This pilot study sought to compile data on the socio-demographic characteristics, perceived health status, asthma-related quality of life, asthma medication use, and health care resource utilization patterns of an urban African American population. Thirty (30) subjects, hospitalized for asthma during July 1995 in three Emergency Departments in the greater Detroit area, were selected and screened for eligibility. Of these, 24 verbally consented to participate and were subsequently interviewed (80% response rate). The subjects were mostly young adults (mean age=31.04), unmarried (83.3%) women (70.8%) who had been diagnosed with asthma for 8.45 years (SD=9.74). One third of the study sample reported an income level of less than $10,000 a year and about half had incomes ranging from $20,000 to $39,000. HMOs (50%) and Medicaid (21.7%) were the leading insurers of medical care for the study sample. Therefore, the authors suggest “insurance barriers and access problems did not exist for these subjects.” Other findings indicate that the “majority of the subjects (63.6%) rated their overall health status as “good to fair” but perceived their asthma-related quality of life very differently. The overall AQLQ score for the sample (M=3.48; SD =0.90) indicated considerable impairment in the subjects’ asthma-related quality of life.” Furthermore, despite the recommendations by the National Institute of Health for use of prophylactic treatment of asthma with inhaled anti-inflammatory medications, “less than half (45.8%) of these patients who visited the ED were regularly using medications of this type.” The use of a home peak flow meter, which is also recommended by the NIH, was used only by one patient on a regular basis, although 10 patients stated that their physician had recommended its use. With respect to the utilization of health care resources, the results indicate that 1.) “the majority of the subjects (62.5%) had made an additional one to three asthma-related visits to the ED in the preceding 3 months,” and 2.) although “three fourths (70.8%) of the patients said they had a physician outside of the ED that they saw regularly for their asthma”, in the prior 3 months, “13 subjects (54.2%) had not spoken on the telephone with either a physician or nurse about asthma-related problems, and almost half the sample (45.8%) had not seen an office- or clinic-based physician for their asthma.”

In an extended discussion of their findings, the authors consider issues of past experience and racial mistrust. “Health-care seeking behaviors of African Americans are greatly influenced by their past experiences of racism and discrimination in both public and private health institutions. African Americans also have traditionally been disempowered politically, economically and socially in United States society and have been prevented, in many instances, from exercising control over their environment. One way, therefore, to improve the management of asthma by urban African Americans may be to focus on empowering them through a culturally appropriate educational process that teaches patients about the rationale and skills required to view and treat asthma as a chronic inflammatory process rather than an episodic, crisis-driven process…Unfortunately, [such] asthma education programs have been evaluated only in populations that are predominantly Caucasian.”