How Minority Children Are Affected by the Disparities in Asthma Health Care - Literature review Example

HOW MINORITY CHILDREN ARE AFFECTED BY THE DISPARITIES IN ASTHMA HEALTH CARE One of the most common and debilitating chronic diseases among children and adolescents is asthma, which affects millions within the 0-17 age group, and causes thousands of hospitalizations and missed school days annually. While medications and management regimens for asthma has significantly improved over the years, disparities in the provision of care keeps the emergency visit rates high among certain members of the population such as the minority groups and those belonging to low-income families. It was observed that African-American and Puerto Rican children have the highest asthma rates, up to three times as many are affected with the disease in comparison with Caucasian children. Factors such a social and financial factors within these affected groups cause weak or lack of adherence to prescribed asthma treatment methods, resulting to increased hospitalizations due to asthma attacks. In order to address the discrepancies in health care provision for asthma, in May of 2012 the Environmental Protection Agency established the Presidents Task Force on Environmental Health Risks and Safety Risks to Children, a collaborative effort to prevent the increased burden of asthma among minority and low-income children. The task force aims to create a positive impact by addressing the factors that can be controlled such as taking down the barriers in preventing affordable asthma care and increasing environmental and psychosocial factors that promote treatment adherence to target groups. It is expected that proper implementation would result to a significant decrease in the number of emergency visits due to asthma attacks among the minorities and low-income groups, in accordance with the objectives of Healthy People 2020. How Minority Children are affected by the Disparities in Asthma Health Care Asthma is a chronic respiratory disease that affects both adults and children, and is characterized by an obstruction of airway due to hyper responsiveness of the immune system, causing inflammation of the cells in the airway which leads to breathing difficulties during the night or in the early morning, as observed among patients showing the symptoms (Barnes, et al., 2009; Shaw & DeMaso, 2011). The disease is not entirely limited to the respiratory system alone, but it is also tied to the inflammatory responses of the body, as well as being influenced by parental genes. It is much like an allergic reaction, and triggers such as dust and air pollution, seasonal changes, and even certain foods could cause the swelling and constriction of the smooth muscles of the airways in the lungs, increased release of immunoglobulin E (IgE) in the bloodstream, and the excessive excretion of mucus. Severity of symptoms vary from patient to patient, ranging from allergic rhinitis (watery eyes, sneezing) to tightening of the chest, breathing difficulties due to excessive coughing, wheezing, and mucus production, or in worst-case scenarios, anaphylactic shock (Harver & Koses, 2010; Shaw & DeMaso, 2011). Management of the disease is deemed important by specialists since it could still affect an individual despite showing no symptoms at all, and a continuous vigilance in avoiding all possible triggers while at the same time addressing the earliest symptoms could alleviate asthma at the earliest onset. Common medications to relieve symptoms of asthma include short-term control or quick-relief medications such as short-acting bronchodilators like β-agonists and oral or intravenous corticosteroids, as well as long-term medications like inhaled corticosteroids (ICS), long-acting β-agonists, or combination inhalers containing both corticosteroids and β-agonists, to relax the airways and provide a relief from constriction or tight feeling in the chest, and corticosteroids to prevent excessive inflammatory responses (Harver & Koses, 2010; Mayo Clinic, 2011). Other treatment methods include antibody suppressants and allergy shots to prevent the production of antibodies in the blood and sputum, which in turn blocks triggering of hyperresponse symptoms. The adherence to asthma management practices such as avoiding triggers such as dust, smoke, pollen, unmonitored exercises, lung infections, and certain foods such as nuts or poultry, as well as keeping note when and how frequent the symptoms appear would not only help in preventing the onset of symptoms, but also to inform the physician or specialist on what kind of management (long or short-term treatment) is suitable to the patient (Akinbami, et al., 2012; Barnes, et al., 2009). It is thus important to address the symptoms at the earliest possible time to maintain the quality of life among patients, especially among young children and adolescents. At present, asthma is one of the most common chronic conditions responsible for significant numbers of morbidity, mortality and health care costs. The prevalence of asthma has increased from 7.3% in 2001 to 8.4% in 2010, and its prevalence grew higher in children and adolescents compared to adults (Akinbami, et al., 2012). Up to 9.6% of the total population of children and adolescents in the US are affected, and it is estimated to cost $19.7 billion dollars annually (Crocker, et al., 2009; Halterman, et al., 2011; Kit, et al., 2011). Despite the improvement of medications for asthma as well as an observed decline in mortality and health care encounters in the primary health care settings, emergency visits