children’s health

From the Philippines to the Pacific Northwest – Working with Communities for Environmental Protection: A Return Peace Corps Volunteer’s Story

By Gina Bonifacino

My Peace Corps site assignment was not what I would have conjured in my mind as a kid, dreaming about a future adventure as a Peace Corps Volunteer in some isolated corner of the world. San Jose de Buenavista, Antique was a busy, medium-sized provincial capital in the Philippines.

I was assigned to the Provincial Planning Office to work on coastal management. With a very general assignment, and being new to the country and the community, my first challenge was figuring out how a fresh college graduate, new to the language and culture of the Philippines, could help.

A co-worker at the Provincial Planning Office was very excited about piloting a new method of gathering planning data, Participatory Resource Assessment (PCRA). As I learned more about this tool, I became interested in exploring it as a means to connect with communities and better understand coastal issues in the province.

After consulting with provincial colleagues and getting support from local officials, we planned and held a series of assessments with five coastal communities. These assessments brought community members and officials together to map and document issues in their communities.

The biggest issues that the communities identified – health concerns, livelihood and environmental degradation – were all closely linked. Many homes didn’t have access to clean water or sanitation. Women had to spend nearly an hour per day just to collect clean water. Without proper sanitation, waterways were polluted and children became sick. Most of these families subsisted on local fisheries, but had in recent years seen numbers declining due to encroachment from illegal fishing boats within municipal waters.

I’d have never been able to understand these issues without direct community engagement. And, I knew that solutions, like establishing a local fisheries policing force, required community involvement. It was incredibly rewarding to work and make friends with the community members.

It’s been more than 15 years since I’ve worked with the communities in the Philippines through the Peace Corps; however, that experience continues to serve me as an EPA employee in our Seattle office. After data showed that poor burning practices and burning in old, dirty woodstoves and fireplaces contributed to unhealthy particulate levels in many Pacific Northwest and Alaskan communities, I drew on my Peace Corps experience, and worked with local agencies, EPA’s Headquarters Office of Air and Radiation, and local communities on a campaign to reduce particulate matter from wood smoke.

The campaign grew and is now known as Burn Wise. As a result of EPA’s work with communities, many households have been able to help reduce particulate pollution from woodsmoke, increase heating efficiency, and improve the air they breathe inside of their homes.

About the author: Gina Bonifacino is with Region 10’s Puget Sound Program.

Provincial Planning office shows off its coastal management map.

Provincial Planning office shows off its coastal management map.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

The Latino Asthma Conundrum

By Elias Rodriguez

Franklin D. Roosevelt East River Drive

Franklin D. Roosevelt East River Drive

It was a hazy and hot day as I sat in my grade school New York City classroom. Suddenly, everyone’s attention was drawn to my classmate’s wheezing and labored breathing. Àngel was one of the biggest kids in our class, but he was clearly in distress and the memory of his pain is vivid. I now understand that my friend was having an asthma attack. Thankfully, our teacher knew precisely what to do and she had his inhaler inside her desk and ready.

Our Manhattan public school was located adjacent to a major highway known as the FDR Drive, which snakes up Manhattan’s eastside near the Williamsburg Bridge. The combination of high population density, cars, trucks and industrial activity was a recipe for dismal  air quality.

Àngel and many of my inner-city cohort shared a Puerto Rican ancestry. To this day, I remain puzzled by the disproportionately high asthma rate among Latinos. Latinos are 30 percent more likely to go to the hospital for asthma, as compared to non-Hispanic Whites. For reasons that are not fully understood, Puerto Ricans have double the asthma rate as compared to the overall Latino population.

While asthma rates have increased in the general population over the past two decades- what accounts for the alarming disparities? Are the reasons economic? Do groups in the lower income strata demonstrate more adverse health effects as a result of limited resources and less access to quality medical care?  Is the reason pegged to location? Does the propensity of certain groups to seek jobs in metropolitan areas lead to higher incidence in geographic clusters? Could culture be a culprit? Spanish was the first language of my parents and there are links between limited-English proficiency and barriers to quality care. We’d love to hear your theories. Solving this socio-economic-medical mystery is imperative for all of us since it is estimated that medical expenses associated with asthma cost a staggering $50 billion every year.

The explanation for these asthma rates among demographic groups is complex and multidisciplinary. The good news is that we have the power to take proactive steps. May is Asthma Awareness Month and it’s a great opportunity to remind people that having an Asthma Action Plan is one of the key tips EPA offers to people who live with asthma. EPA also encourages people to check local air quality at Air Now. The site uses a color-coded system to display whether pollutants exceed air quality standards and indicates the air’s impact on different populations. Give it a try at airnow.gov. Grab a tool. Get a plan and Adelante.

