Oliver Marshall

Source: MassCHIP, Department of Public Health. Found at: http://www.mass.gov/eohhs/researcher/community-health/masschip/topics/asthma-mortality-and-hospital-data.html

According to the CDC “Asthma is a lifelong disease that causes wheezing, breathlessness, chest tightness, and coughing.” Asthma symptoms and attacks can result from triggers such as tobacco smoke, mold, outdoor air pollution, and colds and flu. Proper education on how to recognize and reduce triggers, as well as the development of an action plan and the use of inhaled corticosteroids and other medication, can help reduce symptoms and prevent attacks (CDC).

The above table shows the asthma inpatient hospitalization rates from 2006-2008 in the cities of Boston, Waltham and the state of Massachusetts, and is broken down by race. Two trends become very obvious upon first glance at the table. First, the asthma inpatient rates in Boston are significantly higher, according to the confidence intervals, than Massachusetts State across all races. Secondly, in all three geographic categories the asthma inpatient rates of White, Non-Hispanic, people are noticeably lower than those of either Black, Non-Hispanic, or Latino people.

Based on the CDC’s description of asthma triggers, it can be inferred that the difference between the rates of asthma inpatients in Massachusetts and the rates in Boston are due to Boston being a densely populated city, with heavy traffic, and several industrial sectors throughout the city. As a result Boston is likely to foster many of the common triggers of asthma, much greater than many of the cities in western Massachusetts, and thus elevating Boston’s inpatient rates above the average rates across the state.

Waltham, conversely, is a wealthy suburb of Boston, located just east of the city. It is much less densely populated and consists mainly of residences. As a result the rates of asthma are lower there, since asthma triggers are far less likely.

Most noticeable about the increase in inpatient rates from Massachusetts to Boston, or even Waltham to Boston, however, is the massive increase of Black inpatients, a greater increase than is seen anywhere else in the chart. It is possible that the areas that are highest in asthma triggers are also the areas most densely populated by Black people. This may be due to a combination of reasons revolving around real estate and rental rates. If an area has particularly low air quality, due to industrial facilities or heavy traffic, it is a less desirable living area, and therefore the rent falls. This same effect is seen in areas densely populated by ethnic minorities. As a result of this combination, areas heavily populated by ethnic minorities and areas of poor air quality will have the lowest rents, thus attracting more low-income minorities. Therefore, the black population may not only be concentrated in a single area, but in an area that is also of low air quality, resulting in a disproportionately high rate of Black people with asthma attacks.

The general disparities between the inpatient rates of White, Non-Hispanic, people, and the rates of the other two minorities, may be traced back to the CDC’s call for education in order to help reduce asthma symptoms and attacks. It can be assumed that a large proportion of the Black and Latino groups earn lower income than the Whites, and, thus, have restricted access and limited time for education of this manner. There is a good chance that many may know very little about asthma and may be unaware of the triggers, or even of the symptoms. As a result, any chances of preventing asthma attacks are greatly reduced. Similarly, access to preventative medication, such as corticosteroid inhalers, may also be greatly restricted, since many low-income minorities may not have the money or transportation to acquire these potentially life-saving medications.

The disparities shown in this chart illustrate the divide between the dominant white population and the ethnic minorities who share the geographic areas. The difference is extremely noticeable and demonstrates some of the forms of inherent disadvantages for ethnic minorities in much of America. Beginning with their status as a minority, to their lower access to education, employment, income, and quality housing, disparities such as asthma impatient rates become unavoidable.

References

Centers for Disease Control and Prevention. 2011. “Asthma in the US.” Retrieved April 5, 2012 (http://www.cdc.gov/vitalsigns/Asthma/)

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