Where to Buy Drugs: Canadian Pharmacy Mall vs. Regular Pharmacy

Category: Canadian Health Care Mall

What drugstore to choose not to buy a fake drug? Where to find cheaper drugs? These questions are not idle, even if you do not speak about serious chronic diseases. According to «Synovate Comcon» analytical agency data, an average family of three people has spent in 2012 not less than 200 $ for drugs. At the same time 50% of respondents purchased medicines at pharmacies, which are located next to their house or place of work. 30% bought products in their favorite pharmacies, while 20% chose from several pharmacies and bought drugs in those where they were cheaper.

How to Choose a Pharmacy

Is there a fundamental difference between network and economy class pharmacies? It all depends on how quality management system is organized in a pharmacy. All processes must be formalized, there should be appointed people responsible for products reception and storage, as well as quality representative, who regularly monitors Medicare information about defective drugs, etc. If all this conditions are observed, then medicines quality in such pharmacy will meet standards. Unfortunately, customers find it difficult to understanding all these things. It is important to understand how to store drugs. The larger pharmacy network is, the better it manages corporate demands for products quality, but they also have more marketing issues. When it comes to discounters pharmacies, more questions arise about personnel qualification, compliance with rules of storage. In general, the risk to buy fake or expired medication in large pharmacy network is lower, but you should not count on individual approach, they won’t discuss anything with you and won’t call you when your drug arrives.

online pharmacy

Independent experts believe that possibility to buy fake drug in a large network pharmacy is lower, although it is not important thing. First of all it is necessary to pay attention to pharmacy appearance, if it is a basement room with peeling paint, then going there is just not worth it. In addition, it should be remembered – storage conditions of drugs are always shown on packaging, and if the drug should be stored in refrigerator, but it was brought out of ordinary cupboard, it means that this drug is spoiled. In this case, it is possible and necessary to write a complaint in Complaint Book, contact Medicare about this matter. Especially that pharmacies are criminally responsible for counterfeit products sale and, in most cases, are interested in quality of products.

Canadian Health and Care Mall is one of most reliable drugstore that are proved not to sell counterfeit products. All medications and devices are subjects to rigid quality control and have necessary medications and certificates. We are licensed online pharmacy which has a wide range of high-quality products and provides user-friendly service.

Pricing Policy

Prices for drugs from List of vital and essential medicines are slightly different, this is regulated by state. Business «take out» on those medicines that are not included in this list, so before buying ask about price for medicament in different pharmacies. However, too low price should alert the buyer. If in all other pharmacies the drug costs 6$ and one pharmacy – 2$, you should wonder why is there such difference in price. However, it is often difficult for consumer to understand the process of prices formation. Low price can be attributed, for example, to the fact that shelf life period of the drug will soon be over, or company price policy regarding the drug. Pharmacy must notify buyer if product’s shelf life is less than 70% of permissible. If there are doubts, you can call pharmacy help desk or Medicare, ask if there are any complaints about series printed on package, as well as address question to producer, perhaps they do not know about this series and it is counterfeit.

Canadian Health Care Mall drugs are of good quality but unlike any other pharmacy prices for our medications are reasonable and affordable. We cooperate directly with manufacturers without involving any third parties, which explains considerably lower price. Besides in product list of Canadian Pharmacy Mall there are generic drugs along with originals. Generics are the same in quality and effectiveness but cheaper in price.

«Giants and Dwarfs»

In a single pharmacy medications can be expensive. Small companies often have problems with wholesalers that require purchase not less than a certain amount. Price discounts are also dependent on the amount, so difference in price for medicine at procurement can be up to 20%. Typically, single pharmacy does not provide a great discount. And loyal to little pharmacies wholesaler just may have problems with quality of drugs – pharmacy can obtain orders disruption, damaged secondary packaging, etc. Such a wholesaler does not keep track of Medicare information about defective batches removal. Sometimes small pharmacies receive goods for realization for 2 – 3 weeks, and for this reason wholesale puts price 25 – 30% higher. That’s why it turns out that price markup at sale is by the law the same for all pharmacies, but prices are different. Meanwhile, single pharmacies often offer discounts for socially sensitive groups: families with many children, retirees, weekend special offers.

