Health Care Reform and Asthma Care Disparities in Minority Populations

Abstract

Asthma affects almost 23 million people in the United States and ranks as a leading cause of health disparities among minority and low socioeconomic groups, with the largest impact on minority children. This article will examine how fragmented health care in the United States contributes to asthma care disparities in minority populations and will discuss how health care reform may help overcome these disparities. Causes of asthma care disparities are marked by the socioeconomic relationship of the disease including, but not limited to, underprescribing and underuse of preventative medication, low primary care follow-up after acute exacerbations, and the limited availability of pharmacy resources in urban communities. Furthermore, the importance of health care coverage cannot be overemphasized. With the recent passage of the Patient Protection and Affordable Care Act, health care reform offers significant opportunities to reduce or eliminate disparities in minorities. For health care reform to succeed, it must address the specific needs of minorities and support the development of a wide range of community-based interventions and programs with an emphasis on prevention, primary care, chronic care management, and care coordination. In addition, policies that promote cultural competence and improve access and continuity of care are needed, as they serve as predictors of higher-quality asthma care in minorities. Current asthma initiatives targeting minorities need better coordination and increased funding. Solutions to improve adherence to evidence-based clinical practice guidelines may be a potentially powerful tool for reducing or eliminating disparities in asthma care. For asthma care interventions and policies to be effective in targeting asthma care disparities, they must be implemented in a variety of health care settings.