Asthma Control Obstacles in Black and Brown People7 min read
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.
Receiving Appropriate Treatment
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:
- Structural: Systemic inequality, which includes past racial segregation and discriminatory policies (such as redlining and gerrymandering), still impacts POC today.
- Social: This includes socioeconomic status, education, and the environment in which a person is born and raised.
- Biological: Genes and ancestry can affect disease risk.
- Behavioral: It’s important to limit tobacco use and use prescribed medicines correctly.
When You Are Uninsured
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:
- Tobacco smoke: Almost 17% of adults with asthma smoke. Tobacco smoke particles can irritate your lungs and slowly destroys the tissue. Even being around someone else that is smoking can cause an asthma attack.
- Dust mites: These are microscopic-sized bugs that can be found in homes. Vacuum carpets regularly, don’t use down-filled bedding and keep humidity levels inside your home low (30%-50%) to help manage your exposure to dust mites.
- Outdoor air pollution: This type of pollution can come from wildfire smoke, industrial factories, and cars. Living close to freeways or industrial areas will increase asthma risk.
- Pests: To keep pests like mice and cockroaches under control, keep trash in a closed container, don’t leave leftover meals out, keep clutter to a minimum, and seal cracks in walls, baseboards, and around the plumbing.
- Pets: Even your furry family members can trigger asthma if you have an allergy to pet dander. If re-homing them is not an option, you can limit exposure by keeping your pet out of certain rooms, washing them regularly, and using a HEPA filter.
- Mold: This can grow in damp areas, especially in places with water damage. Use an air conditioner or dehumidifier to keep indoor humidity low, clean visible mold thoroughly, use the bathroom fan when taking showers, and fix water leaks as soon as possible.
- Certain cleaners and disinfectants: Some may not know that cleaning products can trigger asthma, too. Many of them contain chemicals that irritate the lungs. Use less harsh products, always follow directions for use on product labels, and ensure there is airflow throughout your house when cleaning.
Other asthma triggers include viruses like influenza, perfumes, pollen, and acid reflux.
Secondhand and Thirdhand Smoke
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:
- More illness, including a higher risk for bronchitis, pneumonia, and ear infections
- Stunted lung growth
- Increased asthma attacks that are more severe
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).
Accessing Follow-Up Care
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:
Communicating With Healthcare Providers
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:
- Use patient advocates/navigators: These are trained experts that can help you navigate the healthcare system. Sometimes they have personal experience with your health condition (in this case, asthma). They help find healthcare providers, can go with you to appointments, research treatment options, find ways to reduce financial barriers, help you get prescriptions filled, and help translate your healthcare provider’s orders into plainer language.
- Training programs for healthcare providers: This helps healthcare providers identify people who may have social barriers to care and helps them learn how to partner with the community to match them to local resources.
- Make sure asthma care is guidelines-based: Healthcare providers should be educated on how to provide asthma care based on current guidelines and how to best communicate them to POC who may have experienced institutional racism in healthcare settings.
- Expand case management to school settings: For children, their healthcare team should include their school nurse. Studies show that case management that includes care from a school nurse is linked to reduced school absences and improved academic performance.
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.
A Word From Verywell
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.
Frequently Asked Questions
Should people with severe asthma avoid exercise?
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.
What explains the higher rate of asthma in Black people?
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.
Is asthma always chronic?
Asthma is a chronic condition that must be managed every day. There is no cure. Symptoms can be mild or life-threatening.
What specifically exacerbates asthma in Black People, Indigenous People, and People of Color?
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.