Health Care Disparities in Pulmonary Arterial Hypertension
The current approach for the management of pulmonary arterial hypertension (PAH) relies on data gathered from clinical trials and large registries. However, there is concern that minorities including Black, Indigenous, and People of Color are underrepresented in these trials and registries, making current data not generalizable to these groups of patients. Hence, it is important to discuss the significance of race/ethnicity and socioeconomic factors in patients with PAH. Here, we review the current knowledge on health care disparities in PAH. We also propose future steps in the global task of assuring justice and equality ...
Source: Clinics in Chest Medicine - May 23, 2023 Category: Respiratory Medicine Authors: Roberto J. Bernardo, Vinicio A. de Jesus Perez Source Type: research
Race, Racism, and Respiratory Health
The study and practice of pulmonary medicine have been profoundly influenced by race theory, which was ascendant at the time of key developments within the specialty. We explore how, as a social determinant of health, race remains a powerful driver of present-day health disparities in respiratory diseases. Both legacy and contemporary inequities are identified through Dr DR Williams ’s model of cultural, structural, and interpersonal racism. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 9, 2023 Category: Respiratory Medicine Authors: Aaron Baugh, Neeta Thakur Source Type: research
Climate Change, Air Quality, and Pulmonary Health Disparities
Climate change will alter environmental risks that influence pulmonary health, including heat, air pollution, and pollen. These exposures disproportionately burden populations already at risk of ill health, including those at vulnerable life stages, with low socioeconomic status, and systematically targeted by oppressive policies. Climate change can exacerbate existing environmental injustices by affecting future exposure, as well as through differentials in the ability to adapt; this is compounded by disparities in rates of underlying disease and access to health care. Climate change is therefore a dire threat not only to...
Source: Clinics in Chest Medicine - May 9, 2023 Category: Respiratory Medicine Authors: Natalia Smirnova, Adam C. Shaver, Ashish J. Mehta, Rebecca Philipsborn, Noah Scovronick Source Type: research
Rurality as a Risk Factor for Pulmonary Health Disparities
This article describes social determinants of pulmonary health relevant in rural communities, describes examples of existing pulmonary disparities in rural populations, and highlights health policies with potential to mitigate disparities. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 9, 2023 Category: Respiratory Medicine Authors: Claire Leilani Davis, John J. Popovich, J. Christian Widere, Katharine Hsu Wibberly, Drew Harris Source Type: research
Asthma and Chronic Obstructive Pulmonary Disease
In the United States, asthma and chronic obstructive pulmonary disease (COPD) disproportionately affect African Americans, Puerto Ricans, and other minority groups. Compared with non-Hispanic whites, minorities have been marginalized and more frequently exposed to environmental risk factors such as tobacco smoke and outdoor and indoor pollutants. Such divergent environmental exposures, alone or interacting with heredity, lead to disparities in the prevalence, morbidity, and mortality of asthma and COPD, which are worsened by lack of access to health care. In this article, we review the burden and risk factors for racial or...
Source: Clinics in Chest Medicine - May 9, 2023 Category: Respiratory Medicine Authors: Erick Forno, Victor E. Ortega, Juan C. Celed ón Source Type: research
Disparities Across the Continuum of Lung Cancer Care
Despite the overall decline in lung cancer incidence and mortality, minority populations continue to bear a higher disease burden. Lung cancer remains the leading cause of cancer-related death in the United States and disproportionately impacts minority populations. Social determinants of health —including low-socioeconomic status, lack of health insurance, and access to health care— disproportionately impact racial, ethnic, and rural populations resulting in direct consequences on lung cancer disparities. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 9, 2023 Category: Respiratory Medicine Authors: M. Patricia Rivera, Abdi T. Gudina, Francisco Cartujano-Barrera, Paula Cupertino Source Type: research
Occupational Contributions to Respiratory Health Disparities
This article focuses on the occupational contribution to disparities in asthma, chronic obstructive pulmonary disease, silicosis, coronavirus disease 2019, and lung cancer. Because occupational exposures are largely preventable through proper workplace controls, the recognition of occupational causes of disease can provide an opportunity for interventions to bring about health equity. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 9, 2023 Category: Respiratory Medicine Authors: Sheiphali A. Gandhi, Amy Heinzerling, Jennifer Flattery, Kristin J. Cummings Source Type: research
Telehealth Services
We describe the benefits and limitations of these new technologies and their impact on improving equity in pulmonary medicine. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 9, 2023 Category: Respiratory Medicine Authors: Claire Leilani Davis, Karen S. Rheuban, Drew Harris Source Type: research
Aiming to Improve Equity in Pulmonary Health: Cystic Fibrosis
This review summarizes the evidence of health disparities in cystic fibrosis (CF), an autosomal recessive genetic disorder with substantial variation in disease progression and outcomes. We review disparities by race, ethnicity, socioeconomic status, geographic location, gender identity, or sexual orientation documented in the literature. We outline the mechanisms that generate and perpetuate such disparities across levels and domains of influence and assess the implications of this evidence. We then recommend strategies for improving equity in CF outcomes, drawing on recommendations for the general population and consider...
