Skip to main content
NCBI home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 1999 Aug;91(8 Suppl):1S–8S.

Asthma in inner cities.

M A LeNoir 1
PMCID: PMC2608484  PMID: 12653387

Abstract

While the management of asthma has improved over the past two decades, the incidence of asthma in the inner city has not. The inner city, comprising a disproportionate number of people who live close to or below the poverty line, shows increased rates of morbidity and mortality from asthma. African Americans and Hispanic Americans are two to six times more likely to die from asthma than their white counterparts. When federally funded programs have targeted reducing morbidity and mortality in children from these populations, they have succeeded, but in a national study only 18 states had initiatives targeting asthma in low-income populations. This is tantamount to a public health crisis. Patients are not always properly diagnosed and are often without a regular source of health care, and symptoms are seen only in an acute context. Living conditions for the inner-city child have significant allergen triggers associated with house dust, cockroaches, cigarette smoke, chemical pollutants, and particulate matter. Viral infections, such as those caused by respiratory syncytial virus, are worse in crowded living conditions. The desirability of an increased public awareness of the seriousness of the disease and the need for chronic health care are issues that should be raised, through culturally relevant public means and in the knowledge that visual information is most effective. Physicians must understand the proper use of rescue and controller drugs, and asthma education must expand beyond doctors and nurses in their offices. The National Medical Association is committed to doing this aggressively, and community organizations, alliances, and coalitions must also aggressively follow. Public agencies must be lobbied to set high standards for proper asthma care and resources. With organizations acting in concert, the mortality and morbidity from asthma can be substantially prevented in the inner city.

