Study finds correlation between racism and asthma rates among African-American youth

30th September 2019   ·   0 Comments

By Ryan Whirty
Contributing Writer

Devastating factors, both systemic and personal, contribute to higher rates of untreated or inadequately treated asthma among African-American youth than white children, a new study has found.

Pilot research published in August in the medical journal Annals of Allergy, Asthma and Immunology reveals a correlation between an increased amount of stress caused by racism and race-based factors and experienced by African-American parents or guardians and a decrease in the amount of asthma control in their children.

Dr. Bridgette Jones, MD, MS, one of the lead authors of the new study, told The Louisiana Weekly that factors such as redlining – the de facto societal system of reinforcing segregation and poverty by denying minorities and the poor adequate access to quality-of-life services and financial resources – as one of the biggest factors in the decreased amount and quality of the treatment of asthmatic African-American youth.

“There are systemic impact such as the legacy of redlining in the country which may lead to African-American children being more likely to reside in areas that have higher levels of environmental pollutants [and] have less access to adequate health care,” said Jones, who is a member of the American College of Allergy, Asthma and Immunology. “These neighborhoods are also often ‘food deserts’ and lack adequate outdoor environments for exercise, such as parks, which may also lead to [disease factors] such as obesity that contributes to poor asthma outcomes.”

Jones added that underneath such systemic, social results of persistent racism and racial factors also lies more individual, personal experiences on the part of African-American families that can be detrimental to the medical treatment of Black asthmatic children. Such experiences can occur when non-Black medical personnel have fundamental, negative preconceptions about African-American parents, children and families, she said.

“African-American patients may be perceived by non-African-American physicians or non-diverse health care teams as ‘non-compliant,’ ‘uneducated,’ or that they ‘don’t care’ about controlling their disease,” she said.

As a result of such individual biases, she said, Black youth “may not receive adequate evaluation and treatment due to these explicit and implicit biases. All of these factors, both systemic and personal, are ultimately rooted in racism and likely lead to poorer health outcomes.”

Jones noted that existing research and understanding had historically shown that adverse childhood experiences, or ACE, and chronic stress factors can significantly impact the medical treatment received by youth, including treatment for asthma.

She said studies also previously revealed that increased and acute levels of ACEs and stress factors are found among African-American families, a trend that severely and negatively affects the quality and amount of medical treatment received by Black youth, including asthmatic African-American children.

Jones said challenges such as difficulties affording rent, purchasing food and accessing recreational opportunities – as well as the machinations of environmental racism that make poorer, African-American communities more likely to be exposed to pollution, radiation or similar dangers – appear to be crippling families’ ability to medically treat their kids. That, she said, is what spurred the recent research.

“This study came about in continuing [to] recognize the significant and disproportionate impact that asthma has on African Americans,” she said. “ACEs and chronic stress have been studied among children and has been shown to be associated with asthma prevalence.

“However,” she added, “we felt that there may be an impact of ACEs and chronic stressors such as housing instability, food insecurity and racism that may impact very young children with asthma.”

Jones said she and her co-researchers – Dr. Vincent Staggs and Dr. Brianna Woods-Jaeger, both hold doctorate degrees – had heard enough individual examples of racism significantly impacting African-American youth that they knew their research needed to focus on race.

Still, she added, they were somewhat jolted by what they found.

“We decided to include racism in this study based on anecdotal experiences that have been communicated to me by patients and also based on the current climate of explicit racism in our country,” she said. “As this variable was included more as an ‘exploration,’ we were surprised to see this association.”

Jones noted that the recent study is only a pilot, initial look into the subject of racism and pediatric asthma. In addition, the study had a limited size and geographic focus – questionnaires completed by thirty-one African-American parents/guardians of asthmatic children ages one to six years old at an urban Head Start in Kansas City, Mo. – which makes it difficult to establish a concrete, indisputable correlation between racial stress factors, such as societal racism and financial difficulties, and acute, inadequately treated asthma in Black youth overall.

However, Jones said the new research does establish enough of a precedent to warrant further study. In addition, she said, the study will hopefully spur medical professionals – including organizations such as the American College of Allergy, Asthma, and Immunology (ACAAI) – media and local communities to take action to alleviate and even eliminate the negative impact of racism on children with asthma.

Jones said that “working with professional organizations such as ACAAI who have a strong voice among specialists, health care providers, and policy makers” is key to attacking this challenge. She also stressed the importance of “work[ing] with community organizations and patient-led organizations in local and regional communities to get the word out about the impact of racism as a social determinant of health and to drive policy makers to address it.”

“I think that the public and medical community need to get to the root causes of health disparities which I believe are centered around the roots of racism in this country,” she added. “Health disparities should be addressed not from the perspective of ‘what has the patient done or not done’ to make their health worse or put them at risk, but what have we done as a country and society to ensure unequal treatment and health outcomes among African Americans and how can we fix the system to provide equity in opportunity for health and overall health care.”

This article originally published in the September 30, 2019 print edition of The Louisiana Weekly newspaper.