Daily News Archive
February 15, 2006
Find Asthma's Harm Rising Fastest Among Blacks
(Beyond Pesticides, February 15, 2006)
The rates of deaths and hospitalizations of black children from asthma
have increased at a disproportionate rate during the last two decades,
according to three new studies released this week. Researchers continue
to look for reasons why programs aimed at eliminating such health disparities
have not succeeded.
Black children between the ages of 5 and 18 experienced a significant
rise in asthma hospitalizations and deaths between 1980 and 2002, amounting
to an additional 46 deaths per year. White children, meanwhile, experienced
12 additional deaths per year during the same period.
Ruchi S. Gupta, MD, lead author of the article examining the widening
racial gap, which appears in the February issue of the Journal of
Allergy and Clinical Immunology, said it is easy to see that something
as yet undetermined, such as genetics or environment, may play a large
"We need to really look into what's causing this -- whether it's
the quality of care received, the treatments offered to certain populations
and not others," said Dr. Gupta, an assistant professor of pediatrics
at the Northwestern University Feinberg School of Medicine and Children's
Memorial Hospital, both in Chicago.
Generally, African-Americans have a higher prevalence of asthma than
whites. They are five times more likely to die of the disease and four
times more likely to be hospitalized. Asthma prevalence, however, is
highest among Puerto Ricans, followed by Native Americans and non-Hispanic
blacks, the study points out.
Dr. Gupta and the other researchers note that the largest factor associated
with quality in asthma management, beyond access to health insurance,
is the medication used to treat the disease. Black children on Medicaid
had worse cases of asthma, for instance, and less use of preventive
medication than white children, according to Gupta's study.
But other researchers note that little-understood genetic differences
may be influencing how blacks respond to asthma medications. Environment,
especially in urban areas where residents may be exposed to more pollutants,
also has long been suspected as a culprit. Children who live in poverty
in inner cities are the most at risk for asthma, as they live in crowded,
inadequate housing where poor conditions lead to at high risk of many
asthma triggers and causes, including to chemical pesticides—both
legal and illegal—used to control the pests. Additionally, most
housing projects are routinely sprayed with insecticides
Others say treatment may have nothing to do with the disparities, according
to the researchers. "We need to understand how cultural beliefs
and attitudes influence disease management," said Christine Joseph,
epidemiologist with the Henry Ford Health System in Michigan, the lead
author of one of the journal articles.
More than six million American children have asthma, which is the leading
cause of school absenteeism attributed to chronic conditions and the
third-leading cause of hospitalizations among children under age 15.
Asthma can be a life-threatening disease if not properly controlled
through appropriate asthma care management, which relies on physicians’
and nurses’ clinical knowledge and skills, as well as parents’
and children’s daily attention to asthma triggers and medications.
Environmental asthma triggers include allergens and pollutants. Allergens
can be dust mites, cockroaches, animal allergens, molds, and pollens.
Indoor and outdoor pollutants include secondhand smoke, chemicals, pesticides,
combustion by-products, smog and fine particles.
To learn about the link between pesticides and asthma, check out
Beyond Pesticides’ 15-page color booklet, Asthma,
Children and Pesticides: What you should know to protect your family.
The booklet examines children's susceptibility to asthma, the differences
between the causes of asthma and asthma triggers, specific pesticides
linked to asthma, the demographics of asthma, tips for controlling pests
linked to asthma without using pesticides and steps you can take to
avoid asthma causes and triggers. The brochure is available online
or by calling Beyond Pesticides, 202-543-5450 for hardcopies.