How can high rates of asthma be reduced?
What is the Problem?

Asthma is the most prevalent chronic disease among children. Asthma is also a risk associated with housing for people who are sensitive to environmental allergens in the home. Recently, there has been an increase in asthma rates in Providence and it is believed to be one of the most common reasons why children miss school. Asthma is most severe in urban areas like Providence.

Environmental Triggers of Asthma in Homes
  • Smoke and smells: Allow smoking only outside the house and avoid using cleaning fluids near the children.
  • Dust mites: Dust house with damp cloth and vacuum weekly. Wash sheets and blankets in hot water weekly.
  • Cockroaches: Don’t allow food near beds and keep food wrapped up or in refrigerator.
  • Pets: Keep pets out of child’s bedroom and in areas without carpets.
  • Mold: Stay out of moist basements and use bleach to kill mold in sinks and tubs. Fix leaky plumbing.
  • Pollen: Keep windows closed during the worst pollen months and stay inside when pollen counts are high.
  • Weather Changes: Seasonal weather changes often trigger asthma; it is important to recognize what weather changes trigger attacks and minimize exposure during those conditions.

What are the Benefits of Preventing Asthma

 

Asthma Prevention Program

Center for Disease Control and Prevention (CDC) is enacting methods to prevent and control asthma in partnership with state and local health departments. This program includes:

  1. Using surveillance data to target resources and evaluate prevention efforts for those who are at most risk.
  2. Educating health care providers, school personnel, and people who have asthma and their families about asthma. This is important to reduce the economic and personal burdens of asthma by sharing information about asthma triggers, diagnosis and treatment options.
  3. Building partnerships to conduct local initiatives for controlling asthma.
  4. Conducting research to increase understanding of asthma and identify new strategies to control it.

Linking Asthma with Lead Poisoning

Housing conditions that may trigger asthma attacks are similar to those that are causing the lead poisoning in children. A Brown University report indicates that a child living where a lead poisoned child has lived is 2.5 times more likely to visit a hospital for asthma treatment.

 

 What is the Healthy Homes Model?
  • The Healthy Homes Model aims to improve housing conditions by thinking about homes as interconnected systems. For example, cleaning the dust from a home reduces the chance of dust triggering an asthma attack and also reduces the risk of a child ingesting lead dust.
  • EHAP (Environmental Health Action Project) is an ideal model for Healthy Homes efforts; the program conducts home visits with asthmatics from the Providence Community Health Centers and covers basic asthma education and prevention, including reduction of triggers in the home environment. In addition, the conditions of the home that do or might affect lead poisoning are also examined.
  • If we can streamline these programs, such that inspectors or other visitors are aware of several different diseases exacerbated by housing conditions, we will have a much more effective and efficient system of addressing environmental factors affecting children's health.
Housing Quality Concerns
  • According to a recent study, 353 houses in Providence had incidents of both asthma and lead poisoning. An effective and efficient system incorporates programs where inspectors and other visitors are aware of several diseases exacerbated by housing conditions. This suggests that we might be able to eliminate health risks by addressing more than one disease at a time in these homes.
  • In 1998, the U.S. Office of Housing and Urban Development (HUD) announced that it intends to provide resources for state and local programs that address environmental health holistically, by treating more than one health issue at a time. If lead poisoning and asthma are occurring in the same houses in Providence, the City might benefit from creating a healthy homes strategy to prevent these health conditions.
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Affordable Housing Concerns

In the process of identifying needy houses and improving environmental conditions, it is important to not significantly reduce the amount of affordable housing for the lower socioeconomic groups in the City. Though increasing housing quality is extremely important for improving health conditions, it might lead to increased rents as the remediation raises the property value of the home. The community must work toward providing safe housing, along with a system to help families afford such housing, such as grants and low-interest loans.
Strategies for Reducing Lead Poisoning & Asthma Incidents
  1. Identify indicators such that risky houses may be addressed before they poison children.
  2. Housing conditions indicators include housing code violations, environmental violations (rats, illegal trash disposal), property value, owner-occupancy and Section 8 housing
  3. Identify houses that pose risks for multiple health reasons.
  4. Create programs that address more than one risk
  5. Promotion of healthy homes to improve housing conditions that cause other health hazards
  6. The City of Providence’s Lead Hazard Control grant will provide resources to three different tiers of housing, identified according to severity of risk. The houses with cases of multiple poisonings, as shown in the map, should be put into the top tier, along with the houses with asthmatics and lead poisoned children. Houses with the indicators might go into the third tier, to examine whether or not addressing these houses before they poison children is effective. All of these addresses should be released from the DOH to the people in charge of implementing the grant.

Hospitalization for Asthma in Providence

Data From 1993 to 1998
Resources & Contacts
  • Cathy Mansell, Draw A Breath 444-3092, Hasbro Children’s Hospital, 593 Eddy Street, Potter 200, Providence, RI, 02903
  • Chris Camillo, Providence Community Health Centers, EHAP Program Manager 444-0411, 25 George Street, Providence, RI 02906
  • Jasmine Beach-Ferrara, EHAP Project Coordinator, 863-3676, 25 George Street, Providence, RI 02906
  • Providence Community Health Centers, Inc., 444-0400, 375 Allens Avenue, Providence, RI 02905-5010
  • Dr. Mary B. Smuts, EPA Region 1, (617) 918-1528
  • Kristi Rea, EPA Region 1, Urban Environmental Initiative, (617) 918-1595