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Socio-economic dynamics of asthma

Asthma is a complex, chronic inflammatory disease of the lower airways affecting people of all ages. Approximately 300 million individuals are currently suffering from asthma worldwide and 10 per cent of it i.e. 30 million in India. The prevalence of asthma is estimated to range from 3 to 38 per cent in children and from 2 to 12 per cent in adults1. The disease causes lost school and work days, limitations in daily activities, and sleep disturbances. Lung function impairment also occurs, resulting in decreased quality of life unless disease control is achieved and a high annual financial burden is incurred. Achievement and maintenance of control through assessment of clinical manifestations and future risk has become the aim of treatment over the years1. About 15 million disability-adjusted life years are lost annually due to asthma; asthma, therefore, represents 1 per cent of the total global disease burden2. The annual death rate due to asthma is estimated to be 250,000 and the majority of deaths occur in low and middle income countries3. Patients from low- and middle-income countries have more severe symptoms than those in high-income countries, possibly due to incorrect diagnoses, poor access to health care, the unaffordability of therapy, exposure to environmental irritants, and genetic susceptibility to more severe disease4. The apparent racial and ethnic differences in the prevalence of asthma reflect underline genetic variances with a significant overlay of socioeconomic and environmental factors. Asthma found in higher prevalence in developed than in developing nations, in poor compared to affluent population in developed nations and in affluent compared to poor population in developing nations-reflect lifestyle differences such as exposure to the allergens, access to health care, etc5.