Asthma in Hispanic and Latino Communities: What the Data Shows and What South Florida Patients Need to Know

Asthma does not affect all communities equally. Among racial and ethnic groups in the United States, Hispanic and Latino Americans — particularly those of Puerto Rican descent — carry a disproportionately high burden of asthma: higher prevalence, more frequent emergency visits, greater rates of uncontrolled disease, and more deaths than non-Hispanic white Americans with the same diagnosis. In Broward County, where Hispanic and Latino residents make up approximately 35% of the population, this disparity has direct and immediate consequences for tens of thousands of families.

This article examines why these disparities exist, which South Florida-specific environmental factors compound them, and what comprehensive specialist care looks like for Hispanic and Latino patients with asthma in our community.

Prevalence: The Numbers Are Not Equal

The CDC's most recent National Health Interview Survey data reveal a striking picture of asthma by Hispanic subgroup:

Puerto Rican Americans have the highest asthma prevalence of any ethnic group in the United States — nearly double the national average. Importantly, "Hispanic" is not a monolithic category for asthma purposes. The diversity of genetic backgrounds, migration histories, environmental exposures, and socioeconomic circumstances across Cuban, Puerto Rican, Colombian, Venezuelan, Honduran, Dominican, and Mexican communities produces meaningfully different asthma profiles.

Why Puerto Rican Americans Have Disproportionately High Asthma Rates

The elevated asthma burden in Puerto Rican Americans is one of the most studied health disparities in pulmonary medicine. Researchers have identified a convergence of biological, environmental, and socioeconomic factors:

Genetic Factors

The GALA II (Genes-Environments and Admixture in Latino Americans) study, one of the largest genetics studies in asthma disparities, identified specific genetic variants associated with airway hyper-responsiveness and bronchodilator response that occur at higher frequency in individuals with greater Indigenous American and African genetic admixture — patterns common in Puerto Rican ancestry. These variants affect beta-2 adrenergic receptor function, meaning some patients respond less well to standard rescue bronchodilators than their European-ancestry counterparts.

Historical Environmental Exposures

Puerto Rican American communities have historically concentrated in high-pollution urban corridors — New York's South Bronx, Hartford CT, Chicago's Humboldt Park — with greater exposure to traffic-related air pollution, industrial particulates, and older housing stock with higher cockroach and rodent allergen loads. Children sensitized to cockroach allergen in early life carry significantly elevated lifetime asthma risk.

Access to Preventive Controller Therapy

Higher rates of poverty and uninsurance mean disproportionate reliance on emergency departments for acute asthma management rather than consistent outpatient specialist care. This cycle — acute crisis, ER stabilization, discharge without specialist follow-up — is a major driver of avoidable asthma morbidity in minority communities nationwide.

South Florida's Specific Environmental Triggers

Broward County presents a distinctive environmental profile that affects all asthma patients, but compounds the burden for those already at higher biological risk:

For Hispanic and Latino families living in apartments along high-traffic corridors, in older housing with humidity and cockroach issues, the environmental trigger load is substantially higher than for patients in newer, climate-controlled suburban homes — and the financial resources to address it (air purifiers, HEPA vacuums, allergen-proof encasements) may be more limited.

Barriers to Asthma Care in Hispanic and Latino Communities

Access to specialist asthma care is shaped by more than geography. Research identifies several systemic and cultural barriers that reduce the likelihood of Hispanic patients reaching — and remaining engaged with — a pulmonologist:

Language Concordance

When a patient's primary language is Spanish and clinical communication depends on a family member or basic translation, nuanced symptom history is lost. ACT questionnaire scores, trigger identification, inhaler technique instruction, and biologic eligibility discussions all require precise language. Studies show that language-concordant care significantly improves asthma outcomes and medication adherence.

Insurance and Cost Barriers

Uninsurance rates are higher among Hispanic adults than non-Hispanic white adults, and even insured patients may face high cost-sharing for specialist visits and controller medications. Biologic therapies, which can transform outcomes for severe asthma, carry list prices exceeding $20,000 per year — effectively inaccessible without insurance navigation support.

