Black children are at greater risk for a more severe form of asthma, and it’s not due to the air quality where they live or their families’ means, a new study says.
Black race and ethnicity is the single strongest risk factor for “T2-high asthma,” a type of asthma linked to persistently elevated levels of inflammation in the body, researchers reported recently in The Journal of Allergy and Clinical Immunology: In Practice.
Black children are nearly three times more likely to develop T2-high asthma than white children, even after taking other potential risk factors into account, researchers found.
These results run counter to the popular notion that asthma is worse among Black children because they come from poor families or live in disadvantaged neighborhoods, researchers said.
“We hope this puts to rest the myth that environmental and social factors are the main drivers of asthma severity,” lead researcher Dr. W. Gerald Teague, a pediatric pulmonologist and asthma expert at the University of Virginia Health System, said in a news release.
For many people, asthma is driven by allergens or environmental irritants like air pollution or weather changes. Their bodies have an inflammatory response to these factors, causing asthma attacks.
But as many as 50 percent to 70 percent of asthma patients suffer a more severe form driven by type 2 inflammation, according to the Allergy & Asthma Network. People with T2-high asthma suffer from overactive allergic responses that activate an array of immune cells and chemicals that produce worse inflammation.
Children with T2-high asthma tend to suffer from frequent asthma attacks and often have symptoms that are difficult to manage, researchers said.
Previous studies have found that Black children are much more likely to die from asthma than white children, and they are known to suffer T2 inflammation at higher rates, researchers said in background notes.
“For decades we knew that Black children had more adverse outcomes from asthma across the U.S.,” Teague said.
However, experts have struggled to determine whether race or other factors like environment or family income drive this disparity, researchers said.
For the new study, researchers examined more than 450 children in Virginia with either T2-high or T2-low asthma. The kids came from both rural and urban areas.
Results showed that after adjusting for air quality, income, and where children lived, “Black race by far was the most important predictor of type 2 pattern inflammation,” Teague said.
Black children were 2.9 times more likely than white children to have T2-high asthma after adjusting for social and environmental disparities, researchers said.
Further, the study found that Black kids had an even higher risk — 3.8 times higher — in a second analysis that accounted for their medical history of asthma.
Researchers found that by preschool, more than a third of children had developed T2-high inflammation asthma, climbing to more than half by kindergarten.
Going forward, doctors should consider Black children at higher risk for T2-high asthma, performing blood and allergen tests on any kids whose asthma is difficult to manage, researchers said.
“The real emphasis for providers is to consider every child with asthma as unique, and to implement care plans that target the pattern of inflammation and integrate treatment with lifestyle and family expectations,” Teague said.
Future research should investigate the biological differences that put Black children at higher risk for severe asthma, researchers said.
More information
The Allergy & Asthma Network has more on type 2 inflammation and asthma.
SOURCES: University of Virginia Health System, news release, Oct. 16, 2026; The Journal of Allergy and Clinical Immunology-In Practice, Aug. 7, 2026
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