The Challenge of Asthma in Minority Populations

  • Albin B. Leong
Part of the Current Clinical Practice book series (CCP)


  • Although asthma affects all races and ethnic groups, there is a significant disparity in asthma morbidity and mortality. Minority populations suffer disproportionately higher rates of fatalities, hospitalizations, and emergency department visits resulting from asthma. For example, non-Hispanic blacks have more than three times the death rate of non-Hispanic whites in the United States.

  • Few studies have addressed ethnic differences in asthma in countries outside of the United States. International survey data have shown considerable variation in asthma prevalence in both children and adults among other countries, with higher prevalence in English-speaking countries, including the United Kingdom, Australia, New Zealand, and Ireland.

  • In the United States, Puerto Ricans, blacks, and American Indians/Alaskan Natives have the highest current and lifetime asthma prevalence and asthma attack rate.

  • Racial/ethnic designations may disguise important differences within groups. For example, Puerto Rican Americans have the highest Hispanic current, lifetime, and asthma attack prevalence, which are comparable to, and exceed rates for, blacks. The larger numbers of Mexican Americans, who have a low prevalence, mask this difference. Hispanics have consequently been considered to have low asthma prevalence.

  • Low socioeconomic status (SES) is an independent and significant factor for increased asthma morbidity and mortality for many minority groups. When controlling for SES, significant disparities in asthma morbidity and mortality generally remain for racial/ethnic minority populations.

  • Barriers to care exist because of lower SES, with decreased access to care and inadequate care, including underprescription of inhaled corticosteroids, increased environmental exposures in urban settings, substandard living conditions, and increased psychosocial dysfunction and cultural differences.

  • Comprehensive and individualized environmental intervention strategies can be effective in reducing allergen environmental burden in urban settings and reduce asthma morbidities.

  • Asthma-susceptibility genes with different ethnic frequencies have been found, with the strongest evidence for 6p21 in European Americans, 11q21 in blacks, and 1p32 in Hispanic Americans. Questions remain regarding the degree of heterogeneity, gene-gene interactions, and gene-environment interactions for different racial/ethnic groups.

  • Culturally competent strategies can be effective in helping to reduce the disparity in asthma health care and outcomes in racial/ethnic minorities.

  • Reduction of asthma disparity in racial and ethnic minority groups is an important challenge and goal and a national priority.


Allergy Clin Immunol Minority Population Environmental Tobacco Smoke Royal Jelly Asthma Care 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Humana Press Inc. 2006

Authors and Affiliations

  • Albin B. Leong
    • 1
  1. 1.Department of Pediatric Pulmonology and AllergyKaiser Permanente Medical GroupSacramento

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