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Asthma and eczema can impact lifestyle and participation in daily activities. But little is known about how well people with these conditions understand their medical care.

A recent study found that health literacy was oftentimes a barrier to asthma and eczema care among Black and Hispanic/Latino communities. It revealed that being from a low-income home or family impacted healthcare and social determinants of health.

“Social determinants of health” is a broad term that describes conditions in which people are born, live, learn, work, play and worship. These conditions can affect their health and quality of life.

What is the ‘Impact of Social Determinants on the Burden of Asthma and Eczema’ study?

Allergy & Asthma Network partnered with a group of allergists to examine what people with asthma and/or eczema think about their medical care. They used a 94-question online survey to evaluate their perceptions on…

  • burden of disease and treatment;
  • barriers to adequate care.

The study was conducted in the United States between March 24, 2020 and April 6, 2020. A total of 841 adults (18 or older) with asthma and/or eczema participated in the study.

The research was published in the medical journal Advances in Therapy in January 2022. Allergy & Asthma Network President and CEO Tonya Winders and former Director of Research Mary Hart co-authored the study. They were joined by allergists Don A. Bukstein, MD; Adam Friedman, MD; Erika Gonzalez-Reyes, MD; and Bridgette L. Jones, MD.

What are the key takeaways of the study?

The study examined the burden of asthma and eczema. It also addressed how asthma and eczema impacts patients differently. Social determinants of health can affect a patient’s asthma and eczema.

Also in the survey:

  • Some Black and Hispanic/Latino patients said health literacy was a barrier to getting adequate care. These groups also experienced more emergency department visits and hospitalizations than white patients.
  • Low income was a barrier to care for people with asthma and eczema. People with asthma and from low-income homes had fewer asthma management discussions with their healthcare provider. They were less likely to have an Asthma Action Plan than people with higher income. People with eczema and from low-income homes had under-managed symptoms compared to patients with higher incomes.
  • Black and Hispanic/Latino patients, and people with low income, had more difficulty in filling out healthcare paperwork. They also had more difficulty understanding written materials related to their care.

What are some ways to improve access to healthcare in underserved communities?

More effective and culturally informed resources are needed to help Black and Hispanic/Latino patients better understand asthma and eczema.

Shared Decision-Making can help reduce the disease burden on patients. This is especially important for at-risk and low-income groups. Shared Decision-Making is a way for patients to take a more active role in their healthcare. The patient explains what’s most important to them, including their preferences and values. The doctor explains what treatments are available. Together, they make a shared decision on the best treatment option.

Studies show Shared Decision-Making can improve health literacy. It can also improve follow-through on treatment plans.

It’s important to understand the perceptions and beliefs of people with asthma and/or eczema. Health professionals and policymakers can identify ways to improve health outcomes for all.


Reviewed by:
Don Bukstein, MD, FACAAI, is a board-certified allergist and immunologist and a pediatric pulmonologist. He serves as Medical Director for Allergy & Asthma Network. He also volunteers at a Medicaid clinic in inner city Milwaukee. He is formerly the Director of Allergy and Asthma Research at Dean Medical Center in Madison, Wisconsin.