American Lung Association Examines Ongoing Disparities Driven by Socioeconomic and Genetic Factors

Diverse Communities throughout the United States continue to be disproportionately affected by specific lung diseases such as asthma, tuberculosis, lung cancer and chronic obstructive pulmonary disease (COPD), and/or have more risk factors such as genetic predisposition, poor living conditions, and unequal access to healthcare and medications, according to the American Lung Association State of Lung Disease in Diverse Communities 2007 report.

“One alarming trend we see reflected in our research is that diverse communities are especially vulnerable to asthma and other breathing problems linked to both indoor and outdoor air pollution because many of these diverse groups often reside in high pollution areas,” said Dr. Norman Edelman, Chief Medical Officer for the American Lung Association. “It’s just one example of the magnitude of lung disease within diverse communities all across America and increasing understanding of the complex risk factors that cause or contribute to lung disease.”

Over the past 20 years, the air quality levels for pollutants have improved in the United States. However, about 141 million tons of air pollution were released into the air in 2005 and approximately 122 million people in the United States lived in counties that did not meet standards set by the U.S. Environmental Protection Agency (EPA). African Americans are disproportionately exposed to hazardous air pollution. One study found that in 2002, 71 percent of African Americans lived in counties that violated federal air pollution standards, compared to 58 percent of the White population. Another reported found that in 2004 more than 19 million (50%) of Hispanics lived in areas that violated the federal air pollution standard for ozone, one of the major triggers of asthma attacks.

Asthma statistics present a striking example of disparity. While it is prevalent among all populations, Puerto Ricans living in the U.S. and inner-city African Americans have the highest prevalence of asthma. Occupational asthma is the most prevalent occupational lung disease in the U.S., and Hispanics are more likely to be employed in high-risk occupations than any other racial or ethnic group, setting the stage for those Hispanic individuals to be overexposed to respiratory hazards.

“This publication serves as a call to action to legislators and community leaders to fight for stricter air pollution standards,” says Dr. Hugo Alvarez, Deputy Medical Officer and UM/QI Associate Medical Director for Access Community Health Network . “The disparities in lung health continue to drive the American Lung Association’s ongoing work to educate these communities about lung disease, invest in research and advocate for increased access to quality health care for all.”

The American Lung Association State of Lung Disease in Diverse Communities 2007, which presents analyses of data from various surveys and reports across many ethnic and racial groups, illustrates African Americans’ particular vulnerability to lung cancer, COPD, sleep disorders, tuberculosis (TB) and HIV/AIDS. While the spikes in some disease rates may be linked to cigarette smoking and occupational exposures, other findings shed light on genetic and socioeconomic factors. African Americans are less likely to develop or die from COPD, yet they have more emergency room visits and similar disease severity compared to whites who have smoked cigarettes over a longer period of time and are heavier smokers.

“The American Lung Association prides itself on being the most powerful enemy of lung disease that we can be, particularly for vulnerable individuals,” says Dr. Leroy Graham, Partner with the Georgia Pediatric Pulmonology Associates. “Part of that fight involves taking a hard look at who is most affected by lung diseases, and creating stronger connections with diverse populations so that our education, advocacy and research are as effective as possible.”