Lenoir Michael, McGill Cheryl Lynn Walker, Graham Leroy M, Foggs Michael, Robinson Sandra, Crim Courtney, Stempel David A
Bay Area Pediatrics, 401 29th St, Oakland, CA 94609-3581, USA.
J Natl Med Assoc. 2008 Sep;100(9 Suppl):1-23. doi: 10.1016/s0027-9684(15)30098-5.
Asthma continues to be a highly prevalent disease characterized by significant morbidity, unnecessary mortality, and substantial cost to the health care system. After decades of increasing prevalence, the number of current asthmatics in recent years has plateaued at approximately 22 million people in the United States. An additional 10 million Americans have a past history of asthma that is not active. The burden of asthma is higher among African Americans than in any other racial or ethnic group in America. The African-American community continues to experience a disproportional increase in asthma prevalence, morbidity, and mortality. The educational initiatives stemming from the newly revised National Heart Lung and Blood Institute (NHLBI) guidelines provide the opportunity to address the increased burden of asthma in the African American community. These new guidelines, released in August 2007, focus on asthma control as the primary goal of therapy, routine monitoring of asthma control, and use of asthma control assessments to direct treatment. The present review discusses the following: I. The impact of health disparities on outcomes of African Americans with asthma, II. The barriers that prevent asthmatic patients from achieving optimal control, III. The unique factors that challenge practitioners and patients in achieving optimal asthma control in the African American Community, IV. The impact of good asthma control and the need for patients and clinicians to assess asthma control in with a standardized assessment tool, and V. Strategic initiatives and the role of the End The Attacks NOW program in improving outcomes for African American patients with asthma.
哮喘仍然是一种高度流行的疾病，其特征为高发病率、不必要的死亡率以及给医疗保健系统带来的巨大成本。在经历了数十年的患病率上升之后，近年来美国哮喘患者的数量稳定在约2200万人。另外有1000万美国人有既往哮喘病史，但目前病情未发作。非裔美国人中的哮喘负担高于美国其他任何种族或族裔群体。非裔美国人社区的哮喘患病率、发病率和死亡率仍在不成比例地上升。新修订的美国国立心肺血液研究所（NHLBI）指南所推动的教育倡议为解决非裔美国人社区中不断增加的哮喘负担提供了契机。这些于2007年8月发布的新指南将哮喘控制作为治疗的首要目标，强调对哮喘控制情况进行常规监测，并利用哮喘控制评估来指导治疗。本综述讨论以下内容：一、健康差距对非裔美国哮喘患者治疗结果的影响；二、阻碍哮喘患者实现最佳控制的因素；三、非裔美国人社区中影响从业者和患者实现最佳哮喘控制的独特因素；四、良好的哮喘控制所产生的影响以及患者和临床医生使用标准化评估工具评估哮喘控制情况的必要性；五、战略举措以及“立即终止哮喘发作”项目在改善非裔美国哮喘患者治疗结果方面所起的作用。