that resulted from asthma attacks were found to be stable, denoting that there were no observed changes in the number of emergency visits resulting from spontaneous asthma attacks among children or adolescents (Akinbami, et al., 2012). Such reports imply that there are possibilities of non-adherence to asthma treatment or management methods as set by the national guidelines in managing chronic childhood diseases, and the observed variances might be explained by factors other than genetics or medications, such as factors intrinsic to both the attending physicians and the patients coming from minority groups. While there has been a continuous advancement in the treatment and management of asthma in the 0-17-year age group, there have been considerable evidences which show that some members of the said age group were not being able to take the advantage of using such medications in alleviating asthma. Reports show that many members of the minority or those belonging to multiple race groups, along with low-income groups are still disproportionately affected by asthma, with an increased prevalence among females as compared to males (Akinbami, et al., 2012). Persons belonging to African-Americans, American Indians or Alaskan Natives have the highest prevalence of asthma in comparison to persons of Caucasian background, while among Hispanic groups those coming from a Puerto Rican background have higher asthma rates compared to Mexicans. Also, it was observed that more asthma cases were recorded among lower-income groups, which could be linked to financial or social problems resulting to their inability to comply with management and treatment methods (Williams & Sternthal, 2010). Non-adherence to management methods and medication increases the risks of asthma attacks among young patients, which leads to increased rates of hospitalizations and emergency visits. In effect the increases in the numbers of hospitalization rates can be traced to the inability of minority groups and low-income families to adhere to asthma regimens, which may be due to a lack or deprivation of facilities in their communities (James & Rosenbaum, 2009; Williams, et al., 2009). The growing disparity of the treatment and management of asthma between Caucasian whites and members of minority groups could have implications such as inefficient policies in the provision of aid among all children who need medical attention, financial and societal barriers that equally address children’s medical needs, and an eventual human and financial toll if these disparities were not addressed promptly (Berry, et al., 2010; James & Rosenbaum, 2009). In addition, the lack of proper education with regards to managing asthma triggers and the importance of continuing the use of medications also need to be emphasized. There is also a perceived decrease in the quality of life among asthma patients, which is aggravated by other problems such as the competition of other necessities such as food security, income-generation and housing stability (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). Thus, the importance of equally providing medications and medical attention regardless of race or financial status needs to be addressed as soon as possible to improve the wellbeing of minority children suffering from asthma. Data Despite the advancements in treating childhood asthma, there is still an increase in records of morbidity and mortality as a result of mismanagement of asthma within minors. The number of cases involving asthma attacks amounted up to 640, 000 emergency visits and 10.5 million missed schooldays within the years 2005-2007 alone (Kit, et al., 2011). Around 29% within the population of asthma patients do not receive the appropriate asthma control drugs from providers, and some of these patients do not use medications as often as needed, which result to underuse of asthma medications and consequently the increase in hospital visits due to attacks (Stanton & Dougherty, 2005). The lack of information regarding the management of asthma symptoms and attacks, little knowledge with regards to choosing the most effective steroids to relieve asthma, as well as health coverage problems were some of the few problems that contributed to the disparities, and unfortunately were also some problems that were not resolved even after some policies were enacted to address these factors (Crocker, et al., 2009; Flores & Lin, 2013; Galbraith, et al., 2010). While preventive asthma medications (PAMs) are available for the convenience of these at-risk groups, it was described that these are actually underutilized within some members of the population, even with a reported increase in the number of users (Kit, et al., 2011). It was observed that most of the at-risk groups inappropriately use short-term medications such as short-acting β-agonists at an increased rate, which prevents long-term relief from asthma symptoms, as well as an increasing tolerance to medications when used in the long run (Harver & Koses, 2010). There is also a higher risk among minority groups and low-income families in becoming exposed to environmental triggers such as air pollutants and tobacco smoke, which worsen the exacerbations among children suffering from asthma (Halterman, et al., 2011). The underutilization of PAMs and the incorrect usage of short-term relief medications were accounted to some uninsured asthma patients, which were consistent with previous studies that reported that some members of the population such as minority groups and those coming from the lower financial bracket in the population had problems