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Racial Differences in Asthma Outcomes for Older Adults Persist Even After Controlling for Social Determinants

AAAAI News Release

February 5, 2020

April Presnell
(414) 272-6071

New study from The Journal of Allergy and Clinical Immunology: In Practice, an official AAAAI journal, examines health disparities from a large national sample of older adults.

MILWAUKEE, WI – Even after accounting for multiple social determinants, racial differences still had an impact on asthma outcomes in older adults, according to a new study published in The Journal of Allergy and Clinical Immunology: In Practice (JACI: In Practice), an official journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

A total of 4,700 adults, all age 55 or higher were included in this study. Respondents self-identified as Non-Hispanic White, African American, or Hispanic. Of this group, African American and Hispanic respondents were twice as likely to visit the emergency room for asthma compared to Non-Hispanic White individuals.

“As the population continues to age, it’s important that researchers look at the impact of asthma on older populations and how it differs from younger patients,” said first author Nicole M. Cremer, MD. “The number of older adults with asthma is going to increase, and understanding these health disparities is crucial if we hope to provide effective treatment.”

Data was collected and analyzed from the 2015 Behavioral Risk Factor Surveillance Survey and the Asthma Call-Back Survey and was restricted to adults aged 55 and older with current asthma. Asthma outcomes were assessed based on healthcare utilization, including emergency department visits, and asthma control.

Social factors, such as healthcare access and healthcare costs as well as additional demographic data, were collected. African American and Hispanic respondents reported higher BMIs, lower levels of educational attainment, and lower annual household incomes. They were also more likely to be former or current smokers. They reported higher proportions of impaired access to health care because of cost as well as gaps in healthcare coverage. A higher proportion of African American and Hispanic respondents reported not using asthma medication.

According to the study, 32% of African Americans and 23% of Hispanics reported ER visits in the past 12 months due to asthma compared to 14% of Non-Hispanic Whites. After regression analysis, this translated to African Americans and Hispanics being twice as likely as Non-Hispanic Whites to have visited the emergency department due to asthma symptoms. Despite this, African Americans and Hispanics were 40% less likely to report frequent uncontrolled daytime symptoms compared to Non-Hispanic Whites. These findings suggest certain populations may be under-treated, putting them at higher risk for severe symptoms.

“While social determinants certainly account for some asthma outcomes, we found that didn’t account for all of them,” said Dr. Cremer. “While these groups are also less likely to be on an inhaled corticosteroid, we find they are still more likely to visit an emergency room after controlling for medication use. That means there are still factors out there leading to African Americans and Hispanics requiring more frequent ER visits.”

Asthma disparities in older adults require additional studies, particularly in relation to racial differences when it comes to asthma control, emergency room visits and mortality. As the American population continues to age, the burden of asthma on these older populations will be more keenly felt. This burden can be reduced by identifying the areas of prevention and treatment needed to effectively treat older adults with asthma.

You can learn more about asthma on the American Academy of Allergy, Asthma & Immunology website,
The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has nearly 7,000 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.