Population considerations:

  • Access to resources. Some low-income communities may not have access to primary care (LeNoir, 1999; Lopez, 2002). They may seek care in acute care facilities or in emergency rooms. This type of care may address the immediate symptoms but is often insufficient to develop action plans to address future asthma symptoms. People without a regular source of health care frequently have asthma symptoms that go unrecognized and undiagnosed. Financial barriers or lack of access to medical insurance may hinder low-income individuals’ ability to obtain asthma medications and supplies. 
  • Stress. Low-income communities may face a greater amount of life stressors due to the effects of poverty or violence (Wright, 2001).  These higher levels of stress often can trigger asthma episodes.
  • Living Conditions. Low-income families often live in poor quality or crowded living conditions. They may have higher exposure to environmental allergens, such as house dust, cat dander, mold, or cockroaches (LeNoir, 1999).

  Strategies to address these considerations:

  • Increase access. It may be useful to identify mechanisms to enable intervention participants to access low-cost heath care, medications and supplies. 
  • Incorporate stress management. It is important to recognize stressors and build stress management strategies into interventions in order to minimize the stressors and the individual’s reactions to these stressors (Wright, 2001). This could encompass ways to reduce stressor exposure, stress relief methods or counseling to be used in conjunction with asthma management.
  • Provide skills training. Providers in acute care settings should be trained to provide day-to-day asthma management education.
  • Reduce environmental triggers. Many studies have suggested that one way to prevent future asthma symptoms is to create changes in the environments in which people live, work and go to school.  Strategies for improving access to asthma resources and supplies, such as providing bed covers and cleaning supplies can help to reduce exposure to environmental triggers. Access to resources to change these environments may be particularly challenging for some. It may be useful to recognize these challenges by working with community partners to enhance existing resources or to build new resources.

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