As a child, I spent most of my time outdoors. My family and I enjoyed picnics, hiked mountain trails, and flew kites in the park less than a mile from our home. However, the time I spent outdoors was not ideal; I lived less than two miles from the freeway. I was breathing in the smog that was regularly trapped by the surrounding mountains in the San Fernando Valley, a region of Los Angeles, California. The dirty air was likely the source of my asthma growing up, causing my lungs to collapse and landing me in the hospital twice for two weeks. My parents missed work in order to care for me, and I missed several days of school.
Unfortunately, this situation is not uncommon – especially in Environmental Justice (EJ) communities. African American and Latinx communities are disproportionately affected by asthma in the United States. According to the most recent CDC asthma data, 13.4% of black children have asthma while only 7.8% of white children have asthma. Among Latinx groups, 11% of Puerto Rican children have asthma, the highest among their group. A study on East Harlem schoolchildren found that while asthma was prevalent in 23% of schoolchildren overall, 35% of Puerto Rican children in the neighborhood had asthma. This racial disparity in childhood asthma is common among EJ communities and we have to start calling asthma what it is: a public health crisis, and a crisis that will only grow under the current Trump Administration. Here are seven reasons why asthma is an environmental justice crisis:
1. Indoor environments can be just as polluted as outdoor ones
Asthma is a respiratory disease that results in wheezing and shortness of breath. While there is no cure, asthma can be controlled through medication and management of environmental triggers. Indoor triggers include mold, dust mites, pests, pets, lead in dust and secondhand smoke, whereas outdoor triggers are caused by air pollution. In NYC, rental households in high poverty areas are three times more likely to report three or more maintenance deficiencies compared to households classified as low poverty. WE ACT and the Coalition for Asthma-Free Housing are currently working on citywide legislation to reduce the problem.
Air pollution can be attributed to a number of other factors, including climate change, car, factory and power plant emissions. When air pollution levels are highest, it is the most hazardous time for children to play outdoors. Daily air quality information can be found through US EPA’s Air Quality Index in order to monitor timing of outdoor activities.
2. Poor, people of color are more vulnerable to asthma
While asthma can affect individuals of any race, age, or ethnicity, prevalence is closely correlated to race. African Americans are three times more likely to stay in the hospital because of asthma and three times more likely to die from asthma than their white counterparts. Historically, African Americans and other minority groups in the United States have been disproportionately affected by environmental hazards. The United Church of Christ Commission on Racial Justice in 1987 found that while socioeconomic factors played a role in where toxic waste sites were located, race was the most significant factor. These practices are still prevalent today and are evident in the health of low income, communities of color.
3. Access to healthcare can mean life or death
In African American and Latinx children, 40% of asthma is caused by contact with allergens in the house. However, it is difficult for these children to seek healthcare due to discrepancies in socioeconomic levels, difficulties with literacy or language, and lack of doctors in these communities. As a result, African American and Latinx children with asthma do not regularly use daily medication such as corticosteroids, and instead depend on emergency care for treatment.
4. Asthma increases educational disparities.
Hospital visits have a detrimental effect on school children and their parents. A study found that due to asthma, 11-12% of African American and Puerto Rican children were absent from school, missing at least a day per month, in comparison to 3-5% of white children. This potentially excludes students from attending pertinent classes. Overall, asthma is the number one reason children from ages 5-17 miss school, leading to over 10.5 million missed school days annually. In terms of a financial burden, asthma costs the United States $56 billion, with $50.1 billion from hospital stays and $5.9 billion from lost pay due to sickness and lost work productivity from missed school or work days.
5. Climate change
Climate change is expected to exacerbate the effects of asthma as it alters seasons and creates unpredictable weather patterns. This includes an increase in precipitation which proliferates mold spores and an increase in the frequency of droughts which burgeons dust. Changes in the weather patterns have also caused plants to release more pollen earlier and longer, leading to increased allergens which will inevitably worsen respiratory illnesses such as asthma. It is important to note that climate change disproportionately affects low income and/or people of color as they are less likely to have the time or the financial resources to deal with the impacts.
6. Poor and non-existent funding for asthma prevention
Institutional racism and its consequences, including environmental injustice, poor housing conditions, and absence of resources (time and finances) have intensified the adverse effect of diseases such as asthma in low income, communities of color. Therefore, it is important that these issues be addressed by public health officials. Moreover, the association between health and race must be linked to eliminate difficulties in achieving adequate health in vulnerable communities. At the federal level, while there has been some action to address these issues, research on prevention has been a missing component. Only 8% of asthma funds by the National Institute of Health are focused on prevention, with most funds directed to treatment.
7. The Trump Administration
Government cooperation is essential to improving the health of frontline communities. President Trump’s proposed budget cuts will make this task challenging; the U.S. Environmental Protection Agency will receive the most reductions in funds across all federal agencies. The plan reduces the EPA’s budget by a little over 30% and cuts several other significant federal health programs. This ultimately puts the health of low income, communities of color – communities that are already suffering the consequences of environmental pollution – at risk. Cuts to programs such as children’s health resources, support for air quality management, Superfund, the Resources Conservation and Recovery Act (RCRA) and Title VI Compliance are vital in improving the health of our communities. Additionally, the elimination of programs such as Environmental Justice are misplaced, as low income, communities of color are disproportionately affected by the burdens of environmental pollution.
If you have asthma, know someone with asthma, or care about the health of frontline communities,you should contact your local congressperson and inform them of the importance of these programs. Reducing the federal budget, and consequently removing critical environmental programs, is a public health risk that should not be taken lightly. Vulnerable communities – communities of color and/or low socioeconomic status – have the right to breathe clean air. President Trump’s budget proposal will make it difficult to accomplish.