July
1996
Breathing
Space: Asthma in New York City
By Mia MacDonald
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"Who is suffering? The asthmatic or his environment?"
— Aaron Lask, author, Asthma: Attitude and Milieu
The air in Harlem is bad, really bad, and the evidence is far beyond
anecdotal. One key piece of evidence: rates of asthma, a chronic lung
disease that restricts normal breathing and is sometimes so debilitating
that people afflicted are effectively disabled. In Central Harlem,
researchers
found that 14% of residents have asthma — three times the national
average. Mortality rates from asthma for African-Americans and Latinos
in New York City (many of whom live in Harlem) are between three and
five and a half times the rates for whites. The problem of asthma in
Harlem and other New York City communities of color is so alarming that
West Harlem Environmental Action (WE ACT), a community-based environmental
justice organization, declared June "Uptown Asthma Awareness Month" and
sponsored a conference on Asthma and the Environment at Harlem Hospital
on June 1.
At the conference, the first of its kind in New York City, medical
experts and community leaders discussed ways of combatting asthma in
Harlem
neighborhoods. One study, conducted by Dr. Diane McLean of the Harlem
Center for Health Promotion and Disease Prevention, found that people
coming to Harlem Hospital’s emergency room for asthma treatment
deal with a range of environmental factors that seem strongly linked
to the disease. These include: too much heat in their apartments over
which they have little or no control (one man spoke of heat blasting
in his housing project on an 80° day in May), significant problems
with mold, roaches or rodents in their homes, having seen violent attacks
or murders or having been victims of violence, and experiencing an
episode
of major depression. People who visit the E.R. for asthma are also
more likely to be under 40 and unemployed.
Two-thirds of adults visiting Harlem Hospital’s E.R. come three
or more times a year, indicating that their attacks are severe and
fear
of the disease intense. Dr. Jean Ford, Chief of Pulmonary Medicine
at Harlem Hospital, urges greater training in self-management of asthma
for young children, teenagers, college students and adults. Self-management
education would include information on avoiding substances that trigger
asthma, taking medication properly, and monitoring the condition to
know when and what treatment is required.
Although non-environmental factors have been identified as contributing
to attacks, asthma certainly isn’t just in people’s minds
or brought on by life-trauma alone. The air in Harlem is bad. Seven
of the eight Manhattan bus depots are located above 96th Street. These
buses use primarily diesel fuel, which emit more particulates than
cleaner-burning
fuels and is far more irritating to lungs and eyes. A new depot has
just opened on 133rd Street between Broadway and 12th Avenue, across
from an intermediate school. WE ACT Executive Director Peggy Shepard
announced plans to conduct a study of the pulmonary function of seventh
graders at the school to determine the effects of diesel exhausts.
And if the facts about the air in Harlem aren’t bad enough, news
about the water quality is possibly worse. Dr. Kenneth Olden, director
of the National Institute of Environmental Health Sciences, reported
at the conference that one third of kids in Harlem are likely to have
lead blood levels above the level of concern. This, he said, makes the
need for environmental justice self-evident, "a fact." This
conference participant couldn’t agree more.
Mia MacDonald, a vegetarian and animal activist,
works for a non-profit organization advocating women’s health
worldwide. She lives in Brooklyn.
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