World Asthma Day 2026: Uncontrolled Disease and Racial Disparities Demand Structural Solutions, With Juanita Mora, MD

As asthma affects an estimated 27 to 30 million Americans — with a substantial proportion remaining inadequately controlled despite available therapies — World Asthma Day 2026 offers an opportunity to reckon with the structural and systemic forces that are keeping effective treatment out of reach for the patients who need it most, according to Juanita Mora, MD.

Mora, an allergist-immunologist at Chicago Allergy Center and attending physician at Advocate Illinois Masonic Medical Center in Chicago, Illinois, emphasized that uncontrolled asthma in the United States is not primarily a treatment gap but an access and equity gap. The most striking illustration of that inequity is the racial disparity in asthma mortality: according to federal surveillance data, Black American adults are more than twice as likely to die from asthma compared with US adults overall, and Black American children are approximately 3 to 4 times more likely to die from asthma than their white peers — disparities that persist despite decades of therapeutic advances and that Mora characterized as preventable.

She identified several overlapping structural barriers driving these outcomes. Lack of health insurance remains a fundamental obstacle, leaving many patients without reliable access to prescription medications and specialist care. The cost of asthma medications — including both daily controller inhalers and biologic therapies for severe disease — is a second distinct barrier, one Mora noted she has been actively engaged in addressing through advocacy efforts. Geographic access to specialists is a third constraint: patients in many communities must travel 30 or more miles to reach an allergist or pulmonologist, or navigate insurance networks that severely limit specialist options. Language barriers in clinical settings add further complexity for non-English-speaking patients, particularly in Hispanic and other immigrant communities.

Mora outlined several mechanisms she sees as capable of materially reducing these barriers. Telehealth — which expanded substantially during the pandemic and has demonstrated utility in asthma management — allows specialists to reach patients who cannot travel, and she called for continued support for telehealth reimbursement policies that make this access sustainable. Expanded insurance coverage, including coverage for all patients regardless of immigration or income status, was framed as the most foundational change needed. On the technology side, she highlighted 2 developments she sees as particularly promising: ultra-long-acting biologic formulations that reduce the dosing frequency burden and may improve adherence in patients with limited health system touchpoints, and digital smart inhalers that track medication use in real time, allowing clinicians to identify adherence gaps and patients to recognize when controller therapy is being used inadequately.

Environmental determinants received explicit attention. Mora called for reduction in outdoor air pollutants — including ozone and particulate matter — as well as targeted indoor air quality interventions, particularly around household smoking. Both exposures are disproportionately concentrated in urban and lower-income communities, compounding the biologic susceptibility to poorly controlled asthma in precisely those populations that also face the greatest barriers to specialist access and affordable medication. She framed these environmental and structural factors not as background context but as core clinical determinants — ones that clinicians cannot address alone and that require coordinated policy and public health responses.

“I think world asthma day also calls for a day that we have to talk about health equity and disparities in health that we currently exist in the United States,” Mora said.

Mora has no relevant disclosures to report.

Reference

Office of Minority Health, US Department of Health and Human Services. Asthma and Black/African Americans. Updated 2025. Accessed May 2026. https://minorityhealth.hhs.gov/asthma-and-blackafrican-americans