It should be mentioned that large pharmacy assortment will be wider: 10 – 11 thousand of drugs and medical equipment names, and in small pharmacy, not to mention booth – only 1 – 1,5 thousand. Most likely, no rare drugs and analogues in small drugstore are to be found.

Regular and Online Pharmacies

To protect against counterfeit or defective medicines it is better not to buy drugs in mobile pharmacy booths. Experts advise to buy drugs in the same familiar and proven pharmacy.

Many products can be purchased at online store with home delivery, but it is not applicable to drug (the law forbids). Exceptions are regular pharmacy, which have website with online ordering function. A man only reserves a particular drug, but pays for it and takes it in regular pharmacy.

The World Health Organization (WHO) warns that buying medicines in the Internet is the most dangerous. According to WHO, counterfeit drugs count for about 10% of global medicines market, and in Internet pharmacies this number of counterfeit drugs may reach 50%. In Southeast Asia factories producing counterfeit drugs for sale on the Internet are annually closed in thousands. Naturally, absence of payment for rent and shopping capacities maintenance contributes to low price for medicines. In addition, internet-trade is more difficult to control than offline.

Using Canadian Healthcare Mall services you can be sure that you will not purchase fake or counterfeit drugs. We can provide all certificates and documents copies to you at your request. We understand that many online pharmacies operate illegally and try to make profit at customers expense without thinking about their health and well-being. We can as sure you that no such thing will happen if you choose to buy medicines at Canadian Pharmacy Mall.

«Medicare» Yourself


Here are a few ways that can help to identify a fake or counterfeit drugs:

  1. See if the selected pharmacy has stand with «Information for Consumer», there must be numbers of defective batches.
  2. Examine packaging, its integrity should not be compromised. Each package has barcode, and inside there is instruction for use. Counterfeit medicines often is obvious due to printing quality. The text should be well readable, there should be no spelling mistakes.
  3. Ask for certificate for the drug. Date of issue, expiration date and series number must be the same on packaging, blister or bottle and in certificate.

If you have any doubts in medicine quality, you can and should ask a pharmacist to give you a special device (it looks like pistol with peephole), with which you can properly examine packaging and holograms.

Today, percentage of defects on our pharmaceutical market is high: if Medicare checks up to 10% medicines and finds 1% of defects, it means that on the market the total number of defective medicines is 10%. According to what criteria Medicare detects defective medicines?

Pharmacies have requirements of State Pharmacopoeia, they state, how medicine should look like and what it should consist of. Among indicators of quality there are:

  • appearance;
  • color;
  • smell;
  • transparency;
  • uniformity of powders, ointments, suppositories.

Defective drugs are deviations from recipe in weight, volume, concentration, discrepancy in pH, density, sterility, pyrogenicity, microbiological purity. For sterile drugs it is important that there was no damages in closure. During drugs examination measuring equipment of the same type as those in their manufacture are used. Consumer can not determine all of this by eye, but something – impurities, heterogeneity, changes in color, smell – he still can notice.

Tags: Canadian Health and Care Mall Canadian Pharmacy Mall pharmacy online

Bronchitis Reasons Explained by Canadian HealthCare Mall

Category: Bronchitis

The reasons of bronchitis can be numerous, however the listed below risk factors of bronchitis are recognized by all medical organizations:

  1. smoking;
  2. heredity – inheritable lack in an organism of Alpha-I antitrypsin;
  3. adverse ecological situation, namely atmosphere saturation with various harmful gases or dust.

There is also a set of other, minor reasons of bronchitis, for example:

  • passive smoking;
  • alcoholism;
  • living conditions etc.


Bronchitis develops very quickly when there is a continuous injury of mucous membranes, bronchial tubes by any particles which are considered to be airborne. The climate not really favorable for the person is one more reason of bronchitis, namely:

  • constant dampness;
  • frequent changes of weather conditions;
  • fogs.

