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. 2020 Nov-Dec;8(10):3371-3377.e1.
doi: 10.1016/j.jaip.2020.09.015. Epub 2020 Sep 24.

Asthma Disparities During the COVID-19 Pandemic: A Survey of Patients and Physicians

Alan P Baptist  1 , Desmond Lowe  2 , Nadeen Sarsour  2 , Hannah Jaffee  3 , Sanaz Eftekhari  3 , Laurie M Carpenter  4 , Priya Bansal  5
Affiliations

Asthma Disparities During the COVID-19 Pandemic: A Survey of Patients and Physicians

Alan P Baptist et al. J Allergy Clin Immunol Pract. 2020 Nov-Dec.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has demonstrated significantly worse outcomes for minority (black and Hispanic) individuals. Understanding the reasons for COVID-19-related disparities among patients with asthma has important public health implications.

Objective: To determine factors contributing to health disparities in those with asthma during the COVID-19 pandemic.

Methods: An anonymous survey was sent through social media to adult patients with asthma, and a separate survey was sent to physicians who provide asthma care. The patient survey addressed demographic information including socioeconomic status, asthma control, and attitudes/health behaviors during COVID-19.

Results: A total of 1171 patients (10.1% minority individuals) and 225 physicians completed the survey. Minority patients were more likely to have been affected by COVID-19 (eg, became unemployed, lived in a community with high COVID-19 cases). They had worse asthma control (increased emergency visits for asthma, lower Asthma Control Test score), were more likely to live in urban areas, and had a lower household income. Initial differences in attitudes and health behaviors disappeared after controlling for baseline demographic features. Institutional racism was demonstrated by findings that minority individuals were less likely to have a primary care physician, had more trouble affording asthma medications due to COVID-19, and were more likely to have lost health insurance because of COVID-19, and that 25% of physicians found it more challenging to care for black individuals with asthma during COVID-19.

Conclusions: Differences in socioeconomic status and the effects of institutional racism, but not health behaviors, sources of information, or attitudes, are playing a role in disparities seen for patients with asthma during COVID-19.

Keywords: Asthma; Attitudes; COVID-19; Health disparities; Implicit bias; Institutional racism; Structural racism; Survey.

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Figures

Figure 1
Figure 1
Asthma patient's source for information about COVID-19. Each patient could select up to 3 sources. PCP, Primary care physician.
Figure 2
Figure 2
Percent of patients with asthma who agree with each statement regarding COVID-19. ER, Emergency room; hosp, hospital; meds, medicines. ∗P ≤ .05.
Figure 3
Figure 3
Percent of physicians who agree with each of the following statements regarding the care of patients with asthma during COVID-19. Meds, Medicines.
See this image and copyright information in PMC

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