Stolen breath: The Asthma Epidemic
Runny noses, high fevers and persistent coughs—as the chill of San Francisco’s winter season continues, the number of sick San Franciscans continues to rise throughout the city.
Forced to stay indoors because of weather, children are especially vulnerable to falling ill. For children with asthma, the winter season can have much greater effects on their health status.
Asthma is a chronic lung disease characterized by inflammation of the airways, recurrent wheezing and coughing, difficulty breathing and tightness of the chest. In recent years, asthma rates in the United States have reached astronomical numbers.
According to a survey conducted by the U.S. Department of Health and Human Services, 7.1 million children currently have asthma.
Jaime Ruiz, a pediatrician who has been with the Mission Neighborhood Health Center for 16 years, said that since the onset of the winter season, he sees between five and seven asthmatic patients a week.
Nurse Kathleen Ward of Everett Middle School, where approximately 40 students have asthma, says that in addition to taking prescribed medication, there are simple preventative methods that can help keep the lungs healthy.
“If a child who does not have a cold or flu is home because of asthma symptoms there is something wrong in their plan and the health provider should be contacted” said Ward, a parent of an asthmatic child. “Not only are medicines important during illness and before exercise, and for some children daily as prevention, but it is also healthy behaviors of hand washing, drinking water, not overheating the home, and removing triggers for the asthmatic which can help prevent asthmatic episodes.”
As a response to community efforts to combat the rapid rise of poor respiratory health in children, the San Francisco Board of Supervisors commissioned the Asthma Task Force in 2001.
David Lo, an SFDPH health educator since 1995, has worked with the ATF, health care providers, community advocates and teachers to focus on macro-level issues that assess how environmental discrepancies directly contribute to health problems. In 2011, the city government revoked the ATF’s legislative-body status. It must now function as an independent organization.
“Program sustainability is a big challenge,” said Lo. “We lack manpower, resources and funds. There is hardly any paid staff on the ATF, which makes it difficult.”
Lo disclosed various achievements of the program, including the Bleach Project, which spread awareness of the damaging effects of using bleach products within childcare settings. The Compass Children’s Center in San Francisco was the first childcare center to use bleach-free products and have since seen a decrease in asthmatic symptoms among both children and staff.
Despite these achievements, a 2011 ATF survey found that 65 percent of respondents never received, or did not remember, asthma training from SFUSD. According to Ward most children are diagnosed with asthma at the elementary level.
The lack of asthma training among SFUSD teachers and staff is dangerous when considering the fact that from 2006 to 2008, over 200 children from the four neighborhoods with the highest asthma rates—Mission District, Ingleside, Lake Merced and Bayview Hunter’s Point—were hospitalized because of asthma attacks.
The Bayview District, because of environmental factors, has the highest rates of asthmatic children. According to a Healthy American case study conducted by the organization Trust For America’s Health, one-in-six Bayview children have asthma. The neighborhood also has four times the state rate of hospitalization for asthma.
Hospitalizations can take a serious toll on the economic status of families. The average hospitalization cost (3.8 days) is $3,102. Medicine meant to treat asthmatic symptoms, such as inhalers, anti-inflammatories and anti-allergics average monthly between $114 and $233 without insurance—depending on how much it is used.
At the Mission Neighborhood Health Center, where the majority of patients are from low-income Latino, migrant backgrounds, Healthy San Francisco provides the money to pay for these high-cost medicines. According to Ruiz, preventive medicines are not enough. Preventive care, going beyond the medicine into understanding the overall disease, is crucial.
“There’s no way we can do this preventive care by ourselves, it’s much too big of an undertaking,” he said. “But with community partnerships and better education and understanding of the disease for schools, providers and patients, we could do these sort of things.”
This article was produced in partnership with Professor Katynka Martinez’s Latina/Latino Journalism class at SF State University.