Kingston Brown, 8, woke up in his Augusta, Georgia, home last weekend complaining of a headache and gulping for air. His mother rushed him to a nearby hospital, where he vomited in the lobby.
“I don’t want to die,” he told her.
When his father, Michael Brown, saw Kingston, the boy was pale, but his oxygen level was steady.
“That’s the thing that scared me the most. Out of all of the times that I encountered him having one of these episodes,” Brown said of Kingston, who had experienced an asthma attack and was hospitalized overnight at Augusta University Health, “he’s never had one this bad and mentioned death.”
An estimated 25 million people in the United States have asthma, but for those like Kingston, who is Black, their condition can be dire. Health data collected in recent years has indicated a growing imbalance along racial lines: Black people and Native Americans are diagnosed with asthma at higher rates; emergency department visits related to asthma are five times as high for Black patients as for white patients; and Black people are about three times more likely to die from asthma than white people.
The concern among doctors and patient advocates to ensure adequate treatment and access to care comes as the asthma death rate appears to be climbing.
Asthma deaths across the country rose by more than 17% from 3,524 in 2019 to 4,145 in 2020 — the first “statistically significant increase” in more than 20 years, according to federal data examined by the Asthma and Allergy Foundation of America, a nonprofit patient organization that tracks hospital visits and asthma-related mortality rates; it plans to include its findings in an annual report this fall.
For years, the asthma death rate has declined, in part because of better diagnosis and medications.
Kenneth Mendez, the foundation’s president and chief executive, called the year-over-year jump “puzzling” for a disease that is largely manageable through an array of treatments, and said further studies are needed to understand why the number of deaths increased and if a lack of proper care or a severity in cases were to blame.
While Covid-19 may also be a likely factor in the recent increase, there’s more to be studied as a warming climate and hotter days are only worsening the effects on people with asthma and allergy sensitivities, Mendez said.
“We need to connect the dots between climate change, allergies, asthma and the disproportionate burden of these experienced by Black, Hispanic and Indigenous populations,” Mendez said. “Climate change is making allergy seasons longer and more intense. We must do more to reverse these trends.”
Extreme heat a factor
Brown is unsure what directly triggered Kingston’s latest bout of asthma, although he had experienced a milder attack earlier this year and had been given an inhaler to use twice a day. The family plans to have a lung doctor evaluate him further.
On the days surrounding the asthma attack, the temperatures in northern Georgia had been in the 80s and 90s, and Brown believes that extreme heat and weather are playing a part in his son’s condition.
Punishing heat waves from coast to coast and stretching across the globe this summer — part of a pattern of consistently hotter years — can’t be ignored, scientists and allergists say.
Rising temperatures elevate ozone levels in the air, which can aggravate asthma symptoms and irritate airways. Intense wildfires are burning more frequently, creating hazardous smoke and airborne particles that affect air quality. Meanwhile, record flooding and rains fueled by warmer temperatures and rising sea levels can spur mold and microbial growth, potentially inflaming a person’s asthma.
“It’s worse for me on days when it’s really hot and humid,” said Amanda Ernest, 27, of Boston, who spent several days in the hospital in late June for her asthma. Ernest, who is Black and Haitian American, said she’s still unsure what led her to develop breathing problems later in life.
But people of color with a chronic respiratory condition may face added threats that make it harder to breathe.
Recent studies have shown people of color in the U.S., including Black, Latino and Asian populations, are subjected to more polluted air than white Americans, with exposure coming from industrial, agricultural and residential sources. In larger cities, communities of color are more likely to be located in neighborhoods historically overburdened by factories or near highways. And poorer-quality housing in urban areas can be home to asthma triggers, such as mold, cockroaches and mice.