Is Our Air Killing Us? The Asthma Attack On BLACK AMERICA - the prevalence of asthma in the African American community

Ebony, July, 2001 by Joy Bennett Kinnon

FOR reasons that are not entirely clear, not even to specialists, asthma, the chronic lung disease, is attacking African-Americans at a record level. Although the asthma rate is high and growing for all Americans, the rate is consistently higher among Blacks--who are nearly three times as likely as Whites to die from the disease.

All across Black America, from Atlanta to Chicago to Harlem to Oakland, Blacks are dying, being hospitalized and becoming debilitated at a staggering rate.

Dr. Michael A. LeNoir, chairman of the Allergy and Asthma Section of the National Medical Association, says, "An African-American child is three times more likely to die from asthma than other children." Dr. LeNoir, who is a nationally recognized expert on the problems of asthma in inner cities, adds, "An African-American male in New York City is almost 11 times more likely to die from asthma as other males in New York City, so there is no question that African-Americans are disproportionately affected by the disease."

What's behind the devastating asthma epidemic, and why is it picking on African-Americans? It is generally agreed that inflammation and bronchoconstriction are the two main causes of asthma symptoms, which include shortness of breath, wheezing, chest tightness and/or cough.

Asthma is often "triggered" by "something" which causes the airways to swell and constrict. These triggers, doctors say, also play an important role in causing asthma symptoms. Patients may have more than one trigger, but common triggers include:

* Allergens, like dust mites, pollens, molds, pet dander or cockroaches and their waste.

* Irritants in the air, including tobacco smoke, wood fires or charcoal grills, as well as strong fumes or odors from items like household sprays, paint, gasoline, perfume and scented soaps.

* Respiratory infections such as colds, influenza, sore throats and sinus infections (these are the most common asthma triggers in children).

* Exercise and other strenuous activities that make a person breathe harder.

* Weather, especially cold air and sudden changes in weather conditions.

The hard question here is, Why does asthma target or seem to target African-Americans? The answer, or at least part of the answer, Dr. LeNoir says, paraphrasing the surgeon general, is that "being African-American is a marker, but not a risk factor. Asthma is more common in places where you have more crowded living conditions, more infection, less access to health care, and I'm not talking about just health care, but top quality health care where people know what they are doing," he says. He says these are often characteristics of urban inner cities, and Blacks more often live disproportionately in urban inner cities, so they are affected by these dynamics more. "There is nothing really genetic to predispose Blacks to asthma, but the statistics are staggering," he says.

The disease is no respecter of fame or fortune.

Many people know Pittsburgh Steeler Jerome Bettis as the All-Pro running back nicknamed "the Bus." But many people don't know that he has asthma.

"Having an asthma attack is more frightening than looking down the line and seeing Bruce Smith or Reggie White coming after you," Bettis says. "And if a big guy like me is frightened by an asthma attack, just imagine how frightening it is for a little boy or girl."

Bettis was first diagnosed with asthma at age 15. His first symptom was wheezing, which he experienced in junior high, but he thought his breathing problems meant he was just out of shape. Throughout his college and professional career, he used an inhaler between plays to relieve his asthma symptoms. But his poorly controlled asthma caught up with him in 1997, when an attack struck during a nationally televised game, and he had to be carried off the field. Since then, he has brought his symptoms under control by following a daily asthma action plan, whether or not he is experiencing any symptoms.

Olympic gold medalist Jackie Joyner-Kersee has battled asthma for more than 15 years. First diagnosed in 1982, she was slow to accept the diagnosis and even slower to take her medication properly. She couldn't believe that someone in such good shape could have such a serious health problem. Because she frequently stopped taking her asthma medication when she felt good, she had a number of severe asthma attacks which required emergency hospital treatment.

After a "very scary attack" in 1993, she began to realize that asthma is a serious disease requiring daily care--whether you have symptoms or not. "When I was diagnosed with asthma, I thought I'd have to give up running," she says. "Asthma didn't stop me from competing--I learned that with the proper treatment, asthma doesn't have to stop you from doing what you want to do."

Bettis and Joyner-Kersee have joined together with other athletes with asthma and leading medical organizations to educate people on how to help prevent symptoms and reduce the health and lifestyle limitations often caused by the disease.