TENANTS WITH ASTHMA FIGHT TO BREATHE EASY

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June 18, 2007

TENANTS WITH ASTHMA FIGHT TO BREATHE EASY

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Tenants and organizers want home-based sources of asthma

irritation - like roaches and mold - to be granted more enforcement power by the

city. > By Kate Pastor

Mendoza stands with her 20-month-old son Angel outside

their basement

apartment in Sunset Park. Other family members have asthma,

inspiring Mendoza

to become a health activist while pregnant with him.

Mendoza, a 32-year-old Mexican immigrant, has lived in a

two-bedroom basement apartment in Sunset Park, Brooklyn, for seven years. Her

14-year-old daughter and her 6-year-old niece both have asthma.

Alysha , 37, lives on the Lower East Side with her

husband and two children. All three of them have asthma, too - a chronic disease

that constricts the airways, especially when irritated by allergens, and makes

it difficult to breathe.

Both women think their housing conditions are to blame for their

families' compromised health, and despite complaints to their landlords and the

city, have been left to deal on their own with the ongoing presence and problems

of roaches, rodents and mold - all triggers for asthma. Under the banner of the

newly-formed Coalition for Asthma-Free Homes, they were among the advocates who,

along with City Councilmember Rosie Mendez, gathered last week outside 's

building at 10 Stanton Street to demand the city do more to control indoor

triggers of asthma.

City Councilmember Rosie Mendez speaks to a group assembled outside

10 Stanton

Street on the Lower East Side in favor of new ways to combat

asthma's household

triggers. Dr. Lester Blair, right, of New York Downtown Hospital,

also spoke in support.

The Coalition and others are pointing to ever-clearer patterns that

correlate cockroach and rodent infestation and the presence of mold with

low-income households - and all of those things with residents having asthma. A

2005 report by the city Department of Health (DOH) said vermin are most common

in homes in northern Manhattan, south and central Bronx and central Brooklyn,

and disproportionately affect minorities at every income level. DOH also says

childhood asthma hospitalizations were highest in east Harlem, central Harlem,

burg-Bushwick in Brooklyn, and Highbridge-ania, Crotona-Tremont,

and Hunts Point-Mott Haven in the Bronx.

" New York City has pockets, enclaves, that are high in asthma and

they overlap with high poverty rates, " said Ginger Chew, assistant professor of

environmental health sciences at Columbia University's Mailman School of Public

Health.

A recent report by the Fifth Avenue Committee, along with an

affiliated new immigrant worker organization called La Union de la Communidad

Latina, concludes that for the largely immigrant community of low-income renters

in Sunset Park, their homes are hurting their health. The experiences of

Mendoza, a member of La Union de la Communidad Latina, formed one of several

case studies highlighted in the report, which found that the most common chronic

health problems were asthma and other respiratory ailments. In one-third of

surveyed households, at least one household member suffered. Among that third,

nine out of 10 households reported that housing conditions exacerbated their

illnesses. The DOH says that citywide, 17 percent of all children have had

asthma at some point in their lives, while 4.4 percent of adults have had an

episode in the past year.

The Coalition for Asthma-Free Homes - formed around the same time as

La Union's report was issued - last week proposed changes to the city's policies

in dealing with asthma triggers. A major recommendation was for the department

of Housing Preservation and Development (HPD) to reclassify mold, mildew and

infestations of vermin as class C violations - the most serious category - up

from the class B status they receive in most cases. B violations, though

considered hazardous, carry a 30-day window for correction, while class C

violations are immediately hazardous and the owner has 24 hours to respond.

The way enforcement works now, according to HPD spokesman Neill

, is that tenants who can't get their landlords to make repairs can call

311 to contact HPD and get HPD inspectors to write up violations. If that

doesn't get the owner to repair the problem, a Voluntary Repair Agreement (VRA)

sets out conditions to be corrected and a timetable for repair. After

re-inspection, if an owner is not in compliance, HPD's Housing Litigation

Division can bring a case against the owner in housing court. In some of the

most serious cases HPD can ask the court to appoint an administrator to collect

rents, maintain the building and make necessary repairs.

