TY - JOUR
T1 - Addressing asthma health disparities
T2 - A multilevel challenge
AU - Canino, Glorisa
AU - McQuaid, Elizabeth L.
AU - Rand, Cynthia S.
N1 - Funding Information:
Supported by National Institutes of Health grant no. 5P60 MD002261-02 funded by the National Center for Minority Health and Health Disparities and 5 U01 HL 072519-05 Canino (PI) and U01 HL 072438 Fritz (PI) from the National Heart, Lung, and Blood Institute.
Funding Information:
(Supported by an educational grant from Merck & Co., Inc.)
PY - 2009/6
Y1 - 2009/6
N2 - Substantial research has documented pervasive disparities in the prevalence, severity, and morbidity of asthma among minority populations compared with non-Latino white subjects. The underlying causes of these disparities are not well understood, and as a result, the leverage points to address them remain unclear. A multilevel framework for integrating research in asthma health disparities is proposed to advance both future research and clinical practice. The components of the proposed model include health care policies and regulations, operation of the health care system, provider/clinician-level factors, social/environmental factors, and individual/family attitudes and behaviors. The body of research suggests that asthma disparities have multiple, complex, and interrelated sources. Disparities occur when individual, environmental, health system, and provider factors interact with one another over time. Given that the causes of asthma disparities are complex and multilevel, clinical strategies to address these disparities must therefore be comparably multilevel and target many aspects of asthma care. Several strategies that could be applied in clinical settings to reduce asthma disparities are described, including the need for routine assessment of the patient's beliefs, financial barriers to disease management, and health literacy and the provision of cultural competence training and communication skills to health care provider groups.
AB - Substantial research has documented pervasive disparities in the prevalence, severity, and morbidity of asthma among minority populations compared with non-Latino white subjects. The underlying causes of these disparities are not well understood, and as a result, the leverage points to address them remain unclear. A multilevel framework for integrating research in asthma health disparities is proposed to advance both future research and clinical practice. The components of the proposed model include health care policies and regulations, operation of the health care system, provider/clinician-level factors, social/environmental factors, and individual/family attitudes and behaviors. The body of research suggests that asthma disparities have multiple, complex, and interrelated sources. Disparities occur when individual, environmental, health system, and provider factors interact with one another over time. Given that the causes of asthma disparities are complex and multilevel, clinical strategies to address these disparities must therefore be comparably multilevel and target many aspects of asthma care. Several strategies that could be applied in clinical settings to reduce asthma disparities are described, including the need for routine assessment of the patient's beliefs, financial barriers to disease management, and health literacy and the provision of cultural competence training and communication skills to health care provider groups.
KW - Asthma disparities
KW - clinical recommendations
KW - multi-level model of asthma disparities
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U2 - 10.1016/j.jaci.2009.02.043
DO - 10.1016/j.jaci.2009.02.043
M3 - Review article
C2 - 19447484
AN - SCOPUS:67649195926
SN - 0091-6749
VL - 123
SP - 1209
EP - 1217
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 6
ER -