Carisa D. Brewster is a freelance journalist with over 20 years of experience writing for newspapers, magazines, and digital publications. She specializes in science and healthcare content.
Farah Khan, MD, is a board-certified allergist/immunologist who treats pediatric and adult patients in private practice in Northern Virginia.
This article is part of Health Divide: Asthma in People of Color, a destination in our Health Divide series.
Asthma is a disease of the airways that cause them to narrow and become swollen. The most common symptoms of an asthma attack include wheezing, shortness of breath, and coughing. Asthma is a chronic condition, which means it does not have a cure. People who have asthma take medicines to control their symptoms.
Asthma has a higher impact on people of color (POC) when compared to White people. Black people have a 40% greater chance of having asthma and are three times more likely to die from asthma-related causes.
It is important for POC to know their risk for developing asthma. If they have been diagnosed with asthma, it is critical to follow a treatment plan to control symptoms and avoid long-term lung damage. This article will discuss the problems that POC face when trying to get asthma treatment, and resources POC can use for support.
Racial discrimination in the United States has negatively impacted health outcomes for POC, causing health disparities. This means that POC are more likely to have health conditions like asthma. They are also less likely to get proper treatment. The burden on Black children is especially high, regardless of income status.
The reasons behind these asthma disparities are:
There are also racial disparities when it comes to who has health insurance. POC are more likely to be uninsured when compared to White people.
If you can’t afford health insurance and don’t qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can access health services at your local federally qualified health center (FQHC). FQHCs do not turn people away due to inability to pay. However, it is important to note some centers may charge for services on a sliding scale. If you are unemployed, you may qualify for affordable coverage.
For more information on both options, go to healthcare.gov.
It is essential to recognize the most common triggers for asthma. POC are more likely to be exposed to some of these triggers due to systemic racial discrimination. They include:
Other asthma triggers include viruses like influenza, perfumes, pollen, and acid reflux.
Environmental tobacco smoke (ETS) or secondhand smoke is the smoke from a burning cigarette, cigar, cartridge, or pipe. The smoke exhaled by a smoker is also considered secondhand smoke. Children are at higher risk for health problems from secondhand smoke.
Children who have parents or guardians that smoke experience more of the following:
Thirdhand smoke is residue from tobacco smoke. As someone smokes a cigarette, chemicals from the smoke stick to objects and remain on them for a long time after the smoke is gone. These tiny particles can stick to skin and clothes, eventually making their way into people’s bodies. The particles can also react with other pollution in the air that you inhale.
To get free help to quit smoking, call 1-800-QUIT-NOW (1-800-784-8669).
It is important to note structural racial inequality hinders POC access to care to even be diagnosed with asthma. When actually diagnosed with asthma, it may be difficult for POC to access follow-up care. It is critical to have an asthma action plan, a regular healthcare provider, and case management and care coordination to keep asthma under control.
Generally, an asthma treatment plan should include:
Due to systemic racial discrimination in healthcare, the communication between POC and healthcare providers can sometimes break down during care delivery. This can negatively impact asthma control.
The following are tips to make sure POC and their caregivers understand everything they need to know to control their asthma:
Due to the persistence of racism and discrimination in the United States combined with genetic factors, People of color are at higher risk for developing asthma. Many POC struggle to access care and may be living with undiagnosed asthma. Even when diagnosed with asthma, it can be challenging to get proper treatment because of systemic racial inequality and social conditions that make it hard to follow treatment plans properly.
Asthma triggers include tobacco smoke, outdoor air pollution, pests, household pets, mold, and illnesses, such as colds or influenza. Secondhand tobacco exposure is of particular risk to children. Exposure to thirdhand smoke, which is residue from smoke that can stick to surfaces and skin, is also harmful.
Accessing care and following asthma treatment plans are essential to control asthma successfully. There are ways to open access to proper care. These include using patient advocates to help navigate the healthcare system, expanding case management to school nurses, educating healthcare providers on how to spot the social barriers to care, and offering asthma treatment that is up to date with current guidelines.
It can be scary when diagnosed with a chronic condition, such as asthma. It may seem like the task is too large to get the proper care. This experience can be even worse for people of color with asthma.
There are resources to help you find and access affordable healthcare insurance, healthcare providers in your network, and patient advocates to be there at your side during a healthcare provider's appointment.
Eating well, doing as much physical activity as is safe for you, and following your healthcare provider's treatment plan will help keep your asthma under control. If it seems your medicines are not working, consult with your healthcare provider before changing or stopping medications.
People with asthma should not avoid exercise or physical activity. Daily exercise actually improves your lung capacity and blood flow to your lungs, and increases the amount of oxygen your body can use. Consult with your healthcare provider about the types of exercise that are safe for you.
The persistence of racial discrimination is the main cause of higher uncontrolled asthma rates among Black people in the United States. Systemic racial discrimination against a group of people will cause limited access to healthy living conditions for that population, lower incomes, and lower education levels.
Asthma is a chronic condition that must be managed every day. There is no cure. Symptoms can be mild or life-threatening.
People of color are vulnerable to asthma exacerbations for a few reasons that are tied to systemic racial discrimination. They include healthcare providers under-prescribing asthma medications and discriminatory social conditions that prevent people from filling prescriptions or using medicines as prescribed.
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Centers for Disease Control and Prevention. 2018 National Health Interview Survey (NHIS) Data.
U.S. Department of Health and Human Services, Office of Minority Health. Asthma and African Americans.
Asthma and Allergy Foundation of America. Asthma disparities in America.
Kaiser Family Foundation. Health coverage by age and ethnicity, 2010-2019.
Centers for Disease Control and Prevention. Common asthma triggers.
Asthma and Allergy Foundation of America. Tobacco smoke and asthma.
American Lung Association. The health effects of smoking with asthma.
American Lung Association. Being active with asthma.
American Lung Association. What is asthma?
Asthma and Allergy Foundation of American. Ethnic disparities in the burden and treatment of asthma.
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