Asthma prevalence and mortality among Black children exceed levels among whites. Asthma management programs have reduced symptoms, attacks and emergency room usage. However, in 1990 a pattern of underutilization and neglect of care among Black Americans in cases of asthma deaths among Black children indicated the importance of promoting ongoing versus episodic care, reduced exposure to triggers, sensitivity to signs of attacks, attack management, and communication with caregivers, professionals, and teachers. Research in Black communities indicated the importance of informal networks and neighborhood influences, in promoting improved asthma care within low-income Black communities.