Is racial discrimination associated with asthma?

The findings were published in the journal PLoS One.

The research team examined the association between self-reported racial/ethnic discrimination and bronchodilator response among 576 African American youth with asthma ages 8 to 21 years and whether this association varies with tumor necrosis factor alpha level.

Self-reported racial/ethnic discrimination was assessed by a modified “experiences of discrimination” questionnaire as none or any. Using spirometry, bronchodilator response was specified as the mean percentage change in forced expiratory volume in one second before and after albuterol administration. Tumor necrosis factor alpha was specified as high/low levels based on the study population mean. The team used linear regression to examine the association between self-reported racial/ethnic discrimination and bronchodilator response adjusted for selected characteristics.

Almost half of participants (48.8 percent) reported racial/ethnic discrimination. The mean percent bronchodilator response was higher among participants reporting racial/ethnic discrimination than among those who did not. After adjustment, participants reporting racial/ethnic discrimination had a 1.7 times higher bronchodilator response mean than those not reporting racial/ethnic discrimination. Among individuals with tumor necrosis factor alpha high level only, we observed a 2.78 higher bronchodilator response mean among those reporting racial/ethnic discrimination compared with those not reporting racial/ethnic discrimination.

The research team found bronchodilator response to be increased in participants reporting racial/ethnic discrimination and this association was limited to African American youth with tumor necrosis factor alpha high asthma, an endotype thought to be resistant to traditional asthma medications. They concluded that the results support screening for racial/ethnic discrimination in those with asthma as it may reclassify disease pathogenesis.

On why feeling discriminated against matters when it comes to asthma diagnosis, Dr. Borrell explains, “Racial/ethnic discrimination is a common and everyday life experience for many Americans. This research’s findings underscore how racial/ethnic discrimination or racism gets under our skin by changing our body response to medications starting at an early age. We as individuals must work to change the actual rhetoric and behaviors toward groups of our society and be more tolerant to one and another by embracing our similarities and differences.”

Carlson S, Borrell LN, Eng C, Nguyen M, Thyne S, LeNoir MA, et al. (2017) Self-reported racial/ethnic discrimination and bronchodilator response in African American youth with asthma. PLoS ONE 12(6): e0179091. https://doi.org/10.1371/journal.pone.0179091