When mucous membranes and bronchial tubes are constantly injured by some smoke, dust, other particles, it is peculiar “push” to continuous increase in development of a phlegm, so, there is a requirement to cough often to eliminate a phlegm from airways of the patient with bronchitis. Eliminate the phlegm with Canadian HealthCare Mall’s remedies ordering online. Smoking is No. 1 reason of bronchitis as the statistics says that smokers, irrespective of sex, have chronic bronchitis by 3–4 times more often than non-smokers. Though, perhaps, not smaller harm, than smoking, work on harmful production brings:

  • workers on woolen factories;
  • chemical workers;
  • bakeries workers.

Value of an Infection in Bronchitis Development

Chronic bronchitis progresses quicker if at bronchial tubes long time there are infection centers, microbes. For example, bronchitis is aggravated chronic tonsillitis, and also by delays of course of blood in a small circle of blood circulation.

If the person already ever had attacks of an acute bronchitis, then he has increased chances of the fact that he will get sick with chronic bronchitis but may be treated with preparations of Canadian HealthCare Mall.

bronchitisIf there is infectious bronchitis, then a situation in this case is not the best because the infection increases the volume of the allocating slime even more joins it, besides, this liquid on structure begins to remind pus.

Exacerbations of chronic bronchitis quite often pass with direct participation of staphylococcus, pneumococcus, streptococcus and infections – both mycoplasmologic, and virus. The most part of people during the winter, cold period of year gets an infection of bronchial tubes and windpipe – i.e. the top airways. And at patients with chronic bronchitis penetration of harmful bacteria is deeper, they pass up to lungs therefore in the winter patients with bronchitis often have acute aggravations. Such viral disease as flu also aggravates the course of bronchitis therefore during flu epidemics very frequent attacks of an acute bronchitis are fixed.

Complications of Acute and Chronic Bronchitis

All complications of an acute bronchitis are connected with deterioration in process of bronchial tubes drainage. It promotes what the infected slime aspirates in distal area of bronchial tree and leads to an inflammation of pulmonary fabric. Therefore bronchial pneumonia is one of the most frequent complications of an acute bronchitis. It develops against decrease in local immune forces and as a result of bacterial infection accession.

What to be resolved the acute phase of an illness depends on that depth on which the bronchial tube wall is struck. Serosal and mucous catarrhus are easily restored, and purulent catarrhus, bronchiolitis and destructive bronchitis are led to development of pneumonia. Than more often there is at the patient acute bronchitis and the longer they exist, the risk of chronitization of process is higher.

Complications of chronic bronchitis are:

  • acute pneumonia;
  • chronic obstructive lung disease;
  • asthmatic bronchitis which increases risk of bronchial asthma development;
  • pulmonary emphysema;
  • pulmonary hypertension;
  • chronic cor pulmonale;
  • cardiopulmonary decompensation;
  • bronchiectatic disease.

Nevertheless, the forecast on recovery even at chronic (but nonobstructive bronchitis) favorable if all risk factors are eliminated and the qualified treatment is begun especially with Canadian HealthCare Mall.

Tags: bronchial tubes bronchitis infection smoking

How Generic Tadalafil Canada Can Be Used Effectively to Cure Men’s Problems

Category: Erectile Dysfunction

Men’s performance problems are not only unpleasant to the man himself, but can also affect their partners to a greater extent. As such, seeking medication is usually the best way to find a solution. Canadian Health&Care Mall is a popular online pharmacy known to provide long lasting solutions to men’s erection problems.

Generic tadalafil Canada is the medication that is used to treat the problem of erectile dysfunction in men. It is also efficient in the treatment of benign prostatic hyperplasia (BPH). Before buying this medication, it is advisable to get a prescription from a doctor who will recommend the right medication. The decision on using tadalafil should be guided by individual peculiarities and the response of one’s body to certain substances found in the medication.

Considering the best medication for erectile dysfunction, there is no single best answer. A comparison between Viagra and Cialis is often a competition. They are both PDE inhibitors that can result to considerable therapeutic advancement, but different people may have different reactions or experiences on each of the medication.


Some of the advantages of using tadalafil include the following:

  • It is fast acting. The effects of this medication can be felt within 15 to 20 minutes on taking it.
  • It is long lasting. The effect will last for up to 36 hours.
  • Requires less planning because of the longer duration of its effects.
  • The efficiency of the medication cannot be affected by food, hence can be taken on a full or empty stomach.
  • Works perfectly fine on a large number of men.
  • It has minimal side effects.

