Population considerations:

  • Environment.  Apartments or homes in urban areas may have poor ventilation and high levels of allergens including cockroaches, cigarette smoke, dust and chemical pollutants (LeNoir, 1999). People living in urban areas have higher exposure rates to chemical pollutants and particulate matter (LeNoir, 1999).  Urban areas also have higher levels of pollution than less urban or rural areas.
  • Exposure to other health conditions.  Viral infections that can trigger asthma may be worse in crowded living conditions in urban areas.  Individuals in crowded living conditions are more prone to exposure to many types of infections (LeNoir, 1999; ODPM).
  • Low literacy rates.  Literacy rates may be lower in urban areas, which can limit individuals’ understanding of asthma education and asthma management materials (Williams, 1998).

  Strategies to address these considerations:

  • Prevent viral infections. It may be useful to educate individuals about hygiene (e.g., proper hand washing) and other methods of disease prevention to help limit the spread of viral infections.  It also may be important to increase access to resources to treat infections.
  • Increase awareness. Strategies to increase awareness of asthma problems in the greater community may be beneficial. Using mass media outlets to disseminate asthma education and awareness may give visibility to a larger range of at-risk urban residents (LeNoir, 1999). Community outreach approaches should be developed. Incorporation of churches, community organizations, and individuals can help to create awareness of the risk asthma poses to urban communities. Creation of coalitions and alliances may be particularly effective in large urban areas.
  • Provide education.  It may be important to provide individuals and families with information so that they understand the contributions their behaviors (e.g., smoking) may have on others with asthma who live close by. 
  • Tailor to literacy level.  Health care providers should try to incorporate visual information and appropriate literacy level education materials into their asthma counseling strategies and communications.
  • Advocate for change.  It may be important to work with housing authorities and community organizations (e.g., neighborhood associations and the American Lung Association) to provide information to landlords and advocate on behalf of individuals living in harmful conditions. Working together, community members, local businesses, the American Lung Association and neighborhood organizations can advocate for changes to exposure to pollutants and other asthma triggers.
  • Provide skills training.  Health care providers should be specifically trained to work with urban communities. It may be useful to provide training in cultural competency and asthma management to individuals who are working with a community so that they can learn more about the differences within and across communities and how these differences influence asthma interventions. See Cultural Competence for more information.

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