When you think about all the challenges that kids can face growing up in Baltimore, asthma might not come to mind, but it should. In 2020, one in five children in Baltimore had an asthma diagnosis, a rate more than double the national average. As a pulmonologist, I’ve seen firsthand how asthma can disrupt the day-to-day lives of our friends and neighbors, resulting in missed days from school and work, emergency trips to the hospital and expensive medical bills. We should be doing everything we can to ensure healthy air for our kids’ growing bodies and lungs, but far too many children today struggle to breathe due to pollution from homes.

Our homes should be a refuge, a place where we can rest and remain safe from the elements outdoors. Yet substandard building practices that rely on fossil fuels have left millions of Marylanders with homes that expose them to unhealthy air quality, often more polluted than the air outdoors. When burning indoors, gas appliances emit a wide range of pollutants harmful to our health. Not only are children who grow up in a home with a gas stove up to 42% more likely to develop asthma symptoms, new peer-reviewed research shows that 12.7% of childhood asthma cases nationwide can be attributed to gas stoves.

The health threat of fossil fuels doesn’t just exist inside our homes. Baltimore residents have lived under the shadow of ozone pollution driven in part by our reliance on burning fossil fuels for heating our homes. This ozone pollution (more commonly known as smog) is formed by asthma-exacerbating nitrogen oxides, which are vented directly outdoors by millions of fossil fuel heating, ventilation and air conditioning systems and water heaters. In fact, these systems and water heaters emit more than three times as much smog-forming pollution as Maryland’s power plants and are responsible for more than 3,500 asthma attacks each year.

Given that Black Marylanders are exposed to 70% more pollution from buildings than white Marylanders, it’s easy to see how asthma doesn’t affect all Baltimoreans equally. Black children in Maryland have almost five times the rate of asthma-related emergency department visits as white children. This disparity is even further magnified by income and geography: The Southwest inner city has around 28 times more asthma-related emergency department visits than the affluent Roland Park neighborhood in North Baltimore.

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Fortunately, we already know how to fight back against this public health crisis. Building homes to the latest health standards that maximize energy efficiency and require clean energy technologies such as heat pumps can eliminate major sources of health-harming air pollutants in our homes, while they also reduce our energy bills and our greenhouse gas emissions.

It’s time for us — medical professionals, public health experts, people living with asthma and those that care about them — to call on Maryland leaders to enact ambitious policies that reduce the burden of lung disease on our communities. Right now, the Better Buildings Act, which is under consideration during the current 2024 legislative session, would significantly limit pollution and improve the health of Marylanders.

The bill, scheduled for a hearing in the Maryland Senate Education, Energy & Environment Committee on March 4, doesn’t explicitly prohibit builders from installing methane gas lines and gas cooking equipment. But that next step is needed. Homes built to the highest health and safety standards cost less to build, and with incentives from the Inflation Reduction Act, offer more options than ever to invest in the cleanest, best equipment available.

There’s a lot of things we can’t guarantee for our kids in life. But our kids deserve the right to breathe healthy air. The Better Buildings Act is a necessary first step to ensure that our kids can grow up in healthy, affordable homes built for the future, not the past.

Panagis Galiatsatos is an associate professor and physician in pulmonary medicine at Johns Hopkins.