As Asthma Cases Rise, New York's Neighborhoods Especially Hard Hit

Six-month-old Tayvon Sanders has asthma, but he's too young to understand what's the matter. He's just old enough to be terrified by the condition, which has left him gasping for each breath. His mother is even more terrified.

"(It's) scary because I don't know what to expect. You get a fear over you all the sudden because you don't know what to expect -- the worst or the best of anything," worried Pearl Sanders.

Dr. Jean Ford says asthma is a chronic problem

The pediatric emergency room at Lincoln Hospital in New York's South Bronx treats around 7,000 children a year with the disease. Many of them, such as 3-year-old Mark Anthony Pena, visit so regularly that it has become their second home.

"He knows his way around. He knows the doctors. Sometimes he even recognizes the nurses. He knows when he's here it's safe because he's going to get his treatment. He's going to feel better," said Evaristo Pena, the boy's father.

But doctors admit the load can often become overwhelming. Dr. Helen George said there are times the hospital could use two or three doctors just to see asthma patients. "We have patients in the holding area and patients in rooms … just everywhere."

The swelling and blockage of airways in the lungs, which make it difficult to breathe, cause asthma. The condition can be controlled if properly treated, but there is no cure. The number of asthma sufferers has doubled in the last 20 years, while the number of asthma deaths has tripled. More than 17 million people in the United States now have the disease and 5 million of them are children.

Dr. Jean Ford, who has devoted his career to fighting asthma, called it "a major public health problem."

"What's particularly striking about asthma is that a disease that is so common and so simple to treat, given an understanding of it, is running rampant like this in our community."
— Dr. Jean Ford

"We do not have a handle on what the reasons are for this dramatic increase at this point."

Ford heads the Harlem Lung Center in New York, the city that has become the nation's asthma capital.

The increase in asthma has been most dramatic in young people, as well as in black and Hispanic communities along the East Coast. In New York City, it's hit hardest in the Bronx, East Harlem and parts of Brooklyn -- the poorest areas of the city.

Ford noted that asthma is a constant companion in New York's black and Latin communities, adding "There are schools that we know of in New York City where it's not unusual to find that close to 20 percent of the children have been prescribed inhalers."

No one knows exactly what causes asthma, but pollution, tobacco smoke and cockroach droppings are on the long list of triggers that can provoke asthma attacks in people whose lungs are already damaged.

Jackie Brogan and Alfred Dawkins have five children -- all of them have asthma.

"It hurts. I never know if it's going to be their last breath. Sometimes it's so bad, they must be rushed to emergency and I'm praying that, by the time we get to emergency, my kid is still breathing," said Dawkins.

The family lives in a small, inner city apartment in New York. They are frequent visitors to the emergency room at their local hospital - most often bringing their two youngest daughters, Kharysma and Khovani, who suffer from severe asthma attacks.

"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 -- thank God it's there because if we had to do some traveling, I think our children wouldn't be here."

The Dawkins' dependence on their local hospital is typical, according to Ford. About 70 percent of asthma sufferers in Harlem rely on an emergency room for a quick fix, but it doesn't help to control the asthma. Ford noted one frustration among health care workers.

"What's particularly striking about asthma is that a disease that is so common and so simple to treat, given an understanding of it, is running rampant like this in our community."

Treatment for chronic asthma typically involves taking anti-inflammatory medicine, usually with an inhaler. But Ford says the problem is that poor communities such as Harlem and the South Bronx are not properly equipped, many people don't have health insurance and don't understand the disease.

School nurse Shelli Joyner is trying to change that. She uses games and music to teach third and fourth-graders with asthma how to deal with the disease.

"A lot of time they'll come and they won't be able to speak. They're hyperventilating, they're sweating, they're crying, they're nervous. They're not talking and, you know, all you want to do is help them," said Joyner.

One young asthma sufferer, Justin de Jesus, explained, "It's like my chest keeps pulling in. I can't breathe at all. I'm afraid they are going to have to take out my lungs or something."

"I'm really optimistic that with appropriate resources and commitments ... we're going to see major improvements with time."
— Dr. Jean Ford

Joyner believes that educating asthma patients early can make a real difference. Her classes are part of the "Open Airways" program sponsored by the American Lung Association of New York.

"Too many children have it and too many are dying from asthma. We really need to get out there and educate the public about this epidemic."

It is a disease that might one day be eradicated. Researchers at New York's Columbia University will be monitoring 600 pregnant women for the next two years. They want to know what kind of asthma triggers the women were exposed to and how their babies are affected. Scientists hope to finally pinpoint when asthma begins and what causes it.

"If we can understand what is triggering that initial change in the immune system that leads to the development of asthma then it would be possible in many instances, years down the line, to actually prevent asthma altogether. I'm really optimistic that with appropriate resources and commitments on the part of all these groups, we're going to see major improvements with time," said Ford.

The big question is whether that improvement will arrive in time to help youngsters such as Tayvon Sanders and Mark Anthony Pena. If not, they face a future where just breathing can be a medical emergency.