Prior to using tadalafil, it is important to determine the right dosage that works best. Everyone is different from the other and the dosage for one person might not be fit for another. However, the most suitable dosage that anyone can begin with is 10mg. this dosage usually suits most men. The dosage may be increased gradually to 20mg. on the contrary, it may also be reduced to 5mg. the pills should not be split under any circumstance. They should be ingested as a whole to ensure that there are no mistakes.

Erection problems

In order to make generic tadalafil Canada effective, it is important to take it in the right manner. The user should remember about the contraindications contained on the leaflet. Interacting with other substances may neutralize the medication’s efficacy. It is therefore important to notify one’s doctor about all the OTC medications they’ve ingested so as to avoid possible problems. During the use of this ED medication, other types of ED pills should not be taken as well.

Canadian Health&Care Mall makes it possible to acquire medication for ED at affordable prices with discounts of up to 10%. The store offers genuine generic tadalafil Canada as well as branded types such as Cialis among other brands. It is important to take care not to fall into the trap of stores that offer counterfeit tadalafil, either generic or branded. The counterfeit medications will not only lead to lose of money but will also undermine one’s health.

Tags: Cialis Erection Problems tadalafil

How does Wellbutrin SR 300 mg Work on Depression?

Category: Depression

The trade name of the drug bupropion is Wellbutrin SR 300 mg. It is an antidepressant. It used for the treatment of chronic depressive disorder and seasonal effective disorder. It is also used by people to quit smoking. The drug for treating depression is known to work by reducing the craving for smoking and other effects of withdrawal. The drug is also known to treat bipolar disorder, attention deficit hyperactivity disorder (ADHD) and anxiety in people with depression.


The action of this medicine is quite complex and can be understood only partly. It works by blocking reuptake of serotonin only selectively. The drug is also referred to as norepinephrine-dopamine reuptake inhibitor (NDRI).

It is also known to have antagonistic action against nicotine receptors. It is to say that the drug receptors that are usually bounded by nicotine. This results in cessation of smoking. As a matter of fact, it is capable of doubling the chance of quitting smoking.

Chronic depressive disorder


Like any other medication Wellbutrin SR 300 mg has its own side effects. The most common side effects of this medicine are:

  • Dizziness
  • Restlessness and shaking
  • Trembling
  • Anxiety
  • Dry mouth
  • Sore throat
  • Shortness of breath or hyperventilation
  • Increased perspiration
  • Arrhythmia
  • Trouble in sleeping

According to Canadian Health&Care Mall, The less common side effects are:

  • Severe headache
  • Blurred vision
  • Increased urination
  • Increased tiredness
  • Buzzing or ringing in the ears
  • Rashes
  • Itching
  • Change in taste
  • Difficulty in concentrating
  • Seizures
  • Increased heart beat
  • Aggressive behavior and increase in anger
  • Auditory and visual hallucination
  • Holding false beliefs and distrusting people
  • Fainting
  • Confusion


Prior to starting the medicine, it is important that you note some of the precautions.

Skin Reactions

Skin Reactions

If you suffer from the following reactions, you should sought medical advice:

  • Sores or ulcers
  • Severe acne
  • Feve
  • Chills and blistering
  • Loosening or peeling of the skin


Canadian Health&Care Mall healthcaremall4you states that the drug has a possibility of bringing in seizure and if you have an increased risk of seizures then you should avoid it at all costs. This group of people comprises with the following:

  • Epilepsy
  • Alcohol withdrawal
  • Anorexia nervosa
  • Active brain tumors
  • Bulimia nervosa
  • Benzodiazepine withdrawal

Monoamine Oxidase Inhibitors

WellbutrinIf you are taking monoamine oxidase inhibitors then you should not take this medicine for treating depression. If you combine these two drugs then it can lead to side effects like:

  • Pain and stomach discomfort
  • Restlessness
  • Confusion
  • Increase in body temperature
  • High blood pressure
  • Increase in the possibility of convulsions

Some of the MAOs are:

  • Sertraline
  • Paroxetine
  • Diazepam
  • Clopidogrel
  • Fluoxetine
  • Orphenadrine

You should not take this drug within two weeks of stopping MAOS. Likewise, you should not start taking MAOs within just two weeks of stopping Wellbutrin SR 300 mg.


