Breathless in Harlem: No One Knows Excatly What Causes Asthma, but Many Are Convinced the Primary Culprit Is Air Pollution, Especially Particles from Burning Diesel Fuel. (World Reports)
Misner, Michael, Earth Island Journal
Something is taking kids' breath away in a pocket-sized neighborhood in New York City, and the primary culprit is air pollution. Asthma rates among children within a 24-block area in central Harlem are five times higher than the national average, according to the Asthma Initiative, a program administered by the Harlem Hospital Center, the Harlem Children's Zone, and Columbia University's Mailman School of Public Health.
You would never think it meeting 10-year-old Taylor, who lives in the heart of the neighborhood. Her smile lights up her central Harlem street of peeling brownstones and apartment complexes. She plays with her friends on the dusty steps, running, climbing on the railings, and occasionally tickling her infant cousin, who also has asthma.
But her mother easily remembers how bad it was the first time Taylor was coughing and suddenly could not breathe. She rushed Taylor to the hospital and watched the doctors put her on a nebulizer--a machine that turns medication to a fine mist to better penetrate a patient's constricted airways. She was hospitalized for nearly four months, missing Thanksgiving, Christmas, and her birthday.
Robin Judd, Taylor's mother, has short-cropped hair shaded with silver. She speaks with the knowledge of someone who has done the research. She regularly battles her landlord and the city over issues like pest infestation and idling buses, knowing they trigger asthma attacks. Such factors are called triggers because they set an attack in motion--lungs inflame, airways constrict--as if a switch was flicked or a trigger was pulled.
The Asthma Initiative's goal is to screen every child in Taylor's neighborhood under 13 years old--all 2,400 of them--for asthma, and provide comprehensive services to those who have the illness. But midway through the screening, data showing that 25 percent of the children in the area have the illness shocked researchers.
Asthma kills about 5,000 people per year in the US but is not usually life-threatening if managed properly. But asthma costs. It's the number one cause of school absenteeism nationwide. Children with the illness who do make it to class are often too tired to pay attention or participate, since they have been kept awake struggling to breathe, or by their medications.
Children with asthma also make frequent and expensive trips to hospital emergency rooms. Annual treatment of asthma totals about $3.2 billion in the US, according to the American Lung Association. "Our main goal of the initiative is to end emergency room visits and missed school days," says Kellye Jackson of the Harlem Hospital Center.
No one knows exactly what causes asthma but many are convinced air pollution is a big factor, especially small particles emitted by burning diesel fuel, and smog from heavy traffic. "Although there may be a genetic predisposition to asthma, its growth in places like Harlem is almost certainly due to environmental hazards. Young people in a densely populated area like Harlem breathe more pollutants than suburban youth," said education writer Richard Rothstein in a New York Times op-ed. …