ABSTRACT
Despite advances in our understanding and treatment of asthma, the disease is becoming more common, more severe, and more deadly. In the United States, asthma prevalence, morbidity, and mortality are disproportionately higher in large cities, suggesting that factors associated with the urban environment may contribute to the burden of the disease on society (1,2). In New York City, the rate of asthma deaths in children and young adults is three times that of the United States, and in Cook County, Chicago, the rate is twice that of the United States (3). Additionally, in 1986, while New York City housed only 3% of the nation’s population, it accounted for 6% of all asthma hospitalizations in the United States (4).
