An estimated 6.3 million children under the age of 15 years died in 2018. 5.4 million of them were under the age of 5, and 2.5 million of those children died within the first month of life. The figure translates into 15 000 under-five deaths per day (CDC, 2017). Out of the 15 000 under-five deaths per day, more than half is from the minority communities of Blacks and Latinos. African Americans have the highest child mortality rates in the US. This is because of some rampant illnesses which poor African American children are exposed to. Poor African American children are highly exposed to more adversities like illnesses such as asthma, due to disparities in income level and inadequate housing. Generally, African American children from low-income areas are the most affected.

A common problem experienced by African Americans in low-income areas is lack of jobs and decent income hence difficulty in accessing affordable, adequate housing and healthcare. Deaths due to asthma are three times more common among black people than among white people. Hispanics are not a single ethnic group but are culturally, genetically, and geographically diverse, and this diversity is reflected in the asthma statistics.  Today, Black children are four times more likely to be admitted to the hospital for asthma, as compared to non-Hispanic white children. Asthma is a complex disease of unknown etiology characterized by recurrent inflammation of the airways, which, over time, may lead to irreversible airway remodeling and intractable airflow limitation (Campbell et al., 2015). The prevalence of asthma has increased markedly since the latter half of the 20th century, doubling in the United States from 6.7 million in 1980 to 17 million in 1998, and now affects over 20 million people in the United States alone and 155 million individuals worldwide. African American children were 30 percent more likely to have asthma than their non-Hispanic counterparts. Black men and women are two to three times more likely than whites to be hospitalized or die from asthma. And while many factors contribute to the burden of asthma in African Americans — such as access to health care and environmental exposures — rates are disproportionate even when social and environmental elements are taken into account.

African Americans are prone to asthma due to factors such as their socioeconomic status, health provision, and maintenance, type of environment that determines the quality of air, as well as obesity and genetic factors. The phenotype of contracting asthma, which comes as a result of the interaction of genes affected by the environment in which one is in. Environmental factors which are associated with socioeconomic levels directly relate to asthma morbidity. For example, high exposure to cockroach allergen is associated with asthma in children. African Americans are more likely to be exposed to cockroach allergen because of their environment of low-income housing and congestion. This suggests that a genetic difference may exist between African Americans and whites concerning the potential to develop cockroach sensitization, and this difference may be of particular importance for those African Americans living in areas with higher levels of cockroach exposure. The type and condition of a person’s housing also play a role in asthma-related morbidity and death. Considering urban places inhabited by African Americans are mostly low-income areas, they are highly predisposed to factors which may lead to them contracting asthma. Some African American children do not have consistent and effective follow up. Children from low-income families and are black and not fully insured are likely to lack proper healthcare and most likely routine asthma check-up (White et al., 2016). Also, African American children with health insurance are likely to have fewer asthma visits compare to white children with the same health insurance. This lack of consistency in asthma visits to health facilities has contributed significantly to the morbidity of asthma and has led to frequent emergency visits for asthma attacked African Americans. The other notable factor which relates to African Americans in low-income areas is lack of quality care. African Americans in low-income areas are not provided with the appropriate devices to fight asthma at home. They are also very unlikely to have visits by asthma specialists because they cannot afford to pay for the services of a private specialist, even if it is recommended from a health facility. Lack of access to an asthma specialist and financial or formulary constraints are some of the potential barriers to optimal asthma care outcomes. ACEs, food insecurity, and racial discrimination may be significant contributors to the morbidity experienced by African American children with asthma. Interventions to address these factors in children and their families may improve asthma outcomes in this population (Barnthouse et al., 2018).

