Asthma in Pregnancy
Asthma is a chronic disease affecting between nine-and 12 million persons in the United States. It is the most frequent respiratory disorder complicating pregnancy, affecting 0.4-1.3% of pregnant women. There is a demonstrated association between inadequately controlled asthma during pregnancy and adverse infant and maternal outcomes, and there is considerable evidence that achieving good medical control of asthma during pregnancy reduces these risks.
Racial disparities in health outcomes are well documented, although racial disparities in asthma during pregnancy have not been much studied. Good medical control of asthma during pregnancy reduces the risk of adverse maternal and infant outcomes, such as poor fetal growth and low birthweight. Reduced access of minority groups to healthcare is a documented problem that could contribute to the severity of symptoms and to adverse pregnancy outcomes in some racial/ethnic groups. This study examines racial/ethnic differences in asthma during pregnancy, under the supposition that racial health status is largely a function of the social nature of race. A conceptual framework by Williams et al. facilitates understanding the complex relationship between race, social factors, and health status. In the model, multiple factors, including social (race, socioeconomic status), risks/resources (behaviors, medical care), as well as others (macrosocial, biological, religious) contribute to health status. online canadian pharmacy
This analysis attempts to elaborate the complex role of insurance type, maternal education, and prenatal care initiation/utilization in explaining observed racial/ethnic disparities during pregnancy. Maternal education is a commonly utilized but limited measure of socioeconomic status. Insurance type provides information on access to care and socioeconomic status. Finally, initiation/adequacy of prenatal care provides a measure of healthcare access as well as health behavior and, as such, is vitally important to our understanding of perinatal disparities.
There are many possible mechanisms that would explain an association between insurance status and asthma during pregnancy. Firstly, insurance status as a surrogate for access of care might impact on a woman’s likelihood of proper preventive asthma treatment. As a measure of socioeconomic status, an association between insurance status and asthma during pregnancy may be due to the well-documented gradient in health in which those who are of lower socioeconomic status bear a disproportionate burden of health outcomes, including asthma in particular.