In what way may race, ethnicity or culture influence asthma outcomes?

In a civilised society it is important that all those in need of health care should have equal access to it and benefit equally from that which is available. There have been some suggestions that asthma outcomes in the UK for those of South Asian origin may be less good than for the rest of the population. This is a subject confounded by generalisations and by statements which are often based on minimal evidence. Caution is needed in comparing local and national studies and studies done many years apart.

There are two key questions regarding asthma and ethnic minority groups, especially Asians. (1) Does the prevalence of asthma vary between ethnic minorities such as South Asians living in the UK? (2) Are the outcomes for asthma care worse for these groups and, if so, why and how do we improve the situation?

The first question is not the main purpose of this editorial but in the USA physician diagnosed asthma has been reported to affect 13.4% of black children and 9.7% of white children.1Black children with asthma have also been reported to have significantly greater restrictions of activity, fewer contacts with doctors, and to be admitted to hospital more frequently than white children with asthma.2 In parallel with this increased suffering among African American children is an increased adult mortality due to asthma, and the death rate has been reported to be rising more quickly in African Americans than white Americans.3

African Americans constitute approximately 12% of the US population. In the UK ethnic minority groups represent 6.4% of the population and the single largest subgroups are those who came originally from India, Pakistan, and Bangladesh (either directly or via Africa) who represent 3.0% of the total population. (These are subsequently referred to collectively as South …