Boston Globe: Asthma rate higher in US born blacks, Dorchester study finds

[Guest guest]

Ginny Lane and I are involved with the group that published the study in

2006. It's great to see that the Journal of Asthma published the findings. In

this study, the top two asthma triggers were diesel exhaust and mold.

Mulvey son

Asthma rate higher in US-born blacks, Dorchester study finds

White and her children, Verdo (left), 11, and , 12, all have

asthma. ''Everyone has someone in their family with asthma,'' said White. (

s for the Boston Globe)

By

Globe Staff / December 1, 2008

A landmark survey conducted on street corners in Dorchester shows that

African-Americans born in this country are nearly three times more likely to

have

asthma than their black neighbors born abroad, a finding that could yield

important clues about a national epidemic.

The study was conceived in 2005 by frustrated residents of Dorchester who

wanted to understand why asthma is rampant in their neighborhood. The results

appear in the November edition of the Journal of Asthma.

It is believed to be the first study to show varying asthma rates among

African-Americans based on place of birth - although scientists can't say for

sure why Dorchester blacks born outside the United States suffer less from

asthma.

" It has a through-the-looking-glass feel to it, " said Doug Brugge, the

researcher at Tufts University's medical school who presided over the study.

" We're used to thinking that people coming from developing countries have worse

health. "

Theories for the disparity range from more sunlight exposure for foreign-born

African-Americans during childhood, to less time spent cooped up inside,

where mold, cockroach droppings, and other triggers dwell.

One of the most provocative - and even paradoxical - suggestions involves

something called the hygiene hypothesis: Because natives of other nations,

especially those in the developing world, may encounter more infections growing

up, their immune systems often ignore threats such as dust mites and mold. When

the immune system does not regularly confront life-threatening diseases, its

ammunition instead is directed at lesser enemies, provoking allergic

reactions that can spawn asthma.

" There may be a price to be paid for growing up in a more sterile, hygienic

environment with fewer infections as a child, " such as the United States, said

Dr. O'Connor, director of the Adult Asthma Program at Boston Medical

Center. " And the price to be paid is that your immune system may develop more

along the lines of promoting allergic responses. "

The Dorchester findings did not come as a total surprise: Earlier research

had shown that foreign-born Asians and Hispanics appear less prone to the

disease.

The discovery is another piece in the emerging jigsaw puzzle of asthma, which

has roughly doubled in prevalence nationally during the past three decades.

Evidence of the epidemic can be heard all across Dorchester, as the sounds of

suffering ricochet through homes: coughing jags, raspy wheezing,

chest-clenching gasps for air - and time spent in clinics rather than at school

and

work.

Everywhere White turns, the Boston native finds someone whose life has

been defined by the disease, she says, starting with her own. She has asthma

and so do her three sons, and her mother. So did her deceased father.

" When you ask a person, 'Do you have asthma? Do you know what asthma is?' and

then you look in their eyes, you see something, because everyone has someone

in their family with asthma, " said White, a member of the Boston Urban

Asthma Coalition, an advocacy group. " But we wanted to get it on paper. "

So they approached Brugge and asked him to study asthma in Dorchester, as he

had done in Chinatown. He agreed - and then enlisted the people of Dorchester

to help collect the data.

They stationed themselves at T stations, grocery stores, and laundromats.

" You're sitting there waiting for your clothes to dry, and you're always

talking to the person next to you - so why not talk to me? " said Neal-Dra

Osgood, coordinator of the asthma coalition's Strengthening Voices project,

which

works to provide support for families of asthma sufferers.

Using a carefully constructed survey, nearly 20 parents and Harvard medical

students fanned out across Dorchester in 2005 and 2006, with findings on 290

adults and 157 children included in the analysis.

" The idea is that community members know something about the disease that

outsiders don't, both how it affects their bodies and their families, but also,

more importantly, about the community context, " said Corburn of the

University of California at Berkeley, who studies the intersection between

community involvement and urban environmental health, an ethos neatly summarized

in the title of his book " Street Science. "

The study found that 30 percent of African-American adults who were US

natives had been diagnosed with asthma, compared with 11 percent of blacks born

elsewhere. Researchers cautioned that the study is a snapshot of only one

neighborhood.

Still, it reflects an emerging recognition that scientists should stop

regarding racial and ethnic groups as monoliths. " We have to be really aware

that

using a broad brush, you're going to miss some really important differences, "

said Dr. , medical director of the Massachusetts Department of

Public Health.

Asthma has rampaged across New England in recent years; one study estimated

that the number of people in the region diagnosed with the condition rose by

400,000 from 2001 to 2004. The disease is more common here than anywhere else

in the country, with one in seven adults and children affected.

Studies have shown that children who spend pivotal growing-up years in

farming areas are strikingly less likely to develop asthma. Researchers theorize

-

and biological tests suggest - that exposure to germs during childhood

reduces reaction to allergens. But it remains unclear what to do with that

finding.

" Do you definitely want people here to start dealing with all the issues

other countries have outside the United States in order to get rid of asthma and

allergy? " said Dr. Wanda Phipatanakul, an allergist at Children's Hospital

Boston.

White dealt with her family's asthma by moving out of the mold-ridden,

vermin-attracting apartment in the South End where they lived. Now, home is a

two-family in Dorchester. Shoes never touch the living room floor. Dust is

quickly banished. And the floors glisten with shiny wood instead of

wall-to-wall carpeting. All help reduce the asthma symptoms.

She always knew in her heart, White said, that asthma placed an especially

heavy burden on her neighborhood. But with the study, " someone's going to

listen to you now, " she said. " It's proof. And proof is important. "

can be reached at _stsmith@..._

(mailto:stsmith@...) .

© Copyright 2008 Globe Newspaper Company.

**************Life should be easier. So should your homepage. Try the NEW

AOL.com.

(http://www.aol.com/?optin=new-dp & icid=aolcom40vanity & ncid=emlcntaolcom00000002)