The impact of ethnicity on asthma care

Abstract

Asthma is a significant global health problem. Asthma prevalence, its related health outcomes, and associated healthcare utilisation, vary by population group both across and within nations. Evidence of ethnic variations in the prevalence and outcomes of asthma within nations have been well documented. This review examines the impact of ethnicity on asthma, with a focus on the literature from the UK and the USA. Explanations for the unequal burden of disease experienced by ethnic minority groups include: their health beliefs, attitudes, experiences and behaviours; the problem of poor health literacy, which tends to compound the challenges inherent in crosscultural communication; concerns about the quality of care; and the relatively poor socio-economic position of minority ethnic groups and how this impacts on the wider determinants of health. We conclude by suggesting research priorities for asthma and ethnicity, along with practical actions within a collaborative care model.

The association between language proficiency and outcomes of elderly patients with asthma

“…16 Because elderly patients and ethnic minorities have higher rates of low health literacy, an association between limited English proficiency, low health literacy, and asthma outcomes might be presumed. 39,40 However, with the exception of attenuating the association between English proficiency and risk of asthma exacerbations requiring inpatient care, health literacy did not mediate outcomes in our study.…”

Migration and asthma medication in international adoptees and immigrant families in Sweden

“…Language barriers, health seeking behaviour, low health literacy and inadequate access to health care contribute to a reduced utilization of ICS in immigrants [32]. It is reasonable to believe that purchased prescribed ICS as a marker of current asthma may underestimate the true prevalence of asthma in immigrants, particularly among those who have recently arrived.…”

Ethnic and socio-economic differences in the prevalence of wheeze, severe wheeze, asthma, eczema and medication usage at 4 years of age: Findings from the Born in Bradford birth cohort

“…In the UK, the highest rates have been reported in children of Black ethnicity followed by those of White and South Asian ethnicitybackground [7]. PIn addition to the differences in prevalence by ethnicity there is further evidence that phenotypes of asthma, wheeze and atopy may also differ by ethnicity [8].…”

“…Atopy has also been shown to vary by ethnicity, with South Asian children shown to havinge higher rates than their White British peers [9], although it is being increasingly recognised that not all persons who experience asthma, wheeze and/or eczema are also atopic [10,11]. Despite persons of South Asian origin resident in the UK being less likely to experience symptoms of wheeze and asthma, there are reports of poorer outcomes in asthma, with potentially linked to lower rates of adequate diagnosis and being more likely to have both a higher risks of asthma exacerbations and hospitalisations for their asthma [7,12]. However, South Asian populations resident in the United Kingdom (UK) are however heterogeneous, originating from different countries including India, Pakistan and Bangladesh, experiencing differing cultural and socio-economic profiles and.…”