Published online: February 5, 2020
For many years, racial and ethnic disparities in asthma prevalence, morbidity, and mortality have been documented in children and adults under age 65. However, the effect of race and ethnicity in older adults is not well understood. It is becoming increasingly more important to understand how race and ethnicity affect asthma outcomes in older adults, as older adults with asthma make up a significant and growing population in the United States.
In a recent article published in The Journal of Allergy & Clinical Immunology: In Practice, Cremer and Baptist characterized the effect of race and ethnicity on asthma outcomes in a large national sample of older adults. They analyzed data from 4,700 individuals who participated in the 2015 Behavioral Risk Factor Surveillance Survey (BRFSS) and Asthma Call-Back Survey (ACBS). They correlated asthma medication use, demographic variables, healthcare access, and comorbidities with asthma outcomes (e.g. healthcare utilization and asthma control). Multivariable logistic regression was used to further analyze asthma outcome variables.
The study found that racial differences in asthma outcomes persist despite controlling for multiple social determinants of health (including household income and education level) and access to health insurance. Minority patients were twice as likely to visit the ER but less likely to report frequent daytime symptoms.
This study indicates that, while factors such as income, insurance, access to care, and medication use account for some of the asthma racial disparities seen in older adults, there are also other factors involved. Comprehensive strategies to address assessment, monitoring, and treatment are needed to decrease these health disparities. As the U.S. population ages, the burden of asthma seen in among older patients will increase, and identifying specific areas of prevention and treatment should be a public health priority.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.