Breathing in Discrimination: Asthma and Vulnerable Populations in the United States

by Sophia Garbarino, October 14, 2020

Asthma is a quite common diagnosis in children, and cases have risen significantly in the past few decades. From 1980 to 1996, “the number of individuals with asthma in the United States grew to 73.9%,” roughly equivalent to 14.6 million (Brown et al. 125). Scientific evidence has found correlation between asthma and air pollution, while sociological evidence has linked the condition to socioeconomic status (SES) and racial minorities (Brown et al.). Furthermore, SES influences not only who is diagnosed with asthma, but also who has a better health outcome.

According to “The Health Politics of Asthma: Environmental Justice and Collective Illness Experience in the United States,” a 2003 article co-authored by several sociologists and published in Social Science & Medicine, “asthma has become, for many poor and minority neighborhoods, one of the most visible and pressing problems” (Brown et al. 128). These neighborhoods are most commonly urban, with the past three U.S. Censuses revealing that “well over half of America’s largest cities are now majority non-white” (Frey). The increase in asthma has been attributed to the rise in air pollution, which is typically worst in cities. Public transportation, such as diesel buses, has been criticized for discriminatory budgeting in states including Massachusetts, where the Alternatives for Communities and Environment group (ACE) “successfully framed an issue of transit spending priorities into one of health, justice, and racism” in 2000 (Brown et al. 131). At the time, over half of Boston’s population was non-white, and the folks who relied on the buses to get to work and school were forced to use “dirty” buses that “trigger asthma attacks” on a daily basis (Jimenez; Brown et al. 132-133).

In addition to living in the most polluted and asthma-vulnerable areas, minority populations typically have lower SES than their White counterparts. According to the 2000 U.S. Census, the average household income on non-Hispanic Whites was $45,904, while the averages for Hispanics and Blacks were roughly 30% lower at “$33,447 and $30,439, respectively” (Denavas-Walt et al.). Not only do minorities have higher asthma rates, but they are also less likely to be able to afford quality health care. With limited access to quality education and everyday treatments such as albuterol inhalers, “frequent trips to the emergency room are the norm for impoverished families seeking asthma treatment, resulting in both poor management and the loss of control” (Brown et al. 135). Thus, the cycle of poor health continues.

As medical sociologist Irving Kenneth Zola wrote in his 1972 article “Medicine as an Institution of Social Control,” “man’s power over Nature is really the power of some men over other men, with Nature as their instrument” (Zola 599). Asthma is just one example of how SES and race interact, and we have yet to consider other factors such as gender, ability, and ethnicity. Our social structures perpetuate each other and are certainly reflected in our health care system.


Works Cited

Brown, Phil, et al. “The Health Politics of Asthma: Environmental Justice and Collective Illness Experience in the United States.” The Sociology of Health & Illness, edited by Peter Conrad and Valerie Leiter, SAGE Publications, 2019, pp. 125-138.

Denavas-Walt, Carmen, et al. “Money Income in the United States: 2000.” U.S. Census Bureau, 1 Sept. 2001, https://www.census.gov/library/publications/2001/demo/p60-213.html.

Frey, William. “Melting Pot Cities and Suburbs: Racial and Ethnic Change in Metro America in the 2000s.” Brookings Institution, May 2011, https://www.brookings.edu/wp-content/uploads/2016/06/0504_census_ethnicity_frey.pdf.

Jimenez, Carmen Rixely. “New Bostonians Demographic Report.” The Mayor’s Office of New Bostonians, https://www.cityofboston.gov/newbostonians/pdfs/dem_report.pdf.

Zola, Irving Kenenth. “Medicine as an Institution of Social Control.” The Sociology of Health & Illness, edited by Peter Conrad and Valerie Leiter, SAGE Publications, 2019, pp. 591-603.

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