Minority children in the United States are at higher risk for asthma and related hospitalizations than white children, and their asthma tends to be more severe. Empirical studies have yet to demonstrate a definitive cause for their high risk and severity. The strongest candidate-predictors include cockroach allergens, household smoking, air pollution, poor access to quality health care, and underutilization of inhaled anti-inflammatory medications. In particular, recent studies have shown that black and Latino children continue to misuse health care and medications because of lack of access to culturally sensitive pediatricians who understand their needs and barriers, which contributes to more severe, poorly controlled asthma. It has been suggested that interventions for minority asthmatic children focus on improving access to asthma medical homes that deliver culturally appropriate and relevant care tailored to the needs of the family, improving family-provider communication, and improving knowledge and acceptance of asthma clinical practice guidelines, particularly for providers who work in community-based clinics.