African American Asthmatics Disproportionately Affected by Environmental Determinants

An analysis of the disparities in Asthma within Black communities.

Did you know that if you’re Black you’re more likely to struggle with breathing? Breathing while Black can seriously be a challenge for some individuals. Asthma is a disease that affects the respiratory system through inflammation of the airways. Symptoms of asthma include shortness of breath, wheezing, heavy coughing, pressure, or tightness in the chest, and feeling like you cannot take a deep breath. Several factors can trigger one’s asthma such as another illness or infection, exercise, heavy air contamination. Respiratory health can be put at risk from several factors such as one’s living environment or air pollution.

 Black Americans are significantly more likely to have asthma than white Americans. According to the American Lung Association, as of 2018, “Blacks (10.9%) were 42 percent more likely than Whites (7.7%) to still have asthma.” This disparity is due to structural, behavioral, social, and biological determinants. 

Structural determinants that Black people face daily include economic legislation, wages, working conditions, education, and housing.  Socioeconomic determinants to consider are health insurance, health literacy, therapy or treatment adherence and psychosocial stressors.  

In the United States, people with less income or who live in urban areas are disproportionately burdened with asthma. Asthma continues to be higher among people who are not socioeconomically advantaged. Though the asthma mortality rate is gradually slowing down, the disease remains responsible for thousands of American deaths. 


Possible contrasts in pulmonary tests should be investigated attentively and on a wide range of locations, while understanding that race and ethnicity control the various determinants that affect asthmatic factors. Even today there is controversy around the artificial intelligence used in pulmonary tests because different results will come up based on race in the false claim of it being a different body build.

Biologicals are used to stabilize inflammatory triggers for individuals who have long term asthma. Only a handful of biologicals exist today that are FDA approved.  This medication must be doctor prescribed and approved by your health insurance.

Doctors prescribe standard medication such as Montelukast, Albuterol, Claritin, Flonase, Advair, or Symbicort.  Before prescribing they routinely acknowledge the side effects, dosage, discuss adherence to everyday routine of consumption medicine, as well as organization or application of medications when demonstrated. According to the Asthma and Allergy Foundation of America, racial and ethnic minority patients with asthma have lower paces of prescription adherence which adds to poor treatment and lack of improvement in one’s asthma. Minorities tend to have complications when treating their illnesses due to poor insurance coverage or pharmacy availability.

Nina Jones, a junior biology student at Howard University explained how her passion became her pitfall. “My asthma got much worse when I moved to DC, I think it’s because the air quality up here is way worse than back home in the South. Dancing is my favorite form of self-expression so I do it as much as I can on my free time but since moving here it’s been harder.” 

Geographically we see asthma prevailing in the northeast region of the United States. This is due to industrialization over the years. For decades, large corporations, in addition to already large populations, have polluted the air with smog, smoke, and toxic gasses.  Big cities and urban communities are primarily affected by this pollution. Baltimore, MD and Richmond, VA are within the top three cities in the country with the highest population of asthmatic patients (AAFA).

“I started wheezing more often after like 30 minutes of dancing. It’s hard to stay in my flow when I have to take breaks just to catch my breath all the time,” Jones said.

 Dr. Phue Khaing of George Washington Medical Faculty Associates advised, “Environmental influences are more likely to trigger an asthma attack or complications, so invest in your home. Especially since most people are working from home these days, get tools to help you breathe better daily. That looks like checking your air filters every couple months or so, get an air purifier or humidifier.”

Access to clean air is just as important as access to clean water. Air pollution is one of the main environmental determinants that is a top contributor of asthma diagnosis and contamination globally. 

Research shows that 4 million cases of new asthma diagnosis in children are most likely due to an unavoidable poison: Nitrogen Dioxide, which is a gas regularly connected with traffic contamination. Huge contrasts in air quality are accounted for inside urban areas, with neighborhoods overwhelmingly populated by minorities being impacted disproportionately via air poisons when contrasted with White areas, and even though headway has been made, these variations continued throughout the course of many years.

It is important to check for allergies every few years, taking a test could alert you of something that has become harmful to your immune system” Dr. Khaing added.

Initiatives have been made to improve the disparities in asthma today. As of March 14, the Elijah E. Cummings Family Asthma Act was reintroduced to the U.S. House of Representatives. The bill was first brought to Congress’ attention in 2019, which was later named in honor of the late representative who was a prominent advocate for the asthma community. The Act is intended to reduce the number of asthma related casualties, sick days, and hospital or urgent care visits.

Semira Robinson is a reporter and regional bureau chief for HUNewsService.com.