A 10-year-old boy in the New Haven area had developed a bad case of chronic asthma — he could no longer play sports with his friends and had to take high doses of steroids. He was constantly missing school and ending up in the emergency department.
Alice Rosenthal, an attorney with the medical-legal partnership at the Center for Children’s Advocacy, oversaw the case. She said the family was great with keeping up with treatment and medical appointments, but health providers "just couldn’t quite seem to grasp what was going on when the family was doing everything they were supposed to.”
Eventually, a crucial piece of the puzzle fell into place.
“Mom spoke to the pediatrician and said, you know, we’ve had these really old carpets in our apartment,” Rosenthal said. “We’re lived there for five years, they’ve been there the whole time, so I can’t imagine how long they were there before.”
The carpet was eventually removed, which led to a significant improvement in the boy’s health. Cases like this show just how big of an impact housing quality has on health — especially asthma — and wellness advocates are taking notice with more services aimed at addressing housing and environmental issues.
“We can keep putting band aids on all these individual stories, and that’s really important," said Rosenthal. "But when are we going to stop and say this is something we need to change on a more systemic level?”
State data shows that asthma affects about 12 percent of children and 10 percent of adults in Connecticut — rates are higher in urban areas. State officials estimate that this condition accounts for nearly $100 million a year in emergency room and hospitalization costs.
Experts at a recent Connecticut Hospital Association conference said prescribing treatment for the symptoms of asthma is no longer enough — health workers need to help families address the underlying issues that cause or exacerbate the condition. And Erin Boggs said some people need more help than others.
“We also have some of the biggest disparities by race and by income, and you can look at those in terms of education, incarceration, employment and health,” she said, “and so we have some issues to contend with and we need to be thinking creatively on how to solve them.”
Boggs is the executive director of Open Communities Alliance, a non-profit that is currently working on a pilot housing voucher program to address disparities in asthma.
It’s designed to help people with housing vouchers and who have kids with asthma in moving from neighborhoods that have asthma triggers to neighborhoods that have fewer issues. And it won’t be a solution for everyone, Boggs said.
“There are lots of reasons people are connected to their neighborhood and community,” she said, “but we know from the work that's happened in Baltimore, we know from a vast cache of research, that moves like this are likely to make a difference in the health of families.”
Beyond a family’s home, their wider environment can also make a difference. Alyssa Norwood is a program manager at Sustainable CT, which is partnering with municipalities on environmental and health projects.
They’ve included the town of Coventry, which initiated a campaign project that focused on improving air quality in public parks and spaces, as well as New Haven, which has been installing bioswales in its downtown.
“Bioswales are green spaces that are on the streetscape that help with drainage and address flooding issues in a way that is environmentally resonant, but can also address asthma by improving air quality in those communities,” Norwood said.
Experts agree that solving asthma is a complex problem that needs to be addresses from several angles. The goal, they said, is to use new programs and services to get the state’s asthma rate down, even as rates continue to rise nationally.