Category of Equity Issue | Example |
---|---|
Access to care | Underdiagnosis of asthma in the Alaska Native population related to a lack of health care providers [35]. |
 | Job requirements that may limit the ability to access health care services during normal business hours [36]. |
Access to transportation | The role of access to public or private transportation in influencing ambulance service and emergency room use for asthma [30, 36]. |
Discrimination | Potential variability in likelihood of asthma diagnosis due to different standards applied to different ethnic groups [15]. |
Environmental & occupational exposures | Association between lower educational level, poverty, visible minority status, ethnicity, and/or immigrant status and higher risk of developing asthma due to increased exposure to irritants and occupational risk factors [23, 27, 32]. |
 | Proximity of low-income urban neighborhoods to sources of pollutants (e.g. highways and truck routes) [39, 42]. Potential migration of high-risk populations to areas with lower pollutants [40], and potential reduced exposure to air pollutants in rural areas [41]. |
Housing & neighborhood environment | Poor housing conditions in low-income neighborhoods that may increase exposure to cockroach and rodent allergens, dampness, and mold [24, 39]. |
 | Increased stress related to community violence, and insufficient public services resulting in a poor physical environment in low-income neighborhoods [39, 42]. |
Insurance status | Association between lack of insurance or Medicaid and discharge against medical advice and worse asthma control [26, 31]. |
 | Emergency rooms as last resort for patients without health insurance in U.S. [28]. |
Race/ethnicity | Race/ethnicity as a marker for social disadvantage (e.g. low income, lack of insurance coverage) rather a risk factor itself [15, 28, 29]. |
 | Association between black race/ethnicity and increased emergency room visits [28]. |
 | Potential link between stress associated with multiple race identification and higher rates of asthma among adults who are both American Indian/Alaska Native and white [37]. |
Socioeconomic status | Relationship between race/ethnicity and discharge against medical advice neutralized when socioeconomic factors taken into account [31]. |
 | Association between low socioeconomic status or lack of employment and increased asthma symptoms, poor compliance, and worse asthma-related quality of life [29, 33, 34, 38]. |
 | Asthma as both a consequence and contributor to poverty by restricting ability to work and incurring medical expenses [23, 38]. |