Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, University of Connecticut School of Medicine, Farmington, CT, USA.
Department of Psychiatry and Human Behavior and Department of Pediatrics; Bradley/Hasbro Children's Research Center, Warren Alpert Medical School, Brown University, Providence, RI, USA.
Yale J Biol Med. 2021 Sep 30;94(3):497-507. eCollection 2021 Sep.
Asthma is a heterogeneous disease characterized by inflammation in the respiratory airways which manifests clinically with wheezing, cough, and episodic periods of chest tightness; if left untreated it can lead to permanent obstruction or death. In the US, asthma affects all ages and genders, and individuals from racial and ethnic minority groups are disproportionately burdened by this disease. The financial cost of asthma exceeds $81 billion every year and despite all the resources invested, asthma is responsible for over 3,500 deaths annually in the nation. In this overview, we highlight important factors associated with health disparities in asthma. While they are complex and overlap, we group these factors in five domains: biological, behavioral, socio-cultural, built environment, and health systems. We review the biological domain in detail, which traditionally has been best studied. We also acknowledge that implicit and explicit racism is an important contributor to asthma disparities and responsible for many of the socio-environmental factors that worsen outcomes in this disease.
哮喘是一种异质性疾病，其特征是呼吸道炎症，临床上表现为喘息、咳嗽和间歇性胸闷；如果不治疗，它可能导致永久性阻塞或死亡。在美国，哮喘影响所有年龄段和性别，少数族裔群体的个体受到这种疾病的不成比例的影响。哮喘每年的经济成本超过 810 亿美元，尽管投入了所有资源，但哮喘每年仍导致全国 3500 多人死亡。在本篇综述中，我们强调了与哮喘健康差异相关的重要因素。虽然这些因素复杂且相互重叠，但我们将这些因素分为五个领域：生物学、行为、社会文化、建筑环境和卫生系统。我们详细回顾了生物学领域，该领域传统上研究得最好。我们也承认，隐性和显性种族主义是哮喘差异的一个重要促成因素，也是导致许多社会环境因素恶化这种疾病结果的原因。
