Asthmatics living in poverty suffer more, finds study

A new study has revealed that people with low incomes suffer more from the consequences of asthma as compared to those well off.

The report from the UCLA Center for Health Policy Research found that of the more than 600,000 Californians who experience frequent - daily or weekly - symptoms that can signal uncontrolled asthma, a significant proportion (39.1 percent) earn less than 200 percent of the federal government's poverty standard (FPL).

The report's authors also found a relationship between poverty and a lack of access to quality health care and repeated exposure to environmental triggers for asthma symptoms, such as smoking and second-hand smoke.

Those counties with a high percentage of families living in poverty had some of the highest proportions of people currently suffering from asthma. In all counties, however, poverty was associated with asthma.

"The poorest among us suffer most because they lack quality health care and live in high-risk environments," said Ying-Ying Meng, a senior research scientist with the center and co-author of the report.

"That disparity also burdens our health system with costly emergency care and hospitalizations and extracts the additional high cost of millions of lost days of work and school. Asthma has the potential to be debilitating," Meng added, "but it can be effectively controlled through appropriate medical care and avoidance of triggers," Meng said.

Health insurance can provide access to the kind of continuous care needed to manage a complex chronic condition like asthma. Yet low-income Californians suffering from the disease were five times as likely to be uninsured (22.1 percent) as their counterparts with asthma earning twice as much (4.4 percent). They were also twice as likely to not have a usual source of care (19.0 percent vs. 8.6 percent) - a factor that also affects continuity and quality of asthma care.

The results reveal that health care reforms should provide some relief by extending needed insurance to many low-income asthma sufferers. But they also encourage policymakers to support asthma education and quality health care that includes access to a patient-centered medical home, case-management programs, specialty referrals and access to around-the-clock advice from a health professional, as well as multilingual and culturally appropriate programs and education.

"These findings are illustrative of how where you live impacts your health. Low-income communities carry the highest disease burden, largely due to inequities that result in unhealthy environments," said Dr. Robert K. Ross, president and CEO of the California Endowment, which funded the study.
"For example, you won't see diesel trucks driving through high-income communities, but you will see many driving through poor communities, spewing exhaust full of particulates that serve as asthma triggers," he added.

The report's authors also call for improvements in sub-standard housing, restrictions on second-hand smoke and other policies that address the environmental factors that contribute to asthma.