Asthma: A Health Disparity Asthma: in Hispanics as Compared to the General Population of Massachusetts

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1 Asthma: A Health Disparity Asthma: in Hispanics as Compared to the General Population of Massachusetts Alissa Souza, Amanda Lima and Victoria Ramos A Health Disparity in Hispanics as Compared to the General Population of Massachusetts Alissa Souza, Amanda Lima, & Victoria Ramos 1

2 What is Asthma? 2 Definition: a respiratory disorder that causes the lungs to swell, narrow, and produce mucus. Triggered by: Hazardous Substances Secondhand Smoke Pets and Bugs Molds No cure Dust Mites Can be controlled with treatment

3 What is a Health Disparity? 3 Definition: differences between a specific group and the general population in terms of: Incidence Prevalence Mortality of a disease.

Evidence of Disparity 4 17.3% of Hispanic adults and 17% of Hispanic children in Massachusetts report having lifetime asthma, while 14.6% of White adults and 13.

4 Evidence of Disparity % of Hispanic adults and 17% of Hispanic children in Massachusetts report having lifetime asthma, while 14.6% of White adults and 13.4% of White children in Massachusetts report having lifetime asthma. Hispanics have 2.9 times more visits to emergency departments when compared to Whites. The average death rate due to asthma among Hispanics, was 2.7 times the rate among White, non-hispanics. Massachusetts Department of Public Health 2009,

5 Prevalence 5 Hispanics make up 10% of the Massachusetts Population Hispanic 10% Hispanics make up 13% of the Asthma Population Hispanic 13% Non-Hispanic 90% Non-Hispanic 87% State Health Facts 2012

6 Emergency Visits Emergency Department Visits By Ethnicity ED Discharges per 10,000 Residents Year Hispanic White Non-Hispanic Massachusetts Department of Public Health 2009, 83

7 7 Hospitalization Observation Stays per 10,000 Residents Rates of Observation Stays due to Asthma Year Hispanics White Non-Hispanics Massachusetts Department of Public Health 2009, 92

Mortality 8 Death Rate per 1,000,000 Residents 25 20 15 10 5 0 Death Rate Due to Asthma

8 Mortality 8 Death Rate per 1,000,000 Residents Death Rate Due to Asthma White- Non Hispanic Hispanic Race/ Ethnicity Massachusetts Department of Public Health 2009, 116

9 American Journal of Public Health 2010 What is the difference and how did it develop? 9 Determinants: Lifestyle Education Socioeconomic Status

10 45.7% Smoking Secondhand smoke contains at least 250 chemicals known to be toxic. 19.2% 35.3% Secondhand 18.

10 % Smoking Secondhand smoke contains at least 250 chemicals known to be toxic. 19.2% 35.3% Secondhand 18.5% smoke contains at least 250 chemicals known to be toxic. A Profile of Health Among Massachusetts Adults, 2013 Behavioral Risk Factor Surveillance System 2011

8% of Hispanics completed high school. 90.1% of Whites completed high school.

11 Education 11 Total Graduation Rate: 85.0% Prevalence of Asthma Based on Education 66.8% of Hispanics completed high school. 90.1% of Whites completed high school. 4 Year Graduation Rate Report, 2013 Massachusetts Department of ESE A Profile of Health Among Massachusetts Adults, 2013 Behavioral Risk Factor Surveillance System 2011

12 Merrimack Valley Demographics 2008 Data from Status Socioeconomic Hingham Andover $ Medfield Andover $ Chelsea Lawrence $ Somerville Lawrence $ Holyoke Lawrence $ Massachusetts Department of Public Health.

