Asthma is a chronic condition that affects the airways in the lungs. People with asthma have the condition all the time, but symptoms appear when something irritates the airways.
The condition affects more than 24 million people in the United States, according to the CDC. Yet the burden is not shared equally. Black adults were more than twice as likely to die from asthma in 2021 compared with U.S. adults overall, and Black children were nearly four times as likely to die from asthma.
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Asthma and Black Health
Research shows consistently higher asthma rates and more severe outcomes among those in our communities.
- In 2024, Black adults were 14 percent more likely to have asthma compared with U.S. adults overall, according to the CDC.
- Black children were 60 percent more likely to have asthma compared with U.S. children overall.
- In 2020, Black adults were almost three times as likely to visit the emergency department for asthma compared with U.S. adults overall.
- Black children were about two and a half times as likely to visit the emergency department for asthma compared with U.S. children overall.
These disparities reflect environmental exposures, structural inequities, and barriers to consistent medical care.
Why These Gaps Exist
Environmental Exposure
Black communities are more likely to be located near highways, industrial sites, or areas with higher levels of air pollution. Pollution worsens airway inflammation and makes asthma symptoms more severe. Common triggers include chemicals, chlorine, ozone, sulfur dioxide, airborne particles, trees, grass, and weeds. Indoor environments matter too. Triggers inside the home that can increase the risk of an asthma attack include:
- Cigarette smoke and other tobacco products
- Strong fumes, vapors, or odors (such as paint, gasoline, perfumes and scented soaps)
- Aerosol sprays
- Household cleaners
- Charcoal grills
- Wood fires
- Dust mites
- Pet dander
- Poor ventilation
In addition, under certain circumstances, exercise can also trigger asthma symptoms. These circumstances include hot, humid weather; cold air and low humidity; and high pollen counts.
Barriers to Care
Consistent medical care is essential for keeping asthma under control, yet access to that care comes with barriers. Asthma sufferers in our community experience hospitalization rates six times higher than White individuals and rely on emergency departments more than four times as often.
Trust also shapes how and when people seek care. When past experiences include dismissal or bias, it becomes harder to seek help early, even when symptoms begin to worsen.
These challenges show up in clinical settings every day. “Lack of access to care, lack of access to affordable medications, mistrust in the medical system, and limited asthma education all make management harder,” says Juanita Mora, MD, an allergist and immunologist based in Chicago. “Many patients do not know when it is time to seek the help of a specialist or cannot get to one.”
Economic and Social Factors
Asthma is also shaped by the conditions people live in. The condition’s prevalence is higher among people living below the poverty line. Lower-income households face higher exposure to environmental triggers, greater difficulty affording medications, and fewer options for stable housing or transportation to appointments.
These challenges make it harder to maintain consistent asthma control and easier for symptoms to escalate into emergencies.
Spotting Early Warning Signs
Many people get used to frequent symptoms and assume they are part of everyday life with asthma. These patterns often signal that control over their symptoms is slipping. Signs to pay attention to include:
- Using a rescue inhaler more than 2 times per week
- Waking up at night with coughing or tightness more than 2 times a month
- Having repeated flare-ups (worsening of symptoms)
- Feeling winded during routine activities or with moderate exercise
- Needing oral corticosteroids (OCS) more than once or twice a year
- A visit to the emergency room or urgent care in the past 12 months
When one or more of these signs and symptoms start to show up regularly, it is a good moment to check in with your health care provider, especially a pulmonologist or allergist as they specialize in treating asthma and can discuss better asthma treatment options.
“People often overlook that chronic dry cough that does not seem to go away,” says Dr. Mora. “The cough that wakes them at night, worsens with weather changes or allergies, or lingers long after a cold.” She adds that when asthma starts limiting exercise or daily activities, “that deterioration in quality of life is a sign something deeper is going on.”
Managing Asthma More Effectively
Asthma can be managed, but it takes consistency and support. A few key steps can help keep symptoms steady and flare-ups less disruptive.
Know Your Triggers
Pay attention to what makes symptoms worse. Smoke, strong scents, cold air, exercise, and allergens are common culprits. Noticing patterns makes it easier to avoid or reduce exposure.
Build an Asthma Action Plan
A provider can help create a personalized plan that outlines:
- What medications to take and when
- How to track symptoms
- What to do if symptoms start to worsen
- When to call a provider or go to the emergency department
Having a clear plan makes day-to-day management easier and helps prevent emergencies.
Stay Connected to Care
Regular check-ins with a provider can help track symptoms and adjust treatment as needed. Community health centers and federally qualified health centers can also support people who have limited access to care or insurance.
“Patients should be reviewing how often they are using their rescue inhaler, how many steroid courses they have needed in the last year, any ER visits, and whether asthma is limiting things they enjoy,” Dr. Mora says. “Those details tell us a lot about control.”
Where Progress Starts
For individuals living with asthma, understanding symptoms, recognizing triggers, and working with a trusted provider can make a meaningful difference. For communities and health systems, the goal is to ensure that everyone can breathe safely and receive the care they need.
For More Information on Asthma:
Allergy & Asthma Network – Take Control of Your Asthma
Asthma and Allergy Foundation of America Asthma Triggers
Don’t let asthma hold you back
References
The Status of Asthma in the United States
Asthma and Black/African Americans | Office of Minority Health
Reducing health disparities in asthma: how can progress be made – PMC
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