Asthma Risk in People of Color

Table of Contents
View All
Table of Contents

This article is part of Health Divide: Asthma in People of Color, a destination in our Health Divide series.

Asthma is a lung disease that restricts the airways, making it difficult to breathe. It is one of the most common chronic illnesses in the United States, but some populations are more affected than others. Data shows that people from Black, Latinx, and Indigenous communities develop asthma at much higher rates than White Americans, and are more likely to be hospitalized and suffer complications.

While the reasons for these disparities are complex, experts have highlighted an increased exposure to poor air quality and lack of access to health care as some contributing factors.

This article provides an overview of the increased risk of asthma in people of color and discusses equitable treatment options.

Asthma risk disparities in people of color

Zoe Hansen / Verywell

Asthma Statistics and Race Disparities

In the United States, asthma and its complications affect Black, Latinx, and Indigenous communities disproportionately when compared to White populations.

Some statistics to put the disparities into perspective include:

  • Black Americans are 1.5 times more likely to have asthma, five times more likely to visit an emergency room due to asthma symptoms, and three times more likely to die from an asthma episode when compared to White Americans.
  • Puerto Rican Americans are more likely to have asthma compared to any other ethnic group, and are two times more likely to experience asthma attacks than White Americans.
  • Indigenous Americans have the highest rates of asthma and are almost twice as likely to experience asthma symptoms on a daily basis compared to White Americans.
  • Mexican American children are twice as likely to be hospitalized for asthma compared to their White counterparts, and have rates of asthma that are increasing quicker than all other ethnic and racial groups.

Defining Race, Ethnicity, and Health Disparities

The following definitions help describe how health outcomes intersect with different populations of people:

  • Race is a socially constructed term that was created to categorize people based on a description of their physical traits (for example, White, Black, Asian).
  • Ethnicity is a broader term used to describe a person's cultural identification, which may or may not be their place of ancestral origin (for example, Italian, Lebanese, Cuban).
  • Health disparities and health inequities are technically different terms, but often interchangeably refer to avoidable differences in the health of different population groups. These differences are driven by social, economic, or structural factors that may be rooted in racism.

What Factors Increase Asthma Risk in People of Color?

There are several different structural, social, and behavioral factors that increase asthma rates in communities of color, including genetics, increased exposure to pollution or allergens, and reduced access to high-quality health care.


Experts generally agree that there is a genetic component that increases the risk of asthma. Recent research shows some evidence of this, as people of African ancestry in other countries also appear to have higher rates of asthma, similar to Black Americans.

But having a gene in your DNA doesn't automatically mean you'll develop asthma. Environmental factors must also be present, so genetics is only one part of the explanation for asthma disparities.

To Keep in Mind

Much of the existing genetic research on the causes of asthma has been conducted on White populations, so it's not possible to generalize this data for people of other ethnic and racial backgrounds.


Your surroundings can greatly impact your asthma. A person’s physical environment plays a big role in asthma outcomes because asthma is often triggered by an irritant. These can include:

  • Cigarette smoke
  • Air pollution
  • Dust 
  • Chemical fumes
  • Pet dander  

For people of color in lower-income neighborhoods, living environment and air quality are significant drivers for developing asthma. This is due to the lower-quality building structures and more frequent exposure to outdoor pollution.

According to the Centers for Disease Control and Prevention (CDC), children who live in those areas or live in households below the federal poverty level have higher rates of asthma.

Access to Health Care

Being able to access timely and affordable health care is a crucial and often lifesaving part of maintaining a treatment plan for asthma. It's well-documented that people of color are more likely to experience unequal access to health care and health insurance.

Other barriers that limit access to health care for asthma include:

  • Lack of health insurance
  • Inability to take paid time off of work
  • Unreliable transportation to medical appointments

Data shows that Black and Latinx children with asthma are less likely to have a regular healthcare provider and more likely to use the emergency department as a form of medical care than White children. They're also less likely than White children to be prescribed or take recommended treatments to control their asthma.

Behavioral and Cultural Factors

Internal factors like a person's beliefs, behaviors, and cultural upbringing play a role in how a person understands and manages a chronic condition like asthma.

