Asthma Action

Anne Welsbacher

Stemming the global rise in asthma requires not only clinical expertise, but also advocacy work, multidisciplinary cooperation, and creative strategies.

What could you accomplish with 15 million extra years? A new study¹ developed for the Global Initiative for Asthma (GINA) states that about 15 million disability-adjusted life years (that is, healthy years) are lost annually to asthma worldwide. At least 300 million people suffer from asthma, and the number who are children is growing steadily. Air pollution, tobacco smoke, and occupational exposures are barriers to reducing asthma. So are poverty and poor education. Asthma is disproportionately high among African American and Hispanic/Latino communities, and it is higher in urban settings, especially inner cities.

Among the study’s most salient features is a graph detailing the prevalence of asthma in areas worldwide: the line curves steadily higher as it moves into more developed countries. Asthma is barely a tickle in Nepal, Albania, and Macau; in Argentina, Saudi Arabia, Hong Kong, and Sweden, it swells considerably; by the time it reaches the Americas and, especially, the United Kingdom, it soars. On a global scale, richer, it would appear, is not necessarily better—at least, not from the lung’s point of view.

On a local scale, poor does not fare well, either. Other studies echo GINA’s findings. A recent study² of homeless children in New York finds that about half of them in the city’s shelter system have asthma, and 90% are not taking the medicine needed to control it. A new report³ out of Harvard Medical School finds that poor and minority inner-city children are experiencing an epidemic of asthma, due to global warming and air pollution.

How can these statistics be confounded? What can RTs—as individuals and as members of a strong and passionate community—do to address the sociological complexities of the growing problem of asthma?

In Boston, staff in a hospital’s pediatrics department had done what they could clinically to help an asthma-plagued boy living in an apartment with leaky pipes and mite-infested carpeting. Frustrated by the landlord’s deaf ear to requests from both a nurse and the boy’s mother, the department’s chair turned to his facility’s attorneys for help. Within weeks, the carpets and pipes were replaced. The boy’s doctor visits went down and his school attendance went up.⁴

Treating asthma involves more than clinical expertise; political savvy, cooperative efforts among integrated disciplines, and creative tactics are also necessary tools in fighting this growing burden on the health of patients.

—Anne Welsbacher
awelsbacher@medpubs.com

References
1. Global burden of asthma, Global Initiative for Asthma. Available at: www.ginasthma.com.
2. Pérez-Peña R. Children in shelters hit hard by asthma. New York Times. March 2, 2004;sect A:1.
3. Epstein PR, Rogers C. Inside the Greenhouse. Boston: Center for Health and the Global Environment, Harvard Medical School; 2004.
4. Shipler DK. Total poverty awareness. New York Times. February 21, 2004:15.CADWELL