Perceptions of Climate Change, Health Impacts, and Climate Resilience, among Urban Residents Living with Asthma: An Exploratory Qualitative Study

Abstract In the US, rates of asthma, and in particular, uncontrolled asthma, are disproportionately high among historically marginalized racial/ethnic groups and among urban residents. Against the backdrop of climate change and its known consequences, which can exacerbate the environmental triggers of asthma, these inequities are further magnified. This qualitative study explored perceptions of climate change, health impacts, and climate resilience among historically marginalized urban adults with asthma. Black/African-American, Hispanic/Latino, and/or multiracial adults ( $$\ge$$ ≥ 18 years) diagnosed with asthma, and residing in the Chicagoland area, were recruited. Semistructured interviews informed by the capability, opportunity, motivation, and behavior (COM-B) model were conducted, and data were transcribed for thematic coding. Data from 20 interviews revealed four primary themes: (1) climate change awareness, (2) perceived harms of climate change, (3) climate resiliency: barriers and strategies, and (4) perceived outlook on climate change. Participants consistently associated extreme weather with adverse asthma management consequences and highlighted the negative impacts of climate-related events on their outdoor time, physical activity, and social life. Virtually all participants emphasized significant financial burden resulting from their daily living adaptations for managing their condition in the context of climate change. Participants showed variable levels of climate preparedness and reported limited community-level engagement in climate action activities. This study supports enhancing climate resilience as a potentially effective strategy for improving asthma management among historically marginalized urban residents, warranting future research. Findings emphasize the need to strengthen both individual- and societal/environmental-level climate resilience to optimize health and well-being for all.