However, there are some significant programs which currently exist to assist African American children from being highly susceptible to asthma. Some individual plus policy disparities in the African American community such as health care policies, health systems operations, and clinician, patient, family, and environmental factors are significant contributors to asthma among this community. One of such programs is enrolling uninsured African American children into the state health insurance program. In New York State, currently, there is 26 percent of African American children enrolled in health insurance programs. This policy will help in improving access to asthma care. As a result of frequent medical visits, African American children will have fewer asthma attacks, improved quality of care, and a variety of care and disease severity reported by parents. The other policy to address this problem is passing smoking-free legislation and its adoption in enclosed public place and workplaces countrywide. Do smoke-free laws have an impact on the highest risk children, like African Americans with asthma? This policy has been effective considering it has led to decreased exposure of children to second-hand smoke (Wangz et al., 2015). Hospital admission rates for African Americans exposed to asthma will significantly reduce. The success of this policy will entirely depend on how local, regional, and national laws and regulations support population-level changes to improve the environment and decrease triggers in African American communities. In addition to these policies, efforts are being made at the community level to help find a solution to this problem. Partnering with individuals and organizations outside of health care setting is one of such efforts. Its key elements have been to promote intervention centered approach in which adherence to medication in encouraged and development of consistent healthy activities by children. These policies potentially perpetuate issues of oppression by ensuring African American children, some who come from low-income families have equal care with their non-Hispanic white counterparts. The effect of inequality in healthcare has contributed to the systematic oppression of the African American community.

Asthma is a health issue among African Americans. It leads to the loss of lives in this community. African American children exposed to asthma, if they do not receive appropriate health care and medical monitoring do end up losing their lives. During the period 1999-2010, there have been more than 10 000 deaths due to asthma among African-Americans in New York. These rates were similar in both male and female African American children in the same period. In another demographic, African Americans mortality rate were highest for those of 50 years of age and older between 2010 and 2017. Health and proper accommodation are fundamental human rights in the US. It is, therefore, a contradiction of fundamental human rights to deny African Americans their basic right to adequate healthcare and good living conditions, in the African American community. Urgent action needs to be taken to address this issue. Appropriate housing and a clean environment are one of the actions that need to be made. This action is necessary to address the contravention of these fundamental rights and improve equality in the US. Political legislation and laws can be passed by local, regional or national assemblies to address these issues. It is essential to contain and treat morbidity rates of asthma among African American children. This will not only lower death rates but also ensure these children can live a healthy, strong life to pursue their school activities and healthily live rest of their lives without any limitations by any form of ailments.

Learning about how asthma affects African American children, from low-income areas will contribute to my service learning experience in some ways. From this study, I will be able to gain skills in critical thinking, how to solve similar problems faced by poor African American children, be a good decision maker as well as efficiently collaborate and communicate with the community. I now deeply understand one of the problems faced by the African American community and can connect to their experiences. From my service learning, I have grown a lot of respect and empathy as well for this community. As a student, I will be connected with the community as well as the community feeling they are part of the school learning programmes. This will create a good relationship between the school and this community. As a result, it leads to the partnership for future similar programs. Also, this service-learning experience has added practicability to lessons and knowledge gained in class. As a result, we get to practice and have the first-hand experience to issues we learn outside the classroom.

In conclusion, this service learning has given me an opportunity to learn about the African American community in low-income areas. I have effectively found out factual information on asthma prevalence and morbidity among poor African American children, predisposing factors putting them at risk as well as policies set in place to address this problem. The various systems and programs put in place to find an appropriate solution to this problem will be useful with time once they are consistently implemented, together with consistent public awareness and education.

References:

Barnthouse, M., Sexton, C., Vhylidal, C., Woods-Jaeger, B., & Jones, B. (2018). Characterization of the impact of Stress Exposure on Asthma in African American Children. Journal of Allergy and Clinical Immunology, 141(2), AB218.

Center for Disease Control Statistics (2017).

Campbell, J. D., Brooks, M., Hosokawa, P., Robinson, J., Song, L., & Krieger, J. (2015). Community health worker home visits for Medicaid-enrolled children with asthma: effects on asthma outcomes and costs. American Journal of Public Health, 105(11), 2366-2372.

The University of Illinois at Chicago. (2017, January 6). Why is asthma worse in black patients?. ScienceDaily. Retrieved March 9, 2019, from www.sciencedaily.com/releases/2017/01/170106133056.htm

Wang, Z., May, S. M., Charoenlap, S., Pyle, R., Ott, N. L., Mohammed, K., & Joshi, A. Y. (2015). Effects of secondhand smoke exposure on asthma morbidity and health care utilization in children: a systematic review and meta-analysis. Annals of Allergy, Asthma & Immunology, 115(5), 396-401.

White, M. J., Risse-Adams, O., Goddard, P., Contreras, M. G., Adams, J., Hu, D., & Brigino-Buenaventura, E. (2016). Novel genetic risk factors for asthma in African American children: Precision Medicine and the SAGE II Study. Immunogenetics, 68(6-7), 391-400.