Health Disparities: Interventions for Pulmonary Disease - A Narrative Review.

Area of Science:

• Pulmonary Medicine
• Health Disparities Research
• Health Services Research

Background:

• Extensive literature documents health disparities in pulmonary disease.
• Disproportionately few studies focus on interventions to reduce these disparities.

Purpose of the Study:

• To categorize interventions aimed at reducing health disparities in US pulmonary disease care.
• To identify gaps and themes in existing intervention research to guide future initiatives.

Main Methods:

• Narrative review of 211 articles on interventions for pulmonary disease disparities based on race, income, or sex.
• Categorization of interventions into biologic, educational, behavioral, and structural types.

Main Results:

• Few interventional trials exist compared to disparity documentation, with overrepresentation of asthma studies in Black, low-income, urban populations.
• Race and socioeconomic status are not reliable markers for individual pharmacologic treatment response.
• Telehealth shows promise for scaling care but requires further research for marginalized communities.
• Interventions should address societal drivers of disparity, not just individual behavior, and be tailored to local needs.

Conclusions:

• Significant gaps exist in interventional research for pulmonary disease health disparities, including a need for studies beyond asthma and high-quality effectiveness trials.
• Implementing interventions requires balancing protocol fidelity with adaptation to local barriers.
• Future interventions must be comprehensive, addressing societal determinants and local contexts to achieve health equity.