Is There a Stigma Associated With Asthma?

I recently spotted a post asking if the "stigma of asthma" still exists, as it did during the poster's childhood in the 50s and 60s. So, I thought it might be interesting to examine this issue. In today's "enlightened modern age," does this stigma still exist?

Speaking from my own experience growing up in the 60s, I definitely experienced this bias against people with asthma. Although I clearly (looking back) had asthma symptoms as a child, they were generally mild and I was never diagnosed until young adulthood. I'm wondering why? Could it be that my pediatrician did not want to "label" me with a chronic illness?

I do recall a neighbor, though, who had severe asthma and we always pitied her. And I certainly remember hearing that she just "needed to relax and calm down" when her symptoms ramped up and all would be OK.

That attitude infers a belief that asthma is somehow related to emotions or is "all in your head." We know today that this is not at all true. There is still much we need to learn about asthma and causative factors. But, we do know that there is a real physiologic basis to the airway inflammation that causes asthma symptoms.

Yes, anxiety and strong emotions can trigger asthma attacks and/or worsen them. But psychological factors are not the underlying cause of asthma.

There was also a perception in the past that asthma may have been a sort of defect only found in "weak" individuals. This sends the message that, if we are just strong enough, we can exert mind over matter and overcome asthma. Another big misconception!

How the Stigma of Asthma Can Affect Asthma Control

Hopefully, since asthma has reached epidemic proportions, with as many as 25 million people in the U.S. alone affected by this disease, much of the societal stigma no longer exists.

However, among children and teens, who usually want desperately just to "fit in," being embarrassed by asthma symptoms or the need to use an inhaler can have a big impact on asthma control.

Studies have found that teens still believe people with asthma are portrayed in the media as weak. Also, having a chronic illness such as asthma is seen as a negative trait. Because of this, teens may be reluctant to use their inhalers to prevent and treat asthma attacks. In fact, one study suggests that they may only use their inhalers a quarter of the time that they should.

A literature review found that the stigma associated with asthma is one of the important contributing factors for:

• Patient anxiety
• Delays in diagnosis
• Denial and hiding the fact of being asthmatic
• Limiting physical activity
• Avoiding inhaler use in public

In other words, the stigma felt by people with asthma creates a barrier to effective self-management practices and higher rates of morbidity and perhaps even mortality.

What Parents Can Do to Help Kids Feel Less Stigmatized

So, what can a parent do to help kids better accept their asthma and to follow an effective treatment plan?  Here are a few suggestions:

Help them realize they are not alone. Asthma is extremely common these days! Chances are, they have a few friends or classmates who also have asthma. In fact, more than 7 million children in the U.S. have asthma.

Empower your child/teen to take control of asthma when away from home. Most schools today allow kids to carry their inhalers with them, rather than having to visit the school nurse when needed. Check with your school about their policies. If necessary, advocate for kids to have more independence with inhalers in your school.

Share positive asthma role models with your child. There are many famous athletes and stars who have asthma and who have still excelled in their fields. Seeing this may help your child feel less weird and different.

Keep those lines of communication open. It's not always easy to get children, especially during the teen years, to open up with you about how they are feeling. But it's up to you, as a parent, to broach the subject of asthma stigma. Find out if this is an issue for your child and talk through their feelings. You might even look for a peer support group to help them cope.

In Summary

Although stereotypes are definitely changing, it seems evident that a stigma still exists about people who have asthma, especially among children and teens.

So, take the time to address the issue and educate your child about why it's important to overcome these barriers and follow their asthma treatment plan. I promise you, it is worth the effort when it leads to a happier child and better asthma control.