Marginalized Children Struggle to Access Pediatric Asthma Specialists

Study finds structural, communication, and referral barriers limit access to specialized care despite caregiver support

Published on Feb. 10, 2026

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A new study has found that fewer than 2 in 10 children with poorly controlled asthma from marginalized communities in Rochester, New York had seen a pulmonologist or allergist in the prior year, despite 81% of caregivers believing that a specialist visit would benefit their child. The study highlights a disconnect between guideline recommendations and real-world care, with racial disparities and socioeconomic factors playing a significant role in limiting access to specialized asthma treatment.

Why it matters

Uncontrolled pediatric asthma can have serious health consequences, leading to increased hospitalizations, missed school days, and long-term lung damage. This study underscores the need to address the systemic barriers that prevent marginalized children from accessing the specialized care they require to effectively manage their condition.

The details

The study, a sub-analysis of the TEAM-UP trial, examined data from 325 children aged 4 to 12 years in Rochester, New York. The cohort was predominantly publicly insured (80%), with 58% identifying as Black and 35% as Hispanic. Despite high caregiver receptiveness to specialist care, only 37% of children had ever seen an asthma specialist, and just 16% had done so in the past year. Black children accounted for only 39% of those who had ever received specialty care, highlighting significant racial disparities. Children from higher-income households, with more educated caregivers, and with married or partnered caregivers were more likely to access specialty care. Comorbidities and environmental exposures, such as allergic rhinitis and household smoke exposure, were prevalent across the cohort, indicating that all children met referral thresholds regardless of risk factors.

  • The study was published on February 11, 2026.

The players

Emily Aman

An investigator from the University of Rochester Medical Center who co-authored the study.

Rachel White

An investigator from the University of Rochester Medical Center who co-authored the study.

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What they’re saying

“I think the overall perception...is positive. Maybe [there's] some medical mistrust, [but] I think overall, they're receptive to this specialized care. We just need to figure out how to remove some of the barriers that exist.”

— Emily Aman, Investigator, University of Rochester Medical Center (HCPLive)

“This all points to the need for a multi-faceted approach to reducing barriers using things like telemedicine, which you know is being used for many health conditions for children, including asthma.”

— Rachel White, Investigator, University of Rochester Medical Center (HCPLive)

“We're actually working on a project right now that's partnering with school nurses to make specialist care and asthma care in general more accessible to school-age kids. Building those partnerships with school health staff and providers is also very important.”

— Rachel White, Investigator, University of Rochester Medical Center (HCPLive)

What’s next

The researchers are currently working on a project to partner with school nurses to improve access to specialist care and asthma management for school-age children.

The takeaway

This study highlights the significant barriers that marginalized children face in accessing the specialized care they need to effectively manage their asthma, despite high caregiver receptiveness. Addressing these systemic issues, such as through telemedicine and school-based partnerships, will be crucial to ensuring equitable access to quality asthma treatment for all children.