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Asthma continues to be a pervasive epidemic in the United States that disproportionately affects Black and Brown individuals in terms of incidence as well as morbidity and mortality. These disparities may, in part, be due to ancestry. Genetic markers, for example, have shown associations between African ancestry and lower lung function.

However, it is also well documented that environmental factors such as socioeconomic status (SES) contribute to healthcare access and overall health and have strong effects on asthma.

Low SES is associated with several risk factors for asthma, including prematurity, second-hand smoke exposure, air pollution, and obesity. These factors also impact asthma outcomes. Moreover, low SES and racism put chronic stress on an individual, which has been proven to increase asthma morbidity.

The body of research on how health disparities impact asthma incidence and morbidity is not lacking. It is well established that individuals with low SES and racial and ethnic minorities are the most susceptible to poor asthma outcomes. So why, despite this knowledge, have asthma outcomes remained relatively static?

The authors of this article suggest that in terms of our understanding of inequities in asthma incidence and management, we are “at the end of the beginning.” Now that we have a basic understanding of why minority patients are more susceptible to asthma, it is time to move on to the action phase of rectifying asthma disparities.

Some actions suggested by the authors include diversifying research participants, research leadership, and the healthcare workforce, as well as contributing to cost-effective health interventions that are more accessible to low SES communities. These steps must be accompanied, they say, by actions that foster cultural sensitivity and environmental justice [1].

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[1] Rosas-Salazar, C., & Celedón, J. C. (2019). Eliminating health disparities in asthma. Annals of Allergy, Asthma & Immunology, 123(1), 3–5. https://doi.org/10.1016/j.anai.2019.02.001