Atopy and Asthma - Diagnosis and management of the Allergic Asthmatic child

Learning Objectives:

After completing the session, the learner will be able to:

  • Identify that asthma is a chronic inflammatory disease with a complex interplay of genetics, atopy, and environmental exposure.
  • Recognize that African-American  children have a high prevalence of asthma and allergy.
  • Recognize in-vivo and in-vitro diagnostic methods of detecting allergens that identify specific IgE antibodies.
  • Discuss that allergen identification is a key step in effective  environmental control and allergen avoidance

Needs Assessment:

Over 33,000,000 Americans have asthma.  The number of people diagnosed with asthma has increased all over the world but the problem among African Americans has reached epidemic proportions, in spite of significant advancement in the treatment of the disease.  Asthma affects African Americans disproportionately.  Health disparities also exist among persons with asthma, resulting in higher morbidity and mortality rates among minority groups.

According to the 2011Centers for Disease Control and Prevention (CDC) Health Disparities and Inequities Report, racial and ethnic minority groups are poorer  and have greater health needs than non-minorities.5 Higher asthma prevalence among racial and ethnic minority groups caused substantial  personal and economic burden and increased demands on health care systems.11

Asthma affects 7.1 million U.S. children and is the main reason children use urgent care services for a chronic disease1. In 2009, 1 in 5 children with asthma sought care in an emergency department. Asthma prevalence among children and adolescents is estimated to be 9.6% overall, and is highest among non-Hispanic black children (17.0%) Hispanic/Latino and non-Hispanic black children have greater asthma-related risk exposures than non-Hispanic Whites, and are at higher risk for emergency department visits, hospitalizations, and death from asthma. They exhibit lower adherence to medication and only about one-third report using long-term control medicine or receiving asthma care plans from their clinicians Poor outcomes are especially striking among African American children, who have a 260% higher ED visit rate, a 250% higher hospitalization rate, and a 500% higher death rate from asthma than their White counterparts.

Because the risk, severity, and control of asthma are influenced by a combination of genetic, social, and environmental factors, reducing the impact of the condition has proven difficult. However, enhancing clinical care in populations with marked disparities is regarded as a priority effort for the NMA. Asthma is most often managed in the primary care setting and 80% of those affected never visit an asthma specialist given the high prevalence of asthma in children and the associated frequency of visits to primary care practitioners, these health providers are the asthma patients’ primary source of care and education. Thus improving clinical care in these providers offers the potential to reduce the burden of asthma in this underserved population.

Supported in part by educational grant from:

Quest Diagnostics

Program Participant Disclosures:

The following participants declare that they, or their spouses/partners, do not have any relevant financial relationship in any amount with a commercial interest to disclose:

Rosalyn Baker, M.D., MHS
Kelvin Holloway, M.D., MBA
Chanda Nicole Holsey, DrPH, MPH
Anne M. Staveren, M.D.
Thomas A. Scott, M.D.
Cherie Y. Zachary, M.D.
Melody Carter, M.D.


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