Steven Nicholas, director of pediatrics at Harlem Hospital, initiated the study after treating a steady stream of asthma patients at the hospital over the past several years. The problem is “twice as large as we thought it was,” Nicholas said.

Asthma causes swelling and blockage of the airways into the lungs, which makes it difficult to breathe. The condition can be controlled if properly treated, but there is no cure. The rates are higher in Black and Latino communities, especially along the East Coast. Nationwide some 20 million people suffer from the disease—more than double the number who did in 1980. Deaths from the condition have tripled in the same period.

“I come home from work and Kharysma’s wheezing, Khovani’s wheezing, and they can’t breathe, so my immediate reaction is panic. The thing that I do is I get them dressed and we all rush to Harlem Hospital emergency,” said Alfred Dawkins, whose five children all suffer from asthma.

As more working people are denied access to health care, those afflicted with asthma increasingly go untreated or are forced to make a trip to the emergency room to get help. About 70 percent of asthma sufferers in Harlem end up getting treatment at the local emergency rooms, said Jean Ford, head of the Harlem Lung Center.

Robert Mellins, director of the Pediatric Pulmonary Division at Columbia College of Physicians and Surgeons, said lack of access to health care may be in part behind the disproportionate impact of this disease in Harlem and other working-class communities. “Sometimes lack of access to care leads to a delay in seeking care. So, what starts out as a mild, easily treated situation becomes much more serious.”

“Other factors,” Mellins continued, “include crowding, poor living conditions, cockroach infestation, lack of adequate ventilation and sometimes the use of excessive amounts of gas cooking or using gas to heat, which can result in toxic gasses in the home…. Those are some of the reasons. There may be others. Bus depots sometimes are concentrated in poor sections of the city, and diesel fumes may serve as triggers.”

“There are schools we know of in New York City where it is not unusual to find that close to 20 percent of the children have been prescribed inhalers,” said Jean Ford. “What’s particularly striking about asthma is that a disease that is so common and so simple to treat, given our understanding of it, is running rampant like this in our community.” The study, which tested 2,000 children under the age of 13 in a 24-block area, also discovered a large number of kids who suffered from the disease but had never been diagnosed with it. “We found that a lot of kids are floating through life without anyone knowing they have asthma,” said Nicholas. If similar testing were done elsewhere, he remarked, “the rates might be much higher than suspected in any number of inner-city neighborhoods around the country.”  
 
 
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