August 5, 2005

$6 million grant to boost asthma disparities research

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Tina Hartert, M.D., is investigating the reasons for increased asthma morbidity among pregnant African-American women.
photo by Anne Rayner

$6 million grant to boost asthma disparities research

Vanderbilt School of Medicine and Meharry Medical College have received a $6 million grant from the National Institutes of Health to probe racial disparities in asthma-related care.

The two institutions have been named one of five new Centers for Reducing Asthma Disparities, a program of the NIH’s National Heart, Lung and Blood Institute.

Each new center will receive a $6 million grant from the NIH to address one of the top four asthma-related priorities of the U.S. Dept. of Health and Human Services.

In an effort to identify and unveil the reasons for increased asthma morbidity among pregnant black women, Tina Hartert, M.D., and pediatrics fellow, Kecia Carroll, M.D., studied more than 100,000 pregnant women enrolled in TennCare.

Their goal was to identify racial disparities and study the environmental influences that affect disease development and expression in these mothers and among the children born to these women.

“It is very clear that there are significant differences in both the morbidity and mortality related to asthma in minorities,” said Hartert, assistant professor of Medicine.

“Our group's focus is on the preventive health perspective. We want to identify environmental, social and cultural elements that can be changed to decrease asthma morbidity in this population.

“While we know the predisposition of asthma, in large part, is inherited, we don't fully understand all the genetic and environmental factors involved in the development of the disease.”

The group is studying both the environmental and genetic influences that impact asthma development and disease expression.

Hartert is the project principal investigator of the Vanderbilt/Meharry team’s five-year grant to study asthma disparities.

The program is designed to close the gap while linking research intensive institutions with minority-serving institutions so that investigators can study racial disparities specific to asthma, better understand why they exist and develop a solution to eliminate such differences.

The findings were reported in a recent issue of Obstetrics and Gynecology.

“Identifying the existence of disparities is really just the tip of the iceberg,” Hartert said. “But it is an important first step.”

More than 4,300 of the women studied had asthmatic complications.

Of that number, 11 percent required ER visits and 6 percent were hospitalized.

The majority of the complications were found in black women regardless of the level of access to health care, according to the study.

“This study was not able to unveil the reasons why black pregnant women suffer more asthmatic-specific morbidity; that's the next step,” Hartert said.

“In theory, all the women had the same access to health care. There are a few clues that showed that African-American women got a lower quality of prenatal care and fewer number of doctor visits than their white counterparts.”

The next phase of the study will expand on the concept and look at the differences in perinatal and infant outcomes by race as well as study early infant exposure to viral infections and bronchiolitis in the development of asthma.

“Our hope, one day, is to be able not only to eliminate racial disparities in asthma, but to identify modifiable environmental factors, which, by altering, could prevent the development of, or the severity of, asthma among persons genetically predisposed to develop the disease,” said Hartert.