The statistics surrounding asthma in the United States are more than just numbers – they represent a significant and ongoing public health crisis. With over 25 million Americans navigating this chronic condition and more than 3,500 losing their lives to it annually, the stakes are incredibly high for families across the nation. However, the burden is not shared equally, revealing deep-seated inequities in our society.
The most alarming data comes from the CDC, which highlights that Black youths are disproportionately affected, facing hospitalization and death at five times the rate of their white peers. This “asthma gap” is not a biological coincidence; rather, it is a direct consequence of specific, avoidable systemic failures. Ultimately, addressing this issue requires more than just better inhalers; it demands a dismantling of the environmental and systemic barriers that make breathing a privilege for some rather than a right for all.
What is asthma?
Asthma is a chronic respiratory condition that affects the airways, causing the lungs to become inflamed and narrowed during attacks. These can be triggered by exposure to irritants, making it difficult to breathe, resulting in coughing, wheezing and an overall shortness of breath. While there is no cure, the condition can be managed, and several treatment options are available depending on severity. This includes inhalers and oral medications; however, it’s important to remember that the condition can become life-threatening if left unchecked.
Asthma rates tend to correlate with living in high-pollution areas, which is often parallel to social determinants and structural inequalities. These factors have an outsized impact on low-income and often communities of color, including the Black community. When compounded with discrimination within the healthcare industry, receiving a proper diagnosis and adequate care becomes more difficult.
According to air quality research conducted by Lung.org, one in three Americans is subject to unhealthy levels of air pollution, regardless of race. While discussing the state of minorities living in low-income housing, pulmonary and critical care physician Dr. Cedric Rutland articulates, “These areas qualify for some of the heaviest polluted areas in the country. This leads to significant airway inflammation, which shows itself as asthma. These communities were drawn out based upon redlining dynamics, which is why pollution is greater.”
What’s happening in your body?
To understand what happens inside the body during an asthma flare-up, think of your airways as a series of flexible pipes. When asthma “attacks,” those pipes face a triple threat that makes breathing feel like trying to inhale through a tiny, pinched straw. According to the Mayo Clinic and other respiratory experts, the restriction isn’t just one simple “tightening.” It’s a complex biological reaction involving three distinct stages:
Bronchospasm: The muscles surrounding the bronchial tubes constrict or “clamp down.” This is the immediate tightening that makes your chest feel like it’s being squeezed by an invisible band.
Inflammation: The inner lining of the airways becomes swollen and red. This chronic swelling makes the “pipes” narrower even before a flare-up begins, leaving very little room for error.
Mucus Production: To protect itself from perceived irritants, the body produces thick, sticky mucus. This further clogs the already-narrowed pathways, leading to the characteristic rattling cough.
When the body struggles to get enough oxygen, the symptoms escalate from uncomfortable to life-threatening. The difficulty in talking occurs because the lungs cannot hold enough air to vibrate the vocal cords properly. Furthermore, the bluish tint mentioned (cyanosis) is a sign of hypoxia – a critical drop in blood oxygen levels. Because oxygen-rich blood is bright red and oxygen-depleted blood is darker, the skin and nail beds can take on a dusky or blue hue, signaling that the body’s vital organs are starving for air.
Causes of asthma
Unlike some diseases, such as diabetes or cardiovascular disease, asthma doesn’t have a known cause. Some scenarios can increase the chances of someone being diagnosed with it, such as having a family history, obesity, exposure to smoke or air pollution, or a history of allergies.
Since some of the symptoms and triggers of an asthma attack are similar to those of an autoimmune disease, many Americans have made the mistake of assuming it’s an autoimmune disorder. However, autoimmune diseases occur when the body’s immune system begins to attack its own healthy tissues, mistaking them for diseased cells or foreign objects. Asthma, by contrast, is a chronic inflammatory condition that restricts airflow to the lungs due to allergens, smoke or strenuous activities.
