ENVIRONMENTAL CONFLICT & HIGH ASTHMA RATES

Environmental Conflict & High Asthma Rates

Environmental Conflict & High Asthma Rates

Introduction

Asthma rates have risen so much in the US that medical and public health professionals invariably speak of it as a new epidemic. The number of individuals with asthma in the United States grew to 73.9% between 1980 and 1996, with an estimated 14.6 million people reporting suffering from asthma in 1996(Chakraborty and Armstrong, 1997). This is widely believed to be a real increase, not an artifact of diagnosis. In the same period, hospitalizations for asthma rose to 20%, and by 1995 there were 1.8 million emergency room visits a year. The estimated cost to society from asthma is greater than $11 billion a year. As the number of cases has increased, medical and public health professionals and institutions have expanded their treatment and prevention efforts, environmental and community activists have made asthma a major part of their agenda, and media coverage has grown.

In the midst of this attention, there is significant disagreement over the role of environmental factors in causing or triggering asthma (Deutch 2008). The widely accepted belief in psychogenic causes for asthma has shifted in the last two decades to a focus on environmental conditions, including indoor ones such as animal dander, cockroach infestation, tobacco smoke, mold, and other allergens; and outdoor ones, particularly PM2.5 (particles under 2.5 µm in diameter, which penetrate deep into the lungs and are linked to asthma and other chronic respiratory symptoms, especially among children and the elderly). Some environmental groups and community activists have made asthma a key focus, and in several areas, have entered into coalitions with academic research centers, health providers, public health professionals, and even local and state governmental public health agencies. Despite grassroots efforts to highlight environmental factors in asthma, this remains a contentious debate; these disputes are important because they substantially influence public health prevention and government regulation.

Activist groups do not provide direct medical and public health services, and can therefore place a different emphasis on air pollution. These groups define themselves as environmental justice organizations, and view asthma within the larger context of community well being. Those groups emphasize the unequal distribution of environmental risks and hazards according to race and class, and the reduction of environmental factors that they believe are responsible for increased asthma in their communities. In their approaches to asthma, such groups combine general education about asthma with political actions to alter local pollution sources(Deutch 2008).

The problem of air pollution and asthma in the Bronx

Asthma is extremely prevalent in the Bronx, affecting people of all ages and diminishing their quality of life. In some cases, asthma can cause death, and the asthma death rate in the Bronx (6 per 100,000) is double that of New York City (see Fig. 1). The precise causes of asthma are not known, and there may be a multiplicity of causes. Some of these are thought to be outdoor air pollution, indoor air pollution, pollen, allergies, family history, and behavioral ...