At a pediatric clinic located in one of the poorest sections of Buffalo, 7-year-old asthmatic Victor Small sits with his mother Laticka. The hood on his winter coat is pulled over his head, and as he fidgets with his black skeleton gloves, he begins to talk about what it’s like when he has trouble breathing.
“There’s something is wrong with my smelling,” he says.
He and his mother are reviewing a treatment plan with registered nurse Julie Cicero. She points out the inhalers Victor needs.
“So, your yellow zone, this is your caution zone and that’s where you’re actually having symptoms," Cicero says, pointing to a chart that highlights his medication. "So if he’s coughing, he’s wheezing, tight chest, problems sleeping, playing, that’s his Albuterol. That’s his blue one ... ."
But Victor's mother says he isn’t always cooperative.
"He don’t like taking medicine," she says. "He don’t like to listen. He thinks everything is a joke until he notices that he can’t breathe or something."
She’s right, it’s not a joke.
Erie County has some of the state’s highest asthma rates for children under 17. And many of those children, like Victor, live near highways like the Kensington Expressway, which is also know as the Martin Luther King Jr. Expressway.
The U.S. EPA links asthma and other respiratory diseases to a chemical compound called nitrogen dioxide. It’s a gas byproduct emitted by cars and trucks.
“Because it’s such a large problem, I often refer to it as chipping away at an iceberg with a spoon," says Stacie Waddell of the Asthma Coalition of Erie County.
She says several Buffalo neighborhoods are hot spots for minorities with asthma. It’s a burden for minorities across America.
“Air pollution is not distributed at random," says Julian Marshall, a University of Washington professor and co-author of a recent report on nitrogen dioxide emissions. "It tends to be higher at some locations, than others. And, those higher concentration locations tend to correlate, on average, with higher populations of minority groups."
Nitrogen dioxide levels dropped nationwide from 2000 to 2010. But exposure for minorities was still 37 percent higher than for whites. The disparity was especially high in states like New York, Michigan and Ohio.
"Well, we’re rust belt," says Dr. Stanley Schwartz. He sees a lot of asthma patients as the head of the allergy department at the University at Buffalo's Jacobs School of Medicine.
As cities like Detroit, Cleveland, and Buffalo lost manufacturing jobs, some neighborhoods crumbled, he says. “So, air pollution, lack of good sanitary conditions in inner cities all contribute to why you many see a disparity. And who lives in the inner city? Usually it's underserved minority individuals, so that goes hand in glove.”
So, what can be done to address the persistent disparities?
“We’re not going to get everyone to sort of pick up and move randomly, and I don’t think we need to," Marshall says. "That’s not the goal.
"The main finding here is when you clean the air everybody benefits.”
And that means, he says, that the nation should continue its push to reduce air pollution.