Asthma, an inflammatory lung disease, has hit the poor rural neighborhoods of New York City harshly in the past few years.  Roughly one fourth of the children in Harlem are affected by the disease, in which narrowed airways in the lungs evoke attacks of breathlessness and wheezing.

Due to the multi-factorial nature of asthma, scientists have been unable to find a cure and proper treatments.  Triggers such as mold, dust, pollen, and diesel fumes, along with obesity, smoking, and little medical access, all contribute to the fact that Harlem’s childhood asthma rates are amongst the highest in the nation.

“It is impossible to completely abolish all of the causes of asthma,” said Dr. George D. Thurston, a professor of environmental medicine at New York University.  “However, we, as citizens of New York City, must work together to control and diminish the tangible causes, such as diesel fumes and other air pollutions.”

Dr. Thurston hosted a Seminar at Brown University on Friday, October 2nd, on Diesel Air Pollution and Asthma in New York City.  During his time as a researcher at New York University’s Langone Medical Center, he has found evidence indicating that living near to traffic is associated with increased respiratory problems in children.   Exposure to diesel vehicles is the most suspected causal agent in the associations between traffic and asthma.

Six out of the seven bus depots in New York City are located in Harlem.  Buses are the main source of diesel fuel emission.

“To get rid of this issue, we must either use cleaner diesel fuel or bring in hybrids, which burn less fuel,” explained Dr. Thurston, during a brief interview, as he was simultaneously shuffling through his notes for the big upcoming speech.

The problem here is transportation.  The city is surrounded by water; using these waterways for transportation purposes more efficiently would lessen the amount of diesel fuel in the air.  Instead of using buses and cars to transport goods into and out of Manhattan, companies should make use of the vast water ways, and create more water taxis, ferries, and freight ships.

Granted, diesel fume emission is a universal issue that needs to be moderated throughout every busy city.  Moreover, other issues that only affect low-income areas are what causes the asthma rates in places such as Harlem to skyrocket.

Cities scenes, filled with poor maintenance of multi-family housing, grocery stores, and restaurants and difficulties with sanitation and litter cause mice to be a common counterpart of the environment.

“Mice are silent predators for inner-city children.  These pests give off allergens that trigger asthma attacks, and it is just getting worse for those living in old apartment buildings that contain a lot of dust mixed with mouse urine,” said Limas Forte, the Healthy Homes Program Manager at WE ACT for Environmental Justice.

These allergens are what causes the smooth muscle in the lungs to contract during an asthma attack.  Inflammation due to an allergic response causes the blood vessels to widen and the tissues in the airway wall to swell, which as a result, creates difficulties for the child to breath.

Several investigators have seen as association between asthma and sensitization to another common urban pest, cockroaches, and high exposure among those sensitized has been reported as a risk for asthma medication use and a number of asthma-related hospitalizations (Ginger, et al).

This study has found that mouse allergen was indeed prevalent in inner-city apartments, and the self reported frequency of mice sightings were high (90% saw mice in their kitchen).  Surprisingly, however, high levels of mouse allergens were also present in homes where parents never saw mice.  This goes to show that even if the rodents are unseen they are still around and can still cause health issues.

Mr. Forte strongly believes that an effective way to treat this problem is by issuing new pesticide control campaigns that involve all areas of Harlem, not just a few towns.  The best way to initiate this campaign is by cleaning the streets so fewer rodents are attracted to the area.  This can only occur with a collective effort by all of the inhabitants of Harlem.

Consequentially, the major issue regarding the high childhood asthma rates in Harlem is the socioeconomic difference.  “The income disparity really comes hand-in-hand with the high rates of asthma,” explained Sally Findley, a professor of Population and Family Health and Clinical Sociomedical Sciences at the Mailman School of Public Health at Columbia University.

“In places such as the upper-east side, we don’t see as many cases of asthma because the people have enough money to take care of it.  In Harlem, however, it is much harder for the community to spend money on getting rid of the probable causes of asthma.  They do not have enough resources.”

As a result, less money is used for cleaning the streets, getting rid of mold, and exterminating insects that contain allergens or diseases.  One way to help solve this issue is by educating the public.

Professor Findley, who developed two child health promotion coalitions in NYC, the Start Right and Asthma Basics for Children coalitions, is using her asthma research to test multilevel interventions (provider, school or center, teacher, parent advocate/peer, community health worker) to stimulate improved asthma management for children.

If more money is allocated to the health industry and for health education in these inner-city neighborhoods, the asthma rate for children is bound to go down.