About the Author: Elias serves as EPA Region 2’s bilingual public information officer. Prior to joining EPA, the proud Nuyorican worked at Time Inc. conducting research for TIME, LIFE, FORTUNE and PEOPLE magazines. He is a graduate of Hunter College, Baruch College and the Theological Institute of the Assembly of Christian Churches in NYC.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

EPA, Schools and Communities Work Together to Reduce Asthma

By Dr. Teresa Lipsett-Ruiz

Visitors to Puerto Rico often come to bask in the island’s warmth and waves. But, our tropical environment also contributes to the asthma problem that affects about 1 in 10 people here.

In close partnership with EPA, our university-based indoor air quality program builds partnerships with students, schools and the community to improve the environmental conditions in schools and reduce student absences caused by asthma. It has worked! Over the past 6 years, the schools that we’ve worked with have seen significant decreases in the number of missed school days.

Mountainous areas such as the Puerto Rican municipalities of Caguas and Gurabo are surrounded by humid valleys known as “asthma hotspots,” yet asthma education is not always available there. In response, we created a program with EPA that focuses on three key elements: (1) information resources and checklists, (2) school “walkthroughs,” and (3) partnerships with school officials and the community to physically remove indoor environmental asthma triggers.

Our program relies on EPA’s Indoor Air Quality (IAQ) Tools for Schools guidance and Spanish-language indoor checklists to educate the community and schools on managing environmental asthma triggers. Working with the Puerto Rico Department of Education, we hold IAQ Workshops on asthma triggers.

During school walkthroughs, we often find pest problems—cockroaches, rats and mice—as well as moldy, wet cardboard boxes overflowing with paper. We then formulate a plan to address these asthma triggers.
At first, some teachers were skeptical. They were worried that this was another burden piled onto their busy schedules. Enthusiasm grew, however, when the students and the community began to help. As the old saying goes, “many hands make light work.” The school community came together for a “mega green cleaning” of the school. To check our effectiveness, we collected mold samples before and after our plans were put in place and mold counts dropped significantly.

With the support of school officials, we implemented our program at 32 schools, which resulted in a 38 percent reduction in student absenteeism due to asthma. Based on these impressive results, we now are expanding the program in partnership with EPA. To learn more, listen to my presentation in EPA’s Back-to-School Webinar: Managing Asthma in Schools. Our communities are proud to have improved both their health and student attendance. We invite you to pursue similar programs in your schools and community.

About the author: Dr. Lipsett-Ruiz is the Dean of the School of Science and Technology in Universidad del Turabo in Puerto Rico. Her partnership with EPA has trained more than 150 teachers in 100 schools on practical steps to asthma management. The program leverages school clubs, blogs, conferences, theater play, and role modeling exercises, along with EPA information resources to reduce student absenteeism due to asthma.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Have a Question About Asthma?

By Jessica Orquina

Asthma is a serious, chronic disease that is aggravated by environmental triggers, like pollution, mold, and smoke. Here are some basics:

  • Americans with asthma: over 25 million people, including about 7 million kids.
  •  School days missed because of asthma: 10.5 million annually.

The good news is that with medical treatment, and management of environmental triggers, it can be controlled.  That means people with asthma can lead healthy, active lives. However, it’s important to have an asthma action plan and pay attention to the Air Quality Index. Air Quality Awareness Week is April 28 through May 2 and May is Asthma Awareness Month is, so this is a great time to talk about and learn about asthma.

On Thursday, May 1, at 2:00 pm EDT, we’re hosting a Twitter chat about asthma and outdoor air quality. Our experts will be joined by experts from CDC to answer your questions about asthma, air quality, and how to create an asthma action plan. Join the conversation: follow the #asthma hashtag, @EPAlive, and @CDCenvironment. If you don’t have a Twitter account, you can post your questions in the comments below and follow the #asthma hashtag during the chat. We look forward to talking with you!

About the author: Jessica Orquina works in the Office of External Affairs and Environmental Education as the social media lead for the agency. Prior to joining EPA, she served as a military and commercial airline pilot. She lives, works, and writes in Washington, DC.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Progress in Communities: It All Starts with Science

This week is the 43rd Anniversary of the establishment of the Environmental Protection Agency, and we are marking the occasion by revisiting how our collective efforts on behalf of the American people help local communities become cleaner, healthier, and more sustainable. As the Assistant Administrator for the Agency’s Office of Research and Development, I can’t help but see a strong undercurrent of science and engineering in every success story.

Over the past four plus decades, EPA scientists and engineers, along with their partners from across the federal government, states, tribes, academia, and private business, have supplied the data, built the computer models and tools, and provided the studies that have helped communities take action to advance public health and protect local environments.

