This Asthma Week (1-7 September) we’re sharing valuable information about how stigma affects the health of people living with asthma.
Stigma is still an issue for adults living with asthma and can directly impact how well they manage their condition. This is extremely important given asthma is a condition amenable to self-management, which affects one in nine Australians, and claims more than one life each day.
In a new survey we investigated how stigma plays out in Australian workplaces and the embarrassment of using asthma inhalers in public. The good news is that you can help.
These are the top three impacts that we found:
1. Workplaces – 1 in 2 people think their workplace does not view or are unsure if asthma is a valid reason to take sick leave. Asthma Australia is encouraging workplaces to be more transparent about asthma in their leave policies to help remove this stigma.
2. Despite most Australians surveyed (95%) being supportive of someone using their asthma inhaler in public, nearly half (48%) of people who have asthma or care for someone with asthma, say they would feel uncomfortable to use an asthma inhaler in public.
3. COVID-19 has intensified stigma around the asthma cough. Four in ten (43%) of Australians surveyed admitting if they saw someone coughing, they would assume they are contagious. This is reflected in an Asthma Australia COVID-19 survey which found most people with asthma reported feeling stigmatised by their asthma symptoms appearing like COVID-19.
Experts are aligned with Asthma Australia and say the attitudes in the workplace toward asthma and reliever inhalers need to change to help better Australian lives.
In his clinical work, respiratory physician Dr John Blakey has witnessed the ongoing negative impacts of stigmas on people with asthma.
“Being stigmatised for having asthma means people are less likely to take their treatment. This can make their condition worse. This vicious circle leads to avoidable harm,” Dr Blakey said.
“Taking inhalers is one of the parts of asthma self-management that can lead to people experiencing stigma.”
In relation to stigma in the workplace, “Hiding the condition might be literally not telling an employer they have it, but it can also manifest as coming to work when unwell – being present but less productive for fear of being labelled in your absence,” Dr Blakey said.
Lived experiences and this new data tells us workplaces are indeed a hot spot for stigmatised attitudes towards workers with asthma.
One person with asthma has told Asthma Australia when she needed time off from her nursing work to deal with her asthma, she was told she was “stupid” to pursue a career in health care.
A barrier to using inhalers in public
In the survey, Asthma Australia found that while most (95%) Australians said they were supportive of someone using an inhaler in public, more than one fifth of Australia (22%) said that if they had asthma, they would be uncomfortable using one themselves.
The level of discomfort using an inhaler in public increased greatly for people who have asthma or are a health professional caring for people with asthma.
Nearly half, 48% of people who have asthma or care for someone with asthma, say they would feel uncomfortable to use an asthma inhaler in public.
In particular, 56% of people who care for someone with asthma say they would feel uncomfortable (or the people they care for).
People who care for someone with asthma in their job were more likely to say they would feel uncomfortable to use an asthma inhaler in public than people who do not (65% compared to 16%)
This shows that those who live with asthma or understand the stigma around it, are more aware.
Asthma Australia wants health professionals to be aware of the way their interactions can contribute to experiences of stigma and the impact this has on patient health care access.
As a health professional, how do I help remove stigma?
Click here to access free Accredited ThinkGP Asthma Training Modules that focus on lived experience.
Asthma Australia suggests that the first step to reversing the experiences of stigma related to health care is to consider a person-centred approach. Person-centredness in asthma appreciates the whole person and their context and the relationship between and influence of these factors on asthma health. Combining person-centredness with supported self-management in asthma; a model that builds self-efficacy through education, encouragement, reinforcement, reassurance, and feedback, has great capacity to reduce stigma.
If you don’t have time for this in a consult or you don’t have access to an asthma educator in your practice or hospital, you can refer your asthma patients to Asthma Australia’s Asthma Educator Service for free.
Referring patients to get extra help will show them you do care about them living confidently with asthma, and it could be an important gesture that may help your patient overcome their perceived stigma.
There are other helpful resources here: http://asthma.org.au/health-professionals/health-professional-resources/
The survey was commissioned by Asthma Australia and conducted online by YouGov between 4 – 8 August 2022. The sample was comprised of a nationally representative sample of n=1,030 Australians aged 18+. The data has been weighted by age, gender and region to reflect the latest ABS population estimates.