The Cleveland Clinic shares that asthma attacks can be triggered by a variety of factors, including allergies, illness, foreign irritants, and even emotional distress. The most common triggers for those suffering from asthma include mold, smoke, pet dander, pollen, dust mites, and more. Vigorous exercise can also trigger an attack in some individuals, as the lungs strain to take in enough breath.
The World Health Organization (WHO) notes that one of the most important aspects of surviving an asthma attack is identifying your triggers and taking the necessary steps to avoid or minimize exposure to them. Many patients keep track by journaling and maintain a written card with important assistance information in the event of an emergency. Maintaining a deliberate and well-documented asthma action plan is universally recommended by specialists.
According to Healthline, a person might have silent asthma, which refers to attacks that occur without the usual warning signs, such as coughing or wheezing. These can cause asthmatic individuals to undergo extreme stress and experience shortness of breath, chest tightness, fatigue, and dizziness. Because common symptoms aren’t present, nearby individuals may not recognize the situation. This makes silent asthma attacks more severe and life-threatening than the usual coughing fits on average, since it can be difficult for asthmatics to receive crucial medical assistance. The most severe instances of these attacks are sometimes referred to as silent chest, noting that chest tightness is a key symptom.
Dr. Diana Rangaves, PharmD, explains, “It is important to try to lead a balanced life as much as possible. There are nutritional stresses if you are living with asthma and have food allergies. You are forced to be cautious because foods such as soy, wheat, eggs and peanuts can trigger allergic symptoms. Watch for food additives that trigger asthma attacks, such as sodium sulfite, sodium bisulfite and potassium metabisulfite. People with asthma get attacks because of their surroundings, such as environmental stress. Triggers are pollen, dust mites, animals (e.g., cats and dogs), tobacco smoke and cold air.”
Health risks and complications
The biggest risk for asthma is death if care isn’t provided promptly during an attack or flare-up. For this reason, many asthmatics carry rescue inhalers, which are designed to instantly open airways and stabilize breathing. Because asthma is a chronic condition with no known cure, creating a management plan is critical. This usually involves a medication regimen for people with more severe forms of the disease, or simply keeping a rescue inhaler prescription ready for those with milder forms.
Failing to keep asthma managed can mean more time spent in the hospital for emergency events, reduced lung function, or even failure and poor quality of life. This can include getting less restorative sleep, not being able to participate in more physical activities, and even increasing the risk of developing other conditions such as eczema, obesity, obstructive sleep apnea, and even gastroesophageal reflux disease (GERD).
Even when well managed, the Centers for Disease Control and Prevention (CDC) notes that people with asthma are also more likely to experience longer recovery times when they contract any kind of respiratory illness, including colds, the flu or COVID-19.
What to do about asthma
Treating asthma can be different for everyone, as the symptoms and triggers can vary between people. Certain rules are obvious, such as cleaning mold and maintaining a smoke-free home. An asthma action plan, as shared by the American Lung Association, is critical to maintaining optimal respiratory function. The right medication will depend on the severity of a child’s condition. In most cases, a rescue inhaler is for emergencies when flare-ups or attacks occur. These are meant to be used during emergencies and should not be the sole medical solution offered for an asthmatic.
For regular management, doctors might prescribe long-term use of controller inhalers or other daily oral medications to help maintain airway function. Especially in younger children, routine monitoring is not uncommon. This isn’t just to track medications, but also to monitor lung capacity using a peak-flow meter. The Asthma and Allergy Foundation of America recommends them as an early-detection device to help determine whether a flare-up might be starting.
An asthma action plan might mean keeping a rescue inhaler with the school nurse or ensuring that essential caregivers also have one. From there, asthmatics may prefer to take additional precautions such as routine flu vaccinations, breathing exercises, allergy shots, and more. By diligently following these strategies, individuals who suffer from asthma can effectively manage their conditions and lead active and healthy lifestyles.
Asthma looks different for everyone. Some people who had more chronic forms as a child can actually outgrow it in adulthood. Some people might have worsening symptoms as they age. A wide array of factors will influence whether a person’s asthma gets easier or more difficult, including:
Lifestyle changes: Older adults may become less active or experience weight gain. These factors can adversely affect respiratory health, potentially worsening the most common asthma symptoms.
