Does the High Prevalence of Vitamin D Deficiency in African Americans Contribute to Health Disparities?

African Americans have higher incidence of, and mortality from, many health-related problems than European Americans. They also have a 15 to 20-fold higher prevalence of severe vitamin D deficiency. Here we summarize evidence that: (i) this health disparity is partly due to insufficient vitamin D production, caused by melanin in the skin blocking the UVB solar radiation necessary for its synthesis; (ii) the vitamin D insufficiency is exacerbated at high latitudes because of the combination of dark skin color with lower UVB radiation levels; and (iii) the health of individuals with dark skin can be markedly improved by correcting deficiency and achieving an optimal vitamin D status, as could be obtained by supplementation and/or fortification. Moderate-to-strong evidence exists that high 25-hydroxyvitamin D levels and/or vitamin D supplementation reduces risk for many adverse health outcomes including all-cause mortality rate, adverse pregnancy and birth outcomes, cancer, diabetes mellitus, Alzheimer's disease and dementia, multiple sclerosis, acute respiratory tract infections, COVID-19, asthma exacerbations, rickets, and osteomalacia. We suggest that people with low vitamin D status, which would include most people with dark skin living at high latitudes, along with their health care provider, consider taking vitamin D3 supplements to raise serum 25-hydroxyvitamin D levels to 30 ng/mL (75 nmol/L) or possibly higher.

Evaluation of secondhand smoking characteristics in asthmatic children presenting to four emergency departments on O'ahu, Hawai'i.

Exposure to secondhand smoke causes adverse health outcomes particularly in vulnerable groups like children. This multi-centered prospective study examined the household exposure to secondhand smoke among asthmatic children presenting to emergency departments on O'ahu, Hawai'i. Findings revealed that asthmatic children of Samoan, Micronesian, Filipino, Part/Native Hawaiian and Other/Mixed Ancestry had a greater proportion of high exposure to secondhand smoke in the home compared to Japanese, Chinese and Caucasian ethnic groups. Asthmatic children with no insurance or with Medicaid had a greater frequency of high exposure to secondhand smoke in the home than those with private insurance. Additionally, an inverse relationship between caregiver educational level and exposure to secondhand smoke in the home was observed. Recommendations are provided to improve health outcomes and address the disproportionate burden of asthma in such children.