Ambient air pollution, particularly in the urban environment of developing countries, has turned out to be a major health risk factor. We explore the compounded impact of age sensitivity, exposure, poverty, co-morbidity, etc., along with composite air pollution in determining morbidity and health burden of people in Lucknow, India. This cross-sectional study is confined to analyse respiratory health status across different socio-economic and geographic locations using n = 140 in-depth questionnaire method. We used mean daily ambient air pollution data of PM₁₀, PM_2.5, SO_2, and NO₂ for the 2008–2018 period. We used the ecological model framework to assess the risk at different hierarchical levels and compounded severity on a spatial scale. We also used Logistic regression model with log odds and odds ratio to analyze the association of risks outcomes with composite air pollution scores calculated using the principal component analysis method. There is a strong association of location-specific respiratory disease prevalence with an overall 32 percent prevalence. The prevalence of ecological model 1 (individual domain) is 4.3 percent, while ecological model 2 (community domain) has the highest prevalence at 32.4 percent. The logistic regression model shows that respiratory disease load is positively associated with age sensitivity (P < .001) and composite pollution level (P < .001). For another model with suffocation as the outcome variable, composite pollution level (P < .001) and exposure (P < .001) are positively associated. Optimum interventions are required at Ecological models 1, 2, and 3 levels for better respiratory health outcomes.