with regards to the inaccessibility of medications. Meanwhile, the inability to control many environmental risk factors such as pollutant exposure and the lack of knowledge with regards to how pollutants such as dust and tobacco smoke affects and triggers asthma attacks, and this in turn increases the children and adolescents’ risks in developing asthma and prolonging their symptoms. Currently the prevalence of asthma among non-Hispanic black children has been recorded as the highest among minority groups, reaching up to 16% of their population, while the lowest is found among Hispanic children, totaling to 7.9% of their population. The numbers suggest that among the members of minority groups, non-Hispanic black children were unable to get proper medication and treatment on a regular basis, as compared to white or Asian children (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). African-American children are also twice as likely to be hospitalized from asthma symptoms, and are four times more likely to die from asthma attacks in comparison with Caucasian children. Among the Hispanic children, Puerto Rican children have the highest prevalence of asthma, with up to 16.1% of the population affected (Akinbami, et al., 2012). American Indians and Alaskan Natives were also observed to have high rates of asthma cases as well, amounting up to 9.4% of the population. Lastly, low-income families were also observed to have higher asthma prevalence, with those coming from low income-to-poverty ratios having the highest asthma rates, such that 11.2% of persons below 100% poverty level have the highest asthma rates, as compared to 8.7% of persons within 100-200% of the poverty level, and 7.3% of persons with incomes of at least 200% of the poverty level. The data coincide with observations that within minority and ethnic groups, the most affected members of asthma among the populations are African-Americans, Puerto Ricans, American Indians and Alaskan Natives. In terms of income levels, families belonging to lower income-to-poverty ratios have the highest prevalence rates of asthma, which suggests a further disparity in the provision of medications, management methods, and medical attention among various members of the population. Financial problem is mainly attributed to the observed asthma statistics, but other barriers such as the lack of cultural competence of the providers, stereotyping among minority groups, selectivity of minority groups in choosing family physicians, as well as other social and cultural factors such as segregation and housing types also prevent the proper administration of medications and other forms of treatment to children belonging to minority groups (Galbraith, et al., 2010; James & Rosenbaum, 2009; Raphael & Beal, 2010). For example, the differences between the social conditions of Caucasian physicians and patients from minority groups causes disparity in terms of giving treatments, which is suggested by observations from minority patients such as perceived stratification and discrimination, as well as having less motivation in treatment adherence and asthma management (Williams & Sternthal, 2010). There is also the problem of language barriers such as in the case of Hispanic patients which prevent the parents or guardians from understanding the nature of asthma and how to properly administer medications and management techniques. The physicians also have tendencies to generalize patients from minority groups as unable to adhere to prescriptions or strict treatment regimens, thus failing to give them the best possible treatment available. Physicians unable to connect to patients in a deeper level of understanding undermines their capability of preventing an increase in asthma prevalence among members of the minority groups, which in turn blinds them to their responsibilities of preventing such increases (Harver & Koses, 2010). Meanwhile among minority groups, the lack of trust on physicians from a different racial background other than their own, or distrusting physicians which do not understand their social and cultural background prevents them from getting proper medical attention (Galbraith, et al., 2010). This lack of trust in physicians create a gap that prevents the physicians from addressing the treatment needs of the patients, which in turn increases the risks for asthma exacerbation among young patients. This trend has much more profound effects among the minority groups and ethnic groups since there is an observed shortage of doctors coming from minority or ethnic racial backgrounds (Harver & Koses, 2010). In addition, other factors such as low English literacy levels or the lack of basic understanding of English also pose as barriers in obtaining proper asthma medication and adhering to treatment regimen. The problem is even more emphasized in areas where there are no smaller health care units and minority patients end up in larger hospitals or clinics where there are considerably more Caucasian physicians in comparison to physicians coming from minority or ethnic groups (Galbraith, et al., 2010). While patients have better chances of getting proper asthma medication and treatment in larger hospitals, due to the need to converse mostly in English the patients or guardians end up going to smaller community clinics or hospitals even if the medications are not suited to their needs, such as overly-relying on short-term relief medications instead of long-term relief medications. Housing types were also found to increase the susceptibility of minority patients in developing asthma. In a study that compared