who suffer from a disability

Throughout the years knowledge about asthma has grown, as well as treating it effectively. Over 300 million people are said to be victims of this disease with another 100 million being estimated by 2025 globally (Currie and Baker, 2012). In the United Kingdom, asthma is increasingly becoming one of the leading disease affecting individual of different age, ethnicity, race and gender. British Lung Foundation (2011) stated that it is more common at childhood stage and can also occur at a later age. According to Asthma UK (2014) asthma in men is less prevalence than it is in women and children troubled more with asthma than adults. Recent data in the UK shows that in children and occupational asthma in adult is on the rise with an estimate

Childhood asthma impacts scores of youngsters and their families. In fact, the bulk of kids develop respiratory illness before the age of

Experts have yet to understand why the rates of asthma are rising by an average of 50% every decade worldwide. According to the Asthma Society of Canada (2016), asthma is now considered to be a major health concern with approximately 235 million suffering from this illness worldwide. Kuhn et al (2015) states that as at 2012, one out of 12 people in the United States had asthma and the number continues to rise. More people have been diagnosed with this disease and in 2007; over 3000 deaths were linked to Asthma. Furthermore, the costs of treating asthma continue to rise with about 56 billion dollars being spent in 2007 compared to $53 billion in 2002 (CDC, 2011). From data gathered in California, which is our area of study, it was estimated that 2.3 million