Source: Clinics in Chest Medicine - May 8, 2023 Category: Respiratory Medicine Authors: Gabriela R. Oates, Michael S. Schechter Source Type: research
Structural and Social Determinants of Inequitable Environmental Exposures in the United States
American Indian (AI)/Alaskan Natives, African Americans, and Latino Americans have disproportionally high exposure to harmful environmental conditions as a consequence of unjust laws and policies, systemic racism, residential segregation, and discrimination. In this review, we draw connections between historical policies and social movements in the United States ’ history that have been rooted in racism and classism, leading to social isolation and marginalization of AIs, African Americans, and Latino Americans. We then discuss the structural factors that stem from the aforementioned inequities and that contribute to the...
Source: Clinics in Chest Medicine - May 8, 2023 Category: Respiratory Medicine Authors: Courtney Gao, Kimberly M. Sanchez, Stephanie Lovinsky-Desir Source Type: research
Tobacco Use and Tobacco Dependence Management
Tobacco use is a major public health problem and the leading cause of preventable deaths in the United States and worldwide. Tobacco dependence determines tobacco use and is largely due to nicotine addiction. Such dependence is a disease resulting in a strong desire or compulsion to take tobacco, with difficulty in cessation of tobacco, along with persistent use despite overtly harmful consequences. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 8, 2023 Category: Respiratory Medicine Authors: Panagis Galiatsatos, Bekir Kaplan, Dina G. Lansey, Alejandra Ellison-Barnes Source Type: research
Cystic Fibrosis
This review summarizes the evidence of health disparities in cystic fibrosis (CF), an autosomal recessive genetic disorder with substantial variation in disease progression and outcomes. We review disparities by race, ethnicity, socioeconomic status, geographic location, gender identity, or sexual orientation documented in the literature. We outline the mechanisms that generate and perpetuate such disparities across levels and domains of influence and assess the implications of this evidence. We then recommend strategies for improving equity in CF outcomes, drawing on recommendations for the general population and consider...
Source: Clinics in Chest Medicine - May 8, 2023 Category: Respiratory Medicine Authors: Gabriela R. Oates, Michael S. Schechter Source Type: research
Disparities in Sleep-Disordered Breathing: Upstream Risk Factors, Mechanisms, and Implications
Sleep-disordered breathing (SDB) refers to a spectrum of disorders ranging from habitual snoring without frank episodes of obstructed breathing or desaturation during sleep to obstructive sleep apnea, where apneas and hypopneas repetitively occur with resultant intermittent hypoxia, arousal, and sleep disruption. Disparities in SDB reflect its overall high prevalence in children and adults from racially and ethnically minoritized or low socioeconomic status backgrounds coupled with high rates of underdiagnosis and suboptimal treatment. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 8, 2023 Category: Respiratory Medicine Authors: Seyni Gueye-Ndiaye, Ariel A. Williamson, Susan Redline Source Type: research
Aiming to Improve Equity in Lung Health: Sex and Gender
Sex and gender impact risk factors, presentations of, and response to therapy in lung diseases such as chronic obstructive pulmonary disease, asthma, lung cancer, interstitial lung disease, and obstructive sleep apnea. Many physicians lack training in the impact of sex and gender on lung disease, resulting in diagnostic delays. Scales and indices taught in the health care system are largely validated in male populations, thereby limiting their application to females. For transgender and lesbian, gay, bisexual, transgender, and questioning + patients, high rates of bias in health care may limit patients’ willingness to...
Source: Clinics in Chest Medicine - May 8, 2023 Category: Respiratory Medicine Authors: Rachel Wojcik, Alison Morris Source Type: research
Health Equity and Respiratory Diseases in Low- and Middle-Income Countries
Over 80% of the morbidity and mortality related to acute and chronic respiratory diseases occur in low- and middle-income countries (LMICs), a reflection of vast disparities in care for these conditions. Over the next decade, the prevalence of respiratory diseases is expected to increase, as population growth in LMICs exceeds high-income countries (HICs). Pediatric morbidity and mortality from lower respiratory tract infections and asthma occur almost exclusively in LMICs, contributing to a greater loss of quality adjusted life years from these conditions when compared with HICs. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 8, 2023 Category: Respiratory Medicine Authors: Peter Jackson, Stella Zawedde Muyanja, Trishul Siddharthan Source Type: research
