If one thing is clear, the COVID-19 pandemic has exacerbated existing inequities across social determinants of health. Cities and urban environments tend to have large gaps in health care accessibility and correspondent health care disparities. Despite the existence of localized public health infrastructure, such infrastructure tends to be fragmented and cannot fully encompass the level of nuance within its patient population as a result. As such, health care inequities are cyclically perpetuated in part through discontinuous health systems. Smarter, patient-centric approaches are needed to move the needle forward and improve at-risk populations’ clinical care and associated outcomes. While technology is often thought of as the proprietor to achieve this goal, low-cost educational interventions and updated guidelines may serve as equally reliable or even better methods to attain this outcome.

Take the case of asthma, a morbidity that is magnified in urban geographies. In St. Louis, asthma is the greatest health care inequity, with African-American children having an incidence rate greater than 10x that of white children. Children in St. Louis are afflicted by rates of asthma 3x higher than that of the national average, and asthma is currently the leading chief complaint at St. Louis Children’s Hospital. Underserved communities face a multitude of issues that exist beyond the medical aspects of health care. And unfortunately, asthma is not only an issue due to its accompanying signs and symptoms, but for its pertinence well beyond its pathology.

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