If the UK Department of Health's “Independent inquiry into inequalities in health”1 had been carried out in the USA, asthma would probably have occupied a prominent place in the document. In Britain a review of the evidence on inequalities did not mention asthma as a health issue related to poverty. Americans review the association of asthma and poverty on a regular basis in the literature.2-7 Platt-Mills3 suggested that the link between low social class and asthma was a phenomenon restricted to the USA. Is this perception correct and, if so, why should it be? In reviewing the topic it is appropriate to disaggregate several related but separate components. Poverty may contribute to the aetiology, exacerbation, recognition, and management of asthma (box FB1). There is also a historical perspective that needs some consideration. In Britain both coronary heart disease and diabetes mellitus were initially more prevalent among the wealthy, but subsequently became associated with poverty. Studies based on more recent data may therefore show a different association between asthma and poverty than earlier work.