In this MD Newsline exclusive interview with pulmonary and critical care physician Dr. Jamie Rutland, we discuss how asthma disparities affect Black and Brown communities.
MD Newsline:
Why do Black and Brown communities suffer more from asthma? Why do they have worse outcomes?
Dr. Jamie Rutland:
“There’s a couple of answers to that. One, I do think it’s lack of access, a lack of education, not knowing about asthma. Two, where do Black and Brown people live? Under the freeways in the heavily polluted areas in which asthma prevalence is apparent. It’s all over the place, right? Three, they want to be able to trust their physician. They don’t know who to go to. Right?
They might go to a family practice doc around the corner that doesn’t know much about asthma and just gives them an inhaler, right? They may not know to go to a specialist or to an internal medicine doctor that really has an understanding of asthma and how to step up therapy. Right? And so, I think that those are the predominant things that are happening.”
MD Newsline:
How would you recommend physicians and healthcare organizations reach out to Black and Brown communities to rectify asthma disparities?
Dr. Jamie Rutland:
“If I were a big company, if I had the capacity to do so…Long Beach is down the street from here…Long Beach is in an industrial area next to the freeway. There’s lots of Black people there and all the kids there are suffering from asthma. I would go there, have a big community outreach [event] talking about asthma, what it is, these are the therapies, this is how you step up therapies.
And then, from there, I would be able to set up some kind of a clinic so that people who are having trouble with wheezing or shortness of breath can have access. And from an insurance company standpoint, you have to be able to offer them the appropriate medications.”
MD Newsline:
Some research suggests that Black and Brown individuals with asthma don’t respond as well to treatment. Can you speak to that?
Dr. Jamie Rutland:
“Everybody doesn’t respond to treatment in the same way. Everybody’s protoplasm is different, and it’s not because they’re Black or Brown or white or green or whatever. It’s really just because of what’s going on inside of the body, how long they’d been exposed to said antigen that’s causing the inflammation within their airway, and what their protoplasm looks like.
What does their blood eosinophil count look like? What is their IgE level? What is their FeNO level? What are these biomarkers looking like, and what are they telling us they’re going to respond to? And so, what happens is in people who have untreated asthma for years, the airways become more fibrotic, and they are a lot more difficult to treat.
So if you look at a Black or Brown person who presents to your office at 52-years-old, and they’ve had asthma for 23 years, and they haven’t had any treatment, they’re going to be a lot harder to treat than someone that got diagnosed with asthma at 26, that was on some mild treatment for a longer period of time, and now presents to you at 43, and their asthma is just a little bit worse than usual.”
Responses have been condensed and lightly edited.
