1. Rodney Bruno and Iva Hoxha Summer Enrichment Program 2016
Asthma Among African Americans Compared to the General Population of MA
Rodney Bruno and Iva Hoxha Summer Enrichment Program 2016

2. What is Asthma?
Chronic inflammatory lung disorder that narrows the airway
Symptoms:
Wheezing
Chest tightness
Shortness of breath
Coughing
Asthma attack:
Inflammation and Swelling
Increased mucus
Muscle tightening
During an asthma attack, the tubes in the lungs that move air become irritated and close down, making it very hard to get oxygen in and out. If you want to know what it feels like, try breathing through a medium-sized straw – not so bad? Now try climbing a few stairs or walking a short distance – it quickly can become quite difficult and scary to not be able to take bigger breaths as your body asks for more air.  

3. Definition of Disparity
Disparity: difference in the incidence, prevalence, mortality, and burden of disease and other adverse health conditions that exist among specific population groups compared in contrast to a general population
Census

4. Disparity Development
Socioeconomic
Environmental
Genetic
Lifestyle

5. Current News Story: Brockton Back to School
Six year old Grace Twomey
“I worry about her falling behind because she misses so much school – because when she gets sick, she really get sick” Alden (her mother)
Asthma rates are usually higher in lower socioeconomic demographics,” said Lance Lazatin, a doctor in the pediatric unit at Brockton Hospital. “I think the reason is they don’t have the resources to have the education about asthma prevention and asthma management.”
“I’m hoping that this year will be different from last year and the year before,” Alden said.

6. Poverty and Education Level

7. Income

8. List of Medications and Heath Insurance

9. Asthma Population Breakdown

10. Violence and Stress
Stress was significantly correlated with poorer asthma control
Decreased adherence with prescribed medications at baseline and after one year of follow-up
Showed that maternal irritation/anger or emotional suppression was associated with greater asthma severity
Citation for Chart

11. Current News Story: A Prescription of Clean Air
“I had a child for whom diesel emissions from the buses [parked outside school] was a significant exposure. To walk in and out of school, the kids had to walk through the smog of idling.”
“We want children to play outside to get exercise and fresh air, but couldn’t that also expose them to more pollution?”
“As a pediatrician, I can prescribe many things to help you, but I can’t prescribe the air that you breathe”
- Dr. Megan Sandel

12. Air Quality Allergens Asthma Trigger
Allergic sensitization and the bronchial inflammatory changes
Pollution
Ozone (in cities)
Ozone constitute almost 90 percent of the total oxidants in the environment
Diesel exhaust particles (DEP) can favor allergic sensitization
Air Quality
Citation

13. Hereditary Genetics and Environment Interaction
Genome-wide association studies (GWAS) & Meta-analyses
6 Nobel genes identified: ADAM33, VDR, DPP10, PHF11, HLA-G and GPR154
Variation at the 17q21 asthma locus, encoding the ORMDL3 and GSDML gene
variation at the 17q21 asthma locus, encoding the ORMDL3 and GSDML genes
ADAM33, VDR, DPP10, PHF11, HLA-G, and GPR154

14. Vitamin D Deficiency
Vitamin D (1,25-dihydroxyvitamin D) is attained via 2 sources :
Synthesis in the epidermis after exposure to ultraviolet-B radiation
Dietary intake from foods
The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: An emerging public health problem (2014)
Investigate the role of Vitamin D in childhood asthma, allergic rhinitis, wheezing.
1833 children participated

15. African Americans in MA who are overweight
Diet / Food
72.5%
African Americans in MA who are overweight
Obesity and Asthma
Fast Food Proximity
What is Obesity?
An adult who has a BMI between 25 and 29.9 is considered overweight. An adult who has a BMI of 30 or higher is considered obese.

16. 20.5 % 13.3 % MA Residents without Asthma who Smoke
Smoking
20.5 %
MA Residents with Asthma who Smoke
13.3 %
MA Residents without Asthma who Smoke
Citation 1, Then Census and Chart on side 11

17. Housing and Living Conditions
As of 2007, Housing conditions of people with Asthma

18. Summary Asthma is inflammatory lung disorder that narrows the airway.
African Americans consist of 8.3% of the population, but are 24% of asthma cases in MA
Socioeconomic, Environmental, Hereditary and Lifestyle play a significant role in the disparity

19. Work Cited
Pechter, E., and P. Hunt. "188. Work-Related Asthma in Massachusetts Health Care Workers." AIHce 2006 (2006): n. pag. Web. 17 June Health, Massachusetts Department Of Public, Bureau Of Environmental Health, 250 Washington Street, and Ma Boston. Pediatric Asthma in Massachusetts (n.d.): n. pag. Web. 17 June "Asthma." Health and Human Services. N.p., n.d. Web. 17 June Vo, Anh, and Josue Paula Gonzalez. "The Obesity Epidemic in African Americans in Comparison to Whites in Massachusetts." Lecture. "Income Inequality: Different Summary Inequality Measures, around 2010s." (2014): n. pag. Web. 17 June "Institute for Asian American Studies." Data by Race and Latino Origin in Massachusetts, N.p., n.d. Web. 17 June "Asthma Severity among Adults with Current Asthma." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 17 Feb Web. 17 June "Clinical and Molecular Allergy." Genetics of Asthma: A Molecular Biologist Perspective. N.p., n.d. Web. 17 June "Rural Health Information Hub." Rural Health for Massachusetts Introduction -. N.p., n.d. Web. 17 June Giampaolo, L. Di, E. Cavallucci, M. Braga, A. Renzetti, C. Schiavone, C. Quecchia, C. Petrarca, and M. Di Gioacchino. "The Persistence of Allergen Exposure Favors Pulmonary Function Decline in Workers with Allergic Occupational Asthma." Int Arch Occup Environ Health International Archives of Occupational and Environmental Health 85.2 (2011): Web. Weintraub, Karen. "The Doctor Prescribes Clean Air." Boston Globe. N.p., 16 Jan Web. 16 June Yonas, Michael A., Nancy E. Lange, and Juan C. Celedón. "Psychosocial Stress and Asthma Morbidity." Current Opinion in Allergy and Clinical Immunology 12.2 (2012): Web. "Community Commons." Community Commons. N.p., n.d. Web. 17 June "Ethnic Disparities Exist in Asthma Medication Prescribing Even for Children Seen in Private Practices." PsycEXTRA Dataset (n.d.): n. pag. Web. 17 June "Massachusetts School and District Profiles." Enrollment Data ( ). N.p., n.d. Web. 17 June Ober, Carole, and Tsung-Chieh Yao. "The Genetics of Asthma and Allergic Disease: A 21st Century Perspective." Immunological Reviews. U.S. National Library of Medicine, July Web. 17 June Littlefield, Amy. The Enterprise. Asthma Complicates Back-to-school for Many Brockton-area Kids, n.d. Web. 17 June Forno, Erick, and Juan Celedón. "Health Disparities in Asthma." (ATS Journals). N.p., n.d. Web. 17 June "Asthma." Asthma. Learn Genetics, n.d. Web. 17 June 2016.

20. Questions