Asthma Capitals 2018: Poverty

In the  AAFA's Asthma Capitals 2018 ReportDownload PDF, AAFA looked at eight risk factors that can affect asthma rates: poverty, lack of health insurance, poor air quality, pollen counts, long-term control medicine use, quick-relief medicine use, smoking laws and access to specialists.

Asthma can be very hard on families living in poverty. Proper asthma management may be hard when you are worried about paying for basic needs like housing, clothing and food. The cost of care may impact going to the doctor and buying medicines. A lack of transportation may affect attending regular health care appointments.

If your finances are affecting asthma management, look for local resources that may help. There may be safety net (free) clinics that will treat anyone regardless of insurance status or ability to pay.

There are also programs that can help cover the costs of some medicines, such as:

  • State pharmaceutical assistance programs
  • Non-profit programs
  • Assistance programs from pharmaceutical companies


The cost of managing asthma adds to the stress of those already living with limited means. Dr. Tyra Bryant-Stephens, Medical Director of the Community Asthma Prevention Program at Children’s Hospital of Philadelphia, has witnessed the correlation between poverty and asthma and the impact it has on low-income families.

“In the neighborhoods we serve, there is a high rate of poverty, as well as a high rate of asthma morbidity,” says Dr. Bryant-Stephens. “Limited financial resources impact every aspect of their lives, including the basic requirements of adequate food, clothing and shelter which should be a right for all children. It causes more family stress, and sometimes multiple families have to live together which may result in a more chaotic environment.”

Asthma often runs in families, increasing the burden even more. At one time, Shari Duncan in Detroit, Michigan (overall #16 Asthma Capital), was managing her own asthma as well as asthma in all six of her children, who now range in age from 17 to 40. There was a point when managing everyone’s asthma was very complicated.

“There were over 40 meds and often 20 breathing treatments a day,” Shari says. “Sometimes me and two or three of the kids were in the emergency room at the same time. Every day was a challenge.”

Needless to say, the challenges of managing everyone’s asthma, and all of the worry associated with that, was very, very stressful for her.

Today, most of Shari’s children are adults and on their own. But back when there were co-pays for six kids, things were much more difficult. She had to arrange a payment plan in order to pay for all the asthma meds. The cost of buying sheets and pillow cases specially made for those with asthma also added up.