Lung changes: As we age, our lungs naturally lose some elasticity and function, making asthma symptoms more noticeable and harder to control. This primarily affects seniors, though changes in general health can occur at any age.
Changes in medication: Ailments such as arthritis or cognitive decline can make it more difficult to stick to asthma medication schedules, worsening the disorder over time.
Immune system weakening: With age, the immune system can weaken, leaving the body less effective at warding off respiratory infections. This can make it more difficult to anticipate or recover from asthma attacks, and can cause triggering events to occur with more frequency.
Adult-onset asthma: Though asthma is frequently diagnosed in children, it can also develop for the first time in adulthood. Such cases may be more severe and persistent than the standard at-birth iteration, leaving elderly patients with a host of newfound respiratory difficulties.
When to see a doctor
Especially for young children, getting proper medical treatment is critical. Parents or caregivers noticing classic signs of asthma, such as wheezing, coughing, difficulty breathing, difficulty even speaking because a child can’t catch their breath, short, shallow breathing or skin discoloration (depending on skin tone), should seek emergency care.
Likewise, if there’s a family history of asthma and a child tends to take longer to recover from a respiratory illness than others, consider taking them to a doctor. Coughing that’s localized to nighttime, complaints about chest pain or tightness in the chest can also be signs that a child might have asthma.
Does asthma damage your lungs?
While it’s easy to think of asthma as a series of temporary “attacks,” the truth is that poor management can lead to permanent structural changes in the lungs – a process medical professionals call airway remodeling. When the airways are constantly inflamed and irritated, the body attempts to repair itself, but this healing process isn’t always perfect. Over time, the walls of the bronchial tubes can become thicker and more scarred, permanently narrowing the space for air to flow. This structural damage is why consistent management is so vital. If the inflammation isn’t kept in check, the lungs lose their natural elasticity, leading to serious complications.
Bottom line
Structural inequities are one of the main reasons that Black youth are more likely to have asthma than their white counterparts. While this is unfair and speaks to a medical and environmental system that has much work to do, it doesn’t ignore the fact that living with asthma requires taking a proactive stance. If your child has asthma, creating a management plan and seeking effective medical care to keep them flare-up free is critical.
Frequently Asked Questions
At what age does asthma start?
Asthma can develop at any age, from childhood well into adulthood. Still, it is most commonly diagnosed in children, with symptoms typically appearing before age five. According to a study conducted by the Allergy & Asthma Network, roughly 80 percent of all children with asthma will develop symptoms before this age.
Is asthma inherited from the mother or father?
Though this is not always the case, asthma can be passed down genetically from parents to their children. The gene can be inherited from either side of the family, though some studies suggest a slightly stronger link between the maternal line.
Citations
ALA Staff. The Unequal Burden of Asthma on the Black Community. American Lung Association. February 2024. https://www.lung.org/blog/asthma-burden-on-black-community
Mayo Clinic Staff. Asthma – Symptoms and Causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653
Cleveland Clinic Staff. What Is Asthma? Cleveland Clinic. June 2025. https://my.clevelandclinic.org/health/diseases/6424-asthma
WHO Staff. Asthma. World Health Organization. May 2024. https://www.who.int/news-room/fact-sheets/detail/asthma
Alysa Hullett. Silent Asthma: How to Spot the Signs and Breathe Better. Healthline. February 2024. https://www.who.int/news-room/fact-sheets/detail/asthma
CDC Staff. Respiratory Infections and Asthma. Centers for Disease Control and Prevention. May 2025. https://www.cdc.gov/asthma/respiratory-infections/index.html
ALA Staff. Create An Asthma Action Plan. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/managing-asthma/create-an-asthma-action-plan
AAFA Staff. Peak Flow Meters. Asthma & Allergy Foundation of America. https://aafa.org/asthma/asthma-diagnosis/lung-function-tests-diagnose-asthma/peak-flow-meters/
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