Air Pollution Exposure, Pediatric Asthma Control, and Urban Health Governance: A Comparative Environmental Health Analysis of Los Angeles and London

Abstract

Pediatric asthma remains one of the most important chronic respiratory conditions affected by urban environmental exposures, healthcare access, housing quality, and public health governance. This study examines how ambient air pollution influences asthma control among children through a comparative environmental health analysis of Los Angeles and London. The article argues that pediatric asthma outcomes are shaped not only by clinical treatment but also by transport emissions, neighborhood deprivation, indoor–outdoor exposure interactions, school environments, primary care continuity, and urban air-quality policy. Using comparative public health analysis, epidemiological synthesis, environmental exposure interpretation, and health systems evaluation, the study compares two global cities with extensive air-quality monitoring systems but different regulatory histories, urban morphologies, and healthcare access structures. The findings indicate that nitrogen dioxide, fine particulate matter, ozone, and traffic-related air pollution contribute to airway inflammation, exacerbation risk, medication use, emergency visits, and reduced lung function among susceptible children. London demonstrates stronger integration of low-emission transport policy and national healthcare access, whereas Los Angeles demonstrates advanced environmental monitoring and regulatory innovation but persistent exposure inequities linked to freeway proximity, port activity, and socioeconomic segregation. This article contributes to medical and health sciences scholarship by integrating environmental epidemiology, pediatric respiratory medicine, health equity, healthcare governance, and urban policy into a comparative framework for asthma prevention.