Mistrust of the medical system exists in many communities of color due to longstanding historical injustices, mistreatment, and exploitation across generations. This mistrust may be further solidified in first- or second-generation immigrants of color, who may forgo medical treatment for urgent conditions like asthma due to fear, language differences, or other barriers to seeking care.

Chronic Stress and Discrimination

Black, Latinx, and Indigenous American communities have increased exposure to chronic stress in the form of racism and discrimination, violence, and economic disparities. Evidence points to a link between this type of stress and asthma development, worsening symptoms, and less effective treatment.

Some findings have also indicated that it may begin in the womb, showing a connection between long-term maternal stress and an increased risk of childhood asthma.

Asthma Severity in People of Color

Not only are people of color at a greater risk of developing asthma, their asthma cases turn out to be more severe than asthma cases in White populations.

As a staggering example, recent data indicates that Black and Latinx people experience twice as many emergency room visits and deaths due to asthma as White people. Figures also show that Black women are the most likely to die from asthma than women from any other racial or ethnic group.

What's more, many experts hypothesize that these figures are likely underestimated and could be higher. People of color have often been broadly excluded from asthma research, and there's a lack of available data for Indigenous populations.

Equitable Asthma Programs and Treatment

So far, equitable outreach programs and policies in the U.S. have only scratched the surface in addressing disparities in asthma. Because the inequities are complex, solutions will require a multifaceted approach across medicine.

Some local, state, and nationally-based programs have taken steps toward this goal, including:


Asthma is a chronic lung disease that causes difficulty breathing. It is a common condition in the United States, but people of color are disproportionately impacted by asthma compared to White populations.

Health inequities in asthma exist for a variety of complex reasons. However, experts suspect that disparities in access to health care, environmental exposure to allergens, chronic stress from discrimination, and genetics likely play a role in the increased risk of asthma in people of color.

A Word From Verywell

Coping with asthma as a person of color can be difficult, particularly when there's the added stress of potentially discriminatory experiences and substandard access to medical care and treatment. Remember that you are not at fault for being diagnosed with asthma. Do what you can to avoid asthma triggers and advocate for better treatment if you feel it's needed.

Frequently Asked Questions

  • What is the main cause of asthma disparities in Black people?

    Black people face inequities in asthma largely due to socioeconomic factors, such as lower-quality housing and unequal access to health care. These populations routinely experience greater exposure to asthma triggers and less access to asthma specialists than White populations in the U.S.

  • How do you recognize asthma in children?

    Children typically experience the same asthma symptoms as adults, such as wheezing, coughing, and shortness of breath. However, a child may not know how to verbalize how they're feeling. Look for subtle signs, like slow recovery from respiratory illnesses, fatigue, trouble swallowing while eating, and avoiding physical activity.

  • Why do asthma health disparities exist?

    Factors like socioeconomic status, environment, and access to health care or health insurance are underlying drivers for asthma health disparities in the U.S. Other behavioral and biological factors, such as cigarette smoking and genetics, also play a smaller role.

  • What asthma resources are available to people of color?

    Healthcare providers, school nurses, and local health departments should be willing to provide you with equitable resources, contacts, referrals, and services for asthma care. You might also check the Asthma and Allergy Foundation of America or the Allergy and Asthma Network for help in English or Spanish.

27 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Oh SS, White MJ, Gignoux CR, Burchard EG. Making precision medicine socially precise: take a deep breath. Am J Respir Crit Care Med. 2016;4(193):348-350. doi:10.1164/rccm.201510-2045ED

  2. Asthma and Allergy Foundation of America. Asthma disparities in America.

  3. Lowe AA, Bender B, Liu AH, et al. Environmental concerns for children with asthma on the Navajo Nation. Ann Am Thorac Soc. 2018;15(6):745–753. doi:10.1513/AnnalsATS.201708-674PS

  4. Zahran HS, Bailey CM, Damon SA, Garbe PL, Breysse PN. Vital Signs: asthma in children — United States, 2001–2016. MMWR Morb Mortal Wkly Rep. 2018;67(5):149–155. doi:10.15585/mmwr.mm6705e1

  5. Centers for Disease Control and Prevention. Defining and measuring disparities, inequities, and inequalities in the Healthy People Initiative.

  6. Islam MM. Social determinants of health and related inequalities: confusion and implications. Front Public Health. 2019;7(11). doi:10.3389/fpubh.2019.00011

  7. Daya M, Barnes KC. African American ancestry contribution to asthma and atopic dermatitis. Ann Allergy Asthma Immunol. 2019;122(5):456-462. doi:10.1016/j.anai.2019.02.009

  8. Thomsen SF. Genetics of asthma: an introduction for the clinician. Eur Clin Respir J. 2015;2(1):24643. doi:10.3402/ecrj.v2.24643

  9. White MJ, Risse-Adams O, Goddard P, et al. Novel genetic risk factors for asthma in African American children: precision medicine and the SAGE II Study. Immunogenetics. 2016;68(6-7):391-400. doi:10.1007/s00251-016-0914-1

  10. American Lung Association. What causes asthma?

  11. Keet CA, Matsui EC, McCormack MC, Peng RD. Urban residence, neighborhood poverty, race/ethnicity, and asthma morbidity among children on Medicaid. J Allergy Clin Immunol. 2017;140(3):822-827. doi:10.1016/j.jaci.2017.01.036

  12. Centers for Disease Control and Prevention. Most recent asthma data.

  13. Shen MJ, Peterson EB, Costas-Muñiz R, et al. The effects of race and racial concordance on patient-physician communication: a systematic review of the literature. J Racial and Ethnic Health Disparities. 2018;5(1):117-140. doi:10.1007/s40615-017-0350-4

  14. Kaiser Family Foundation. Disparities in health and health care: 5 key questions and answers.

  15. Holsey CN, Collins P, Zahran H. Disparities in asthma care, management, and education among children with asthma. Clinical Pulmonary Medicine. 2013;20(4):172-177. doi:10.1097/CPM.0b013e3182991146

  16. Environmental Protection Agency. President's task force on environmental health risks and safety risks to children.

  17. Callaghan-Koru J, Riekert KA, Ruvalcaba E, Rand CS, Eakin MN. Medication beliefs are associated with not having controller medications available among head start children with asthma. Am J Respir Crit Care Med. 2017;195:A2991.

  18. University of Michigan School of Public Health. Understanding Black distrust of medicine.

  19. Banta JE, Ramadan M, Alhusseini N, et al. Socio-demographics and asthma prevalence, management, and outcomes among children 1–11 years of age in CaliforniaGlob Health Res Policy. 2021;6(17). doi:10.1186/s41256-021-00199-y

  20. Martinez A, de la Rosa R, Mujahid M, Thakur N. Structural racism and its pathways to asthma and atopic dermatitis. J Allergy Clin Imunol. 2021;148(5):1112-1120. doi:10.1016/j.jaci.2021.09.020

  21. Yonas MA, Lange NE, Celedón JC. Psychosocial stress and asthma morbidity. Curr Opin Allergy Clin Immunol. 2012;12(2):202-210. doi:10.1097/ACI.0b013e32835090c9

  22. Forno E, Celedon JC. Asthma and ethnic minorities: socioeconomic status and beyond. Curr Opin Allergy Clin Immunol. 2009;9(2):154-160. doi:10.1097/aci.0b013e3283292207

  23. Kozyrskyj AL, Mai XM, McGrath P, et al. Continued exposure to maternal distress in early life is associated with an increased risk of childhood asthmaAm J Respir Crit Care Med. 2008;177(2):142–147. doi:10.1164/rccm.200703-381OC

  24. Israel E, Cardet JC, Carroll JK, et al. Reliever-triggered inhaled glucocorticoid in Black and Latinx adults with asthma. N Engl J Med. 2022:NEJMoa2118813. doi:10.1056/NEJMoa2118813

  25. Asthma and Allergy Foundation of America. AAFA rolls out national roadmap to address serious asthma disparities impacting Black and Hispanic Americans.

  26. Centers for Disease Control and Prevention. Community asthma initiative to improve health outcomes and reduce disparities among children with asthma.

  27. American College of Allergy, Asthma, & Immunology. Asthma in children.

By Cristina Mutchler
Cristina Mutchler is an award-winning journalist with more than a decade of experience in national media, specializing in health and wellness content.