Asthma and Planning

M. Sophia Newman explains the connections between planning decisions and the public health outcome of asthma rates.

More than 26 million people in the U.S. have asthma, a condition involving spasms in the lungs that makes breathing difficult; it’s among the most common chronic diseases in the country. May is Asthma Awareness Month when public-health officials hope to increase education about the condition.

The article focuses specifically on asthma rates in Philadelphia, which suffers the chronic ailment at higher rates than the rest of the state of Pennsylvania. African-American residents are particularly susceptible, caused by a century of planning and policy decisions.

The pernicious legacy of institutional racism has segregated communities of color in underserved neighborhoods in cities across the country — districts with poor-quality housing stock clustered near areas of heavy industry, transportation centers and other sources of air pollution. What’s ultimately at the core of addressing asthma and its disparities, according to a wide range of researchers, activists, and public health professionals, is not attention to race itself at all. Rather, useful interventions range from clinical care to housing policy to confronting corporate and government polluters.

The article provides insight into numerous potential solutions, both for individuals and at scale. Housing policies, such as improving the ability of tenants to remediate in-home triggers of asthma, figure prominently as solutions to the problem, as does dealing with air pollution sources that impact the public realm. On that latter point, Newman notes a lack of consensus: "The premise that outdoor air pollution aggravates asthma may be more controversial than any other in asthma care."