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July 2016

The “Black Box” of Racial Disparities in Asthma

Author Affiliations
  • 1Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
JAMA Pediatr. 2016;170(7):644-645. doi:10.1001/jamapediatrics.2016.0564

In the United States, racial disparities in asthma have been well documented. African American children have higher rates of asthma and disproportionately worse asthma outcomes than white children including higher rates of hospitalizations and deaths.1 The causes of these disparities are multifactorial. It has been documented that African American children have an increased exposure to residential allergens and pollution,2 overuse of rescue medications, and underuse of long-term asthma controller medications owing to clinician underprescribing, failure to fill prescriptions, or poor adherence.2 They also have higher risk owing to socioeconomic and neighborhood factors such as violence and stress that accumulate over the life course.3

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