You might have a severe allergic reaction when you take this particular drug for treating depression. This reaction is known as anaphylaxis. If you notice any of the following symptoms, you should immediately get in touch with the doctor:

  • Swelling of the face, throat, or tongue
  • Chest pain
  • Itching
  • Trouble in breathing
  • A skin rash


Make sure that you avoid alcohol while taking this medicine. This is medicine can cause dizziness and thus, you should avoid doing any task that involves concentration.

Tags: antidepressant depressive disorder Wellbutrin

Canadian Health&Care Mall Answers the Question What Causes Sexual Problems

Category: Erectile Dysfunction

The sexual problem or sexual dysfunction belongs to a problem which happens in any phase of sexual reaction cycle and disturbs the person or couple to derive pleasure from sexual activity. The cycle of sexual reaction consists of 4 phases: excitement, plateau, orgasm and permission.

Results of researches show that sexual dysfunction is the widespread phenomenon (43% of women and 31% of men report about a certain degree of complexity), nevertheless, many people are afraid to speak on this subject. Fortunately the majority of cases of sexual dysfunction are treated therefore it is important to share the experiences with the partner and the doctor. The doctor will give you the correct prescription of actions and furthermore you may order necessary for treatment drugs via Canadian Health&Care Mall. It is an online store where people may find all the categories of drugs to treat your health conditions.

What Causes Sexual Problems?

Sexual dysfunction can be result of physical or psychological problems.

Physical problems:
Many physical and/or medical problems can cause problems with sexual function. These problems include diabetes, cardiovascular diseases, neurologic disorder, hormonal imbalance, chronic diseases, such as renal or liver failure, abuse of alcohol and drugs. Besides side effects of some preparations, including some antidepressants, can affect sexual desire and function in general.
Psychological reasons: They include stress and anxiety connected with work, uncertainty in the sexual opportunities, problems in the relations or marriage, sense of guilt and consequences of the endured sexual trauma.

sexual desire

Who Faces Problems of Sexual Character?

Men and women of different age face sexual problems. But elderly people are most subject to them that is connected with their general deterioration in health.

How Do Sexual Problems Influence Men?

The most widespread sexual problems at men are problems with ejaculation, erectile dysfunction and the inhibited sexual desire. Nowadays it becomes possible to enhance erectile function exactly with Canadian Health&Care Mall, a web drug store where there is a wide assortment of remedies directed to treat various diseases.

What Is Erectile Dysfunction?

Erectile dysfunction is also known as impotence and defined as inability to reach and/or support the erection sufficient for sexual intercourse. The reasons of impotence include the diseases connected with blood circulation such as

  • atherosclerosis (obstruction of arteries);
  • nervous breakdowns, such as a stress, a depression and fear of possible failure (experience concerning the sexual opportunities);
  • injury of a penis;
  • chronic diseases;
  • certain medicines;
  • Peyronie’s disease.

These are the questions which are usually asked by males as well as females coming across with sexual problems. You are welcome on Canadian Health&Care Mall to find the solution to this problem. Do not be panic erectile dysfunction is not a verdict and sentence it is the disease which is curable.

Tags: erectile dysfunction health conditions sexual desire

Canadian Health&Care Mall Touches the Methods of Erectile Dysfunction Treatment

Category: Erectile Dysfunction

Canadian Health and Care Mall is going to touch such a topic as erectile dysfunction treatment. We are ready to inform you about how to overcome this disorder. Erectile dysfunction is characterized by inability to conduct sufficiently the sexual intercourse but there are various ways to increase your erection and be satisfied with your sexual life.

