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Pediatric asthma in inner cities is often severe and children living in these urban locations with socioeconomic disadvantage experience greater asthma morbidity. There are many interconnected risk factors that individually, and in combination, enhance asthma morbidity. These include biologic factors innate to the child, such as genetics and allergen susceptibility, as well as factors related to the family and neighborhood context. The biopsychosocial model can be used to frame these risk factors and develop interventions specific to the inner city. Successful inner city asthma interventions exist and key characteristics include multi-tiered components that operate within the community to coordinate disease management resources between patients, families and health care systems., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Asthmatic children living in low-income families in United States inner city communities continue to have disproportionately high rates of hospitalizations, emergency department visits, disability, and death. Current research implicates a combination of environmental, biologic, and disease mismanagement factors that underlie these poor outcomes. Multifaceted studies are underway to better understand this inner-city path to severe asthma. Efforts to optimize interventions, to implement them broadly, and to sustain them are also underway on local and national levels. It is hoped that these efforts will limit the severe consequences of asthma, narrow disparities in outcomes, and substantially reduce medical expenditures for asthma.