the prevalence of childhood asthma in both private and public housing facilities in urbanized areas, it was discovered that residents in private housing units have lesser asthma prevalence in comparison with public housing units. Resident living in any kind of private housing had lower asthma rates, around 7.38% of the population as opposed to a higher rate observed in the population living in public housing units, with up to 21.8% of the population of children and adolescents suffering from asthma exacerbations (Northridge, et al., 2010). Factors that add up to the data included the quality of housing facilities, sanitation levels, and the presence of pests within the vicinity. When such factors such as poor quality of housing units as well as the presence of various asthma triggers are found in combination with the lack of knowledge in management of asthma attacks, higher emergency rooms visits resulting from such attacks may be expected. Such observations were found among members of minority groups relying on public housing or were found to be living in areas without proper sanitation or have poor control over asthma triggers. Due to the various factors that can be attributed to the disparities in the provision of care and medication to children coming from minority groups, various measures and policies were created to alleviate these effects. A task force was initiated to bridge the gap between providing effective measures for treating and managing asthma among children belonging to minority groups was established to address such needs. Results Various policies were created in the hopes providing equal treatment between Caucasian patients and those coming from a multiracial background. However, the lack of effective and clear policies in doing so did not close the gap, especially when there were still a steadily increasing number of emergency visits and hospitalizations among members of the minority groups due to asthma (Clark, et al., 2010). Poorly-designed interventions such as asthma risk-assessment, education regarding asthma symptoms and management, control over certain environmental factors, and the use of pharmacologic therapy did not prevent the increase of asthma prevalence among at-risk groups (James & Rosenbaum, 2009). The lack of control over the rising numbers of patients suffering from asthma annually posed necessary changes in policies. Thus, in May of 2012, the Presidents Task Force on Environmental Health Risks and Safety Risks to Children was established under the Environmental Protection Agency (EPA). The EPA, in coordination with other agencies such as the Health and Human Services (HHS) and the Housing and Urban Development (HUD) formed the task force in order to collate the factors that contribute to the inequality in the provision of medical attention (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). In this task force, particular attention is given to the provision of asthma medications and management methods among members of minority groups, aiming to address the need to increase the quality of life among at-risk populations. In the formation of the task force, various barriers to prompt and adequate provision of care were identified, such as limited access to asthma care and management information, low levels of health literacy, difficulty in adhering to medications due to costs, the lack of control over environmental factors such as pollutants, and other competing family priorities such as securing food and housing, to name a few (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). An action plan was created as a result of identifying various obstructions in properly administering the right kind of asthma care and medications, particularly to children coming from minority groups. Preventable factors were also identified, such as medical care factors and physical, psychological, and environmental factors. Medical care factors which were identified to be hindrances in properly administering asthma care and management education among members of the minority groups were: limited access to patient-centered and culturally-sensitive quality health care and asthma education; fragmented and episodic care, which arises from cost issues as well as cultural norms that affect the capacity of patients in choosing adequate and effective care; high levels of health illiteracy, especially among guardians and parents of asthma patients; and the lack of control over other environmental and financial factors, which blocks treatment adherence and increases the likelihood of asthma attacks in at-risk groups (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). Aside from medical factors as hindrances to proper asthma management, there are also identified physical, psychological and environmental factors in preventing asthma attacks. These are: constant environmental exposures to pollutants both at home and school; the lack of family or community support in asthma self-management; high chronic stress levels associated with community settings; and conflicts of asthma treatment regimen with other family priorities such as food security and housing stability (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). While it is not expected that all barriers could be addressed, putting additional focus in controllable factors allows the reduction of problems such as lack of adherence to treatment regimens within the targeted at-risk groups. Identifying which factors were acting as hindrances in the prompt and proper provision of asthma medications among underserved populations such as members belonging to minority