Esther Bejarano鈥檚 son was 11 months old when asthma landed him in the hospital. She didn鈥檛 know what had triggered his symptoms 鈥 neither she nor her husband had asthma 鈥 but she suspected it was the pesticides sprayed on the agricultural fields near her family鈥檚 home.
Pesticides are a and are commonly used where Bejarano lives in California鈥檚 Imperial Valley, a landlocked region that straddles two counties on the U.S.-Mexico border and is one of the main producers of the nation鈥檚 winter crops. It also has some of the worst air pollution in the nation and one of the highest rates of childhood asthma emergency room visits in the state, according to data collected by the
Bejarano has since learned to manage her now-19-year-old son鈥檚 asthma and works at , a local rights organization focused on environmental justice in the Imperial Valley. The organization trains health care workers to educate patients on proper asthma management, enabling them to avoid hospitalization and eliminate triggers at home. The course is so popular that there鈥檚 a waiting list, Bejarano said.
But the group鈥檚 program and similar initiatives nationwide face extinction with the Trump administration鈥檚 mass layoffs, grant cancellations, and proposed budget cuts at the Department of Health and Human Services and the Environmental Protection Agency. Asthma experts fear the cumulative impact of the reductions could result in more ER visits and deaths, particularly for children and people in low-income communities 鈥 populations to the disease.
鈥淎sthma is a preventive condition,鈥 Bejarano said. 鈥淣o one should die of asthma.鈥
Asthma can block airways, making it hard to breathe, and in severe cases can cause death if not treated quickly. Nearly 28 million people in the U.S. have asthma, and about 10 people still die every day from the disease, according to the .
In May, the White House released a that would the Centers for Disease Control and Prevention鈥檚 National Asthma Control Program, which was already gutted by in April. It鈥檚 unclear whether Congress will approve the closure.
Last year, allotted $33.5 million to state-administered initiatives in 27 states, Puerto Rico, and Washington, D.C., to help communities with asthma education. The funding is distributed in four-year grant cycles, during which the programs receive up to $725,000 each annually.
Comite Civico del Valle鈥檚 academy in Southern California, a clinician workshop in Houston, and asthma medical management training in Allentown, Pennsylvania 鈥 U.S. city to live in with asthma 鈥 are among the programs largely surviving on these grants. The first year of the current grant cycle ends Aug. 31, and it鈥檚 unknown whether funding will continue beyond then.
Data suggests that the CDC鈥檚 National Asthma Control Program has had a significant impact. The agency鈥檚 has shown that the program saves $71 in health care costs for every $1 invested. And the asthma death rate decreased 44% between the 1999 launch of the program and 2021, according to the .
鈥淟osing support from the CDC will have devastating impacts on asthma programs in states and communities across the country, programs that we know are improving the lives of millions of people with asthma,鈥 said Anne Kelsey Lamb, director of the Public Health Institute鈥檚 Regional Asthma Management and Prevention program. 鈥淎nd the thing is that we know a lot about what works to help people keep their asthma well controlled, and that鈥檚 why it鈥檚 so devastating.鈥
The Trump administration cited cost savings and efficiency in its April announcement of the cuts to HHS. Requests for comment from the White House and CDC about cuts to federal asthma and related programs were not answered.
The Information Wars
Fresno, in the heart of California鈥檚 Central Valley, is one of the country鈥檚 top 20 鈥渁sthma capitals,鈥 with high rates of asthma and related emergencies and deaths. It鈥檚 home to programs that receive funding through the National Asthma Control Program. Health care professionals there also rely on another aspect of the program that is under threat if it鈥檚 shuttered: countrywide data.
The federal asthma program on asthma rates and offers a tool to study prevalence and rates of death from the disease, see what populations are most affected, and assess state and local trends. Asthma educators and health care providers worry that the loss of these numbers could be the biggest impact of the cuts, because it would mean a dearth of information crucial to forming educated recommendations and treatment plans.
鈥淗ow do we justify the services we provide if the data isn鈥檛 there?鈥 said Graciela Anaya, director of community health at the Central California Asthma Collaborative in Fresno.
Mitchell Grayson, chair of the Asthma and Allergy Foundation鈥檚 Medical Scientific Council, is similarly concerned.
鈥淢y fear is we鈥檙e going to live in a world that is frozen in Jan. 19, 2025, as far as data, because that was the last time you know that this information was safely collected,鈥 he said.
Grayson, an allergist who practices in Columbus, Ohio, said he also worries government websites will delete important recommendations that asthma sufferers avoid heavy air pollution, get annual flu shots, and get covid-19 vaccines.
Disproportionate Risk
Asthma disproportionately affects communities of color because of 鈥渉istoric structural issues,鈥 said Lynda Mitchell, CEO of the Asthma and Allergy Network, citing a higher likelihood of living in public housing or near highways and other pollution sources.
She and other experts in the field said cuts to diversity initiatives across federal agencies, combined with the rollback of environmental protections, will have an outsize impact on these at-risk populations.
In December, the Biden administration through the EPA鈥檚 Community Change Grants program to help disadvantaged communities address pollution and climate threats. The Trump administration moved to cut this funding in March. The grant freezes, which have been by the courts, are part of a by the Trump EPA to eliminate aid to environmental justice programs across the agency.
In 2023 and 2024, the National Institutes of Health鈥檚 received $40 million for research, including on the link between asthma and climate change. The Trump administration has that money. And a essentially halted all NIH grants focused on diversity, equity, and inclusion, or DEI 鈥 funds many of the asthma programs serving low-income communities rely on to operate.
On top of those cuts, environmental advocates like Isabel Gonz谩lez Whitaker of Memphis, Tennessee, worry that the of environmental regulations will further harm the health of communities like hers that are already reeling from the effects of climate change. Shelby County, home to Memphis, recently on the American Lung Association鈥檚 annual for having so many high ozone days. Gonz谩lez Whitaker is director of EcoMadres, a program within the national organization Moms for Clean Air that advocates for better environmental conditions for Latino communities.
鈥淯rgent asthma needs in communities are getting defunded at a time when I just see things getting worse in terms of deregulation,鈥 said Gonz谩lez Whitaker, who took her 12-year-old son to the hospital because of breathing issues for the first time this year. 鈥淲e鈥檙e being assaulted by this data and science, which is clearly stating that we need to be doing better around preserving the regulations.鈥
Back in California鈥檚 Imperial Valley 鈥 where the majority-Hispanic, working-class population surrounds California鈥檚 largest lake, the Salton Sea 鈥 is an area called Bombay Beach. Bejarano calls it the 鈥渇orgotten community.鈥 Homes there lack clean running water, because of in the groundwater, and residents frequently experience a smell like rotten eggs blowing off the drying lakebed, exposing .
In 2022, a in Bombay Beach after an asthma attack. Bejarano said she later learned that the girl鈥檚 school had recommended that she take part in Comite Civico del Valle鈥檚 at-home asthma education program. She said the girl was on the waiting list when she died.
鈥淚t hit home. Her death showed the personal need we have here in Imperial County,鈥 Bejarano said. 鈥淒eaths are preventable. Asthma is reversible. If you have asthma, you should be able to live a healthy life.鈥