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The fact that racial/ethnic minorities experience higher asthma incidence and worse asthma outcomes than their white counterparts has been well documented; however, the etiologies of this disparity are less understood. Asthma is a complex disease with many factors at play in its development and management, making it difficult to pinpoint what causes it to occur and worsen.

This study tackled this question by approaching it from the opposite angle—namely, by seeing what mediators could improve outcomes for at-risk populations. The researchers followed a cohort of adults with asthma for three years while noting factors such as demographics, socioeconomic status (SES), health literacy, and asthma outcomes.

Not surprisingly, unadjusted results showed that minority race or ethnicity was significantly associated with worse quality of life and more emergency care visits related to asthma, but only indirectly, through the effects of income and health literacy.

This finding has a powerful implication—that race/ethnicity alone is not causational for poor asthma outcomes. Instead, the correlation between race and SES, health literacy, and other environmental factors are all at play. This information can be applied to improve asthma outcomes in at-risk populations.

In conclusion, improving health literacy and mediating income barriers can be considered some of the most important targets when designing programs for racial/ethnic minority patients with asthma. This intervention might look like increasing and emphasizing patient-provider communication, making transportation to medical care more accessible, and continuing research on this intersection of health, literacy, and environment [1].


[1] Seibert, R. G., Winter, M. R., Cabral, H. J., Wolf, M. S., Curtis, L. M., & Paasche-Orlow, M. K. (2019). Health Literacy and Income Mediate Racial/Ethnic Asthma Disparities. HLRP: Health Literacy Research and Practice, 3(1). https://doi.org/10.3928/24748307-20181113-01

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