Viagra online and Erectile dysfunction

The associations among race/ethnicity, SES, and various measures of asthma severity and morbidity are complex. We found marked racial/ethnic differences in chronic asthma management. Black and Hispanic asthma patients lacked PCPs more often, reported a greater likelihood of lifetime hospitalization, and reported more numerous ED visits in the past year. Importantly, they also were less likely to use inhaled corticosteroids and less frequently owned a spacer and a peak flowmeter. Not only do they present to the ED more often, but also our data show that they presented to the ED Canadian HealthCare Mall with somewhat more severe exacerbations.

However, their course and treatment during the ED visit did not seem to differ dramatically, they were not hospitalized during their index ED visit at greater rates than whites (except when controlling for confounding factors), and they did not seek urgent medical care within the 2 weeks after hospital discharge more frequently than whites. As mentioned earlier, the reason that minorities exhibit such deficient chronic asthma management is probably, at least in part, due to SES and the substandard health care that accompanies lower SES. Other environmental factors associated with low SES may lead to deficient chronic disease management, such as increased risk of respiratory infections due to overcrowding, and greater exposure to allergens and irritants, but these were not assessed in our study.

Although we found that most differences were attributable to differences in SES, other research suggests that residual race/ethnicity differences may still be present even after adjusting for SES. This implicates other sociocultural and psychological factors. Some authors have speculated that racial/ethnic discrimination among health-care providers is a possible cause for the inequities observed in health care, although it is probably not conscious or deliberate. Several other explanations have been mentioned in the literature but have not been researched well enough to form conclusions. At best they offer direction for future research. These include race-based differences in health beliefs and practices emphasizing rescue rather than preventive strategies, impaired illness perception and judgment of disease severity, lower selfefficacy regarding asthma management, and greater comorbid psychopathology, such as depression, anxiety, and panic disorders.