As the Observer reported Monday, Resilient Dallas, a plan for building a better city ready to face the future, told us a lot we already know about inequality between Dallas' northern and southern halves, rich and poor, and white, black and Latino populations. One stark fact it revealed was surprising: Black Dallas children are much more likely than white kids to have asthma.
One white child in 10 in Dallas has asthma. Among black children, the number is 1 in 8.
Nationally, according to figures from the Centers for Disease Control and Prevention, about 1 in 12 Americans have asthma, a chronic lung disease that inflames and narrows airways, causing wheezing, chest tightness, trouble breathing and coughing. It's not curable, but can be controlled. According to the CDC's most recent statistics online, asthma killed 3,518 people in the U.S. in 2016. Deaths and cases are more prevalent among blacks than whites, lower among Hispanics and Asians and much higher among poor people.
Shammara Norris has face-to-face experience confronting asthma in Dallas. She's a career respiratory therapist who serves asthmatic children across southern Dallas from her mobile education clinic, Positive Breathing, also known as Asthma Chasers. She has served on the American Lung Association’s advisory panel. Norris founded Asthma Chasers in 2011, responding to the deadly asthma crises of children she treated in hospital emergency rooms across Dallas County.
“People ask, what was the reason a child has asthma?” Norris says. “Asthma Chasers-Positive Breathing allows me to go out and educate families, and to see why children are dying and what the parent is experiencing, the socioeconomic issue.
“You look at genetics, you look at socioeconomic status. Were they born early? These are reasons why a child could have asthma. Sometimes it runs in a family. But where the children were living, was what I call environmentally challenged areas.”
Asthma attacks are triggered by exposure to irritants in the air. Poor children living in deteriorated housing in the inner city are more likely to breathe in things known to exacerbate asthma.
“Basically, you know, low income areas, whether It be an apartment or a home, where they have high pest [levels], like cockroaches," Norris says. "Or they live in an area that has high air pollution, because there's a lot of transportation, with buses coming through their communities. Or mold … they have leaks in their homes and they're very expensive to repair. I see so many homes with leaky roofs that collect water.
“Mold is actually a trigger, it can be, not every child. Cockroach dander is a trigger for asthmatics, cigarette smoke exposure. These are things that trigger asthma attacks in children.”
She operates a mobile clinic because the areas she serves lack medical facilities. She works in Fair Park, “a little bit” in West Dallas and in South Oak Cliff for four years.
“A lot of these communities don't have health clinics nearby. If you don't have a vehicle, you don't have access to health care. So that's a huge thing. If my mobile health clinic comes to you in your neighborhood, all you have to do is to make an appointment.
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“Easy access to health care is one of the things that will help the risk factors that these families deal with. Sub-optimal care in most of these African-American communities is a fact.
“When you get sub-optimal care … your kids get sick, you’re rushing them to the emergency room. They are being misdiagnosed with other conditions, and they're not receiving proper follow-up care. You can’t pinpoint the disease. And then, you have a population of people who really don't understand the disease. Just being educated on it brings on confidence, ‘I can maintain, I can maintain and help my child live with this disease.’”
Norris responds to calls from school nurses when children’s asthma is out of control and their parents lack the knowledge to help. In addition to educating parents, she helps them access their insurance coverage. “In 2019, we will expand to asthma therapy, with a nurse practitioner on board,” she said. A grant from United Way and donated matching funds will finance the expansion.
Dilapidated housing prone to pests and leaks, income inadequate to repair it, lack of nearby medical facilities, lack of transportation to remote health care, lack of patient education and follow-up care. Those aren’t conditions Dallasites with incomes above the median or living on the north side ordinarily encounter.