In every area of environmental and human health action, EPA researchers have helped local communities make progress. While examples abound, here are just a few:
More

Editor's Note: The views expressed here are intended to explain EPA policy. They do not change anyone's rights or obligations.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Advancing Children’s Environmental Health: Our Best Investment

Reposted from EPA Connect, the Official Blog of EPA’s Leadership

Group of children at schoolAnyone who has ever enjoyed watching a toddler explore their world knows that along with that marvelous sense of discovery comes potential trouble. Young children crawl around on the floor, play in the dirt, and don’t hesitate to retrieve a wayward cookie or other delectable treat hidden among the dust bunnies underneath the couch—and pop it straight into their mouth.

Behaviors like these, as well as their smaller bodies and still developing internal systems, make children more vulnerable to pollution and other environmental risks than us adults. That’s why we here at EPA make protecting children’s health a top priority.

read more…

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Changing the Health of a Community – Beyond Land Cleanup

By Mathy Stanislaus

When I went to Omaha, NE last week, I was excited for Superfund’s big announcement: the delisting of over 1,000 residential parcels from the Omaha Lead Superfund site. This was an important milestone in EPA’s overall site cleanup activities, particularly for the residents whose properties were contaminated with toxic lead from the ASARCO smelter cleaned up.

It was also important to the children of the community – our efforts resulted in measurable health improvements: the percentage of children in eastern Omaha with elevated blood lead levels have been reduced from nearly 33 percent before 1998 to less than two percent today.

By reducing blood lead levels, you change people’s lives. You protect a child for his/her entire life and you change the health of a community. As part of one of the largest cleanup projects – particularly in an urban setting – in the Superfund program with over 40,000 largely lower-income residencies, I was very proud to acknowledge the public health impacts from eliminating lead exposure (significant reduction of blood lead levels in children) and the economic benefits of the cleanup.

I spoke with several people when I made the announcement and two really stood out in my mind. One individual explained that what began as basic outreach on public health resulted in a permanent institution in the community to look at children’s health at a multiple of ways that go beyond the lead cleanup.

I also spoke with the person that fields the calls from residents to deal with their issues on a day-to-day basis. They explained how challenging the work can be but understood how EPA can deal with community concerns regarding cleanups and explain how cleanups are done in a way that is protective but also accommodates their lives.

This isn’t easy work. Nor was the cleanup. It was easy to see how challenging these resident-by-resident cleanups were and I’m proud of the work EPA and contractors have done. This cleanup created hundreds of high-paying seasonal jobs and contributed to the development of a skilled labor force with job training funded through an EPA cooperative agreement with the Omaha Metropolitan Community College. Not only are we contributing to improving children’s health, but we’re transforming the community economically.

About the author: Mathy Stanislaus is assistant administrator for EPA’s Office Solid Waste and Emergency Response.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Asthma Awareness Month: Tackling Prevention

By Sally Darney 

SoccerplayerwithballWhen my daughter decided to join a soccer team, I was delighted.  Sports would provide healthy exercise, along with a host of other physical and mental benefits.  So we were dismayed when she complained of tightness in her throat and difficulty breathing during the games.

A trip to the doctor revealed “exercise-induced asthma,” but thankfully she was able to manage her symptoms with an inhaler and stay on the team.  I had little awareness of this disease at the time, but now know that childhood asthma is common, affecting nearly one in ten American children.

This month we celebrate Asthma Awareness Month learning about asthma triggers and the latest advances in medical treatment and comprehensive care for our children.

But what causes asthma to begin with?  Asthma is a curious disease that can first appear in toddlers, school-aged children like my daughter, or even in adults. Furthermore, studies have shown ethnic and economic-related disparities of who is most at risk. African American children, children of certain Hispanic groups, and children living in poor communities are more likely to get asthma, and to suffer more severe attacks, than Caucasian children and those in the higher social-economic groups. (For more information, download America’s Children and the Environment.)

This disparity suggests that the causes of asthma involve a complex interplay of environmental and social-economic factors, which in turn interact with a genetic-based predisposition. These factors can  play a role in both causing the disease itself, and in exacerbating the symptoms.

EPA researchers and partners from across the federal government are banding together to address asthma causes and disparities.  I was fortunate to be on the taskforce behind the landmark report: The Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities.

Working with scientists from the Centers for Disease Control and Prevention, the U.S. Department of Housing and Urban Development, and other agencies, EPA is helping implement the Plan, which emphasizes how research into the causes of asthma can help inform ways to tackle this burdensome disease.

We can’t change our genetics, but we can change the “environmental stressors” that contribute to, and cause, asthma.  To advance that work, researchers in ORD and from across the network of Centers for Children’s Environmental Health and Disease Prevention, co-sponsored by EPA and the National Institutes of Environmental Health Sciences, are exploring causes of asthma that can be prevented even before a baby is born. For instance, recent research has revealed that women who smoke during pregnancy, or are exposed to high levels of air pollution and/or certain environmental chemicals, are at increased risk of having a baby who develops asthma as a child.

