**9. Summary and conclusions**

To the pulmonologist, inner city asthma is a complex and challenging entity that requires consolidated management efforts and a comprehensive approach that includes awareness of the unique predisposing factors, the increased acuity, and the need to focus on improved access to care. A multifaceted approach that targets a wide array of risk factors including allergens, indoor pollution, housing quality, and external sources of pollution, such as neighborhood trash collection receptacles must be utilized. Guidelines-based management that is effective in other types of asthma may not be sufficient to provide adequate control. In addition, the structure of the healthcare system must change to allow the needed access and the recognition and management of social factors which impact on asthma management.
