Research Links Asthma Rates to Neighborhood Violence
Training to be a pediatrician, Ruchi Gupta saw plenty of kids with asthma. And something about it bugged her. Children from certain parts of town seemed to have it more often, and worse. But it wasn't until she laid out data from 50,000 children on a map of Chicago that she understood how wide the gap is.
GUPTA: And what we found was really astonishing for me. So, that was a much bigger difference than we had anticipated.
Even when you take race and poverty out of the equation, asthma still clusters in a few neighborhoods on the South and West sides.
GUPTA: That made us think there's something else about the neighborhoods themselves that's causing these differences.
Gupta has spent the last six years at Children's Memorial Hospital trying to figure that out. At one point, she and her team had a hunch. Over that map of asthma, they laid another map: police reports. They found that asthma rates correlate with violent crime. To explain what she saw, Gupta met me at one of the map's hot spots: Ogden Park, on the South Side.
GUPTA: We're here because Englewood not only has a high asthma prevalence, one of the highest in the city, but it also has one of the highest violent incidences in the city. So it is kind of red-red. It's hot on both fronts.
So the question is, why? What does a fight down the street have to do with a child needing an inhaler? The experience of Melba Miles might offer a clue.
MILES: You see the drug sellers, shoot. You hear the helicopters.
GUPTA: Just right outside the door?
Miles has lived around the corner from Ogden Park for almost 40 years. Her house is spotless -- hardwood floors gleam, red fabric drapes the chairs. She has asthma, and she's watched her son, her nephew and her grandchild struggle with it too.
MILES: Well you know it's really scary, cause at times if they get to breathing hard, it scares me, cause I'm scared to sleep cause I'm watching them. Then it's the kind of thing like if you don't have insurance, it's kind of even scarier at the hospital.
Miles says she's learned how to identify her triggers – like dust, chemicals …and stress.
MILES: I notice when I got upset and stuff was going on, violence in the neighborhood, I notice I would start breathing hard. I thought I was having like heart attacks, and come to find out, they told me it was some of the stress that would trigger the asthma.
Stress. It's become trendy to talk about stress being bad for your body. But scientists have started to uncover how that works. Christopher Masi is an assistant professor of medicine at the University of Chicago. He says chronic stress can throw off a person's hormone levels. A hormone that relaxes the airway decreases … one that causes inflammation goes up.
MASI: That combination really can predispose an individual to asthma.
So could stress be the missing link? Masi, who was not involved with Gupta's study, says it's not that simple. It could be that asthma and violence are both side effects of something else, something wrapped up in poverty and segregation. Or the link could be indirect – maybe kids in rough neighborhoods stay inside more, and get exposed to more dust and cigarette smoke. The study didn't control for those factors.
MASI: So even though the study makes perfect sense based upon what we know about asthma physiology, it's a little too early to say we know that crime is the culprit.
With so many factors at play, proving cause-and-effect is almost impossible. Ruchi Gupta is the first to admit that. But she's pretty sure she's on to something. And regardless, for the kids she sees, causes and effects all feed into a big vicious cycle. Social disadvantages lead to poor health, and poor health makes it harder to overcome tough circumstances.
GUPTA: I mean, just yesterday, I had a kid rushed in who ended up being admitted to the hospital who had an asthma attack. And the third one in four months. I mean, how is that going to impact their school, their lives, their families? And it just doesn't need to happen.
That's why Gupta says it's crucial to tease out those connections, especially in Chicago, where your health has so much to do with which neighborhood you call home.
The association between community crime and childhood asthma prevalence in Chicago
Geographic variability in childhood asthma prevalence in Chicago
Music Button: Brad Mehldau, "John Boy", from the CD Highway Rider, (Nonesuch)