Full text

PDF
1S

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ali S., Osberg J. S. Differences in follow-up visits between African American and white Medicaid children hospitalized with asthma. J Health Care Poor Underserved. 1997 Feb;8(1):83–98. doi: 10.1353/hpu.2010.0450. [DOI] [PubMed] [Google Scholar]
  2. Atmar R. L., Guy E., Guntupalli K. K., Zimmerman J. L., Bandi V. D., Baxter B. D., Greenberg S. B. Respiratory tract viral infections in inner-city asthmatic adults. Arch Intern Med. 1998 Dec 7;158(22):2453–2459. doi: 10.1001/archinte.158.22.2453. [DOI] [PubMed] [Google Scholar]
  3. Call R. S., Smith T. F., Morris E., Chapman M. D., Platts-Mills T. A. Risk factors for asthma in inner city children. J Pediatr. 1992 Dec;121(6):862–866. doi: 10.1016/s0022-3476(05)80329-4. [DOI] [PubMed] [Google Scholar]
  4. Campbell S., Hood I., Ryan D., Biedrzycki L., Mirchandani H. Death as a result of asthma in Wayne County Medical Examiner cases, 1975-1987. J Forensic Sci. 1990 Mar;35(2):356–364. [PubMed] [Google Scholar]
  5. Corn B., Hamrung G., Ellis A., Kalb T., Sperber K. Patterns of asthma death and near-death in an inner-city tertiary care teaching hospital. J Asthma. 1995;32(6):405–412. doi: 10.3109/02770909409077751. [DOI] [PubMed] [Google Scholar]
  6. Crain E. F., Kercsmar C., Weiss K. B., Mitchell H., Lynn H. Reported difficulties in access to quality care for children with asthma in the inner city. Arch Pediatr Adolesc Med. 1998 Apr;152(4):333–339. doi: 10.1001/archpedi.152.4.333. [DOI] [PubMed] [Google Scholar]
  7. Dezateux C., Stocks J., Dundas I., Fletcher M. E. Impaired airway function and wheezing in infancy: the influence of maternal smoking and a genetic predisposition to asthma. Am J Respir Crit Care Med. 1999 Feb;159(2):403–410. doi: 10.1164/ajrccm.159.2.9712029. [DOI] [PubMed] [Google Scholar]
  8. Dinkevich E. I., Cunningham S. J., Crain E. F. Parental perceptions of access to care and quality of care for inner-city children with asthma. J Asthma. 1998;35(1):63–71. doi: 10.3109/02770909809055406. [DOI] [PubMed] [Google Scholar]
  9. Gilthorpe M. S., Lay-Yee R., Wilson R. C., Walters S., Griffiths R. K., Bedi R. Variations in hospitalization rates for asthma among black and minority ethnic communities. Respir Med. 1998 Apr;92(4):642–648. doi: 10.1016/s0954-6111(98)90511-x. [DOI] [PubMed] [Google Scholar]
  10. Hartert T. V., Windom H. H., Peebles R. S., Jr, Freidhoff L. R., Togias A. Inadequate outpatient medical therapy for patients with asthma admitted to two urban hospitals. Am J Med. 1996 Apr;100(4):386–394. doi: 10.1016/s0002-9343(97)89513-7. [DOI] [PubMed] [Google Scholar]
  11. Kang B. C., Johnson J., Veres-Thorner C. Atopic profile of inner-city asthma with a comparative analysis on the cockroach-sensitive and ragweed-sensitive subgroups. J Allergy Clin Immunol. 1993 Dec;92(6):802–811. doi: 10.1016/0091-6749(93)90057-m. [DOI] [PubMed] [Google Scholar]
  12. Lang D. M., Polansky M. Patterns of asthma mortality in Philadelphia from 1969 to 1991. N Engl J Med. 1994 Dec 8;331(23):1542–1546. doi: 10.1056/NEJM199412083312302. [DOI] [PubMed] [Google Scholar]
  13. Lozano P., Connell F. A., Koepsell T. D. Use of health services by African-American children with asthma on Medicaid. JAMA. 1995 Aug 9;274(6):469–473. [PubMed] [Google Scholar]
  14. Malveaux F. J., Fletcher-Vincent S. A. Environmental risk factors of childhood asthma in urban centers. Environ Health Perspect. 1995 Sep;103 (Suppl 6):59–62. doi: 10.1289/ehp.95103s659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Malveaux F. J., Houlihan D., Diamond E. L. Characteristics of asthma mortality and morbidity in African-Americans. J Asthma. 1993;30(6):431–437. doi: 10.3109/02770909309056751. [DOI] [PubMed] [Google Scholar]
  16. McDermott M., Silva J., Rydman R., Giachello A. L., Yarzagaray E., Robinson D., Peragallo N., Barquero H., Arrom J. O. Practice variations in treating urban minority asthmatics in Chicago. J Med Syst. 1996 Oct;20(5):255–266. doi: 10.1007/BF02257039. [DOI] [PubMed] [Google Scholar]
  17. Murray M. D., Stang P., Tierney W. M. Health care use by inner-city patients with asthma. J Clin Epidemiol. 1997 Feb;50(2):167–174. doi: 10.1016/s0895-4356(96)00333-2. [DOI] [PubMed] [Google Scholar]
  18. Rao M., Kravath R. E., Abadco D., Arden J., Steiner P. Childhood asthma mortality: the Brooklyn experience and a brief review. J Assoc Acad Minor Phys. 1991;2(3):127–130. [PubMed] [Google Scholar]
  19. Rosenstreich D. L., Eggleston P., Kattan M., Baker D., Slavin R. G., Gergen P., Mitchell H., McNiff-Mortimer K., Lynn H., Ownby D. The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. N Engl J Med. 1997 May 8;336(19):1356–1363. doi: 10.1056/NEJM199705083361904. [DOI] [PubMed] [Google Scholar]
  20. White M. C., Etzel R. A., Wilcox W. D., Lloyd C. Exacerbations of childhood asthma and ozone pollution in Atlanta. Environ Res. 1994 Apr;65(1):56–68. doi: 10.1006/enrs.1994.1021. [DOI] [PubMed] [Google Scholar]
  21. Wissow L. S., Gittelsohn A. M., Szklo M., Starfield B., Mussman M. Poverty, race, and hospitalization for childhood asthma. Am J Public Health. 1988 Jul;78(7):777–782. doi: 10.2105/ajph.78.7.777. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES