Black children are more likely to have asthma.
A lot comes down to where they live
- teen years
HARTFORD, Conn. – Amid the balloons, cake and games at his best friend’s birthday party on a farm, 5-year-old Carter Manson clutched his small chest.
“He just kept saying ‘I can’t breathe, I can’t breathe,’’’ his mother, Catherine, recalled tearfully. “I picked him up and told him it was OK and to just breathe. Just breathe.”
It was the first time Carter had an asthma attack in public, and the inhaler he sorely needed was in the family car. Catherine calmed her terrified son and ran to get the inhaler; only then was Carter able to breathe easily.
“You say in your head as a parent that I’m going to be prepared next time,” Catherine, 39, said.
“But anything can trigger them,” she said.
Black children are more likely to have asthma than kids of any other race in America. They're more likely to live near polluting plants, and in rental housing with mold and other triggers, because of racist housing laws in the nation's past. Their asthma often is more severe and less likely to be controlled, because of poor medical care and mistrust of doctors.
About 4 million kids in the U.S. have asthma. The percentage of Black children with asthma is far higher than white kids; more than 12% of Black kids nationwide suffer from the disease, compared with 5.5% of white children. They also die at a much higher rate.
Across America, nearly 4 in 10 Black children live in areas with poor environmental and health conditions compared to 1 in 10 white children. Factories spew nitrogen oxide and particulate matter. Idling trucks and freeway traffic kick up noxious fumes and dust.
The disparities are built into a housing system shaped by the longstanding effects of slavery and Jim Crow-era laws. Many of the communities that have substandard housing today or are located near toxic sites are the same as those that were segregated and redlined decades ago.
“The majority of what drives disparities in asthma, it’s actually social and structural,” said Sanaz Eftekhari, vice president of corporate affairs and research of the Asthma and Allergy Foundation of America. “You can tie a lot of the asthma disparities back to things that have happened, years and years and decades ago.”
Asthma is treatable. It can be managed with medicine, routine appointments and inhalers. But Black children often struggle to get treatment, and are more likely than white kids to end up in the emergency room with asthma symptoms.
Kamora Herrington, a community organizer in Hartford, Connecticut, doesn't need to study the statistics to know that the children of her city are suffering.
“We know that our emergency rooms in the middle of the night during the summer are filled with children who can’t breathe,” Herrington said.
The prime cause, she said, is just as apparent.
“People need to demand change for real and people need to not be reasonable. At what point do you say, this is bull - - - -? White supremacy and racism have everything to do with it.”
The stubborn mold spores reappeared, no matter how hard Catherine Manson scrubbed the walls of her apartment, outside of Connecticut’s capital of Hartford.
As the mold began to spread further throughout the home, it dotted the walls of the bathroom and even on the bottom of one of the family’s sofas. Catherine became increasingly worried about her family’s health, noticing both she and the kids were coughing more. Their nebulizer treatments became more frequent while they lived there, and Catherine herself was prescribed an albuterol inhaler and diagnosed with asthma.
The property was owned by two different landlords during the four years the family lived there. The first didn’t attempt to fix the mold; the second tried, but failed, Catherine said.
The family thought the apartment would be a good place to raise their children. After all, it was in a relatively quiet neighborhood and affordable.
But as the mold worsened, the family increasingly felt stuck and unable to leave. It was at the height of the COVID-19 pandemic and funds were tight. Catherine suspects the mold began to form because the owners failed to address a leaky roof. The family noticed water and moisture on the walls, whenever it snowed or rained.
“I was so angry,” she recalled. “Everybody was lacking funds. There was nothing we could have done different.”
The family finally moved in 2021.
It’s a common problem for Black families.
The nation’s discriminatory housing policies make Black Americans more likely to live in rental housing. Throughout the 20th century, federal housing policies promoted homeownership and wealth generation — but those benefits were largely inaccessible to Black families.
Rental units are much more likely to have deficiencies or inadequacies and fewer means to address problems that increase exposure to asthma triggers.
In Connecticut, more than half of Black households rent, compared with a quarter of white households. In Hartford, almost 7 in 10 Black households rent.
An Asthma Allergy Foundation of America report examining asthma disparities found that Black renters were more likely to report the presence of mice, cockroaches or mold in their homes. Black people also live in older housing at higher rates, exposing them to triggers like dust and mold. In Hartford, 63% of Black households live in structures built before 1960, according to DataHaven, a nonprofit community organization.
“So many of our children are living in these just utterly disrepair homes with mold, open cracks, leaking, and vermin,” said Dr. Jessica Hollenbach, co-director of the Asthma Center of Connecticut Children’s.
Pollution is also a major factor in asthma rates.
In Connecticut, poor neighborhoods in the state’s five largest cities — Bridgeport, Hartford, New Haven, Stamford, and Waterbury — have high concentrations of kids with asthma.
Those same communities are at a higher risk for chemical and environmental exposures that are known asthma triggers.
A recent Environmental Protection Agency National Emissions Inventory shows Fairfield, Harford, New Haven and New London counties produced more than 10% of the state’s total nitrogen oxide emissions. All four of the counties include census tracts with the highest combined asthma rates.
Nitrogen oxide gases are typically emitted from vehicle exhaust, coal, oil, diesel and natural gas burning and can cause health issues such as eye irritation and asthma aggravation.
Dr. Mark Mitchell, a former director of Hartford’s health department and a founder of the Connecticut Coalition for Environmental Justice, has tried to sound the alarm on Hartford’s asthma rates.
The coalition began investigating and advocating for environmental justice after concerns arose about a regional landfill expansion and possible links to high rates of asthma, cancer and other diseases in communities neighboring them. Mitchell recalled how, in the mid ’90s, he examined about 30 kids and found that a third of them had asthma. He urged the state to look into what he believed was a clear pattern of disparities.
“They told me … we don’t really know who has asthma and doesn’t have asthma, and besides, it’s not unusual for a third of inner-city kids to have asthma,” said Mitchell, who is now associate professor of climate change at George Mason University.
The state’s health department did not respond to multiple requests for comment on its efforts to combat its asthma rates.
Mitchell said his research and work have led him to believe that the state’s asthma rates are heavily tied to traffic-related air pollution, as well as other air pollutants.
Black people suffer the brunt of it. Exposure to pollutants — specifically, fine particulate matter — is often disproportionately experienced by Black and Hispanic populations, while the emissions are disproportionately caused by white populations.
Between 2018 and 2021, more than 21% of children in East Hartford had asthma — compared to 13% statewide, according to DataHaven.
Kamora Herrington has lived in Hartford for much of her life. She launched a gathering space, Kamora’s Cultural Corner, for residents in a north-end neighborhood in Hartford — a mostly Black area of the city facing many socioeconomic challenges and the rippling effects of racism that have led to high poverty rates, poor health outcomes and shortened life expectancies.
Herrington remembers that for decades, where a garden now sits, rows of milk delivery trucks would idle daily, pouring black smoke into the air and clouds of dust. Toxins seeped into the ground as trucks were also repaired on the lot. Across the street sat low-income apartments and multifamily houses; children played nearby. They’re still there today.
The ground is too toxic to plant in, so they use raised flower beds. They’re raising funds to do an environmental cleanup of the lot.
But she wonders about the health impact on generations of Black children who have traversed the neighborhood and the city’s north end. While people may prefer to blame Black parents, saying they should make better choices for their families, she points to the years of inequities that have led people to live where they can.
“As a Black woman who is also a Black mother, I have experienced ridiculous amounts of blame and abuse from a larger system that understands they’re culpable but understands that the issues are so big, that it’s a whole lot easier to say, ‘Black mommy, you’re the problem,’” she said.
Since much of the city’s rental housing stock predates the 1960s, Herrington noted, it often lacks air conditioning or proper ventilation — a burden on asthmatic children during hot summers.
Abimbola Ortade, an activist and board member of Hartford’s Black Lives Matter 860 chapter, recently lost his sister to COVID. Like many Hartford residents, she had asthma for most of her life, and diabetes, a combination that proved deadly. Ortade also has asthma, along with two of his children. He worries frequently about their future — and his.
Asthma, Ortade said, is merely one example of how structural racism fuels health disparities that are likely to worsen as Black children go through life — including the toll of toxic stress on their mental health.
“In my neighborhood, you’ve got to worry about the police killing you, stress killing you, heart failure or asthma killing you,” he said.
Ortade is critical of elected officials and what he believes is a reluctance to truly address the disparities and root causes.
Asthma, he said, “is like a ticking time bomb.”
Carter Manson has an ally in the fight against asthma -- Caydence, his shy, 9-year-old sister.
She is fiercely protective and comes to his aid when his asthma is flaring.
But she, too, has asthma.
Caydence Manson and her brother, Carter Manson, play in the garden of their relative's home.
Black kids have other things working against them when it comes to asthma risks.
Low birth weight, which is highest among Black babies, is one risk factor.
The confluence of toxic stress, racism and discrimination that many Black people endure, heightens the risk of preterm births and low birth weights — and the disorders, like asthma, that may follow. These factors are present regardless of socioeconomic level.
Segregated or low-income communities are less likely to have easy access to health care facilities or specialty medical clinics, which are predominantly in or next to white or higher-income communities.
Advocates say increasing representation of Black doctors — including pulmonologists, allergists, immunologists and researchers — is key to better care, eliminating bias and disrupting valid mistrust in doctors.
Catherine Manson said it’s been challenging to find the right health care professionals to help control her kids’ asthma.
“I feel like the pediatricians are not as knowledgeable as they should be,” Manson said. “As a parent, you have to make those decisions on your own. I’m the advocate for my kids.”
Asthma can be particularly disruptive for Black children and their families beyond its health implications, creating a trickle down effect in other facets of their lives.
Carter, and his 9-year-old sister Caydence who also has asthma, have missed weeks of school, leaving them behind in schoolwork. And in turn, their parents were forced to miss work to care for them – putting a strain on the family’s finances.
“I’m the parent, the teacher, the nurse,” Catherine said, of the toll. “It feels like you’re kind of failing them.”
First: Catherine Manson holds back her tears while recounting a time when her son, Carter Manson, suffered an asthma attack at a friend's birthday party. Second: Catherine Manson sits on the front porch of her aunt's home while her children, Caydence Manson, middle, and Carter Manson, play close to her.
There have been efforts to bring asthma under control.
Dr. Melanie Sue Collins, director of the Pediatric Pulmonary Fellowship and Cardiopulmonary Lab at Connecticut Children's, pointed to the hospital’s Easy Breathing program, which involves more than 330 pediatricians in more than 90 practices in Connecticut and has been adapted for use in schools.
More than 150,000 children have been screened and more than 41,000 have been diagnosed with asthma. The program focuses on improving diagnosis rates and creating a standardized approach to help keep asthma under control.
“I think the biggest issue is that asthma is a chronic disease that requires care every single day,” she said. “And what I see many of my patients and families struggling with is the basic needs of life.”
HUSKY Health, which includes the state’s Medicaid and the Children’s Health Insurance Program, covers about 22% of the state population.
On a federal level, resources have been put toward various housing and health grant programs. An Asthma Disparities Subcommittee was formed by the National Institutes of Health in 2010 and published a federal action plan in 2012. And the Affordable Care Act broadened coverage access for millions.
But advocates say more asthma-specific legislation and funding is needed. Overall asthma rates have trended downward in recent years but rates among Black children remain outsized and disparate.
In Connecticut, the prevalence of asthma in the state’s public school system has slightly decreased over time but about 1 in 8 students have asthma. The incidence among Black students is about 50% higher.
That often means absenteeism — and in the near and long term, failure.
“If you miss school, you can’t succeed in school,” Collins said of a fraught cycle many kids encounter. “And if you don’t succeed in school, you have a really difficult time having a life where you can do things comfortably, whether it’s eating, having shelter or a successful job.”
After seemingly endless years of stress, things are improving for the Manson children. Catherine has done well adhering to the children’s asthma control plan. The hard work appears to be paying off.
Carter is playing flag football, something that would have been unheard of just a year ago, and Caydence is running track.
Carter hasn’t used his inhaler since last November. They haven’t missed a day of school this year. It’s a win his mother is proud of.
Still, worry lingers in the background as the seasons change and potential triggers loom.
“I’ve missed work, their dad has missed work,” said Catherine, who now works in the medical field as a patient service representative, after leaving a beloved career in part to focus on her family’s health.
“But you have to pay the bills. Then you miss work and you miss money and that comes out of your budget. It affects everything.”
Digital Presentation Credits
Producers: Samantha Shotzbarger, Josh Housing, Wong Maye-E
Data Analysis: Angeliki Kastanis
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Stafford, based in Detroit, is a national investigative race writer for the AP’s Race and Ethnicity team. She was a 2022 Knight-Wallace Reporting Fellow at the University of Michigan.
The percentage of Black children with asthma is far higher than white kids; more than 12% of Black kids nationwide suffer from the disease, compared with 5.5% of white children.Why is asthma more common in black people? ›
An Asthma Allergy Foundation of America report examining asthma disparities found that Black renters were more likely to report the presence of mice, cockroaches or mold in their homes. Black people also live in older housing at higher rates, exposing them to triggers like dust and mold.What race is most affected by asthma? ›
The burden of asthma in the United States falls disproportionately on Black, Hispanic and American Indian/Alaska Native people. These groups have the highest asthma rates, deaths and hospitalizations.What is the prevalence of asthma disparities among African American children? ›
African American children have 1.6 times the odds of being diagnosed with asthma compared to Caucasian children, and African Americans are five times likely to die from asthma than Caucasians (Smith, 2005; Bryant-Stephens, 2009).Which child is more likely to develop asthma? ›
Boys are more likely to develop childhood asthma, as compared with girls, at least until the point of puberty. This has been explained by smaller airway size in boys compared with girls under age 10 years, which predisposes to worsened airway reactivity, as compared with girls of the same age, height and weight (21).Why is asthma more common in children? ›
Researchers believe several factors may be leading to more and more children developing asthma. These factors include: Exposure to more allergens such as dust, air pollution and secondhand smoke. Not enough exposure to childhood illnesses that build up their immune systems.How does asthma affect the black community? ›
Burden of Asthma on Black Populations
Black people are also at risk of worse asthma outcomes. They are: Two times as likely to have a hospital stay due to asthma. Three times as likely to die from asthma.
Risk factors for asthma in African Americans
Compared with white people with asthma, African American people with asthma are five times more likely to visit the emergency room for symptoms.
ethnic group in the U.S.
Nearly 25 million people in the United States are living with asthma,1 but prevalence rates differ significantly by race and ethnicity. Puerto Ricans have the highest rate of asthma prevalence. Black Americans are also disproportionally diagnosed with asthma compared to white Americans.
|State or Territory||Number With Current Asthma||Percent With Current Asthma (SE)|
- #5: Louisville, Kentucky.
- #4: Philadelphia, Pennsylvania.
- #3: Dayton, Ohio.
- #2: Richmond, Virginia.
- #1: Springfield, Massachusetts.
- Poughkeepsie, New York. ...
- Harrisburg, Pennsylvania. ...
- Charleston, South Carolina. ...
- Fresno, California. ...
- Lakeland, Florida. ...
- Allentown, Pennsylvania. ...
- Cleveland, Ohio. ...
- Detroit, Michigan.
In the United States, racial disparities in asthma have been well documented. African American children have higher rates of asthma and disproportionately worse asthma outcomes than white children including higher rates of hospitalizations and deaths.What causes high asthma rates? ›
Exposure to a range of environmental allergens and irritants are also thought to increase the risk of asthma, including indoor and outdoor air pollution, house dust mites, moulds, and occupational exposure to chemicals, fumes or dust. Children and adults who are overweight or obese are at a greater risk of asthma.Is asthma more common in poor people? ›
Living in low-income, overcrowded households has a greater impact on persistent asthma among children than any other factor, researchers said. Factors linked to poverty significantly increase a child's chances of developing life-long asthma, according to new research.Is asthma genetic or environmental? ›
Rather, asthma is a polygenic, multifactorial disorder, which means that many factors contribute to its development. These factors are both genetic and environmental; accordingly, the combined action of several genes interacting with one another and with environmental factors causes the condition (1).Is asthma most common in children? ›
Asthma often starts during childhood, usually before age 5. Many children have asthma - it is the most common chronic disease of childhood.How common is asthma in children? ›
1 in 12. About 6 million children in the US ages 0-17 years have asthma.How does the environment affect asthma? ›
A wide range of indoor and outdoor allergens, irritants, as well as cold temperatures, can exacerbate asthma. Household exposures to dust mites and cockroach allergens, and the irritant effects of environmental tobacco smoke, contribute significantly to asthma morbidity.Why is asthma worse in urban areas? ›
Particulate matter is also a significant source of indoor air pollution for children with asthma living in urban centers. The primary source of indoor PM in urban homes is tobacco smoke, but other sources include cooking, heating, sweeping, and candle or incense burning.
In addition to indoor air pollution, children living in urban communities also have higher exposure to outdoor air pollution. Traffic-related air pollution (TRAP) and energy generation are the main sources of outdoor air pollution.What are African Americans most at risk for? ›
Compared to their white counterparts, African Americans are generally at higher risk for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, and HIV/AIDS, according to the Office of Minority Health, part of the Department for Health and Human Services.What genetic factor causes asthma? ›
Your inherited genetic makeup predisposes you to having asthma. In fact, it's thought that three-fifths of all asthma cases are hereditary. According to a CDC report, if a person has a parent with asthma, they are three to six times more likely to develop asthma than someone who does not have a parent with asthma.Are African Americans more prone to heart disease? ›
Heart disease is the leading cause of death in the United States. And for African Americans, the statistics are even more serious. According to the U.S. Department of Health and Human Services, African Americans are 30% more likely to die from heart disease than non-Hispanic whites.Where in the world is asthma least prevalent and why? ›
The lowest rates were observed in Vietnam (1.0%), Bosnia-Herzegovina (1.4%), and China (1.4%) . The higher prevalence observed in more developed countries may be due to increased urbanization/westernized lifestyle, higher rates of obesity, and/or pollution.What percentage of Americans have asthma? ›
Asthma is a chronic inflammation of the lung airways that causes coughing, chest tightness, wheezing or shortness of breath. 8.3% of Americans have asthma. Of these 26.5 million, 20.4 million are adults and 6.1 million are children.How prevalent is asthma in low income countries? ›
Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs) .Is a dry or humid climate better for asthma? ›
According to the Environmental Protection Agency (EPA), it is best to keep humidity levels between 30–50%. Lower humidity decreases mold growth, dust mites, and cockroaches, all of which can trigger asthma symptoms.What is the best climate for asthma? ›
A small study suggests that the best room temperature for people with asthma is between 68 and 71°F (20 and 21.6°C). This air temperature is mild, so it won't irritate the airways. Additionally, an indoor humidity level between 30 and 50 percent is ideal.What state has the least asthma? ›
- Texas 7.4%
- Iowa; South Dakota 7.9%
- Nevada 8.0%
- North Dakota 8.2%
- Minnesota 8.3%
Breathe in the salty air
Sea air, which contains iodine, salt, and magnesium, encourages respiratory health and can reduce the symptoms of asthma, promote respiratory health, improve allergies and skin problems, and stimulate the immune system.
Heat and Humidity
Hot, humid air can cause asthma symptoms as well. Humidity helps common allergens like dust mites and mold thrive, aggravating allergic asthma. Air pollution, ozone and pollen also go up when the weather is hot and humid.
Heat and High Humidity
High levels of humidity means the air is full of moisture and often very stagnant, which when inhaled by asthma sufferers, can trigger your asthma symptoms. It also creates an optimal environment for mold and bacteria growth, which can affect your asthma.
- Oklahoma City, Oklahoma. Oklahoma City is not going to be a pleasant and easy-to-live-in location for people with asthma due to its low air quality and a high level of pollen. ...
- Detroit, Michigan. ...
- Philadelphia, Pennsylvania. ...
- Richmond, Virginia. ...
- Memphis, Tennessee.
New York City has one of the country's highest rates of hospitalizations and deaths due to asthma among children and young adults, and African American and Latino patients accounting for more than 80% of the cases.Can asthma be prevented? ›
While there's no way to prevent asthma, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks. Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack.What is black box epidemiology? ›
The use of observational epidemiological methods and inference to arrive at conclusions about cause-effect relations between risk factors and disease outcomes without necessarily understanding or attempting to explain detailed causal mechanisms or the pathogenesis of the specific disease that is being studied.How to prevent asthma? ›
- Quit smoking and avoid secondhand smoke.
