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Speaking the language of asthma

Yale Medicine Magazine, 1999 - Winter


Asthma is the most frequent cause of hospital admission for children in the U.S. The damage of all sorts done to the children who suffer from asthma is great, including the health effects, social isolation and school days missed. The cost of caring for them mounts well into the billions of dollars annually. However, minorities require hospitalization for asthma and die from the disease at much higher rates than whites. The differences between the two groups are significant in Connecticut. Asthma rates are generally comparable between whites and non-whites in Connecticut, yet non-whites, who form 13 percent of the state’s population, account for 48 percent of hospital admissions for asthma. Moreover, non-white Hispanics, who make up only 6 percent of Connecticut’s population, compose close to a quarter of all hospital admissions for asthma in the state.

Differences in environmental exposures to allergens or population genetics cannot completely account for these heavily skewed rates. Studies show that cultural barriers to proper understanding and treatment of asthma may underlie the higher rates. Developing an integrated approach that will allow physicians to address all of these issues represents a complex challenge for Yale’s Pediatric Asthma Program. In addition to providing educational tools and activities for both primary care providers and families with asthma, last fall the program established the Pediatric Asthma Clinic to reach out to minority populations in the New Haven region.

The clinic combines the expertise of pediatric pulmonologists and allergists, and it is geared toward providing children with asthma and their families with comprehensive care without the need for several clinic visits. As part of the clinic’s work, Spanish-speaking health care providers teach non-English-speaking Hispanic patients how to avoid asthma triggers and how to use medications properly to prevent attacks. Program director Jose Calderon, M.D., assistant professor of pediatrics, who is originally from Colombia, believes that such “culturally and linguistically attuned” clinics and outreach programs could decrease the number of emergency room visits and hospital admissions in the targeted populations by as much as 70 percent. Says Dr. Calderon: “We want to educate, to speak their language, understand their concerns and establish a partnership.”

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