Stemming the global rise in asthma requires not only clinical expertise, but also advocacy work, multidisciplinary cooperation, and creative strategies.
What could you accomplish with 15 million extra years? A new study1 developed for the Global Initiative for Asthma (GINA) states that about 15 million disability-adjusted life years (that is, healthy years) are lost annually to asthma worldwide. At least 300 million people suffer from asthma, and the number who are children is growing steadily. Air pollution, tobacco smoke, and occupational exposures are barriers to reducing asthma. So are poverty and poor education. Asthma is disproportionately high among African American and Hispanic/Latino communities, and it is higher in urban settings, especially inner cities.
Among the studys most salient features is a graph detailing the prevalence of asthma in areas worldwide: the line curves steadily higher as it moves into more developed countries. Asthma is barely a tickle in Nepal, Albania, and Macau; in Argentina, Saudi Arabia, Hong Kong, and Sweden, it swells considerably; by the time it reaches the Americas and, especially, the United Kingdom, it soars. On a global scale, richer, it would appear, is not necessarily betterat least, not from the lungs point of view.
On a local scale, poor does not fare well, either. Other studies echo GINAs findings. A recent study2 of homeless children in New York finds that about half of them in the citys shelter system have asthma, and 90% are not taking the medicine needed to control it. A new report3 out of Harvard Medical School finds that poor and minority inner-city children are experiencing an epidemic of asthma, due to global warming and air pollution.
How can these statistics be confounded? What can RTsas individuals and as members of a strong and passionate communitydo to address the sociological complexities of the growing problem of asthma?
In Boston, staff in a hospitals pediatrics department had done what they could clinically to help an asthma-plagued boy living in an apartment with leaky pipes and mite-infested carpeting. Frustrated by the landlords deaf ear to requests from both a nurse and the boys mother, the departments chair turned to his facilitys attorneys for help. Within weeks, the carpets and pipes were replaced. The boys doctor visits went down and his school attendance went up.4
Treating asthma involves more than clinical expertise; political savvy, cooperative efforts among integrated disciplines, and creative tactics are also necessary tools in fighting this growing burden on the health of patients.
1. Global burden of asthma, Global Initiative for Asthma. Available at: www.ginasthma.com.
2. Pérez-Peña R. Children in shelters hit hard by asthma. New York Times. March 2, 2004;sect A:1.
3. Epstein PR, Rogers C. Inside the Greenhouse. Boston: Center for Health and the Global Environment, Harvard Medical School; 2004.
4. Shipler DK. Total poverty awareness. New York Times. February 21, 2004:15.CADWELL