Newsday
15 June 2003

Study Finds 1 in 4 Children In Harlem Have Asthma

by Tom Rock

They called it shocking. Stunning. The preliminary results of a study by the staff at Harlem Hospital Center released last month buckled the knees of asthma research around the world. The report, which should be completed and published this summer, found that more than a quarter of all children in a 24-block area of Harlem have asthma.

"When we looked at the numbers, we were stunned," said Stephen Nicholas, director of pediatrics at Harlem Hospital Center who undertook the study. "We've discovered the underbelly of the iceberg and it's twice as large as we thought it was."

But not everyone was so impressed by the findings.

"I wasn't surprised, not up here," said Ted Dorset, who coaches three varsity sports and teaches physical education at A.P. Randolph High School in Harlem. "There are a lot of kids with asthma in this neighborhood."

In fact, there has been a long-standing link between economic conditions and asthma. In 1999, the New York City Department of Health released a study on asthma. Among the significant findings were:

Children in New York City are almost three times as likely to be hospitalized for asthma as children in the United States as a whole.

From 1988-97, New York City asthma hospitalization rates increased by 22 percent; the largest increase was seen in children from low-income communities, where it rose more than 60 percent.

The Bronx is the New York City borough with the highest rates of both asthma hospitalizations and deaths.

Acidic air particles, sulfur dioxide, and overexposure to ozone - all forms of air pollution that are far more prevalent in urban communities - have been linked to increases in patients' emergency room visits and hospital admissions.

Even things such as the stress of living in a high crime area have been linked to asthma rates. A Harvard University study presented at the 2000 International Conference of the American Thoracic Society suggested that violent crime and higher levels of vacant housing was each associated with a 40-percent increased risk of having physician-diagnosed asthma among children over age 2.

Evidence also exists that dust, cat dander and even cockroaches can cause asthma symptoms to develop in predisposed people and worsen symptoms of known asthmatics.

"You're going to have cockroaches in the neighborhood and perhaps in your house," said Dr. Michael Kaliner of Washington Hospital Center's Institute for Asthma in D.C. "They turn out to be the most important indoor allergen in the inner-city community."

The latest study by the Harlem Hospital Center found that children with asthma were 50 percent more likely to have someone in the home who smokes cigarettes. Another issue was that even parents who seek medical care often have a poor understanding of their children's condition and treatment and do not give the medication properly.

Asthma, the study found, is the leading cause of school absenteeism in the Harlem neighborhood.

Dorset said there are two players on his varsity boys basketball team with asthma, "two that I know about." He said even when sending athletes to clinics for preseason physicals presents a "crapshoot" whether the doctor will probe deep enough for a proper diagnosis. Dorset said he had one basketball player with epilepsy who passed a physical and later had a seizure on the court.

"This is a very poor community where a lot of the families have very troubled lives, with lots of stresses," said Geoffrey Canada, president of Harlem Children's Zone, which helped in the research. "That not only makes the problem more severe, it makes it much harder to even identify the problem and treat the problem."