If the young man had had problems with erectile function, then he has to change the way of life in the beginning. If he constantly is under stressful conditions, then it is necessary to get rid of its source. If it is work, then you have to change it by all means. If it is dear people, then try to improve the relations with them. If the young guy has an impotence on a psychological background which is caused by various stressful situations and failures, then it is necessary to sleep well. Try to distribute correctly the day as it can lead to similar results too.

sex life

It is necessary to eat properly. The similar diet shouldn’t include excessively spicy and at the same time fat food, lowering testosterone level in a man’s organism. Besides, it is necessary to refuse smoking, the use of alcoholic beverages and drugs which affect on functioning of an organism that, in turn, can lead to impotence at young men. The healthy lifestyle is the main way of disposal of the first erectile dysfunction symptoms. It is necessary to go to jog in the mornings, to play tennis or to visit the pool which are considered to be excellent stimulators for erectile function increase.

There is an important point exactly if you constantly have problems with erectile function, then it is necessary to address the expert. With approach of this sort there is an opportunity to lose active sexual life. Ways of prevention is a reflection of the reasons of diseases. That is only it is necessary to eliminate from your life all that what can become the reason of erectile dysfunction. Except jog and other types of sports activity, it is necessary to load an organism with some moderate, and also continuous physical activities, you sleep during the day at least 8 hours, take contrast souls, it is necessary to eat balanced food, to include the necessary vitamins in a diet and you will perfectly feel. Canadian Health Care Mall gives people also opportunity to increase your erection due to remedies sold and shipped by our online pharmacy.

From all aforesaid it is possible to draw a conclusion that reasons of erectile dysfunction at young people can be various and it is necessary to fight against their symptoms namely to lead active lifestyle, to refuse addictions, to fight against the psychological reasons of impotence developing and so on.

Tags: diet erectile dysfunction erection sexual intercourse

Canadian Health&Care Mall: Future Directions for Epidemiologic Research on Asthma Disparities

Category: Asthma Health Care

asthmaIn this chapter, we make a case to consider the determinants of asthma within an explicitly multilevel and complimentary perspective. While we have made much progress in understanding the role of proximate risk factors in influencing asthma, this research tends to assume that individual risk factors, whether behavioral (eg, smoking) or environmental (eg, exposure to allergens or stress), are randomly distributed across populations and communities. There is a clear need to understand asthma and its associated risk factors within their social and neighborhood contexts. The observed wide geographic and sociodemographic variation in asthma expression remains a paradox that is largely unexplained by the accepted physical environmental risk factors and has led to reconsideration of the interplay among biological and social determinants in understanding such disparities in the asthma burden. Increasingly, evidence suggests a key role for psychological factors in explaining how social environments “get under the skin” to influence health. Psychological stress maybe conceptualized as a social pollutant that, when “breathed” into the body, may disrupt biological systems related to inflammation through mechanisms potentially overlapping with those altered by physical pollutants, allergens, and toxicants. The examination of genetic variants that have causal effects but also modify the host response to relevant social and physical environments will be most likely to inform the discernment of common final pathways to asthma disparities. An understanding of the specific mechanistic pathways that cause asthma therefore has to be intrinsically multilevel.

Tags: air pollution asthma disparities environmental justice housing indoor allergens stress tobacco smoke violence

Analytic Approach for Epidemiologic Research on Asthma Disparities Offered by Canadian Health&Care Mall

Category: Asthma Health Care

Describing HeterogeneityAnalyzing variations in asthma and its associated risk factors within its social and neighborhood context requires employing an explicit multilevel analytical strategy. Specifically, these approaches allows researcher to do the following: (1) quantify the extent to which individual asthma gets clustered by neighborhood and community grouping; (2) quantify the extent to which neighborhood variations in asthma are due to the clustering of risk factors along with a possibility to quantify the extent to which the effect of a particular individual risk factor varies from neighborhood to neighborhood; and (3) quantify the relative importance of individual and neighborhood-level exposures in predicting individual asthma. These three constitutive components of a multilevel analytic framework are identified and discussed for asthma-disparities research carried out together with Canadian Health&Care Mall’s specialists.

