Health care group preaches prevention
In poorly-maintained apartment buildings in Hunts Point and Longwood, conditions that trigger asthma hide in plain sight.
So Urban Health Plan, the Hunts-Point-based network of health centers, has taken the fight against the asthma epidemic indoors.
Less-generally-known as a cause of asthma than the air pollution that vocal environmentalists battle, mold, roaches and other vermin in run-down buildings have helped make the South Bronx the asthma capital of New York and one of the most afflicted regions in the nation. So, in addition to treating the disease, Urban Health Plan doctors are seeking to raise awareness of the impact housing conditions have on the asthma epidemic in Hunts Point and Longwood.
“At Urban Health Plan, our intent is on managing asthma. We mainly focus on indoor interventions; there’s not much we can do about outdoor triggers,” said Dr. Acklema Mohammad, the head of the pediatrics department. “But the patients who live in apartments that have mold growing inside and deal with cockroaches, we can help.”
Urban Health Plan partnered recently with NBC’s “Dateline” in a six-part series that exposed the failure of the New York City Housing authority and private landlords to make repairs and provide pest control in households where children suffer from asthma.
Residents of apartments in poor condition complain frequently about infestations of mice and cockroaches and about leaks that cause mold. Decaying cockroach corpses, cockroach excrement and saliva are asthma triggers for children with an allergic sensitivity to them, and mold is a potent asthma trigger, according to Mohammad.
“Cockroach and mold presence is very prominent here,” she said. “The patients will tend to avoid asthma if educated.”
As it treats patients, Urban Health Plan also educates families in a step-by-step program to help them manage the disease, which has no cure, by reducing the triggers that lurk in their homes.
“We place the patients on a 14-day period in which they take medication and rid their houses of rat and cockroach droppings, and clean the mold,” said Mohammad. “We collect data for those 14 days. We then ask the patients: ‘How many days in the last 14 did you have symptoms such as coughing spells and weakness?’ The average is 12 out of 14 days with no symptoms.”
In the program, called Asthma Relief Street, “We teach them how to prevent roaches in the home. We tell them to keep their countertops, tables and sinks clean and to store food in air tight containers. Mold should be kept off by using Clorox and water,” Mohammed continued.
Conditions, though, are not always in the patients’ control. Urban Health Plan drafts letters for patients to send to their landlords, but Mohammed acknowledges that many landlords just shrug them off.
“It doesn’t mean landlords will make changes,” she said when asked about the effectiveness of the letters. “When patients moved to a cleaner house, the asthma effects aren’t as severe. If the roaches and mold are triggers, the biggest challenge is to get the landlord to fix it.”
Hunts Point and Mott Haven led the city in the rate of emergency room visits for asthma and the rate of hospitalizations in 2007 and 2008, the last period for which statistics are available, according to the New York City Department of Health and Mental Hygiene.
The Hunts Point market is a crucial provider of jobs, argue Community Board 2 and the Hunts Point Economic Development Corp., but they join with the environmental justice movement in calling for solutions to the outdoor air pollution from the thousands of trucks that traverse local streets on the way to and from the market. Josephine Infante, executive director of the economic development corporation, wants the Port Authority to conduct a study and offer solutions to the traffic issue.
As to conditions in local apartment buildings, Joyce Campell-Culler, a longtime tenant advocate who chairs the housing committee of Community Board 2, said she wished more residents would bring their complaints to the board. “We advocate for our residents,” said Campbell-Culler. “We will call the agencies if the residents tell us about the mold and roach problems.”
The highest rates of asthma in the city continue to be in low-income neighborhoods, but statistics kept by Urban Health Plan show a decline in the number of cases locally.
“We empower them to manage their asthma so that it is well controlled. We don’t have as many patients as we had six to eight years ago,” said Mohammad. “That means our program is working.”