Updated 12 April 2019

Poverty may affect the outcome of asthma treatment

New studies suggest that patients from low-income households are likely to have worse asthma outcomes.

People with asthma or food allergies who are poor have worse treatment outcomes, two new studies suggest.

Independent risk factor

"We found that patients who have asthma and come from lower income households – making less than $50,000 every year – are one and a half times more likely to see treatment fail. They are also almost twice as likely to have an asthma exacerbation," study co-author Dr Juan Carlos Cardet said in a news release from the American Academy of Allergy, Asthma & Immunology (AAAAI).

Cardet, who is from Brigham and Women's Hospital in Boston, and his research team surveyed nearly 400 people with asthma. They found that lower income was strongly linked with poor treatment outcomes, regardless of race, stress and education levels.

"Income is an independent risk factor for worse asthma outcomes," Cardet said.

Read: Why we need to take asthma more seriously

But the study did not show a cause-and-effect relationship between income and asthma and allergy treatment failure.

A second study, led by Dr Ruchi Gupta from Northwestern Medicine and Lurie Children's Hospital in Chicago, looked at families with food allergies. Families of children with food allergies in the poorest households spent two and a half times more on costs related to ER visits and hospitalisations, the study showed.

Cost can be a barrier

The researchers found families with lower incomes spend less money on specialists. But, these families end up paying a lot more in out-of-pocket medication expenses.

Read: Your 10-point action plan to manage asthma

"The first line of treatment for anaphylaxis [a life-threatening allergic reaction] is epinephrine, but costs can be a barrier for many families," Gupta said. "Some patients may keep expired autoinjectors or cannot afford to fill their prescription in the first place."

Gupta said mandates are needed to ensure life-saving medications for anaphylaxis are more accessible and available, particularly in public places.

The findings are to be presented at the AAAAI annual meeting in Los Angeles. Research presented at the meeting will be published in an online supplement to The Journal of Allergy and Clinical Immunology.

Read more: 

What is asthma? 

Symptoms of asthma 

How is asthma diagnosed?


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Professor Keertan Dheda has received of several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others.Read his full biography at the University of Cape Town Lung Institute

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