Advocates for asthma policy change - which include such groups as

the American Lung Association of the City of New York, New York City Aids

Housing Network and the New York Immigration Coalition in the Coalition for

Asthma-Free Homes - are asking that guidelines for proper mold and pest removal

be turned into enforceable regulations in the city's health code, as is the case

with lead - which has been known for centuries to cause a variety of serious

health problems. Right now, there are guidelines, but no provision for HPD to

enforce best practices for dealing with mold and mice, rats and roach

violations.

They also recommend better training for inspectors, landlords and

supers in identifying mold hazards and their causes, along with increased

education for inspectors, landlords and tenants. A report published last year by

Public Advocate Betsy Gotbaum, entitled " Unhealthy Exposure: Mold In New York

City Homes, " made similar recommendations.

Mold on the bathroom ceiling of 10 Stanton Street resident

Sandy Lo. Residents of this building complain of mold, rodents

and roaches, all of which can be irritants for asthma sufferers.

While groups are taking inspiration from the way the city deals with

household lead, wrote in an e-mail that the most recent iteration of the

city's lead law " has been very expensive for building owners and the City with

no evidence to show that it has had any impact on already declining rate of lead

poisoning. We would see it as a very bad model for correcting other housing

maintenance code violations. "

The city health department does not address mold and infestation the

same way it handles lead because asthma can be the result of numerous

pollutants, and mold is not a hazard to the general population the way that lead

is, said DOH spokesperson Sara Markt. " Some housing conditions, such as roof and

plumbing leaks, floor cracks and building defects do lead to issues such as pest

and mold. Landlords are required to fix these conditions regardless of tenants'

health status, " Markt said. DOH calls on both landlords and tenants to do their

part, and coordinates a New York City Asthma Initiative which includes training,

programs in schools and daycare centers, a community integrated pest management

program and more.

Although City Council created a significant new housing enforcement

tool last month in the Safe Housing Act, activists say it doesn't provide enough

help when it comes to asthma. The Act targets the 200 worst buildings for

increased HPD enforcement, requiring owners to correct 80 percent of hazardous

and immediately hazardous violations within four months, or else the city will

make repairs at owners' expense. And yet " you might have very, very bad asthma,

but you don't live in one of the worst 200 buildings in the city, " said Irene

Tung, a member of Make the Road by Walking, a community group that supported the

legislation and is a member of the Coalition For Asthma-Free Homes.

s , executive director of the American Public Health

Association, said some of the advocates' recommendations are worth a try. " I

think it would be interesting to look at and see if it would actually work, " he

said about modeling an asthma program on lead interventions. But Ginger Chew

from the Mailman School pointed out challenges in regulating acceptable levels

of mold, roaches and rodents. " We don't know what a safe level would be for each

person, " she said, since sensitivity varies.

La Union de la Communidad Latina is looking for other structural

changes, too. It wants to see the city move away from a complaint-driven system,

which puts the burden on tenants to report substandard conditions to the city.

According to Artemio Guerra, director of organizing for the Fifth Avenue

Committee, occupants of affected apartments may not be named on the lease, or

may think they're breaking overcrowding laws and therefore choose to live with

vermin and mold rather than complain. Even Mendoza, who now appears fearless in

her leadership of La Union de la Communidad's environmental justice committee,

said, " I was afraid that the landlord would threaten me. The landlord would say,

you either like it or you go. " Her fear was realized when her landlord called

the police and the Administration of Children's Services on her for withholding

rent, she says.

Fifth Avenue Committee is working with Lutheran Medical Center in

Sunset Park on a medical-legal partnership, a local initiative that would

include housing advocacy. As it stands, when a person comes to the medical

center with asthma, the patient is assigned a nurse, and sometimes a community

health educator to conduct an environmental assessment of the patient's home.

What Fifth Avenue Committee is proposing is an additional step in which

community educators could opt to call on housing advocates who could organize

tenants, assist in mediation with the landlord, or call on a lawyer to help

settle the housing issue. Then, when a doctor writes a prescription for an

asthma sufferer to avoid allergens like mold, mites or roaches - as a physician

recently did for Mendoza's niece, with no result - " an enforcement mechanism

will be triggered, " Guerra said.

The program would be modeled after similar public health approaches

at the Medical-Legal Partnership for Children at Boston Medical Center, said

Kathy Hopkins, director of community-based programs for Lutheran Family Health

Centers. Hopkins said among the largely immigrant and undocumented community

that her center serves in Sunset Park, " There's a fear of losing their home.

That's why advocacy is so important. "