groups allows for affordable treatment and care methods, which can be administered even at the community-level. Bringing proper treatment closer to marginalized members such as minority groups benefits them by contributing to the reduction of treatment disparities in various ages and income groups (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). Bridging the gap of asthma treatment disparities is one of the few ways in which the aims of Healthy People 2020 can be realized, and that greatly reducing the number of patients suffering annually from asthma ensures a great reduction in mortality rates in succeeding generations. Discussions The trends in the treatment of asthma has been progressing for the last few decades, and with this progress it is expected that there would be fewer patients that suffer from asthma due to the availability of treatment regimen for patients. However, statistics show that there are still a considerable number of patients suffering from asthma annually, and most of these are from multiracial or minority groups (Akinbami, et al., 2012). Emergency visits were observed to be consistently high instead of decreasing annually, which leads many researchers and coalitions to question the effectiveness of asthma reduction and prevention policies (Clark, et al., 2010). The constant numbers of emergency visits associated with asthma attacks were tied to a number of factors that in turn prevent proper administration of medication to a larger proportion of at-risk groups. Various factors were identified that were directly linked to observed disparities in the provision of proper asthma treatment among children and adolescent members of minority groups. One of the most significantly observed factors is the cost of available medications, and the inability of certain members of minority groups to purchase the right treatment due to high costs prevent asthma exacerbations among young patients (Akinbami, et al., 2012). As a result of a false perception of treatment by relying constantly on cheaper short-term relief medications, parents and guardians of asthma patients tend to provide inappropriate medication, which increases the risk of developing increasingly severe symptoms as well as an increased tolerance to short-term asthma medication. If such issues were not addressed as early as possible, aside from the possibility of prolonging the symptoms of asthma attacks, inappropriate treatment could result in mortality among patients, especially in families where there is a high health illiteracy along with the presence of language or social barriers. Other factors that were identified as hindrances in providing the appropriate care for asthma are the lack of communication and connection between available physicians or specialists and the parents or guardians of minority children. This is much more profoundly observed among Caucasian physicians attending to patients from Hispanic background (Harver & Koses, 2010). Language barriers prevent parents or guardians in understanding the necessary precautions in the prevention of asthma triggers, as well as the importance of remaining in a strict medical regimen. This also increases their frustration in keeping up with visits, resulting to the physicians’ losing track of disease progression and prescription of treatment methods (Lob, et al., 2011). Such people also have strong tendencies of choosing which physician to ask help for, and that they feel that people from their own race or group could provide better understanding and treatment methods as opposed to those which are either Caucasian or those that do not have sufficient cultural background about them. This in turn causes them to overly-rely on inappropriate asthma treatment methods, which further worsens symptoms of asthma in the long run. Members of the minority groups are not the only ones that have problems in adhering to proper asthma medications. On the side of physicians, having tendencies in being biased and stereotyping patients such as believing that patients are always unable to keep up with treatment regimens and that short-term medications should be sufficient to their needs create barriers in connecting with them as well as providing them with proper alternative treatment that works better in the long run (Harver & Koses, 2010). Due to the intimidating and impersonal perception of minority patients to physicians, the latter are less likely to understand how the decisions of the former are tied to their cultural norms, as well as being unable to realize their role in reducing asthma prevalence within high-risk groups such as those belonging to the minority. Such views regarding inequality in providing treatment and medical attention not only prevents proper treatment of asthma among targeted at-risk groups, but also increases the likelihood of fragmented treatment, or the lack of proper medical attention (Galbraith, et al., 2010). Also, the overgeneralization of patients in terms of their attitude towards asthma treatment in turn prevent physicians from giving the patients the best treatment methods available and at the same settling to those which seem easier or simpler to follow as well as having lower costs (Crocker, et al., 2009; Vargas, et al., 2010). It is important that providers are aware of problems that could arise from becoming biased in giving medical attention to members of the minority groups, especially since it is expected that in a few years the minority groups would comprise at most 50% of the entire population of the US run (Harver & Koses, 2010). By being much more knowledgeable with