Asthma isn’t a disease that strikes all individuals equally—some people, such as African Americans, get hit much harder. Why this is, is complex and multifaceted.
Asthma is a long-term lung disease that can affect anyone, of any age, sex, race, or ethnicity.
But because of several factors—such as socioeconomic status—African Americans have a greater likelihood of being hospitalized, or even killed, by asthma.
This article discusses why asthma is more dangerous to African Americans. It also addresses general information on causes, treatments, and prevention for this chronic respiratory disease.
Risk Factors for Asthma in African Americans
(RealPeopleGroup/Getty Images)
Non-Hispanic African Americans in the United States, as of 2018, are approximately 40% more likely to have asthma than non-Hispanic white Americans.
As of this information, 10.6% of non-Hispanic Black individuals suffered from asthma, while only 7.6% of non-Hispanic white individuals did.
African Americans with asthma are also five times more likely to wind up in the ER with symptoms compared to white asthma patients.
Asthma is also more common in advanced forms among African Americans. For instance, Black individuals are almost three times more likely to die from asthma symptoms compared to white individuals.
Scientists are only beginning to understand why African Americans are more likely to die of asthma.
One is airway inflammation, which is occurring more frequently in African Americans and causing tough-to-control asthma. The other major area is healthcare disparities.
While scientists investigate, some of the likely reasons have already been identified by experts.
A 2017 study examined 1,018 patients with asthma who were white or African American. Researchers tested sputum samples for eosinophils (white blood cells associated with airway inflammation).
Results indicated higher eosinophilic inflammation in African American participants than in white participants—despite receiving the same dose of asthma medication.
Because eosinophilic inflammation causes asthma symptoms (such as difficulty breathing), scientists think that this may be one reason why asthma tends to be worse in African Americans.
But other factors are probably at work as well, such as:
Genetics
While social and medical disparities are important, biology might also play a role.
Some genetic differences could predispose African Americans to asthma or make the symptoms worse.
A study published in the American Journal of Respiratory and Critical Care Medicine investigated how racial groups react to asthma medication. The researchers monitored 1,441 African American, Puerto Rican, and Mexican American subjects.
Both common and uncommon genetic variations associated with a reduced response to albuterol (a common asthma bronchodilator) were identified by them. Such genetic variations may explain part of asthma disparities.
Healthcare Inequities
Systemic racism and discriminatory policies lead to healthcare gaps.
Discrimination has an impact on economic stability, restricting health care access—through which can develop poorly controlled asthma.
Social Determinants
Housing conditions and income are involved.
Low income or poor housing could mean greater exposure to asthma triggers (such as mold or air pollution).
Low Birth Weight
African American infants are more likely to have low birth weight due to research in the Journal of Health Economics, increasing childhood asthma risks.
This, too, could be a result of healthcare disparities—particularly prenatal care for African American mothers.
Symptoms
Asthma symptoms differ in severity and type. Typical ones are:
Wheezing
Shortness of breath
Coughing
Excess mucus
Chest tightness
Diagnosis
Physicians diagnose asthma by physical examination and tests such as:
Spirometry – Determines how much air you can inhale/exhale and how quickly.
Peak flow – Measures how hard you can blow air out.
Chest X-ray – Eliminates other causes (though cannot diagnose asthma).
Treatment
Treatment doesn’t vary by race but, because of asthma’s severity in African Americans, adhering to a plan is essential. Treatments include:
Medications – Such as bronchodilators (open airways), steroids (decrease inflammation), or combination drugs.
Trigger Reduction – Knowing and staying away from asthma triggers (e.g., allergens, pollution).
Allergy Shots – Increases tolerance to allergens that cause asthma.
Lifestyle Changes – Exercise routinely, don’t smoke, and change your diet.
Prevention
Not everyone with asthma can prevent it, but taking the following steps can be helpful:
Don’t smoke – Particularly when pregnant or around children.
Policy Reform – Removing health disparities and pollution.
Community Education – Classes on low birth weight prevention and smoking cessation.
Mobile Clinics – Enhancing access to healthcare in disadvantaged communities.
Summary
African Americans are at greater asthma risk—and experience worse consequences—than white Americans.
This is probably due to a combination of factors: health disparities, potential genetic differences, and socioeconomic conditions.
Policy corrections on healthcare access and enhancing community education might aid in decreasing asthma’s effect among African Americans.