March 11, 2024

Dr. Mike's Top of Mind

Asthma in the Black Community

This edition of the EHR deals with Asthma in the Black community. It is the first in a series of special reports which highlight those chronic medical issues that impact our community the most like Heart Disease, COPD, Cancer, Diabetes and Obesity. While we focus on the African American community, checking out the information any family or patients with Asthma might benefit from.

Stay Healthy,

Dr. Mike

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This Week

And Black America

• Black People are Most at Risk from Asthma
• Social Determinants Work Against Black Patients
• How to Better Manage my Asthma
• Asthma, Lead Poisoning, and the Flu: You are Where you Live

Asthma, a chronic disease, is unfortunately prevalent among hospitalized children in the United States. Shockingly, African American children are most affected. Despite evidence-based guidelines, these are concerning. It is crucial that we disseminate effective, understandable, and actionable guidelines to healthcare providers, patients, and their families. Together, we can strive towards reducing, if not eliminating, these unjust discrepancies. 

1. Black people have the highest rates of Asthma of any U.S. racial or ethnic group.
2. They also are more likely to experience serious complications from the condition. This includes needing to go to the emergency room (ER) for an Asthma attack, which can be a sign that Asthma is not well controlled
3. Black women are 84% more likely to have Asthma than Black men.
4. Black children are 8x more likely to die from Asthma than white children.

It is not as clear to me why these statistics are so daunting. While there may be some genetic factors associated with Asthma it seems that the quality of care is partnership between patients, parents and caregivers. But no one should die from Asthma, but it's the same old story. It appears that with proper management and regular exams from the doctor, we as a community can reduce both the sickness, days missed from school or work, trips to the ER and deaths in our community. The more information you have the better you will be clinically.

When we talk about Asthma outcomes the usual triggers are often discussed: allergens, diet, pollen and the regular use of medications are discussed, While these triggers are important to control, there are some triggers that are beyond the control of the individual Black patient.

Low Income 

Black people are more likely to live in densely populated or lower income areas, which can put them at higher risk for Asthma. People living in older, lower-income housing may be exposed to potential Asthma triggers such as rodents, insects, mold, and other things that can trigger Asthma attacks in people who are sensitive to them. 

Pollution 

Black people across the country are exposed to more air pollution than white people, no matter the region where they live or their income levels. Air pollution can greatly worsen Asthma symptoms. 

Racism 

There is growing literature examining health consequences of racial residential segregation 9. This economic and social disadvantage results in reduced access to primary and specialty care, particularly high-quality care, and disinvestment in community health resources that still exist today.

Know the Symptoms. 

Know Your Triggers. 

Know Your Medications 

Know What Medications Are Out There 

Have An Action Plan 

Don't Hesitate to Ask for a Referral to an Asthma Specialist

Know Your Symptoms: Problems like coughing, wheezing, chest tightness, and shortness of breath are all signs of Asthma. Frequent coughing with exercise or at night may be the most common symptom. Wheezing is a very dangerous symptom. 

Know Your Triggers: They can be inhalants or environmental. Asthma exacerbations can be triggered by infection, exercise, smoke, smog or other pollutants.

Know Your Medicines: Medications should be used for chronic Asthma. It does not replace avoidance of triggers and should be part of an action plan. ALBUTEROL IS NOT A MAINTENANCE MEDICATION. 

• Albuterol - Use as a rescue medicine only. If you are using it more than 1 or 2 times per month please consult with your physician
• Inhaled Corticosteroids - Maintenance Medicine for chronic Asthma 
• Combinations of Medicine - Combinations of long acting and now short acting bronchodilators with inhaled corticosteroids. 
• Steroids - to be used only in emergency situations or with intractable Asthma exacerbations 
• Biologics - Newer Medications for severe or intractable Asthma 

Have an Asthma Action Plan:

Together you can create an Asthma action plan that works for you. This plan will help you:

• Plan what to do in an emergency. Learn to keep track of your symptoms between visits to know if your plan is working. There are lots of new medications if you need them. But like other issues in medicine, Black folks are the last to know about them and they are not often prescribed.
• Don't Hesitate to Ask for a Referral to an Asthma Specialist. Many doctors know how to manage Asthma effectively but many just don’t. So if you are not getting better and you are doing the things you are supposed to do, you make the choice and ask to see a specialist. 

A Talking Too:

As an Asthma specialist, for over 40 years, many of the reasons all Americans suffer more than they should from Asthma, is that they don't do their part. Yes I said it! Too much Albuterol and too few doctor visits. Asthma is a chronic disease and it requires that you know about Asthma and its management as your doctor. And, you have to see your doctor on a regular basis. 

Where to go for Information:

There are lots of sources of information. The African American Wellness Project partners with the Allergy and Asthma Network, to provide the most comprehensive information platform on Asthma and Allergy, in our estimation. You get the latest data on Asthma in Black Communities along with programs to help you manage your Asthma with your own Asthma coach. Program. Visit: https://allergyasthmanetwork.org/free-asthma-coach-program/ for more information.

The Asthma and Allergy Foundation of America’s (AAFA) Health Equity Advancement and Leadership (HEAL) program also addresses health disparities in communities that bear the heaviest burden of Asthma. Promoting health equity is a core value and mission-critical priority of AAFA. 

These opinions about Asthma are strictly my own. Developed as a result of 40 years of Asthma practice in all communities, including the urban inner city.

Join us for today's African American Wellness Watch in honor of Black History Month! This week, we're diving into the crucial topic: "Asthma, Lead Poisoning, and the Flu: You are Where you Live."

Our esteemed guests, Samantha Artiga, VP & Director of Racial Equity and Health Policy at KFF, and our Founder, Dr. Michael LeNoir, are here to discuss the impact of environmental factors on health disparities in the African American community.

Learn how Asthma, lead poisoning, and the flu disproportionately affect communities of color and the vital steps we can take to address these challenges.

Don't miss this important Wellness Watch! Tune in to gain valuable insights and empower yourself with knowledge to promote healthier living.

Let's come together to raise awareness, advocate for change, and create a healthier future for all!

For more information, go to our website at www.aawellnessproject.org. or listen to our podcast at Blackdoctorsspeak.org on any podcast platform.

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