Asthma Cases Among Asians

In a civilized society it is important that all those in need of health care should have equal access to it and benefit equally from that which is available. There have been some suggestions that asthma outcomes in the UK for those of South Asian origin may be less good than for the rest of the population. This is a subject confounded by generalizations and by statements which are often based on minimal evidence. Caution is needed in comparing local and national studies and studies done many years apart.

There are two key questions regarding asthma and ethnic minority groups, especially Asians. (1) Does the prevalence of asthma vary between ethnic minorities such as South Asians living in the UK? Are the outcomes for asthma care worse for these groups and, if so, why and how do we improve the situation?

The first question is not the main purpose of this editorial but in the USA physician diagnosed asthma has been reported to affect 13.4% of black children and 9.7% of white children. 1Black children with asthma have also been reported to have significantly greater restrictions of activity, fewer contacts with doctors, and to be admitted to hospital more frequently than white children with asthma. 2 In parallel with this increased suffering among African American children is an increased adult mortality due to asthma, and the death rate has been reported to be rising more quickly in African Americans than white Americans.

Asians with asthma have higher hospital admission rates than whites without any evidence of increased asthma severity. There is limited information as to whether these differences are due to language or communication difficulties, variable knowledge and cultural attitudes to asthma or deficiencies of medical care. A qualitative study with 60 participants (12 participants with asthma for semi-structured interviews and 48 participants for focus groups) was designed to explore knowledge about asthma, attitudes, perceptions, health beliefs and health needs of those from Pakistan and India (South Asians). Overall, most of the patients with asthma were aware of the symptoms and trigger factors of asthma and were well informed about the ‘reliever’ and ‘presenter’ properties of their inhalers. They were also well informed about alternative/complementary therapies and were willing to try them should the treatment provided by their general practitioner (GP) fail to resolve their symptoms. Most were dissatisfied with the asthma care provided by their GPs e.g. delays in making the diagnosis and deficiencies in providing both verbal and written information on asthma. There was lack of awareness about self-management plans although when explained, the concept of self management was well received and there was approval for the concept of written action plans. All the focus group participants seemed to know something about asthma and amongst those with the condition (or with relatives with the condition), knowledge of the disease and its treatment seemed to be good. It was concluded that improved dissemination of written and verbal information on all aspects of asthma and increased awareness, training and support for adoption of written self-management (action) plans is needed to provide a more efficient and effective service for South Asian patients with asthma.

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Thursday, July 21, 2011

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