regards to the factors that affect their medicine intake and follow-up consultations, providers could increase their cultural-sensitivity as well as efficiency in treating their asthma, or other chronic diseases for that matter. This could also help them in designing long-term asthma treatment plans that would be easier to follow among patients coming from a multiracial or minority background (Piper, et al., 2010). At the same time, establishing a trusting and respectful rapport among minority patients could also increase their likelihood of adhering to treatment methods and to be open to additional visitations and follow-up visits, as opposed to physicians having an impersonal or cold relationship with them (Crocker, et al., 2009). Aside from social, cultural and financial factors that prevent proper treatment of asthma within the minority population, there were also noticeable inadequacies in the health care system such as the lack of the establishment of an affordable community-based asthma care system, alongside the lack of systems that enable researchers and other parties in identifying the most at-risk members of the population of minority groups. A proposed action plan was created in order to address all inadequacies that hinder the administration of asthma medication among asthma patients in any financial or racial status, as well as to maximize the impact of previously-implemented policies regarding the equal provision of health care in the most asthma-susceptible age groups (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). Various barriers in the proper implementation of existing asthma prevention policies were identified and addressed in the action plan. By identifying which medical factors could be addressed at the local or community level, this helps in initiating appropriate actions such as improving the services from small clinics or community health centers. This is relevant especially since members of minority groups more often than not seek medical attention from smaller hospitals than in larger facilities (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). This in turn brings quality treatment and medication closer to target at-risk groups, and helping them have greater accessibility to appropriate asthma treatment. It could also be expected that there would be better patient-provider communication, a much more profound cultural competency and sensitivity among physicians serving minority populations, and an increased health literacy in parents and guardians coming from minority populations, as the result of addressing the disparity gap in terms of medically-tied factors for treatment adherence. With regards to other factors such as physical, psychological and environmental barriers, it is suggested that improvement in access to asthma care such as rearranging strategies in treatment administration, inventing creative methods that reaches out and facilitates increased engagement of parents and families in asthma education and information campaigns within minority communities, as well as reducing the exposure to environmental pollutants and other asthma triggers through well-thought and realistic policy-changes, which would be easy to follow and sustainable in communities (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). By involving the community in the prevention of asthma and reducing its prevalence, this creates a better environment in reducing risks for developing asthma as well as removing the disparities being perceived in the provision of asthma treatment among minorities. Also, this supports families with affected children for better management of the disease, which in turn increases their quality of life as well. Aside from the aforementioned medical and physical, psychological and environmental hindrances in providing quality asthma care for minority patients, other inadequacies such as a lack of a solid inter-agency efforts and relatively-limited cost-benefit analyses and models in relation to administration of asthma medication and management among the target at-risk group were also addressed in the action plan (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). There is also a need to have reliable and standardized measures in assessing and identifying which groups (based on age, race, locations, etc.) are most susceptible in developing asthma, as well as identifying risk factors and creating additional ways to intervene onset of asthma among high-risk groups. If such methods were created and are reported to have a high sensitivity, it would be easier to identify which groups needed to be studied, as well as to design possible asthma interventions for them and see if there would be any observed improvement in their overall wellbeing. It is expected that by following the proposed action plan set forth by the EPA, aside from reducing the morbidity and mortality rates due to asthma in minority groups, issues such as inaccessibility to asthma medications, apprehension of patients and their guardians in seeking medical attention and gaining information, as well as the lack of cultural and social sensitivity from the side of health care providers could be resolved. By using a multi-level approach in addressing this problem, in due time a long-term and sustainable method of providing care in asthma among members of minority groups could be devised, which in turn could contribute in attaining the objectives of Healthy People 2020 (Canino, et al., 2009; Kit, et al., 2011; Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). In lieu of such actions, aside from implementing the new