http://bmj.com/cgi/content/full/323/7308/302
BMJ 2001;323:302 ( 11 August )
News
Asthma "crisis" for black Americans
Janice Hopkins Tanne
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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© BMJ 2001
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