Asthma is a respiratory disease that makes breathing difficult. Sometimes it is connected to plant and animal allergies. Asthma is not a contagious illness; it cannot be transmitted from person to person. Instead, asthma is a health condition that is triggered by environmental factors, such as indoor and outdoor pollutants that make the air dirty. But health experts are noticing a new phenomenon. Asthma appears to be getting worse in low-income, urban areas, affecting more and more children who live there.

Studies of rich and poor neighborhoods have shown big differences in asthma rates. In 2010, the low-income Bronx area of New York City—where 43% of children live in poverty—had the highest rate of child asthma. Out of every 10,000 children, 91 were hospitalized for asthma. The wealthiest region, Staten Island, had the lowest rate: only 22 cases per 10,000 children. Many asthma triggers, like mold and cockroaches, are far more common among low-income residential buildings. Factories, power plants, and other industrial facilities are major contributors to another asthma trigger: air pollution. Many poor residential communities are located near these industrial areas. Low-income families often have little choice in where they live, so they may not be able to protect their children from power plants, factories, and traffic.

One major source of asthma that parents can control is smoking. There are many laws against smoking in public places, but people are free to smoke in their own homes. Children who grow up in households where someone smokes are much more likely to develop asthma, and secondhand smoke is a trigger for acute, or severe, asthma attacks. Asthmatic children sometimes end up in emergency rooms to receive breathing interventions simply because their parents are unwilling to suspend smoking at home or in the car. Why don’t these parents make asthma prevention a priority? Should there be a law against smoking in any confined space where children are present, even at home?