- Wear a mask when painting, doing construction work or yard work.
- Get your flu shot.
- Use HEPA filters in your vacuum, furnace and air conditioner.
- Use protective bedding and pillow cases to reduce allergies.
The stigma associated with asthma is one of the important contributing factors for frequent patient anxieties, delayed diagnosis, denial and limited disclosure of being asthmatic, limited physical activity and avoidance of inhaler use in public.Is asthma caused by poor air quality? ›
Air pollution exposure is thought to potentially cause asthma in children by impacting the developing lung and immune system. Air pollution, especially traffic-related pollution, can increase the chances of developing asthma in adults as well.
Bono, born Paul David Hewson, is the front man of one of the most popular rock bands of all time and has one of the most influential voices in the music industry. However, most fans are unaware that off stage, he and one of his children manage the symptoms of asthma.Does climate change cause asthma? ›
Higher temperatures that come with climate change also promote more ground-level ozone pollution. Ozone is a powerful lung irritant and can trigger asthma attacks. As the climate warms, the pollen season is getting longer, which can trigger asthma attacks in those children whose asthma can be triggered by allergies.Who is most popular in asthma? ›
Asthma is more common in female adults than male adults. Around 9.7% of female adults have asthma, compared to 6.2% of male adults. It is a leading chronic disease in children. Currently, there are about 4.8 million children under the age of 18 with asthma.Why do more black children have asthma? ›
Research shows that Black children are more likely to live near polluting plants, and in rental housing with mold and other triggers, because of racist housing laws in the nation's past. Their asthma often is more severe and less likely to be controlled, because of poor medical care and mistrust of doctors.How does asthma affect a child social development? ›
Feelings of depression or loneliness can occur in children who have asthma (4). They are also unable to establish independence from their parents, which negatively affects the socialization processes and inhibits maturing (4).What are the racial disparities in childhood asthma? ›
The seven-year observational study conducted across 18 states using electronic health record data of 41,276 children with asthma found 54% of black children had fewer than two visits annually, while for white and Spanish-preferring Latino children, it was 49.2% and 30.1%, respectively.Is asthma mostly genetic? ›
You're more likely to develop asthma if it's in your close family, such as your parents or brothers and sisters. This is partly down to genetics and partly down to the shared environment you live and grow up in.Why are children in low income families at a higher risk for asthma? ›
Children who live in substandard housing are more likely to be exposed to asthma triggers like mold or pests at home, particularly in urban and low-income communities. When children are exposed to certain triggers in the home early in life, they may be at increased risk of being diagnosed with asthma.Is there a correlation between poverty and asthma? ›
The connection between poverty and asthma is due to a variety of factors, including: A shortage of healthy housing in poor neighborhoods means that people experience a range of housing conditions like mold, pests, and leaks that trigger asthma and make it worse.What triggers asthma? ›
Sinus infections, allergies, pollen, breathing in some chemicals, and acid reflux can also trigger attacks. Physical exercise; some medicines; bad weather, such as thunderstorms or high humidity; breathing in cold, dry air; and some foods, food additives, and fragrances can also trigger an asthma attack.
If both parents have asthma, a child has a 70% chance of developing it. Like other diseases, asthma likely results from both a tendency present in the genes and exposure to environmental factors.Are you born with asthma or does it develop? ›
While no one is born with asthma itself, you may be born with genes that dictate whether you'll get it as an infant or young child. In fact, it's estimated that children are up to 3 times more likely to develop asthma if their mothers have it, and 2.5 times more likely if their fathers do.Is asthma from inbreeding? ›
The results of this study suggest that parental consanguinity does not increase the risk of bronchial asthma in children. It is generally believed that bronchial asthma is caused by the interaction between genetic susceptibility and environmental exposure.What people are prone to asthma? ›
Those who grew up or live in urban areas have a higher risk for asthma. Children and adults who are overweight or obese are at a greater risk of asthma. Although the reasons are unclear, some experts point to low-grade inflammation in the body that occurs with extra weight.