Take a deep breath, as this may surprise you: Nearly one in 13 school-age children has asthma. It is the leading cause of school absenteeism in the U.S. due to chronic illness, accounting for more than 10 million missed school days per year.
"Many people still think of asthma as a disease of inconvenience, not as a disease that can kill," said Dr. Michael A. LeNoir, a practicing consulting allergist and pediatrician in Oakland, California. LeNoir also is president of the Ethnic Health Institute at Alta Bates/Summit Medical Center and CEO of the Ethnic Health America Network, a series of radio and television programs that focus on how health care impacts minority populations.
"Asthma can kill. And it's not the sick who die from asthma -- it's the poorly controlled."
These statistics frustrate LeNoir -- a nationally recognized expert on asthma in inner cities -- because unlike other serious diseases, most cases of asthma can be controlled with little effect on a person's daily life. Problems occur when the disease is not treated properly -- especially in children. Children who suffer from persistent asthma often have problems in school, social situations and sports because of their inability to effectively move air through their lungs.
Asthma is often inadequately treated because it frequently goes undetected. "The most common symptom in children is not the wheezing most parents think of, but chronic cough," said LeNoir, a father of four and grandfather of two. "If a child coughs when he exercises or laughs, or coughs at night when he's not sick, it's a warning sign."
According to LeNoir, the most common triggers of asthma are allergies and house dust. Once a child develops asthma, many environmental factors can exacerbate its effects such as viral infections, exposure to pollution in major cities, and hydrocarbons from automobiles and diesel fuels.
LeNoir believes two separate problems contribute to poor asthma outcomes in African American communities -- health disparity and health care disparity. "Health disparity is because of who you are. African Americans are genetically more at risk for certain diseases," LeNoir said. "Health care disparity is because of who you represent, racially or ethnically. There should be no statistical difference, and yet there is a difference in the quality of care."
To combat both issues, LeNoir devotes time to education and outreach. He lectures at medical meetings and conferences to teach health providers the proper methods of controlling asthma, since unaware physicians frequently prescribe rescue medicines such as Albuterol for long-term asthma maintenance, which is not an effective treatment.
"My goal is to make a difference beyond being a physician," said LeNoir, who enjoys cooking and playing golf. "I want to be a good member of the community who is interested in the health of the entire community."