AASA and NSBA RESOURCE SHEET
Children’s Asthma Health Disparities
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(Adapted from Ethnic Disparities in the Burden and Treatment of Asthma Report)
Key Findings
 In the United States, the burden of asthma falls disproportionately on the black and Hispanic populations, and especially on
minority children (Table 1-2; Figure 1-7).
 These groups have disproportionately high rates of asthma and hospitalizations and deaths from the disease (4, 6, 7, 9, 10).
 Access to health care is hampered by differences in income, shortages of primary care physicians in minority communities, and
language and literacy barriers (4, 5, 6, 9).
 Underuse of asthma medicines, especially of long-term control medications, is more common in minority than in white
children. Specifically, minority children are less likely than white children to use inhaled corticosteroids, which are
recommended long-term control medications (2, 3, 4, 6).
 Adherence to asthma medication regimens in minority children may be compromised by their parents’ beliefs about the role,
usefulness and cost of medications, concerns about adverse effects, poor literacy, and distrust of and poor communication with
physicians (3, 5, 7).
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School-based asthma management programs
Most asthma management programs targeting minorities have focused on children.1-8 Some of these programs have been carried out in
schools.1,2,8,9:


One such program improved asthma knowledge and inhaler technique among Hispanic inner-city schoolchildren,1
A study of largely minority children with asthma demonstrated that providing daily long-term control medications at school
improved symptoms and reduced absenteeism.8
Importantly, good outcomes were seen only among schoolchildren not exposed to secondhand smoke. Asthma education programs
should therefore emphasize the harmful effects of secondhand tobacco smoke in the home of a child with asthma.
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References
1. Christiansen SC, Martin SB, Schleicher NC, Koziol JA,
Mathews KP, Zuraw BL. Evaluation of a school-based
asthma education program for inner-city children. J
Allergy Clin Immunol 1997 Nov;100(5):613-7.
2. Persaud DI, Barnett SE, Weller SC, Baldwin CD,
Niebuhr V, McCormick DP. An asthma self-management
program for children, including instruction in peak flow
monitoring by school nurses. J Asthma
1996;33(1):37-43.
3. Greineder DK, Loane KC, Parks P. Reduction in
resource utilization by an asthma outreach program.
Arch Pediatr Adolesc Med 1995 Apr;149(4):415-20.
4. Evans R 3rd, Gergen PJ, Mitchell H, Kattan M,
Kercsmar C, Crain E, et al. A randomized clinical trial to
reduce asthma morbidity among inner-city children:
results of the National Cooperative Inner-City Asthma
Study. J Pediatr 1999 Sep;135 (3):332-8.
5. Kelly CS, Morrow AL, Shults J, Nakas N, Strope GL,
Adelman RD. Outcomes evaluation of a comprehensive
intervention program for asthmatic children enrolled in
medicaid. Pediatrics 2000 May;105(5):1029-35.
6. Hendricson WD, Wood PR, Hidalgo HA, Ramirez AG,
Kromer ME, Selva M, et al. Implementation of
individualized patient education for Hispanic children
with asthma. Patient Educ Couns 1996 Nov;29(2):
155-65.
7. Jones JA, Wahlgren DR, Meltzer SB, Meltzer EO, Clark
NM, Hovell MF. Increasing asthma knowledge and
changing home environments for Latino families with
asthmatic children. Patient Educ Couns 2001
Jan;42(1):67-79.
8. Halterman JS, Szilagyi PG, Yoos HL, Conn KM,
Kaczorowski JM, Holzhauer RJ, et al. Benefits of a
school-based asthma treatment program in the
absence of secondhand smoke exposure: results of a
randomized clinical trial. Arch Pediatr Adolesc Med
2004 May;158(5):460-7.
9. McEwen M, Johnson P, Neatherlin J, Millard MW,
Lawrence G. School-based management of chronic
asthma among inner-city African-American
schoolchildren in Dallas, Texas. J Sch Health 1998
May;68(5):196-201.
10. Tobacco use among U.S. racial/ethnic minority
groups—African Americans, American Indians and
Alaska Natives, Asian Americans and Pacific Islanders,
Hispanics. A Report of the Surgeon General. Executive
summary. MMWR Recomm Rep 1998 Oct;47(RR-18):
v-xv, 1-16.
References from Table 1.2 and Figure 1.7
33. Akinbami LJ, Schoendorf KC. Trends in childhood
asthma: prevalence, health care utilization, and
mortality. Pediatrics 2002 Aug;110(2 Pt 1):315-22.
38. Freeman NC, Schneider D, McGarvey P. Household
exposure factors, asthma, and school absenteeism in a
predominantly Hispanic community. J Expo Anal
Environ Epidemiol 2003 May;13(3):169-76.
This document was adapted from the report, Ethnic
Disparities in the Burden and Treatment of Asthma, ©
January, 2005 by the Asthma and Allergy Foundation of
America and the National Pharmaceutical Council.
Download the complete report at:
www.npcnow.org/resources/PDFs/AsthmaEthnicDis05.pdf.
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