The role of housing markets in producing respiratory health disparities

Asthma is a chronic lung disease affecting an estimated 27 million people in the United States. It is much more prevalent and severe among Black, Hispanic, Indigenous, and working-class communities. Substandard housing disproportionately exposes poor people and communities of color to pests, mold, poorly regulated temperatures, and psychosocial stress. This role of housing as a driver of respiratory health disparities is well-established. However, less attention has been paid to the economic and political forces that produce the current distribution of substandard housing, which enables this unequal exposure and disease burden to persist. This review examines how harmful conditions arise from the political, legal, and economic relationships that govern housing’s production, maintenance, and distribution in the United States. We review emerging evidence that identifies power relations—most importantly the landlord-tenant relationship—as the motor that creates and reproduces disparities in exposures and the downstream disparities in asthma burden.