Fourth Annual Asthma SymposiumBy Leon Tulton
By Leon Tulton
Photographs By Leon Tulton
A local asthma group held its fourth annual symposium Saturday, May 22, 2004 to discuss how obesity, smoking, and indoor allergens from housing-related problems contribute to the high asthma rate in East Harlem and to show residents how they can reduce the impact of the respiratory disease. The East Harlem Asthma Working Group, Inc., the coalition coordinating the event, held the symposium to address health concerns expressed by the East Harlem community in a survey distributed in February 2004. Speaking to the attendees at Public School 57, Delfina Cruz, chair of the East Harlem Asthma Working Group, the coalition coordinating the symposium, explained the purpose of the event. “Our goal is to not only educate our audience about the various aspects associated with asthma, but also to let residents know that they have the power to control this disease, not the other way around,” she said. According to Cruz, the topics discussed at the symposium, such as obesity and smoking, were concerns expressed by the East Harlem community in a survey distributed in February 2004.
Israel Soto, principal of Public School 57 explained how the problem of asthma and obesity is affecting his school. He stated that over 24 percent of the student population at P.S. 57 was diagnosed with asthma. Soto also cited how his school’s clinic weighed 592 students and discovered that over 40 percent of the student body is either overweight or obese. “We go beyond the national norm of 25 percent so this is another area that’s a big concern of P.S. 57,” the principal said.
Invited speakers discussed the behavioral factors associated with making asthma worse. Benjamin Ortiz, M.D., a general pediatrician at Columbia University-Harlem Hospital Center, stated that the medical community is still trying to understand the association between asthma and obesity. According to Ortiz, many studies are attempting to clarify the interaction between these illnesses. He speculated that some people with asthma may believe that they can’t participate in physical activities, such as sports, believing that such activities will precipitate an asthma attack. Prolonged physical inactivity will leave these adults and children vulnerable to becoming overweight or obese. Ortiz explained that a person’s culture may also play a role in contributing to the problem. “We [Latinos] use words like “full-figured” or “big-boned” to describe our kids,” the pediatrician said. “In our culture, being overweight isn’t necessarily seen as a bad thing and that’s a major problem in this community.” Ortiz recommended that parents encourage their children to be more physically active and spend quality time together during meals. He cited a study that found a connection between family members who spent less time together at the dinner table and an increase in their weight. “Parents are the first line of defense [against obesity-related medical problems, including those children with asthma],” Ortiz stated. “Physical fitness improves asthma symptoms and prevents weight gain.”
Maria Botello-Cabrera, Ed.D of the New York State Psychiatric Institute explained how smoking worsens the respiratory health of asthmatics. “Tobacco smoke is a powerful asthma trigger,” she said. She stated that tobacco smoke, when inhaled, impedes the cilia’s ability to sweep microbes and tiny debris out of the lungs and may cause health problems like asthma. Botello-Cabrera added that cigarette smoke promotes excess production of mucus, making an asthmatic’s narrow airways even narrower. She recommended that asthmatics who smoke seek smoking cessation programs that intervene through support groups and the use of drugs to deal with the physical addition of nicotine.
In addition to the obesity and smoking factors associated with the respiratory disease, the symposium also addressed how problems in the home can exacerbate asthma. The audience viewed an 11-minute film that explained how housing-related problems, such as leaking pipes and non-working vents in bathrooms, can create an excessive moist environment that encourage the growth of mold, a trigger of asthma. Susanne Lachapelle and Ray Lopez of Little Sister of the Assumption, the organization that created the short movie, stated that residents who know how to identify housing problems that contribute to asthma are more empowered to control the impact of the disease. Michael Bosnick, assistant commissioner of the anti-abandonment division of the New York City Housing Preservation and Development (NYCHPD), explained that his agency recognize mold as a serious hazard to tenants’ health. According to the assistant commissioner, NYCHPD issues class-C violations to landlords if mold covers more than 25 square feet of the area of a room. A Class-C is a housing code violation that identifies a housing problem as immediately hazardous and demands swift action to correct the problem. Bosnick stated that NYCHPD will send an emergency repair unit to fix housing violations if the proprietor takes too long to correct the problem and later bill the landlord for services rendered.
Andrew Lehrer, an attorney from Legal Aid Society, told the audience that they have certain legal rights to push landlords to correct violations that may aggravate their asthma. He suggested that tenants put their complaint in writing and send it to the property owner by certified mail, and document housing problems for their personal records by taking photos and dating them. Lehrer stated that residents, either individually or collectively, have the right to withhold their rent to protest substandard living conditions until repairs are made. “The landlord can’t evict without first taking you to court,” the attorney said. He explained that a tenant can tell a housing court judge the reason for withholding rent and the landlord can be ordered by the court to fix the housing violation. Lehrer added that a tenant must give the landlord any back rent withheld during the rent strike once the court order has been completed.
One segment of the symposium dealt with the benefits of homeownership as an option to reduce the impact of asthma in residents’ lives. “Migdol Realty Management is promoting home ownership among community members in Harlem because owning a home gives residents control over their living conditions and builds personal wealth,” said Gerald S. Migdol, Esq. of Migdol Realty Management, LLC, a co-sponsor of the event. He explained that many tenants have little or no control over their landlords’ use of pesticides or neglect of mold, which may aggravate their asthma. “Home ownership in Harlem is at 6 percent, compared to 25 percent for the rest of New York City, and we want to bridge that gap.” Migdol also added that many residents may be intimidated by the financial process of buying a home. “My organization has strong ties to this community and we want to show Harlem residents that they have the ability to achieve home ownership and generate wealth through low down payments and low monthly payments equivalent to what they would normally pay in rent,” the realtor said.
Earlier, the East Harlem Asthma Working Group proposed three policy recommendations to the audience and elected officials to help alleviate the asthma problem affecting the lives of East Harlem residents. Two of the recommendations are giving the New York City Department of Health and Mental Hygiene’s mold guidelines mandatory enforcement status applicable to landlords and mandating integrated pest management and vent cleaning to decrease environmental exposures to tenants. Elected officials commented on the points of the coalition’s policy recommendations. Describing the points as “doable”, New York City Councilman Philip Reed, who represents East Harlem, expressed his support for the policy recommendations. “I’m committed to making those things [policy recommendation points] happen with you [the community].” Manhattan Borough President C. Virginia Fields stated that she felt it was important to make the city’s health department’s mold guidelines mandatory to help alleviate poor housing conditions that exacerbate asthma. “When we do that, we will see a tremendous difference,” Fields told the audience.