Disparities in Asthma and Allergy Care: What Can We Do?

J Allergy Clin Immunol Pract. 2021 Feb;9(2):663-669. doi: 10.1016/j.jaip.2020.10.030. Epub 2020 Oct 23.


The coronavirus disease pandemic and the growing movements for social and racial equality have increased awareness of disparities in American health care that exist on every level. Social determinants of health, structural racism, and implicit bias play major roles in preventing health equity. We begin with the larger picture and then focus on examples of systemic and health inequities and their solutions that have special relevance to allergy-immunology. We propose a 4-prong approach to address inequities that requires (1) racial and ethnic inclusivity in research with respect to both participants and investigators, (2) diversity in all aspects of training and practice, (3) improvement in communication between clinicians and patients, and (4) awareness of the social determinants of health. By communication we mean sensitivity to the role of language, cultural background, and health beliefs in physician-patient interactions and provision of training and equipment so that the use of telecommunication can be a resource for all patients. The social determinants of health are the social factors that affect health and the success of health care, such as adequacy of housing and access to nutritious foods. Using this 4-prong approach we can overcome health disparities.

Keywords: Asthma; COVID-19; Food allergy; Food insecurity; Health disparities; Implicit bias; Social determinants of health; Structural racism.

MeSH terms

  • Adult
  • Black People
  • Child
  • Female
  • Health Equity*
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino
  • Humans
  • Hypersensitivity / ethnology*
  • Male
  • Middle Aged
  • Racism