Diane Gold and Rosaline Wright (2005) “Population Disparities in Asthma” Annual Review of Public Health. Annual Review of Public Health 26:89–113.


Diane R. Gold and Rosalind Wright work at Harvard medical school in Boston Massachusetts. In their collective paper POPULATION DISPARITIES IN ASTHMA the raise interesting questions about previous asthma research and findings. Interestingly, this paper suggests that order of birth, being in day care, or having a dog early in life might affect your chances of having asthma or allergies later. Ultimately Gold and Wright pose two important questions to readers:
Would it be better to allow children to face bacteria, viruses, and toxins early on in life so that might build immunity against them later or would it be a better approach to try to remove such things and rely on medication?
There are many things that have been linked to asthma, do things such as poverty, ethnicity, and stress really increase the risk of asthma or does it only appear that way because these apparent triggers coexist with other factors that are actually the problem?
These questions are never really answered, only pondered.
Gold and Wright do an excellent job making distinctions between all of the possible asthma triggers. They make it clear that certain suspected triggers of asthma may in fact have nothing to do with causing asthma. Much of the data included in this article is very interesting; however, the authors do not take definitive stances on any matters. In many instances they will present a possible asthma/allergy trigger, give all the reasons why it could be an asthma trigger and then promptly provide details as to why it may not be an asthma trigger. For example they write,
There is no question that asthmatic individuals who are sensitized to animals
such as cats, and who have higher exposure to these animals, have an increase
in allergic symptoms compared with sensitized asthmatic individuals with lower
exposure (82). However, multiple studies also suggest an association between
early-life exposure to dog or cat in the home and reduced risk of asthma or allergic
sensitization (96, 100).
Gold and Wright do not provide any specific results of their own, but they do suggest avenues for further research. Since the paper does not make any direct claims it doesn’t really have the opportunity to contain much bias. Essentially they point future researchers in the right direction. I feel that sometimes this is just as important as providing results. This article may even pose some interesting ideas for our class to look into.







Diane R. Gold and Rosalind Wright are both M.Ds and teach and work at Harvard Medical School, Channing Laboratory, Brigham and Women’s Hospital.. This article addresses the that “The prevalence of asthma in the United States is higher than in many other countries in the world” (1) . It also says that it is the most chronic disease among youths in America.

The experiment focuses on the “ differences in “hygiene” (e.g., family size, use of day care, early-life respiratory infection exposures, endotoxin and other farm-related exposures, microbial colonization of the infant bowel, exposure to parasites, and exposure to large domestic animal sources of allergen), diet, traffic pollution, and cigarette smoking”(1)
The study “present data on socioeconomic and ethnic disparities in asthma prevalence and morbidity in the United States and discuss environmental factors contributing to asthma disparities”
Data is collected form different countries and analyzed. On of the conclusions that is drawn is that Daycar plays a role in viruses speading. The reson for this is that kids are more incontact with eachonther and if one kid gets a virus it can spread esily to the others..
Another thing that is interesting is there is a hypothesis that having kids drink raw milk from a cow can protect against wheezing. Another way to look at this is that the antibiotics that treat the milk could be a factor.
“Asthma was negatively associated with consumption of foods containing Vitamin E in the prospective U.S. Nurses’ Health Study of 77,866 female nurses (54). Increases in allergy and asthma may be related also to decreases in dietary intake of n-3 polyunsaturated fatty acids” (6)
“In the United States, asthma prevalence, hospitalization, and mortality are higher for Black/African American compared to Caucasian (White) children” (7) “Black children still had 1.6 times the odds of asthma diagnosis
compared with White children” (8) Also people who live in the poorest neighborhoods of NY are more likely to die of Asthma. One reason that was cited was lack of good medical care.
The hygiene hypotheses are sometimes challenged to be in accurate. But I think the real reason for hygiene related issues in the city is the lack of space in the household. There will be less circulation of air and a greater chance per square foot that something is contaminated.



“Population Disparities in Asthma” was written by two doctors from Harvard Medical School. Gold’s research focuses on environmental exposures and their connections to respiratory diseases while Wright is directed toward chronic respiratory diseases. This gives the notion that they are both well educated in diseases like asthma. They wrote this article to bring together many different studies that have been done in the search for the cause of asthma. The main point of their article is to discuss differences in the importance of asthma depending on one’s location and socioeconomic status. There are huge discrepancies in what is considered important when it comes to this disease. This can be shown simply by the fact that there are a number of different definitions of the disease depending on where one looks. They start by giving a background of the impact asthma has socially and economically; then they move on to supposed causes that have been studied around the country and around the world. The two state that the worldwide literature of different tests for causes was growing in number, but so far no one has said much on the idea that region disparities might have an important impact on what is studied. They attempt to accomplish this by collaborating a great deal of information from various national and international sources such as the U.S. National Institutes of Health Guidelines for Management and Diagnosis of Asthma, ISAAC, the CDC, and various studies from countries like Germany, Switzerland, Australia, and England.
A variety of tests and studies were done by outside groups and compiled together in the writing of this article. These studies consisted of health surveys, ethnic comparisons, and the National Cooperative Inner-City Asthma Study which covered asthma inducers in inner-city environments. Overall, there was a wide range of studies covered. However, in the end they all seemed to point back to the same things having higher risks of asthma. For example, urban areas have higher asthma rates over rural areas; poverty over affluence, exposure to animals, air quality, and some family attributes are also seen to cause higher rates of asthma. The most important and probably the most looked over, they argue, is stress. They note at the end that most of these studies are about the things that worsen asthma, not the things that cause it and that the causes may not be fully physical forces. “Future research may need to pay increased attention to social, political, and economic forces that result in marginalization of certain populations in disadvantaged neighborhoods, which may increase exposure to these known environmental risk factors.”
The implications of this study are that there is not a single cause that should be studied. Many things contribute to asthma and these are all interconnected. By trying to study just one possible source, many others may be neglected which might be affecting the study of the one source. While in this article they do not completely bring things together, they at least hint that there may be some connection among the sources. “Independent of income and ethnicity, the degree of housing disrepair has been associated with increased cockroach allergen levels…” All of the studies mentioned were discussed because at one point or another it was a trend in the study of asthma. The two also try to be diplomatic about discussing everyone’s ideas on the sources of asthma even though some ideas are weighted more heavily than others (stress). This article shows the expertise of the authors since it admits that there is not just one cause of asthma. They question the causes versus the forces that just make the disease worse. Overall, they try to be impartial on asthma and its contributors even though they emphasize stress as a main cause.
This article relates to our research group’s shared questions as it discusses many groups that are not related all focusing on the study of the foundation of asthma. Many of them are government agencies around the world. It is being studied at federal, state, and sometimes city levels. We also learn that people in Europe tend to think in different ways than us while thinking similarly to each other. Whether that has to do with proximity to one another or some causes just not seeming plausible is yet to be determined. Asthma is said to be studied more intently within cities than in rural areas as well.