World Asthma Day 2024: Experts weigh in on current challenges, advancements

Key takeaways:

• World Asthma Day highlights government policy and access to care among asthma patients.
• Advances in treatment bring forth new challenges in asthma equity.

Asthma is a disease that affects over 25 million people in the U.S. alone, with a consistently rising prevalence that experts say is exacerbated by changing climates and substantial health care costs.

Healio spoke with a leading asthma organization about the burden of asthma in our population as well as the role that World Asthma Day, celebrated each year on the second Tuesday of May, has in advocating for asthma health care funding, its global health impacts and equity in care.

“There are virtually no communities in the United States, in fact, globally that are not affected in some way by asthma,” Gailen D. Marshall, MD, PhD, president of the American College of Allergy, Asthma and Immunology, told Healio.

“That single day calls to attention the challenges, the possibilities and the difference that appropriate diagnosis and treatment can make for patients who have asthma,” Marshall, said.

According to the ACAAI, there are more than 4,200 reported deaths every year from asthma and almost 10 million physician or hospital outpatient department visits, of which 1.8 million are in the ED.

“This results in a significant impact on activities of daily living as well as on our economy,” Marshall said. “Fourteen million lost workdays, 10.5 million lost school days, 189,000 hospitalizations, and this is not over decades. This is annually.”

Furthermore, the annual costs of care amounts to $82 billion, which is approximately $3,300 a patient.

“The more severe the illness, the more expensive it is to take care of,” Marshall added.

According to recent reports, disparities still exist within asthma care, disproportionately affecting communities of color and those with lower socioeconomic standing.

“It’s not a trivial illness in any way, shape, form or fashion,” Marshall said. “It is a problem that is of particular severity in our underserved populations in this country.”

The CDC states that populations 100% below the poverty threshold and Black and American Indian/Alaska Native communities among other ethnic groups experience the highest prevalence of asthma. Marshall highlights education and language barriers as contributors to these high numbers.

“Part of it could be the availability of proper medications but also receiving education in reasonable terms,” he said. “Not all patients have PhDs, so they don’t necessarily understand high-level explanations. It’s important to communicate to them in a language they can understand, including whether they speak English or not.”

The importance of medical literacy and patients being able to understand the current treatments available to them is crucial in advancing care, according to Lynda Mitchell, MA, CAE, CEO of Allergy & Asthma Network.

“Asthma education can empower people to follow through on their treatment plan, correctly use their asthma inhaler to get the most out of their medication, and keep their symptoms well-managed,” Mitchell told Healio. “Asthma education is especially important for people in under-resourced communities who face higher rates of asthma and are at risk for poorer health outcomes, including death. “

While recently there have been advancements in asthma care such as biologics therapy and SMART, or MART, therapy, access to these medications still remains limited for many due to cost, availability and policy.

“These are not cheap medicines. These are more expensive than the classic medicines, the inhalers, etc, that are being used,” Marshall said.

New methods of testing for asthma also bring new challenges for health care professionals and underline the need for specific training. Challenges such as over- or under-ordering tests can result in patients becoming more ill in the process.

“The problem in testing is that like in anything else, it’s a level of skill to know when to order it and how to interpret the results that come from that,” Marshall said. “That’s where asthma specialists come in. ... They’re intimately related in terms of the expertise. That expertise is expanding. Others are learning how to interpret the information. And the challenge is to translate that to the appropriate resources necessary to care for patients with asthma.”

Cost and accessibility of medicine brings about another important issue highlighted by asthma experts. As new research and data point to climate change and racial and socio-economic standing as links to an increased risk for asthma, experts point to policy as a crucial way to mitigate these effects.

“What is irrefutable, as it relates to asthma, is that pollen seasons are getting longer because the climate is staying warmer,” Marshall said. “We’re seeing more wet weather and that helps the plants grow and produce more pollen, as well as mold.

“The scientific and clinical result is that environmental pollution particularly from petrochemicals has been demonstrated to be a factor in exacerbating existing asthma,” Marshall continued. “And there are some significant data to suggest that it can be involved in creating new asthma in patients. And that argument cannot be made, it cannot be ignored. So, in terms of a major issue related to policy, that’s certainly one.”

Policymakers need to not only take into account research and science as a driver in change but also the economic impact that asthma care, or rather the lack of it, has on society.

The cost of asthma care is currently estimated to be in the hundreds of billions of dollars over the next 20 years. Experts warn that without continuing efforts to improve education, enact research-driven policy and increase advocacy for better health care to address asthma, the prevalence of the disease could go up.

“On World Asthma Day, we’re advocating for our share of the health care dollars to take care of patients who have asthma,” Marshall said. “There is a tremendous benefit even to people that don’t have asthma to acknowledge, pay attention, learn and advocate for proper therapy for these patients. It is the idea of global health and of the value of us as citizens to look out for one another, to preserve and maintain our health.”