Asthma is a chronic lung disease that affects 24.8 million Americans. But the way asthma impacts those with the disease differs greatly depending on factors including race, gender and economic status. Specifically, Black individuals in America are nearly 1.5 times more likely than other races and ethnicities to be diagnosed with asthma in their lifetime. In addition, they are also more likely to experience complications; including five times more likely to visit an emergency department because of asthma, and three times more likely to die from an asthma related problem. Black women and children are at an even higher risk of death than Black men. What is causing these major disparities and how can we address them?
Understanding the Stats
The American Lung Association’s Asthma Trends Brief explains that in 2018, Black individuals were 42 percent more likely than white individuals to be living with asthma. This is in part because of social determinants and structural inequities stemming from discrimination. Black people have suffered from limited access to quality healthcare and resources due to their socioeconomic status, which in return, makes it difficult to get help when they have an asthma episode.
Environmental pollution is a known factor that makes asthma symptoms worse. According to our State of the Air report, more than one in three Americans live in places with unhealthy levels of air pollution. Additionally, research suggests that Black people are more likely to live in low-income areas, which can put them at higher risk for asthma. Asthma rates are also significantly higher (11.0%) among those who are living below the poverty line as compared to above it.
After discussion with Italo M. Brown, MD MPH, Board-certified Emergency Physician, an Assistant Professor in Emergency Medicine, and Health Equity & Social Justice Curriculum Thread Lead at Stanford University School of Medicine, Cedric Rutland, M.D., a triple board-certified internal medicine, pulmonary and critical care physician, said, “When you look at where minorities live, these areas qualify for some of the heaviest polluted areas in the country. This leads to significant airway inflammation which shows itself as asthma. These communities were drawn out based upon redlining dynamics which is why pollution is greater.”
Steps to Managing Asthma
Once diagnosed, asthma can be managed if you work closely with your healthcare providers. Unfortunately, many Black people struggle to get treatment. The long-standing history of racial bias in healthcare impacts access to care and trust in providers, leading fewer Black people to seek help when having asthma symptoms.
However, regularly monitoring your asthma can reduce the likelihood of an asthma emergency and prevent an emergency department visit, or even death. Your healthcare provider can help assess and track your symptoms so that you can keep them in control. They can also assist you in creating an Asthma Action Plan, which is an individualized worksheet completed with your provider that shows you the steps to take to keep your asthma from getting worse. Additionally, it provides guidance on when to seek help by calling your healthcare provider or heading to the emergency department.
Making a Change
Over the last ten years, some progress has been made in reducing asthma disparities. Rates of asthma and asthma-related issues have declined since 2010, and now over 2.7 million Black people have healthcare coverage under to the Affordable Care Act. But there is much more to be done as asthma equity can only be achieved if everyone works together. “We need to establish federal qualified health centers in our neighborhoods, and we need to continue to address air pollution in general. We need to increase access, and address affordability,” Dr. Rutland said.
The American Lung Association is committed to addressing health disparities. For instance, our HBCU Breathe Well, Live Well on Campus initiative aims to help college students, specifically those of color, improve their asthma self-management skills and quality of life, while simultaneously addressing asthma disparities.
Blog last updated: February 28, 2024
