Asthma Study Shows Inequities in Care
A study published in the Archives of Internal Medicine this week of 5,062 adults with asthma concluded that African Americans are "less likely than whites" to get proper dosages of medication, information on self-care or help from a specialist, the Boston Globe reports. According to the study, conducted by researchers at Johns Hopkins University, blacks receive inferior care in the following areas:
- 35% of African Americans get proper medication for asthma, compared to 54% of whites
- 38% of African Americans are advised in how to avoid triggering asthma attacks compared to 54% whites
- 28% of African Americans receive care from a specialist, compared to 41% of whites
The Globe reports that people with asthma in "predominantly minority neighborhoods" may have a more difficult time receiving care because of inconvenient clinic hours, clinic locations, a lack of transportation or inability to pay for co-payments for inhalers. All participants in the study were insured and the researchers made "adjustments" to "rule out" age, education and employment, which "could point to a larger, systematic problem," according to the Globe. John Rich, medical director for the Boston Public Health Commission, said there is "a history of inequities ... built into institutions" but that the lack of care for blacks is "not overt racism" and rather "a complex combination of economic and social factors" (Atkins, Boston Globe, 7/11).
This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
A study released Tuesday by the Trust for America's Health revealed that more than 27 states do not track asthma, including 12 of the top 20 states with the highest air pollution. While no nationwide network exists to track asthma or other chronic diseases like cancer, the report, "Short of Breath: Our Lack of Response to the Growing Asthma Epidemic and The Need For Nationwide Tracking," says that if tracking were used, doctors, scientists and public health officials could use the data to "develop prevention strategies." TFAH estimates that a country-wide tracking system would cost approximately $275 million, while pointing out that asthma costs $14.5 billion a year in health-related fees and "lost productivity," according to the CDC. Neil Schlackman, a doctor and Senior Medical Director for Aetna US Healthcare, said, "Over 90% of our national healthcare dollars are spent on treatment. Our inability to prevent diseases is a very critical part of the growing burden of health care costs today." The 12 states that fail to track asthma despite being in the top 20 highest air pollution states include: Alabama, Georgia, Idaho, Indiana, Nevada, New Jersey, Ohio, Pennsylvania, Tennessee, Texas, Virginia and West Virginia. The other states not tracking the disease are: Alaska, Colorado, Delaware, Kansas, Kentucky, Louisiana, Maine, Maryland, Minnesota, Mississippi, Montana, New Hampshire, New Mexico, South Dakota and Wyoming. The report also found that some states that track asthma are "only tracking a few elements" of the asthma problem (TFAH Release, 7/10).