guidelines, monitoring methods must also be devised as needed, to keep track on the progress of asthma patients as well as to record their adherence to treatment regimens. In the meantime, apart from adhering to the proposed new guidelines in providing better asthma medication and management plans to members of the minority groups, additional researches with regards to the applicability of the action plan in areas where there are many minorities identified to be at a great risk in developing asthma, as well as performing researches within a certain timeframe is needed so as to assess the effectiveness of the action plan. Using research data could help policymakers as well as physicians or health care providers in designing various and alternative methods of administering treatment to members of minority groups, as well as creating adjustments in accordance to what is observed to be effective in each group or community. Also, lapses in the part of implementing bodies or ineffective policies can also be identified and replaced with better ones, or those with a better feasibility or is found to be much more suitable in each location to be studied. Putting research into action could prevent wasteful efforts in the part of providers or facilities, as well as creating new and better methods for implementing the action plan as deemed appropriate for each cultural group or community. Following such measures would ensure that aside from relying on the success of patient-provider interactions, there would also be an increase in the sustainability of the action plan in the long-run since the communities as well as participating agencies and facilities can be considered to be support groups in maintaining and sustaining the action plans, thereby reducing both the prevalence of asthma among most-susceptible groups, as well as closing the gap in health care disparities between Caucasians and minority groups (Presidents Task Force on Environmental Health Risks and Safety Risks to Children, 2012). Conclusions Various studies were able to identify hindrances with regards to removing the biased provision of asthma treatment and disease management between Caucasian minors and those from members of the minority groups. Results from various researches showed nearly similar results and that aside from a high prevalence of asthma among members of minority groups, children and adolescents from this group were also unable to continue their medications due to high costs of medications. There is also the inability of providers to address social and financial issues that plague most members of the minority population, which affect the capability of these people in adhering to strict treatment regimens. Also, providers have stereotyping tendencies, such that instead of prescribing effective and long-term medicine to patients, short-term relief, ineffective or less-potent medicines are given to them. Other factors such as the lack of adequate background in asthma management, cultural and social barriers, as well as housing types contribute to the difficulty in reducing the number of minority groups suffering from asthma annually. Because of the various difficulties in maintaining proper asthma management, minority groups have higher tendencies of suffering from the effects of asthma, such as decrease in the quality of life, and increase in morbidity and mortality-risk from the disease. In identifying the factors that prevent the proper administration of asthma medication and treatment to the most susceptible within the minority population, a need to fully integrate existing policies as well as to increase their accessibility to asthma medications arose. The Presidents Task Force on Environmental Health Risks and Safety Risks to Children was established in 2012 for the purpose of reducing the gap and disparities observed in the provision of asthma medication and treatment among children and adolescents from multiracial or minority groups. The task force was created in order to address the social, economic, cultural and financial barriers that prevent the prompt provision of care for asthma sufferers through a multi-level and inter-agency approach, with particular attention to the needs of members from the minority groups such as cultural and financial sensitivity, among others. The task force was able to identify barriers to the provision of quality asthma care and medication among members of minority groups, and appropriately created a step-wise action plan in bridging the gaps and closing the disparities of asthma health care between Caucasians and minority groups. Additional researches regarding the implementation of the action plan are needed in the future in order to fully assess whether the action plan was able to alleviate the problem of an increasing the number of people, with particular attention to minorities suffering from asthma symptoms annually. There is also an additional need to put research into action, especially since the action plan may not be fully applicable across various people from cultural backgrounds. It is expected that by following the suggested action plans in the guidelines, as well as creating modifications to or removal of ineffective policies as necessary, various problems which contribute to the inability to reduce the number of children and adolescents suffering from asthma in minority populations could be resolved, in effect following the objectives of Healthy People 2020. References Akinbami, L., Moorman, J., Bailey, C., Zahran, H., King, M., Johnson, C., & Liu, X. (2012). 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