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Why Asthma Threatens Vulnerable Communities

Asthma-vulnerable communities-rates-pollution-air
Asthma-vulnerable communities-rates-pollution-air

Air quality inequity leaves children and those living with chronic heart and lung diseases at risk for asthma. The Respiratory Health Association aims to change that.

Brian Urbaszewski

Director of Environmental Health Programs, Respiratory Health Association

First, could you talk about the serious issue of racial disparities in lack of access to clean air? 

One of the challenges of asthma in places like Chicago is that people are not exposed to equal amounts of air pollution. Many people live near busy roadways or industrial activity, and unfortunately, this is disproportionately true for people of color who live in lower-income communities.  Increased exposure to air pollution isn’t the sole cause of increased asthma in those communities, but it compounds the existing inequalities people live with due to reduced access to medical treatment, housing stability, employment stability and even having to regularly face violence.  So the end result is that we have many people who are already some of the most vulnerable in our region living where the air pollution is worst. 

How serious and prevalent is this problem?

The problem is big and it’s systemic. In Chicago, it has led to the City Department of Public Health analyzing the intersection of social vulnerabilities and air pollution exposure together (excellent map in that report) to see where people vulnerable to air pollution live. The resulting map showed that it was lower-income communities on the city’s west and south side that were primarily communities of color that faced the greatest health threats from air pollution. It’s led to huge fights in communities as well, with residents opposing efforts to put heavy industry in or right next to neighborhoods. Communities have been fighting to have huge fossil fuel power plants shuttered, and working to prevent car-shredding plants, asphalt plants, and even huge warehousing operations that bring hundreds of diesel trucks into neighborhoods from poisoning the air their children breathe.  It’s also led to deep questions being asked by local government officials about the fairness of where such operations are allowed, how to ensure pollution laws are being enforced, and how to develop in a way where pollution sources are not being concentrated in vulnerable communities as efforts concentrate on ways to attract more green industry and accelerate zero-emission transportation.

What can you share regarding the effects polluted air has on our lung health?

Air pollution makes people sick and it also kills people. There is no clearer way to lay out the threat it poses. And the problem is it is everywhere because the sources are everywhere. Fine particulate matter, a product largely of burning fossil fuels like coal and petroleum products like diesel, can penetrate deep into the lungs and even into the bloodstream. Asthma attacks, respiratory ER visits and hospitalizations, strokes, and heart attacks all increase with higher amounts of particulate matter. It also increases the number of premature deaths. The more people breathe, the worse the health outcomes. And there is no concentration that has been found where those impacts disappear; any amount other than none causes health damage. Ozone, the main ingredient of summertime smog is also associated with many of those same health effects and because of the caustic nature or that chemical that burns tissue it contacts, it’s a particular threat to people already living with lung diseases like Chronic Obstructive Pulmonary Disease (COPD) and asthma. People with such chronic diseases are often the first to feel the damage done by air pollution and to face the worst health outcomes.

Who is most vulnerable?

The old, the young, and people living with chronic heart and lung diseases. People who work outside in summer or near big pollution sources are also at increased risk. Children’s lungs grow into the early adult years, and the lung capacity then declines over time. Damage done early on means children exposed to chronic air pollution have less lung capacity as their age and be more vulnerable to sickness and earlier deaths.

Any basic stats available related to this issue?

In Chicago, Black children are more than 4 times more likely to be taken to the emergency room for asthma as compared to White children, and that disparity has not changed much over time. The impact of pediatric asthma in the United States is profound. Nationally, asthma is the third-leading cause of preventable hospitalizations for children, and children with asthma miss twice as many school days as other children. In Chicago, 16% of families have a child who has ever been diagnosed with asthma, above the 11% rate across Illinois and 12% nationwide.

The impacts of air pollution are sobering. One recent report by the Clean Air Task Force looked at the impact of fine particulate matter from diesel engine exhaust emissions alone. In Illinois, they caused 416 deaths, 199 heart attacks, and over 5000 asthma attacks a year from diesel engine pollution alone.

What can be done to remedy the situation?

We need to work toward a fossil-fuel-free economy where everything is largely electrified.  Illinois has already started on this path of phasing out coal and natural gas power plants, and moving toward an electric grid powered by clean renewable sources. It also means moving transportation from running on fossil fuels to electric as well. This is doable. In 2022, Illinois factories are making electric pickups, SUVs, panel vans, and school buses.  The Climate and Equitable Jobs law Illinois passed last fall is phasing out generating electricity with coal by 2038, gas by 2045, and simultaneously beginning the process of getting a million electric vehicles in Illinois within the decade. Industry will also be getting greener as less-polluting strategies minimize liability and maximize profit.

Can you briefly discuss your organization’s vision of healthy lungs and clear air for everyone and why it’s so important?

RHA believes that everyone deserves clean air wherever you may live and that we all deserve healthy lungs.  Our work is aimed toward seeing a world free from lung disease where everyone breathes clean air. We aim to get there by promoting medical research, advancing education initiatives that help people keep themselves healthy, and by promoting public policy initiatives that result in cleaner, healthier air for all.

What are the main thoughts you’d like to leave with the reader?

Clean air can’t be taken for granted and not everyone has the privilege of breathing clean air, and in many cases, people with the fewest resources are breathing the dirtiest air. As a country, we need to consciously work to support strong local, state and national policies that prevent pollution and protect human health for everyone, no matter where they live.  Everyone deserves to breathe air that won’t sicken or kill them or their loved ones.

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