Although blacks and Hispanics are disproportionately affected by asthma in the United States, they are more likely to be dissatisfied with their care teams and underrepresented in research, according to abstracts at the 2022 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting.
Research presented at the 2022 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting highlighted some of the ways in which non-white populations experience suboptimal asthma care.
Black/African American and Hispanic Americans in the United States are disproportionately affected by asthma, with increased prevalence, morbidity, and mortality.
It is already known from previous work that different population groups and those receiving Medicaid and other publicly funded plans are dissatisfied with their experiences when attempting to access medical care for asthma. These difficulties are associated with “poor perceptions of asthma control and lower satisfaction with therapy,” researchers say.
Researchers examined whether racial/ethnic or socioeconomic factors were associated with the perceived quality of care team interactions in patients with asthma, since health outcomes can be influenced by the patient-care team relationship.
Between August 2021 and October 2021, surveys were emailed to 550 people across the country by the Allergy & Asthma Network. The survey asked patients about their perceptions of their providers in terms of trust, equality, empathy and communication.
The surveys were completed by 212 people aged 6 to 74 years. Half were female and the majority self-identified as Black (66%). Although there were slight racial/ethnic differences, 98% of respondents had health insurance.
Overall, non-white and publicly insured individuals perceived interactions with their care teams less positively. The vast majority of patients who were white or had private health insurance were satisfied that their health care providers had given them “fair medical advice.”
However, more diverse demographics disagreed with the notion that they were receiving fair advice. Specifically, 23% of Blacks and 12% of Hispanics and Native Americans and Alaskans disagreed; According to insurance status, 32% of the statutory insured (compared to 10% of the privately insured) patients spoke against fair advice from their team.
Similar observations were made for perceptions of equality/respect, as patients who reported satisfaction on this aspect were more likely to report well-controlled asthma symptoms (75%) and satisfaction with current therapy (86%) than patients who did not report equality/respect perceived. Respect (29%).
However, patient-reported asthma symptoms and treatment satisfaction did not differ significantly between racial/ethnic or public/private insured groups.
Another study examined the racial/ethnic makeup of clinical trial participants, which fed into the 2020 focused update to the National Heart, Lung, and Blood Institute (NHLBI) asthma management guidelines. As in other areas of clinical research, different population groups are often underrepresented in clinical and translational research studies on asthma, creating an obstacle to achieving equity in health.
Researchers analyzed papers to determine the frequency of papers reporting racial/ethnic demographics and the percentage of identified racial/ethnic groups in the studies.
Less than half of the articles describing clinical trials reported race/ethnicity data. White participants were generally overrepresented and Black and Hispanic populations were underrepresented in the studies.
In particular, only 36% (16/45) of the newspapers reported on racial demographics.
For studies in the US only (n=6), all papers reported racial/ethnic demographics, but only 2 reported demographics for the white racial group.
In all papers reporting race/ethnicity, the breakdown was as follows:
- 70.8% (n=31,675) of the participants identified as White
- 10.4% (n=4653) as Black
- 0.2% (n=91) as Hispanic
Native American/Alaskan Native/Hawaiian Native/Pacific Islander made up 2.6% and the classification as Other was 6.1%.
“Deliberate inclusion efforts are needed to increase the racial/ethnic diversity of studies included in national asthma guidelines,” the authors concluded. “These factors should also be considered when developing such guidelines.”