The Merrimack Valley Study 13 Identified locations and emissions from several factories in the Merrimack Valley Identified population demographics and

13 The Merrimack Valley Study 13 Identified locations and emissions from several factories in the Merrimack Valley Identified population demographics and prevalence of asthma Tested to determine if higher incidence of asthma was due to poor air quality or social factors Massachusetts Department of Public Health 2008

14 Environmental Influence on Asthma: Lawrence, MA 14 Race Lawrence : Asthma Count Total Students Prevalence (%) Race Comparison Community: Asthma Count Total Students Prevalence (%) Hispanic White Hispanic White High Pollution Area Massachusetts Department of Public Health 2008 Low Pollution Area

The asthma rate in Holyoke is twice the state average and my wife suffers from terrible asthma herself, said Carlos Rodriguez a

15 Mt. Tom Coal Operations Closing 15 June 2,2014: The company decided to shut down its factory in Holyoke, MA due to economical reasons. Action for a Healthy Holyoke! The asthma rate in Holyoke is twice the state average and my wife suffers from terrible asthma herself, said Carlos Rodriguez a community leader in Action for a Healthy Holyoke, so, while we are very glad to know our air will be cleaner, responsible retirement also means working with our community and the workers for clean up and transition. Holyoke, MA Profile 2013 MDPH 2014

16 How do the air conditions around Logan Airport affect the Hispanic population more significantly than the general population? 16 Who lives within the zip code of Logan Airport: Zip code: Massachusetts Department of Public Health 2014 Boston, Massachusetts Profile 2013

The Logan Airport Study 17 In the Logan Airport area, the effects of air pollution on the development of asthma had the most significant impact on children.

17 The Logan Airport Study 17 In the Logan Airport area, the effects of air pollution on the development of asthma had the most significant impact on children. COPD, a disease similar to chronic asthma, was also demonstrated to be impacted by the effects of air pollution. AirInc., a local organization, is tasked with creating a health initiative to begin controlling the emissions of the airport and reviewing the air quality of the area. Massachusetts Department of Public Health 2014

18 Decreasing the Gap 18 Reduce exposure to asthma triggers Community based education Cultural Competence Centers for Disease Control and Prevention Affordable Care Act

19 Questions 19 Are there any questions?

20 References 20 Air Pollution and Pediatric Asthma in the Merrimack Valley, Bureau of Environmental Health, Environmental Epidemiology Program, Massachusetts Department of Public Health. Asthma and Your Environment Brochure Massachusetts Department of Public Health, Bureau of Environmental Health. Aud, S., Fox, M., and Kewal Ramani, A. Status and Trends in the Education of Racial and Ethnic Groups U.S. Department of Education, National Center for Education Statistics. Washington, DC: U.S. Government Printing Office. City-data.com. "02128 Zip Code Detailed Profile." Zip Code (Boston, Massachusetts) Profile. Onboard Informatics, Web. 16 June City Data.com. "01040 Zip Code Detailed Profile." Zip Code (Holyoke, Massachusetts) Profile. Onboard Informatics, Web. 12 June 2014 Frieden, T. A Framework for Public Health Action: The Health Impact Pyramid American Journal of Public Health. Graduation Rate Report (DISTRICT) for All Students 4-Year Graduation Rate Massachusetts Department of Elementary and Secondary Education. Huisingh, Carrie. Burden of Asthma in Massachusetts Massachusetts Department of Public Health, Asthma Prevention and Control Program. Keitz, Anders and Joel Martinez. Mt. Tom Will Discontinue Coal Operations WWLP 22 News. Krueger, Elaine and Brian Dumser. Logan Airport Health Study Massachusetts Department of Public Health, Bureau of Environmental Health. Lynds, John.. "Study shows Logan Airport Impacts Health of Residents." East Boston Times. Print. McKenna, Maria, Gonsalves, Diane, Backus, Bertina and Helen Hawk. A Profile of Health Among Massachusetts Adults Massachusetts Behavioral Risk Factor Surveillance System. Secondhand Smoke: Massachusetts Fact Sheet Massachusetts Department of Public Health, Tobacco Control Program. Web. 6 June U. S. Census Bureau Population Distribution by Race/Ethnicity: United States. State Health Facts. Who Smokes: Massachusetts Fact Sheet Massachusetts Behavioral Risk Factor Surveillance System. Web. 6 June Zotter, Jean and Carrie Huisingh. Strategic Plan for Asthma in Massachusetts Massachusetts Department of Public Health and the

Massachusetts Healthy Aging Initiative

Massachusetts Healthy Aging Initiative Joining Forces to Build Healthier Communities Anita Albright, Director Office of Healthy Aging Massachusetts Department of Public Health Chronic Disease in MA While