Esteban G. Burchard, MD, MPH

Asthma is the most common chronic disease among children. In the U.S., childhood asthma prevalence is highest among Puerto Ricans (18.4%), followed by Blacks (14.6%), Whites (8.2%) and Mexicans (4.8%). These disparities extend to asthma mortality, which is four-fold higher in Puerto Ricans and African Americans compared to Mexican Americans. There are marked differences in drug response to asthma therapies between racial and ethnic groups, which contribute to health disparities in asthma morbidity and mortality. Albuterol, a short-acting β2-agonist, is the most commonly prescribed asthma medication in the world. We and others have demonstrated that Puerto Rican and African American children with asthma were significantly less responsive to albuterol than European American children. In addition, long-acting β2-agonist (LABA) usage has been associated with increased mortality among African American subjects. These findings suggest that poor response to asthma therapies contributes to health disparities in asthma morbidity and mortality. Racial/ethnic differences in drug response are partially explained by genetic differences. We study the interplay between genes and the environment to determine the root causes of asthma health disparities in children and adolescents to identify and develop targeted interventions to improve asthma outcomes.

I work in collaboration with a multi-disciplinary team of investigators from several Universities, which includes scientists with expertise in epidemiology, biostatistics, medicine, molecular and cell biology and genomics. Using tools from these disciplines, we perform comprehensive research (genetic, social and environmental) designed to untangle why populations differ in health and disease. We have leveraged the rich ancestry of racially mixed (admixed) populations to untangle complex gene-environment interactions for health and disease. We have developed specific expertise in population-based genetic studies in admixed populations. Most importantly, we are working to ensure that modern advances in research will benefit all populations.