In This Corner
Scenes from a Marriage
Bridal-chest paintings gathered by a Tufts art historian offer glimpses of wedded life in the Italian Renaissance, and are now on view at the Isabella Stewart Gardner Museum
Breathing Space
The incidence of asthma among U.S.-born blacks living in Boston is much higher than their foreign-born neighbors
“If future research confirms that the U.S.-born black population has a higher prevalence of asthma than the foreign-born black population, resources such as asthma screening and detection can be directed to populations or communities most in need,” says Doug Brugge. Photo: Mark Morelli
Rates of asthma among urban African Americans is known to be high, but it might be even worse than suspected. That’s because inner-city blacks who were born in the United States have a much higher incidence of the disease than their neighbors who were not born here, according to a recent study published in the Journal of Asthma.
“We already know that African-American children have somewhat higher asthma prevalence compared to white populations,” says Doug Brugge, an associate professor in the department of public health and family medicine at Tufts Medical School who led the study.
“What I think this study points to is the potential that within the black/African-American population, there may be—or at least were in our survey—two distinct groups with very different levels of asthma,” he says. “There may be a sub-population of U.S.-born blacks who are even more likely to have asthma than when all blacks are averaged together.”
Teams of community parent leaders and students from Harvard Medical School conducted the survey in Boston’s Dorchester neighborhood, using questions that had been validated by research studies. Among the topics covered were place of birth—U.S. or abroad—of the adults and their children, occurrence of asthma symptoms and environmental factors that would lead to asthma, such as maternal smoking during pregnancy, mold growth in the home and vehicle traffic near the home.
Brugge and his colleagues, including Mark Woodin, a senior lecturer in civil and environmental engineering at Tufts, reported that 30 percent of the U.S.-born African-American adults surveyed in Dorchester were diagnosed with asthma, compared with only 11 percent of black adults born outside of the U.S. Similarly, 23 percent of U.S.-born black children there had been diagnosed as having asthma, but none of the African-American children born outside the country was diagnosed.
One explanation for the discrepancy is the so-called hygiene hypothesis. It suggests that those who are exposed to infections earlier in life develop some resistance to asthma and other allergic and autoimmune diseases, Brugge says. That’s because as the immune system is attacked by serious infections, it does not bother mounting defenses against lesser contagions, such as dust motes and mold, which trigger asthma. The theory is that people born in developing countries are exposed to more infections, and thus develop more resistance to asthma.
Brugge cautions about drawing too many conclusions from the study, though. He notes that he and his colleagues focused on only one neighborhood in Boston, and didn’t determine the exact place of birth, for example.
That said, he was not particularly surprised by the findings. “I knew, both from earlier work in Boston’s Chinatown and from the literature, that foreign-born Chinese and Mexican immigrant children were less likely to have asthma than their U.S.-born counterparts,” Brugge says.
“If future research confirms that the U.S.-born black population has a higher prevalence of asthma than the foreign-born black population, resources such as asthma screening and detection can be directed to populations or communities most in need,” he says.
“Asthma is a community issue for Boston,” says Neal-Dra Osgood, co-author of the study and project director of the Strengthening Voices Project at the Boston Urban Asthma Coalition. “Many parents are concerned because knowing that their children suffer from asthma is stressful, especially if they feel they don’t have the information needed to help their children effectively,” Osgood says. “This study helps us understand which population is hit the hardest by this chronic disorder and helps direct our community efforts.”
