Solutions for Asthma Disparities

Childhood asthma prevalence has plateaued and may have declined for the first time since 1980.1 Although this news is promising, it is important not to lose sight of the significant disparities in asthma outcomes that remain by race, ethnicity, and socioeconomic status. We must reduce these disparities, and health care organizations’ increasing focus on population health presents a prime opportunity to do so. Now is a critical time to invest in research and quality improvement initiatives that directly target the persistent disparities in childhood asthma outcomes. Disparities in asthma outcomes have been documented since the 1980s. Children of racial or ethnic minorities face higher morbidity and mortality due to asthma when compared with white children. Non-Hispanic African American children have 2 to 3 times higher rates of hospitalization and emergency department visits compared with non-Hispanic white children. African American children face a 4.9-fold higher asthma mortality rate. In addition, Hispanic children are 2 times more likely to visit an emergency department and 1.5 times more likely to die due to asthma when compared with non-Hispanic children.2 Numerous individual- and system-level factors contribute to asthma disparities, including health care policies, health systems operations, and clinician, patient, family, and environmental factors. For example, minority children are less likely to be prescribed a controller medication when indicated and are less likely to adhere to therapy that is prescribed. Additional factors driving disparities include clinic-centric care, indoor allergen exposure, limited primary … Address correspondence to Anna Volerman, MD, Departments of Medicine and Pediatrics, University of Chicago, 5841 S Maryland Ave, MC 2007, Chicago, IL, 60637. E-mail: avolerman{at}uchicago.edu