Disparities/Minority Health

Minority adults with asthma in the inner city spend more time in the emergency department and hospital

Minority groups who live in inner cities suffer disproportionately higher asthma rates than other groups. This problem is particularly serious in East Harlem, New York, which has one of the highest asthma hospitalization rates in the country and an asthma mortality rate that is nearly 10 times higher than the national average. A new study, supported in part by the Agency for Healthcare Research and Quality (HS09973 and HS13312), links lack of an established asthma care provider, language barriers, and allergy to cockroaches to more asthma-related emergency department (ED) visits and hospitalizations among minority East Harlem adults with asthma.

Juan P. Wisnivesky M.D., M.P.H., of Mount Sinai School of Medicine, and colleagues interviewed 198 adults hospitalized for asthma at 1 hospital over a 1-year period. Participants were asked about their asthma history, access to care, asthma medications, and allergies to airborne allergens.

Nearly half (49 percent) of patients visited the ED or were hospitalized for asthma within 6 months. After adjusting for several factors, including asthma severity, patients with a doctor in charge of their asthma care had a 60 percent lower risk of hospitalization or ED visits. Conversely, patients with a history of cockroach allergy had twice the risk of hospitalizations or ED visits. Asthma-related quality of life was worse among patients who spoke mostly Spanish or who were allergic to cockroaches.

See "Predictors of asthma-related health care utilization and quality of life among inner-city patients with asthma," by Dr. Wisnivesky, Howard Leventhal, Ph.D., and Ethan A. Halm, M.D., M.P.H., in the September 2005 Journal of Allergy and Clinical Immunology 116(3), pp. 636-642.

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