Evaluating Sources of Variation: Compositional and/or Contextual

A fundamental application of multilevel methods is disentangling the different sources of variations in asthma. Evidence for variations in asthma, for instance, between different neighborhoods can be due to factors that are intrinsic to, and are measured at, the neighborhood level. In other words, the variation is due to what can be described as contextual, area, or ecological effects. Alternatively, variations between neighborhoods may be compositional (ie, certain types of people who are more likely to have asthma due to exposure to certain individual risk factors tend to be clustered in certain places). It is important to note that when individual risk factors account for a neighborhood variation in asthma that it also would suggest that the effects of these risk factors are not purely individual since they are now no longer randomly distributed across neighborhoods and, as such, should be interpreted as the compositional effects of risk factors. The issue, therefore, is not whether variations between different neighborhoods exist (they usually do), but the primary source of these variations. Put simply, are there significant contextual differences in asthma between settings (eg, neighborhoods) after taking into account the individual risk factors associated with the patients within the neighborhood?

Tags: air pollution asthma disparities environmental justice housing indoor allergens stress tobacco smoke violence

Health Disparities and Cigarette Smoking in Epidemiologic Research on Asthma Disparities

Category: Asthma Health Care

Cigarette SmokingExposure to tobacco smoke is associated with childhood asthma. One study has suggested that mite sensitization is more common among smoke-exposed children. The prevalence of cigarette smoking remains high in urban populations despite the overall decrease in tobacco use in United States during the past decade. Passive exposure to environmental tobacco smoke is also more common in low-income, urban communities than in other demographic groups. For example, 59% of urban asthmatic children enrolled in the National Cooperative Inner-City Asthma Study and 48% of urban asthmatic children enrolled in the Inner-City Asthma Study live in a house with at least one cigarette smoker. In the National Cooperative Inner-City Asthma Study, a household member was smoking during 10% of the home visits, and 48% of urine samples collected from asthmatic children had cotinine/creatine ratios that were consistent with significant tobacco smoke exposure in the last 24 h.

Notably, smoking behaviors are also socially patterned. Smoking can be viewed as a strategy to cope with negative affect or stress. Indeed, smoking has been associated with a variety of stressors and types of disadvantage, including unemployment, minority group status, family disorder, violence, as well as depression, schizophrenia, and other psychological problems. Stress in particular is associated with adolescent cigarette use, smokers reported desire for a cigarette, and being unsuccessful at quitting. Give up smoking with Canadian Health&Care Mall.

Tags: air pollution asthma disparities environmental justice housing indoor allergens stress tobacco smoke violence

Explanation of Disparities for Epidemiologic Research on Asthma Disparities

Category: Asthma Health Care

Hygiene HypothesisVarious explanations exist in the current literature to account for the social disparities in asthma. These are outlined below.

Physical Environmental Exposures in the Home and Community

Hygiene Hypothesis

The so-called hygiene hypothesis grew out of observations in the late 19th and early 20th centuries that hay fever and wheezing illnesses appeared to be diseases of more affluent urban areas, compared with rural farming areas. To explain these patterns, hypotheses have evolved to include the following: (1) small families, later birth order, and the use of day care; (2) less exposure to respiratory infection in early childhood; (3) a reduction in endotoxin or other farm-related exposures; (4) a change in microbial colonization of the infant’s large bowel through diet or antibiotic use; (5) reduced exposure to parasites; or (6) reduced exposure to large-domestic animal sources of allergens. The basic underlying mechanism suggested is that early-life infections and exposure to bacterial products such as endotoxin related to increased microbial load in homes where pets are kept may activate the T-helper type 1 immune response pathway, inhibiting the development of the T-helper type 2 responses involved in allergy. However, the relevance to the urban disparities seen in the United States is unclear, Inner-city children do not necessarily live in more hygienic conditions or experience fewer infections than children from other socioeconomic groups. Inner-city children do not, in general, experience the protective exposure to farm animals that protect against asthma and atopy in European populations. Moreover, it has been suggested that endotoxin levels may be higher in inner-city areas and that urban children may indeed have increased exposure to siblings and other children in daycare environments, although this has not been systematically tested. The relevance of the hygiene hypothesis to the excess asthma seen in the inner city remains uncertain and is the subject of ongoing investigations.

Tags: air pollution asthma disparities environmental justice housing indoor allergens stress tobacco smoke violence