Asthma and Multimorbidity Amongst Ethnic Minority Groups in High Income Countries

Asthma is one of the commonest noncommunicable diseases worldwide. Poor clinical outcomes have been reported in asthma amongst ethnic minority groups (EMGs) and reasons are likely to be multifactorial. There is a suggestion that underlying disease may behave differently amongst EMGs, alongside other factors including deprivation, cultural, religious, social, literacy, patient beliefs, healthcare access, treatment adherence, alongside greater burden of multimorbidity. Multimorbidity (presence of ≥ 2 long-term health conditions) in asthma is increasingly known to contribute to greater asthma burden, with differences in multimorbidity burden and patterns seen across ethnicities with a tight association with deprivation. Earlier onset of multimorbidity with relatively reduced survival has been reported amongst EMG patients, particularly those from a deprived background compared to White patients. Data regarding asthma, multimorbidity and ethnicity are scant, but emerging data suggest that multimorbidity is heterogenous, and that ethnic background is associated with variations in asthma outcomes and multimorbidity phenotypes. What is currently lacking is population-based research with a joined-up interrogation of primary care and secondary care databases to determine the prevalence and patterns of T2 and non T2 multimorbidity in asthma amongst EMGs, and analysis of patterns of associations and link to socio-demographic variables and clinical outcomes. Deeper insight into views of EMG patients and their carers regarding lived experiences of asthma and multimorbidity management, as well as those of healthcare professionals is needed, to allow development of culturally tailored resources. These studies are likely to shape a holistic culturally tailored multidimensional and an equitable approach to management of asthma with multimorbidity amongst EMGs.