The National Medical Association, the professional organisation of 25000 African-American doctors, declared at its annual meeting earlier this week that asthma is a public health crisis for black people in America.
Dr Michael LeNoir, chair of the allergy and asthma section of the association and an associate professor of paediatrics at the University of California in San Francisco, said that African-Americans are two to six times more likely to die from asthma than white people. “Seventeen million Americans have asthma. The number keeps getting worse. Every year more than 5000 people die from this preventable disease.”
The disease disproportionately affects African-Americans. A black man in New York city is 11 times more likely to die from asthma than other men in the city.
The reason why asthma is more common among black people and other inner city residents is unclear. Being an African-American is a marker, but not a risk factor. African-Americans tend to have poorer access to care and information. Many don't have a regular doctor and use overcrowded clinics and emergency departments when they have a crisis. Doctors may be rushed and ill-informed, so patients don't come back and therefore lack continuity of care.
Public information is not reaching the community, Dr LeNoir said. “People don't recognise the symptoms. A chronic cough is the most common symptom. Wheezing is a symptom of moderate to severe asthma.”
People use “rescue medicines” like albuterol (salbutamol) whereas they should be controlling their asthma with inhaled corticosteroids combined with albuterol.
To deal with this crisis, the National Medical Association plans an educational programme similar to the direct to consumer advertisements for drugs seen in the United States. Radio and television are the best ways to reach inner city residents and people with asthma and give them straightforward messages. The programme will tell consumers about asthma's symptoms and treatments and will direct them to doctors so that they can ask informed questions.
For doctors, the association will also offer a full-day asthma certification course.
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AP PHOTO/JOHN HARRINGTON
The US surgeon general, Dr David Satcher, left, looks on as rapper Coolio discusses his experiences of asthma