Abstract Background Asthma remains a significant chronic respiratory condition influenced by socioeconomic, demographic, and healthcare access factors. Understanding changing patterns in asthma exacerbations among U.S. adults can inform targeted prevention and equitable care strategies. Methods We analyzed the 2019-2024 National Center for Health Statistics (NCHS) adult dataset. Respondents reporting a physician diagnosis of asthma were included. Annual prevalence of asthma attacks and trends across sociodemographic, clinical, and socioeconomic variables were evaluated using χ² tests, with p 0.05 considered statistically significant. Results Adults aged 50-64 years had the highest annual asthma attack rate (4.1%, p 0.05) and the greatest increase (+20%) during the study period. Females reported nearly twice the attacks as males (4.8% vs 2.3%, p 0.05) with an 18.2% rise since 2019. Black adults had higher attack prevalence (4.1%) compared to White (3.6%) and Asian (2.0%) adults; however, Asians experienced the largest increase (+84.6%) while Blacks declined (-15.9%). Individuals with disabilities (8.9% vs 3.1%), functional limitations (5.5% vs 2.1%), or unemployment (4.2% vs 3.3%, all p 0.05) were disproportionately affected. Among those 65 years, Medicaid patients had the highest attack rates (6.5%) but saw a decline (-29.9%), while privately insured adults had a 28.6% increase. In those ≥65 years, dual Medicare-Medicaid enrollees had the highest prevalence (5.7%), but Medicare Advantage recipients experienced the largest rise (+50%). Lower income (100% FPL) was associated with greater asthma burden (5.9%), though higher-income groups had increasing trends. Conclusions Asthma exacerbations among U.S. adults are rising, particularly among women, middle-aged adults, Asians, and privately insured individuals. Disparities persist by disability status, income, and insurance type, underscoring the need for targeted asthma control initiatives and improved access to preventive care. This abstract is funded by: None
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