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HONOLULU -- Sexual and gender minoritized (SGM) adults are at an increased risk for severe asthma, according to an analysis of a nationally representative study.

Compared with straight people, asthma attacks that required the use of steroids were more likely among SGM patients (OR 1.47, 95% CI 1.01-2.15), reported Tugba Kaplan, MD, of Luminis Health-Anne Arundel Medical Center in Annapolis, Maryland, during the CHEST annual meeting hosted by the American College of Chest Physicians.

SGM patients were also more likely to have asthma attacks that kept them for normal daily activities (OR 1.33, 95% CI 1.10-1.61), and more likely to experience shortness of breath during any given week (OR 1.82, 95% CI 1.32-2.51).

Previous studies have indicated that SGM patients experience many healthcare disparities, which may be related to insurance gaps, the need for culturally competent healthcare providers who are trained in caring for SGM patients, and concerns about discrimination from healthcare providers, which could lead to less access to more regular healthcare, Kaplan said.

She noted that there is little research on respiratory health in particular among SGM patients. "To the best of our knowledge, this is the first study assessing asthma severity among SGM people in a nationally representative longitudinal cohort study."

Kaplan said that she hopes that this research, and acknowledging the disparities for SGM people, will lead to more diverse research on health impacts unique to SGM patients, as well as better preparation for providers to meet that challenge.

"For fair health outcomes, I think it is so important to implement specific health promotion efforts tailored to different cultures, offer cultural sensitivity training to healthcare professionals, and conduct research with a focus on targeted interventions," she added.

For this analysis, data on adults were taken from the Population Assessment of Tobacco and Health (PATH) waves 3, 4, and 5, which spanned 2015 to 2019.

Kaplan and team included a total of 14,694 participants; 9.4% identified as SGM, and 90.6% identified as straight.

Six questions assessing asthma severity were used. The response options were dichotomized as "intermittent=0" and "persistent=1" based on the asthma severity index.

Questions covered asthma attacks requiring steroids, emergency or urgent care visits, asthma preventing daily activities or productivity, rescue inhaler use, shortness of breath, and asthma symptoms waking participants at night.

They also asked about tobacco use, including use of both electronic cigarettes and traditional combustible tobacco cigarettes, combustible use of tobacco cigarettes alone, lifetime use of electronic cigarettes, switching to electronic cigarettes after using traditional cigarettes, and never having used any form of tobacco products.

Among participants who responded that they had lifetime exclusive electronic cigarette use, SGM participants were 7.81 times more likely to have asthma symptoms that woke them up at night compared with straight participants.

For participants who never used any tobacco products, no significant differences were seen between the SGM and straight patients.

As for future research, Kaplan noted during a Q&A portion of the presentation that while marijuana use and its effects were not included in this study, it is a potential target for future research.

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