By Eric Jankiewicz and Sara Sugar
Jennifer Mora lives with her 4-year-old son Devin in an apartment with one window. For most people, the lack of natural light would be an inconvenience, but for Devin, it’s potentially life-threatening: poor ventilation can trigger his asthma.
Even before his first birthday, Devin had trouble breathing.
“His body would get tight like a piece of wood and he would hold onto me,” Mora said, recalling her son’s asthma attacks when he was 1 and 2 years old. “I couldn’t do nothing. I felt helpless. He just couldn’t breathe.”
When Devin’s asthma was at its worst, Mora was lucky to get an hour of sleep. But this rarely happened – her son would wake every few hours short of breath.
“He used to always have to be in the hospital every three days. It was horrible,” said Mora, a lifelong resident of Bushwick, one sunny afternoon, keeping an eye on her preschooler. Don’t run too fast or else, she warned, “you’ll get the bad feeling in your chest.”
Devin reflects a growing problem in north Brooklyn. An estimated one in 20 children in Bushwick and Williamsburg suffer from asthma. In 2009, child asthma-related hospital visits in Williamsburg and Bushwick ranked fifth highest in all of New York City.
According to the Centers for Disease Control, there is no known cause for asthma, but attacks can be triggered by a number of factors, including allergies and environmental and lifestyle factors, such as secondhand smoke.
Dr. Natalie Langston-Davis, pediatrician and medical director at La Providencia Family Health Center in Bushwick, said that parents often tell her that if they do smoke they don’t do it around their children. But Davis said this doesn’t take into account third-hand smoke that stays in clothing.
Pollution also plays a role in the prevalence of asthma, experts say.
The air quality in Bushwick, with its heavily trafficked streets and few parks, has one of the highest concentrations of pollution in New York City, as reported in the New York City Community Air Survey. According to the city, the polluted air led to 292 out of 100,000 asthma-related hospital visits in 2010.
Devin’s mother suspects his asthma could be related to his father’s smoking and admits that she often limits his outdoor activity.
“Last year he didn’t go to the beach. Nothing,” Mora said. “Because I was so afraid he would get an attack.”
Though not directly related, socio-economics plays a heavy role in whether a child will suffer from asthma. According to a 2009 health report, the rate of child asthma-related emergency room visits was three times higher in poor neighborhoods than in wealthy ones. In Bushwick, more than 41 percent of children under the age of 18 are living in poverty, according to the 2007-2009 American Community Survey, compared with the rest of Brooklyn, where the rate is slightly above 30 percent.
Davis said that the majority of those seen at her clinic rely on some sort of Medicaid managed care.
Older housing stock, Davis said, is partially to blame for the high number of children in Bushwick with asthma. That’s the case with the poorly ventilated apartment Mora shares with her son.
Asthma is also exacerbated by children’s allergies to rodent and cockroach droppings, Davis said.
According to the New York City Housing and Vacancy Survey, in 2011 an estimated 39.1 percent of households in Bushwick reported seeing at least one cockroach in the last month. Almost 50 percent of households reported seeing at least one mouse or rat within the previous 90 days.
Generally among children growing up in poverty, there are more incidences of asthma, diabetes and obesity, said Dr. Curtis Skinner of the National Center for Children in Poverty.
“Chronic health conditions can help perpetuate the cycle of poverty,” he said.
Dr. Lynn Roberts, a professor at the CUNY School of Public Health at Hunter College, said that poor health conditions are merely symptoms of a larger issue in low-income neighborhoods that includes lack of access to healthful foods, adequate housing and health education.
“Poverty itself is the issue,” Roberts said.
Obesity, for example, cannot be attributed to a single factor in poorer areas of the city, and no one issue is more concerning than another, she said.
The rate of obesity in Williamsburg and Bushwick is one of the highest in the city at 24.5 percent, according to 2011 data from the Health Department. More than one in four children in Head Start programs and public elementary schools in Bushwick and Bedford-Stuyvesant suffer from obesity, according to a report put out by the New York City Department of Health and Mental Hygiene in 2007.
Local doctors in Bushwick don’t have the personnel and infrastructure they need to combat the problems, said Davis, who has been practicing medicine for 15 years.
“You begin to look for resources outside of your institution and it’s not there,” Davis said in her office on a Monday morning as the health clinic’s waiting room quickly filled with patients.
Though there have been recent improvements, pockets of Bushwick still have a dearth of access to healthy food choices. Supermarkets and fresh produce can be hard to find, and fast-food restaurants are plentiful.
Davis said that she refers her patients needing nutrition counseling to the Brooklyn Hospital Center. Some children who suffer from low hemoglobin have long-standing anemia that requires treatment with iron supplements. A large number of children with anemia are also obese. It again is linked to their access to healthy food options, she said.
Davis doesn’t talk to her patients about “outgrowing” asthma – she says it’s a chronic disease.
“Although you may be a mild intermittent asthmatic that has not had symptoms in years, there may be something, an environmental allergen or other cause that triggers you into an attack,” she said.
Now at age 4, Mora’s son lives a relatively normal life. He can’t run as much as the other kids and he must always wear a sweater to protect his chest. But even when things are good, Mora worries.
“He’s a strong boy but I still wake up at night to check up on him and I pray that his condition doesn’t get worse like it use to be,” she said. “When your kid has asthma it’s the worst. No one knows what I go through at night.”