Asthma is a chronic inflammatory disease that is characterized by swelling and narrowing of airways. The patient experiences shortness of breath and chest tightness (Fanta, 2009), among other symptoms. Once the airways have been inflamed, this initiates an asthmatic attack. On the other hand, the lining of air passage also swells (Brozek et al., 2010). In Japan, the prevalence of bronchial asthma is at 5% and is steadily increasing among the adult population (Brozek et al., 2010). In Japan, bronchial asthma causes nearly 3000 deaths annually and although it has been declining in recent years, it is still high in comparison with other Western countries (Koyanagi et al., 2009). Therefore, bronchial asthma among the Japanese population is a significant issue in as far as asthma management is concerned.
Factors that cause asthma among Japanese
In a study conducted by Nakazawa and Dobashi (2004) to determine the factors contributing to the high rates of asthma among the adult population in Japan, it emerged that fatigue, respiratory infections and stress are among the leading causes of fatal asthmatic attacks. Other reports have also suggested that the recent rapid reduction in Asthma deaths among the Japanese could be linked to increased use of inhaled corticosteroids. The rapid increase in asthma deaths has also been linked to poor asthma education among patients, lack of enough education on asthma, and the inability by medical practitioners to effectively examine the severity of the condition. In a review carried out by Alvarez et al (2005), it emerged that abrupt cessation or improper treatment of such agents as inhaled corticosteroids (ICS) is one of the leading risk factors for fatal or near-fatal asthma. Additional factors include rhinovirus or influenza infection and older age.
In a report by Nakazawa (2004) in which the author sought to determine the trend of asthma mortality among the Japanese population, emotional stress and fatigue emerged as the leading factors for the causation of asthma. A number of factors have been noted to be the major causes of asthma exacerbation, including near-fatal or fatal attacks. In this regard, the Japanese Society of Allergology has come up with 16 factors that are closely related to asthma exacerbation. In their study in which they sought to determine the link between asthma exacerbation and thunderstorms, Girgis et al (2000) noted that thunderstorms resulted in exposure to such antigens as certain allergens and pollen, thereby exacerbating asthma. In this regard, exposure to allergens and several weather changes have played a key role in worsening the asthmatic condition of patients in Japan.
Environment
In spring, the Asian dust storm (ADS) that sweeps across East Asia, including Japan and these winds have been noted to have severe effects on the health of the Asian populace. This observation prompted Wanatabe et al. (2011) to conduct a correlation study among the population in Western Japan to determine the link between ADS and worsening asthma attacks among the population. The respondents to the study were interviewed via a telephone survey. The research findings revealed worsening lower respiratory symptoms among 22 of the 98 patients in the month of April which coincided with an increase in pollen levels. This observation prompted the researchers to conclude that ADS worsened lower respiratory symptoms among asthma patients in Western Japan.
Social-cultural determinants of health
A growing body of research has linked health to cultural and social factors (Marmot & Wilkinson, 2006). Social variables such as socioeconomic status, sex roles, ethnicity, gender, race, poverty, acculturation, social networks and poverty potentially impact on health outcomes in the complete disease etiology right from its onset to progression and finally, survival. Additional factors include social cohesion and income distribution. All of them play a key role determining the prevalence and aetiology of asthma.
Controlling the spread of asthma
The spread of asthma can be prevented by identifying and controlling asthma triggers. Examples of asthma triggers to avoid include smoking and second hand smoke. Quitting smoking and living in a smoking free setting goes a long way towards reducing the spread of asthma. Dust and dust mites should also be avoided and reduced. This can be accomplished by dusting of the living and working areas regularly, and maintaining low indoor humidity (van Dellen et al., 2008). Animals with feathers of fur should also be avoided and preferably kept out of the house. Homes should be kept free of dampness and well aerated to avoid mold and mildew that may trigger asthma. Pollen should also be avoided.
Effects of populations’ beliefs and values on treatment options
Patients and doctors have differing beliefs as regards the treatment options for asthma. Also, families’ and patients’ exploratory models (Ems) tend to differ based on sociocultural factors and personality. As such, it is important for health care practitioners to ensure that they are fully acquainted with the different beliefs patient beliefs as regards asthma so that they can play a key role in enhancing patient-doctor communication. This would go a long way towards ensuring that asthmatic patient stick to the treatment regimen prescribed to them. Proper management of asthma calls for a thorough understanding of patients’ beliefs on the illness and its treatment. Asthma can only be managed well when we have the right understanding of the widely held beliefs by patients (Nishima, 2009). One such belief holds that asthma is not a chronic illness but an acute one. Furthermore, most patients lack the necessary knowledge on self-management and course of asthma (Brozek et al., 2010). There is need therefore for health care providers to become acquainted with such beliefs and to also share such beliefs in asthma educational programs.
Preventing asthma at the community level
If at all we are to prevent the escalation in the prevalence of asthma, it is important to identify and develop health promotion and wellness strategies that can be implemented at the community level. One of these strategies is creating awareness among the community members that asthma is a significant public health issue that needs to be prioritized (Marmot & Wilkinson, 2006). This can be accomplished by holding periodic asthma awareness campaign in which various stakeholders such as the health care practitioners and community leaders mobilize and educate members of the community on the need to identify risk factors for asthma and how to avoid or reduce their impact on the health of the populace. Also, a community resource center can be established whereby information on asthma can be disseminated. Another strategy should be to incorporate a surveillance and evaluation program aimed at not only defining the burden of the disease, but also the program planning and guide policy, in addition to evaluating the effects of strategic plan activities aimed at reducing the prevalence of the disease. This can be accomplished by organizing annual monitoring programs aimed at identifying disparities and trends of the disease burden in the community.
Reference List
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Brozek, J. L., Bousquet, J., Baena-Cagnani, C. E., Bonini, S., Canonica, G. W., & Casale, T. B., et al. (2010). Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol., 26(3), 466-76.
Fanta, C. H. (2009). Asthma. N Engl J Med., 360, 1002-1014.
Girgis, S. T., Marks, G. B., Downs, S. H., Kolbe, A., Car, G. N., & Paton, R. (2000). Thunderstorm-associated asthma in an inland town in south-eastern Australia. Who is at risk? Eur Respir J., 16, 3-8.
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Marmot, M. G., & Wilkinson, R. D. (2006). Social Determinants of Health. Oxford, England: Oxford University Press.
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Nishima, S. (2009). Present state and problems of asthma treatment in Japan. JMAJ, 52(1), 50-53.
van Dellen, Q et al. (2008). Asthma beliefs among mothers and children from different ethnic origins living in Amsterdam, the Netherlands. BMC Public Health, 8, 380.
Wanatabe, M et al. (2011). Correlation between Asian Dust Storms and worsening asthma in Western Japan. Allergology International, 1, 60, 267-275.