Black Americans, culturally competent care, and adult asthma

Asthma is a chronic respiratory condition that makes it more difficult for a person to breathe. Asthma affects the airways inside the lungs, a series of branching tubes that air travels through as a person inhales and exhales. When a person has asthma, inflammation causes the airways to swell, become narrow, and produce more mucus. This affects how air moves in and out of the lungs. Common symptoms include coughing, wheezing, and shortness of breath.

Asthma affects people of all ages. While asthma is one of the most common chronic health conditions in childhood, many people are diagnosed in adulthood. “Adult asthma” refers to asthma that is diagnosed after the age of 20.

The severity of asthma can vary significantly from person to person. For some, asthma is a mild condition that can be managed with minimal treatment. For others, asthma can be severe, with exacerbations (asthma attacks) that are potentially life-threatening.

How are Black Americans impacted by asthma?

Black Americans are disproportionately impacted by asthma. Data published by the U.S. Department of Health and Human Services Office of Minority Health (OMH) compared asthma among Black American populations and non-Hispanic white populations.

According to the OMH, Black American adults and children are more likely to:

• Have asthma
• Visit an emergency room for asthma-related reasons
• Be hospitalized for asthma
• Die from asthma-related causes

Inequalities in social determinants of health are significant contributing factors in these disparities. The social determinants of health are "the conditions in which people are born, grow, live, work, and age." Environmental factors that increase disease risk, access to healthcare within a community, and a person’s financial and social resources are all examples of social determinants of health.

How is asthma treated?

There is no cure for asthma and the goals of treatment are to control symptoms, prevent asthma attacks, and reduce the risk of complications.

As mentioned above, how these goals are achieved will vary from person to person. The severity of symptoms and how asthma responds to a medication are important factors to consider. The out-of-pocket cost of a medication, insurance coverage, and concerns about medications are also factors that need to be considered. A treatment will only work as intended if a person is able to take it as intended.

For these reasons—and many others—it helps to have a good working relationship with your healthcare provider. Cultural competence can be an important part of that relationship.

What is culturally competent care?

In healthcare, cultural competence is the ability to acknowledge how factors like race, ethnicity, cultural background, language, and location can shape an individual’s health and their experiences with healthcare providers. By acknowledging these factors, a healthcare provider can better understand an individual’s needs—and deliver care that meets those needs.

As a person seeking care for a health condition, cultural competence may mean working with a healthcare provider that has a similar cultural background to your own, or a healthcare provider that has treated other members of your community.

Signs of culturally competent care in a healthcare setting:

• Feeling respected by a healthcare provider and other staff members.
• Being comfortable asking questions and bringing up concerns during an appointment.
• Feeling that your questions and concerns are taken seriously and addressed by your healthcare provider.
• Feeling that you can be honest with your healthcare provider.
• Being able to communicate in a language you feel comfortable and confident speaking.
• Leaving an appointment with a good understanding of what you and your healthcare provider discussed and the next steps you need to take.