Why Are Black Children So Much More Likely To Die Of Asthma? : Shots - Health News Most genetic studies look only at people of European descent. But black and Hispanic children are far more likely to die of asthma, and genetic differences may help explain why.

Scientists Seek Genetic Clues To Asthma's Toll On Black Children

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Asthma - it is the leading chronic disease among children. And it hits some populations more than others. African-American children have asthma at much higher rates than white kids. Some of the causes are environmental. But as Lesley McClurg from station KQED in San Francisco reports, genetics plays a role as well.

LESLEY MCCLURG, BYLINE: Zunika Crenshaw cringes as a tire swing whips her kids around in circles on a sunny afternoon.

ZUNIKA CRENSHAW: You guys, be careful. I think that's a little too fast.

MCCLURG: The family is playing in a park in the city of Pleasanton, an eastern suburb of San Francisco. Four of her kids have asthma. So does Crenshaw herself. Three-year-old Jhase runs over to her mother wheezing.

CRENSHAW: Are you feeling OK?

MCCLURG: Crenshaw grabs an inhaler.

CRENSHAW: Ah, go ahead. Ready?



JHASE: Perfect.

CRENSHAW: (Laughter).

MCCLURG: Crenshaw drops the inhaler in a purse full of medications.

CRENSHAW: Zyrtec. And this is ClariSpray. And there's albuterol and Dulera.

MCCLURG: And there are more drugs at home. When the kids start missing lots of school from asthma attacks, it's time to re-evaluate prescriptions and head to something called the Breathmobile, a long motorhome converted into a free-roaming clinic in the Bay Area.

MARY FRAZIER: Tiny breath in. Now take that big one, as big as you can. Deep breath.

MCCLURG: Inside the nonprofit's mobile clinic, a nurse tests the lungs of a 5-year-old girl fiddling with her tight braids. According to the Centers for Disease Control and Prevention, this African-American girl is twice as likely to have asthma compared to a white child and 10 times more likely than white kids to die of asthma-related complications.

Mary Frazier, a registered nurse with the Breathmobile, says asthma is caused by a number of external environmental factors, including air pollution, access to health care...

FRAZIER: ...Pests, molds, mildews, pets in the house, someone who smokes in the house.

MCCLURG: But asthma also runs in the family. And Frazier says her pediatric patients are more likely to have asthma if their parents suffer from the disease.

Marquitta White is a geneticist at University of California, San Francisco. She specializes in minority groups with asthma.

MARQUITTA WHITE: On average, 60 percent of what's going to determine whether or not you have asthma or not is going to be due to genetic factors.

MCCLURG: The subject hits home for White. She's African-American and has three nephews with the disease. White hopes her research can help fill in missing scientific data.

WHITE: The majority of genetic studies, not just in asthma but in most diseases, are done in Caucasian or European-descent populations.

MCCLURG: This general focus on Caucasians pushed Congress to pass legislation in 1993 requiring that publicly-funded medical studies include more minorities. But a recent review of studies since the law passed found that only 5 percent of publicly-funded research on lung disease included non-white patients.

WHITE: Which means that most patients aren't getting the best care because we don't really know what the disease ideology is in their particular population.

MCCLURG: In fact, White recently published a study finding that the majority of genetic information scientists have about asthma only applies to Caucasians.

White works in an ethnically-diverse lab, led by pulmonologist Esteban Burchard. He believes a lot of health disparities could be explained if more minorities were included in genetic research. Burchard uses the analogy of heart disease to make his point. There was a time when doctors only studied men who suffered from heart failure.

ESTEBAN BURCHARD: But women present differently than men do for heart attacks. And so a whole generation of physicians were misclassifying, misdiagnosing women, simply because women were not involved in the original clinical trials.

MCCLURG: And so Burchard's lab is now studying why inhalers provide relief for some children but not for others. The scientists are studying the genes of black, Mexican-American and Puerto Rican children to better understand drug responses in each population.

BURCHARD: This is the first thing that people throw away, the package insert.

MCCLURG: Burchard unfolds a giant sheet of directions inside a box of a common asthma medication.

BURCHARD: I've highlighted in yellow and circled in big red ink.

MCCLURG: He points to a technical paragraph printed in tiny font, stating that there's a much higher risk of death from the medication for African-Americans than for white patients. He says that's tragic.

He hopes there will be a day when researchers and doctors prioritize race and ethnicity when studying a disease or prescribing drugs. He says that would at least, in part, level the playing field and provide better care to African-Americans.

For NPR News, I'm Lesley McClurg in San Francisco.

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