Cultural Health Beliefs and Symptom Minimization

In some Latin American cultural contexts, healthcare is sought primarily for acute illness rather than preventive or chronic disease management. Asthma symptoms that have become normalized over years may not be perceived as warranting specialist care. Familismo (the value of family over individual health-seeking) can also mean a patient delays care to avoid disrupting work or family obligations.

Lack of Awareness of Available Resources

Patient assistance programs for biologics, clinical trial participation opportunities, and community health programs are not uniformly accessible in Spanish. Many patients who would qualify for free or subsidized biologic therapy are never told it exists.

Biologic Therapies and Health Equity

The biologic revolution in severe asthma has produced transformative outcomes — but only for patients who can access it. All five FDA-approved biologic agents for asthma (dupilumab, mepolizumab, benralizumab, tezepelumab, omalizumab) have manufacturer patient assistance programs (PAPs) that provide medication at no cost for qualifying uninsured or underinsured patients. Navigating these programs requires dedicated clinical support.

Additionally, clinical trial participation offers another pathway to access cutting-edge biologic therapy at no cost to patients. Lung Research Florida, affiliated with Advanced Asthma Clinic, conducts trials in severe asthma, COPD, chronic cough, and bronchiectasis. All study-related care, medications, and visits are provided at no charge to eligible participants.

What a Comprehensive Specialist Visit Looks Like

For a Hispanic or Latino patient presenting to Advanced Asthma Clinic with poorly controlled asthma, a complete evaluation includes:

1. Detailed symptom and trigger history — including housing conditions, occupational exposures, neighborhood environment, and prior medication use in country of origin
2. Asthma Control Test (ACT) scoring — establishing an objective baseline
3. Spirometry with bronchodilator response — quantifying airflow obstruction and reversibility
4. FeNO (fractional exhaled nitric oxide) — measuring type-2 airway inflammation to guide biologic selection
5. Blood eosinophil count and IgE — key biomarkers for biologic eligibility
6. Allergen sensitivity testing — identifying specific triggers (dust mite, cockroach, Brazilian pepper, mold, pet dander)
7. Asthma phenotype determination — guiding individualized treatment
8. Insurance and assistance program review — ensuring biologic access if indicated

Practical Steps for Patients and Families

If you or a family member in the South Florida Hispanic community has been told you have asthma, or if symptoms are not controlled despite using an inhaler, the following steps can make a meaningful difference:

• Do not normalize breathlessness. Daily cough, nighttime awakening, and limitation of activity are not an expected part of asthma management — they indicate that control has not been achieved.
• Ask about your ACT score at every visit. A score below 20 is a guideline-defined signal that your current treatment is not working.
• Address indoor triggers. Allergen-proof mattress and pillow covers, HEPA air filtration, and cockroach control are high-yield interventions in South Florida housing.
• Ask about biologic therapy if you have been hospitalized, used oral steroids, or required frequent ER visits for asthma. Cost should not be a barrier — assistance programs exist.
• Ask about clinical trials if standard therapy has not provided adequate control. Trial participation is free and may provide access to treatments not yet commercially available.
• Bring a family member to your appointment if language support is helpful. Let the clinic know your language needs when scheduling.

Asthma Care in Plantation, FL — Serving All of Broward County

Advanced Asthma Clinic is located in Plantation, FL 33324, within easy reach of the densely populated communities of western and central Broward County where much of South Florida's Hispanic and Latino community lives and works. Dr. Frank Hull, M.D. — board-certified pulmonologist and clinical researcher with over 20 years of pulmonary research experience — provides comprehensive asthma evaluation and treatment for patients from Plantation, Fort Lauderdale, Davie, Miramar, Hollywood, Pembroke Pines, Cooper City, Weston, Tamarac, Sunrise, and Lauderhill.

This article is intended for educational purposes only and does not constitute medical advice. Always consult a qualified physician before making any changes to your asthma treatment plan. Advanced Asthma Clinic — 10059 NW 1st Court, Plantation, FL 33324 · 954-522-7226.