Native American Children Face Many Barriers to Asthma Care

By Bruce Bender, PhD

Certain groups of children with asthma experience severe health disparities. African American and Hispanic children develop asthma more frequently and with greater severity than white children.

Asthma among Native American children, including American Indian, Alaska Native and Native Hawaiian children, has been under-recognized for decades. Cases often equal or exceed those of most other minority groups. Only recently has the need for greater understanding about health disparities of Native American children with asthma become a priority.

How common is asthma among Native American children?

Many Native American children live in rural areas, often in remote locations on large reservations in the West. As a result, national surveys that document asthma have in the past underestimated how many Native American children have asthma.

We know that, as of 2018, 16% of African-American children and 13% of Hispanic children had asthma at some time in their life, in contrast to about 7% of white children.

Recent surveys of Native American children show wide variations in asthma prevalence. Rates are as high as 27% among some groups. These children are hospitalized and die from asthma more often than almost any other group.

What challenges do Native American children face living with asthma?

Native American children living on reservations face many barriers that may undermine their health. These barriers include poor air quality – both indoor and outdoor – and lack of access to quality healthcare.

Air Quality Barriers

Indoor	Outdoor	Healthcare Barriers
Heat and cook stoves Commercial tobacco smoke Ceremonial smoke Mold Dust	Coal-fired plants Diesel exhaust Oil and gas extraction or mining Desert dust storms Wildfires	Poor access to healthcare Lack of asthma specialists Lack of culturally competent providers Financial constraints Preference for traditional healers Lack of community understanding

What can be done to improve the health of Native American children?

Native American children need greater access to quality healthcare. It should be provided by healthcare professionals who are knowledgeable about both evidence-based treatments and the culture of their patients.

In some cases, healthcare professionals trained in Western medicine must work cooperatively with traditional Native American healers to fully engage patients.

More research is needed to better understand rthe factors that cause asthma in Native American communities. We must find more effective ways to offer healthcare services to Native American children.

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Bruce Bender, PhD, is head of the Division of Pediatric Behavioral Health and co-director of the Center for Health Promotion at National Jewish Health in Denver, Colorado.