The Unjust Burden of Asthma

By Suril Mehta

Painful wheezing, chest tightness, shortness of breath. I’ve seen friends and family alike suffer through asthma, which now plagues more than 24 million Americans. You’d think that such a common chronic disease would affect all ages and races equally. The unfortunate truth is that asthma most heavily burdens minority children from under served areas.

I witnessed this inequality while working with asthmatic children in East Harlem in New York City last year. East Harlem, also known as Spanish Harlem, is home to one of the highest childhood asthma rates and asthma-related hospitalizations in the country. What’s even more shocking is that a child living in East Harlem has almost three times the risk of asthma than a child living only ten blocks away.

As a recently-graduated environmental health epidemiologist, I wanted to figure out why children from this vibrant and culturally-diverse neighborhood are so heavily burdened by asthma.

I evaluated an effective city program which provides East Harlem asthmatic children services to better control their asthma. Most of the enrolled children belonged to poor Hispanic and African-American families. Prior to enrollment, many children had little access to healthcare services and no plan of action during an asthma attack.

Why is a neighborhood like East Harlem a high risk area for asthmatics?

Though we don’t exactly know what causes asthma, we do know what triggers asthma attacks. East Harlem is home to poor housing conditions. I had the privilege of visiting one of the enrolled child’s housing buildings, and the hallways of this low-income project smelled of mildew and cigarettes. Indoor environmental triggers such as mold, roaches, rats, pet dander, and smoke can all trigger asthmatic attacks. Additionally, these city-dwelling children were exposed to outdoor triggers such as air pollution and dust from construction work.

Every child, regardless of race, ethnicity, gender, location, or poverty level deserves proper access to healthcare and healthy living conditions. What can we do to help reduce these differences in asthma rates in the US?

Even though asthma cannot be cured, children can control their asthma by avoiding triggers, using proper medications, and creating an asthma action plan.

It’s time to act on reducing disparities in asthma.

About the author: Suril Mehta works at the EPA’s Office of Children’s Health Protection on efforts to reduce environmental exposures of childhood asthma.

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