Armed with more knowledge about the causes of asthma, pregnant women, mothers of young children, health care providers and decision makers can take actions to avoid risky exposures and provide healthy, asthma-free environments for women and children—preventing asthma from the start.

I’ll never know why my daughter got asthma, but I am happy to work at a place that is looking to prevent it. I have faith that together our research will do that, and eliminate racial and ethnic asthma disparities. Whether you play soccer or not, it’s a goal we can all shoot for.

About the Author: Sally Perreault Darney, Ph.D. is a senior health scientist at EPA working on  coordinating Agency research on children’s environmental health.      

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

Asthma Disparities: Making an Impact in Chicago’s Public Housing

Several links below exit EPA Exit EPA Disclaimer

By Melissa Gutierrez Kapheim

It’s Asthma Awareness Month! For hundreds of asthma community programs across the country, raising asthma awareness is a year-round reality as we work to improve the lives of people living with asthma every day.

As a 2010 winner of EPA’s National Environmental Leadership Award in Asthma Management, my organization, Sinai Urban Health Institute (SUHI), is always excited to partner with EPA. We strive to share successful strategies that will help programs across the nation deliver environmental asthma management as part of their asthma care services to underserved communities.

Later this month, on May 16th, I will co-present an EPA webinar with Andy Teitelman from the Chicago Housing Authority (CHA) on our collaboration efforts for a program called Helping Children Breathe and Thrive in Chicago Public Housing (HCBT).

With funding from the U.S. Department of Housing and Urban Development, SUHI partners with the CHA to implement HCBT in a community where asthma affects 25–30 percent of children, a rate twice the national average. Through community engagement and partnerships, we provide asthma education, assistance navigating the healthcare system, and environmental home assessments.

HCBT uses a Community Health Worker (CHW) model to deliver its services. We hire and train people who live in the same building to educate residents about asthma management. This approach is effective in accelerating honest communications in which people with asthma and their families feel comfortable discussing their home environment.

The visits include a home assessment to identify asthma triggers. HCBT refers triggers to CHA’s case management service, which works with property management to resolve the issue. This referral system was developed so participants can report their housing concerns to CHWs, who shepherd them through the process of getting the problem fixed.  As a result, a variety of housing issues that exacerbate asthma, such as mold, roaches, carpet, and mice, are referred to property management. To date, 80 percent of those referrals have been resolved.

Through our partnerships with CHA and residents of the housing developments, we have achieved results indicative of improved asthma symptoms and control. Specifically, preliminary six-month outcomes of the HCBT program indicate a 56 percent reduction in asthma symptoms, significant reductions in health resource utilization, and statistically significant and clinically associated improvements in quality of life. The project is slated to end in the fall of 2013.

Please join us for our webinar on May 16th. For more information and to register, visit

About the author: Melissa Gutierrez Kapheim, MS, is an epidemiologist at the Sinai Urban Health Institute (SUHI) in Chicago, IL. She has worked in the field of health disparities and community-based health interventions for more than eight years. Since joining SUHI in 2006, she has worked on three consecutive asthma interventions that utilize the community health worker model to improve the health and well-being of children and adults with asthma living in Chicago’s most vulnerable communities.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

A Brief Insight into the World of Asthmatics

By James T. Young

The expanded conversation about Asthma Awareness in recent years is very good. I imagine that only people who actually suffer from it can appreciate how frightening or fatal an attack can be.

I had a summer job at a bakery in Richmond, Virginia. There were several steps in baking commercially. Next to the last step was was placing the dough in a pan and placing the pan on a rack. When the rack was full it was pushed into the steam room, where the bread rose, before going into the oven. One day the foreman told me to go into the steam room and straighten the racks up because they were all stacked near the door. I opened the door and began to push the racks deeper into the steam room. I tried to inhale while in the back. I inhaled, nothing! So, I inhaled again, nothing! I came out of that steam room like a shot out of a rifle. Once outside I took a deep breath and my lungs filled with air as I inhaled deeply.

All of the regular employees were laughing because that was a sort of “initiation”. They all knew that once you left the area where the door was open that there was no oxygen further back in the steam room and after a little exertion one found that out. That is the same type of reaction that Asthma sufferers must go through, except their bronchial tubes constrict keeping the air from reaching their lungs.

As terrifying as my “steam room” experience was, can you imagine what an asthmatic child or adult must cope with knowing that at any moment the air they breathe, food they eat or what they drink may trigger an attack? May the search for a cure and the dissemination of information about asthma awareness continue.

About the author: James T. Young, SEE empoloyee in the Office of Public Engagement.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.