Asthmatic blacks get less high-quality asthma care

The care of asthmatic African Americans falls short of many recommendations contained in national guidelines, compared to whites, according to a new study by Johns Hopkins researchers, reported in the July 9th issue of Archives of Internal Medicine. The finding, say researchers, may explain, in part, why African Americans are more likely to have more severe asthma symptoms. The researchers also found that asthmatic women of both races are less likely to comply with daily medication use and to see an asthma specialist.

"The discrepancy in care is striking because it cannot easily be explained by socioeconomic factors or access to care," says Jerry Krishnan, M.D., an instructor in the Hopkins School of Medicine's division of pulmonary and critical care medicine and lead author of the study. "We need to further investigate whether these differences in asthma care were due to doctor, patient or health care system-related barriers."

In a study of 5,062 adults enrolled in managed care organizations, fewer African-Americans than whites reported care consistent with guidelines from the National Asthma and Education Prevention Program (NAEPP). Differences existed even after researchers adjusted for age, education, employment and asthma severity. The group included individuals with at least moderate asthma symptoms and was 14 percent African American and 72 percent female. Roughly 35 percent of African Americans reported using inhaled corticosteroids daily, compared to 54 percent of whites. Forty-two percent of African-Americans had enough information provided to them on how to manage their asthma during an attack, compared to 54 percent of Caucasians. Thirty-eight percent of African-Americans reported receiving adequate information about how to avoid asthma triggers, compared to 54 percent of whites. And while 41 percent of whites were seen by asthma specialists, only 28 percent

Contact: Kate O'Rourke
Johns Hopkins Medical Institutions

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