Where You Live, Work and Play Can Impact Your Asthma and Eczema Care

Side closeup view of a Black man with a beard. He's scratching his face from eczema.

Asthma and eczema are conditions that can impact your ability to take part in your work, school, play or worship activities. But little is known about how well patients understand these conditions and medical care. We decided to gain a better understanding of these unknowns.

In 2021, Allergy & Asthma Network worked with allergists to learn what people living with asthma and/or eczema think about their medical care. The study found that health literacy was oftentimes a barrier to asthma and eczema care among Black and Hispanic/Latino communities. The study also shared that where you live, play, work and worship (known as social determinants of health) can impact your asthma and eczema care. 

Social Determinants of Health

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’ Survey study?

A 94-question online survey was used to evaluate participants’ perceptions about…

  • influence of their disease and treatment;
  • ability to receive medical care.

The survey took place online between March 24, 2020 and April 6, 2020. A total of 841 adults (18 or older) with asthma and/or eczema participated.

The study results were published in the medical journal Advances in Therapy in January 2022. 

Allergy & Asthma Network former President and CEO Tonya Winders and former Director of Research Mary Hart co-authored the study with allergists Don A. Bukstein, MD; Adam Friedman, MD; Erika Gonzalez-Reyes, MD; and Bridgette L. Jones, MD.

blue quote iconThe importance of this study is that the patient’s voice resonates with a clear message that health literacy and barriers to care are real. Healthcare practitioners who care for patients from Black and Hispanic communities must do a better job with breaking down these barriers to care. It is important as a healthcare practitioner to embrace all communities and their specific needs. This will empower patients to better manage these chronic conditions, decrease the burden of living with asthma and/or eczema, and improve their quality of life.”

— De De Gardner, DrPH, RRT, RRT-NPS, FAARC, FCCP
Director of Research and Evaluation at Allergy & Asthma Network

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What are the key takeaways of the study?

The study looked at the impact of living with asthma and eczema. It examined how the conditions affect each person differently. Where you live, work, play and worship can affect your asthma and eczema.

Also in the survey:

  • Some Black and Hispanic/Latino participants said a lack of understanding about their disease and management made it difficult to get medical care. 
    • These groups had more emergency department visits and hospitalizations than white participants.
  • People who are low income found it harder to receive health care.
    • People with asthma and from low-income homes had fewer discussions about their asthma management with their healthcare provider. They were less likely to have an Asthma Action Plan than people with higher income.
    • People from low-income homes living with eczema had less managed symptoms compared to people living with eczema in higher income homes..
  • Black and Hispanic/Latino participants, from low-income homes, had more difficulty filling out healthcare paperwork. 
    • They also noted having a harder time understanding written materials related to their care.

To view a concise infographic detailing the findings of this study, please see infographic here.

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What are some ways to improve access to healthcare in your community?

  • Ask for culturally informed resources so you can better understand asthma and eczema.
  • Shared Decision-Making can help you reduce the consequences of having asthma or eczema. 
    • Shared Decision-Making is a way for you to take a more active role in your health care. You can explain what’s most important to you, including your own preferences and values. Your healthcare provider explains what treatments are available. Together, you make a shared decision on the best treatment option for you.
  • Studies show Shared Decision-Making can improve understanding of the disease and management or treatment. It can also improve follow-through on treatment plans.

Infographic breaks down 4 actions you can take to help manage your asthma and/or eczema. They include: 1. Take notes to share with your doctor 2. Ask for health info in your language 3. Have hard conversations about costs of treatment with your provider. 4. Use shared decision making for getting the most benefit from your health car provider.

What Can I Do?

It’s important for your healthcare providers to understand what is most important to you and your asthma and/or eczema. Health professionals and policymakers can identify ways to improve health outcomes for all.

Transcript below

The Influence and Outcomes of Where You Live, Work, Play, and Worship on Asthma and/or Eczema Infographic Transcript

Allergy & Asthma Network partnered with allergists to survey what people with asthma and/or eczema think about their medical care. A total of 841 people participated in the study.

Study Participants: 713 higher income participants, 99 lower income participants 

421 participants identify as white. 252 participants identify as black. 95 participants identify as hispanic. 554 participants live with asthma. 111 participants live with asthma and eczema. 398 participants live with eczema. 

People who have an Asthma Action Plan: 

42% of low income

53% of high income

People who discuss asthma with their provider:

54% of low income

69% of high income

People who have not tried eczema treatments:

35% of low income

15% of high income

Some Black and Hispanic/Latino patients reported difficulty using health information to make decisions related to their asthma and eczema care. This proved to be a barrier to getting medical care.

People with eczema from low-income homes were more likely to have under-managed symptoms than those with higher incomes.

ER Visits and Hospitalizations:

52% of black participants had emergency department visits.

31% of black participants experienced hospitalizations.

49% of hispanic participants had emergency department visits.

39% of hispanic participants experienced hospitalizations.

31% of white participants had emergency department visits.

16% of white participants experienced hospitalizations.

Participants in all racial/ethnic and income-level groups reported that their asthma or eczema impacted their lifestyle and daily activities. Learn more at AllergyAsthma.org/Asthma-Eczema-Research

What Can I Do to Better Manage My Asthma and/or Eczema? 

I can take notes of my asthma/eczema symptoms and share them with my healthcare provider. 

I can ask for health information in Spanish if I am more fluent in that language. 

I can have open conversations with my healthcare provider and talk about the costs of medical care and prescription drugs to find out what best fits my budget and needs. 

I can work together with my healthcare provider to share decisions and find the treatment that works best for me and fits my lifestyle. 

Find all data and more information by visiting: AllergyAsthma.org/Asthma-Eczema-Research

Impact of Social Determinants on the Burden of Asthma and Eczema: Results from a US Patient Survey.
Don Bukstein, Adam Friedman, Erika Gonzales Reyes, Mary Hart, Bridgette Jones, Tonya Winders.
January 2022, Advances in Therapy
DOI: https://doi.org/10.1007/s12325-021-02021-0

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