How come there is a variation in skin color among individuals with high ASTH levels?

Air pollution has been a persistent issue in the United States for many years. The National Ambient Air Quality Standards (NAAQS) were established in 1970 as a result of the CAA’s enactment of extensive federal regulations on Air emissions, which are still used today to protect public health and measure Air Quality. An amendment to the CAA in 1990 imposed additional regulations on hazardous emissions, which were later strengthened 1.

The CAA reports a 78% reduction in air pollution of the six most common pollutants between 1970 and 2020, but many Americans still breathe unhealthy air outside and find little respite in their homes 2. Long-term exposure can result in serious health consequences.  

Air pollution is the most significant risk to human life expectancy, reducing the global average lifespan by 2 years. 3 years. The amount is over three times greater than the result of alcohol use, and five times as significant as the impact of transportation injuries 5.

For people with Asthma —7. Air pollution poses a significant threat to the health of individuals in the United States, who make up 7% of the population 6. The worsening of air quality has been the subject of numerous studies Asthma symptoms Exposure to pollutants can result in asthma attacks, worsen symptoms, and cause more frequent hospitalizations. Exposure to vehicle emissions, fossil fuel burning, and secondhand smoke is a significant risk factor for asthma, which can be particularly severe in children 7.

Identifying the impact of air quality on asthma rates and severity is challenging due to the interplay between factors such as race, location, and socioeconomic status

I’m a middle-class asthmatic from California, of mixed race. Consequently, my encounter with diagnosis, treatment, and management is markedly dissimilar to that without my privilege. My healthcare and medication were readily available to me. I had a support system that supported my health and well-being. During my time in a progressive state, I worked tirelessly to reduce air pollution. Many asthmatics, particularly those of color, face historical and structural barriers to resources, care, and prevention, which are not the case for many others

Air Pollution and Racial Discrimination in Asthma

The Census Bureau categorizes densely developed residential, commercial, and nonresidential areas as a means of decreasing air quality, which is not unexpected. ” 8. About 80% of the U. S. Population lives in an urban area, and on average, these areas experience 47.5 days of extremely poor air quality, as compared to 3.8 days in rural areas 9. All told, this means that most Americans spend 13% of their year in poor air quality

The burden of these statistics is not carried equally across either racial or socioeconomic groups. Your race and socioeconomic status directly impact your exposure to pollution, not just where you live 10. On average, people of color are exposed to and breathe in more air pollution, with both Black and Hispanic populations experiencing higher exposure rates than white populations 11.

However, separating location from race and socioeconomic status can be difficult. The United States has a long history of oppression and discrimination that impacts where people of color, especially Black Americans, live and work. Historical redlining, for example, has been linked to disparities in air pollution exposure 12. It’s even been shown to worsen some of the environmental risk factors that cause asthma 13. 14. The now-illegal practice limited the development of green spaces and eventually raised city temperatures, two factors that can increase asthma risk 15. 16. 17.  

It’s in part due to policies like these that people of color make up 52% of those who live in areas affected by at least one form of pollution, despite making up only 4.6% of the U. S. Population 19.

All of this helps us to understand why Black, Hispanic, and Indigenous populations have the highest asthma rates, deaths, and hospitalizations of any other racial groups in the U. S 20. The numbers are staggering. Black Americans are 42% more likely than white Americans to be living with asthma 21. Puerto Ricans have the highest rates of asthma when compared to any other racial or ethnic group in the country. American Indian and Alaskan Native children are 50% more likely to have asthma than other groups 20. The body of research only continues to grow

Addressing the Structural and societal inequalities That have created these problems takes time and persistence—and while that work is being done, people with asthma still need to find a way to move through a world that already makes it difficult to breathe

Managing Asthma In a Polluted World

“As easy as breathing” takes on a different meaning when you have asthma in a world with unclean air. Even in the best of circumstances, managing asthma can feel like a constant guessing game. The situation becomes more alarming when you factor in the social and structural barriers that people of color with asthma face. Apart from putting these communities at higher risks for asthma, it can also prevent them from receiving care for their condition

One of the most important components of asthma management is regular appointments with a primary care provider. However, that requires Having A primary care provider. The legacy of discrimination in the medical field is well known, and this long history of mistrust between the Black community and medical professionals has created many racial disparities in healthcare, including asthma care 22.

Black Americans, for example, are more likely to rely on the emergency room (ER) for medical treatment, rather than a primary care provider 23. While data on how other racial groups view medical providers needs further research, it isn’t hard to see how other people of color may be repeatedly discouraged by similar mistrust of doctors.   

Closing these gaps, and many others like them, is central to taking the disproportionate effects of asthma off of communities of color. This work takes many forms, from making changes that dismantle Systemic racism In the medical community to smaller-scale projects, like replacing Gas stoves In the homes of kids with asthma. That’s work The Children’s Hospital of Philadelphia (CHOP) is undertaking with its CAPP+ Home Repairs Program. You can read more about their work ahead.  

For those of us with asthma, it takes a combination of changes both big and small to manage our condition. That’s on a good day when it’s not aggravated by the air around us. While it may seem bold to claim that cleaning the air improves asthma outcomes, the link is well established. Environmental improvements and health outcomes go hand in hand. Asthma is just the start