OPINION: Detroit ranks 15th worst in the nation for asthma. Here’s why we need to change our transportation sector.

By Susan Mudd, Senior Policy Advocate, Environmental Law & Policy Center & Kathleen Slonager, RN, AE-C, CCH, Executive Director of the Asthma & Allergy Foundation of America Michigan Chapter 

Detroit is among the worst places to live with asthma in the United States, ranking 15th out of 100 cities ranked annually by the Asthma and Allergy Foundation of America. We rank worse on average for asthma prevalence and the crude death rate — ranking 8th for asthma-related deaths. About 10 people lose their life to asthma every day in the United States, and those numbers have not improved over the last decade.

Source: AAFA 2021 Asthma Capitals Report

The impact of asthma in the city and region is significant. Asthma impacts about 11.3% of Detroit’s kids compared to 9.7% of kids statewide, The national rate in kids is about 7.0%.

Air pollution can trigger asthma symptoms and make them worse, and Black children are more vulnerable than other groups. A 2017 State of Michigan study shows that health problems associated with air pollution, like chronic obstructive compulsive disease (COPD) and asthma, are worse in the city than in the state. 

The impact on our community is significant and rife with disparity. Black patients visit the emergency room for asthma-related reasons at a rate five times more often than white patients. And most of those visits are children, with kids under four having the highest rate of emergency visits. 

Having asthma negatively impacts kids’ ability to attend school and learn. A 2017 report found that Black kids in Detroit are among the top 10 cities in the nation for asthma attaches and lost school days due to asthma. Children living in areas of Detroit with higher asthma rates were found to have higher rates of chronic absenteeism.

Exposure to air pollution affects children more because they’re smaller, their lungs are smaller and still developing, and their brains are developing. Air pollution impacts kids’ neurodevelopment, leading to lower IQs, lower test scores, and not getting through school grades as they should. 

Air pollution also increases the chances of developing illnesses beyond asthma, like COPD and other kinds of respiratory dysfunction and heart disease. And air pollution may cause some childhood cancers. It’s also linked to preterm birth, which disproportionately impacts Black,  Hispanic, and Latino women. 

A recent analysis linked air pollution to six million preterm births globally every year. Outdoor PM2.5 (fine particulates) pollution, was linked to one-third of low birth weight and preterm birth cases. The World Health Organization (WHO) recently announced a reduction in its recommended air quality standards for six air pollutants. US EPA standards are already less protective than the prior WHO guidelines for PM2.5.

And while we often think of industrial smokestacks as the major contributor to air pollution, our transportation system contributes the lion’s share of many toxins in our air. According to the U.S. Environmental Protection Agency, the transportation sector contributes to more than half of the nation’s NOx pollution; it also contributes to particulate matter pollution and ground-level ozone. Diesel exhaust from trucks, buses and construction equipment is a leading toxic air pollutant, contributing to respiratory irritation, headaches, respiratory disease, and lung cancer. 

The Metro Detroit region is a nonattainment area for ozone, meaning it is out of compliance with federal Clean Air Act standards.  NOx emissions from transportation are a substantial contributing factor to ozone.

The transportation sector is also the most significant contributor of greenhouse gases in the United States, with cars and trucks accounting for more than 80% of that. As the climate warms, asthma and respiratory diseases will worsen

One way children get exposed to air pollution is if their schools are located near roadways. University of Michigan researchers found that a substantial proportion of Detroit students have high exposures to traffic-related pollutants at school and recommend proximity to roads as a factor in future decision-making on where to site schools.

We must change our transportation sector to prevent suffering and death. We advocate the following policies:

  1. Reduce idling. The Argonne National Labs has estimated that heavy-duty trucks alone are responsible for 11 million tons of carbon dioxide, 55,000 tons of nitrogen oxides, and 400 tons of small particulates every year. Anti-idling ordinances are good to have on the books, but there are problems with enforcement across the country, mainly due to understaffed agencies. We must make it even easier for those driving vehicles, especially trucks and buses, to avoid idling, such as with automatic shut-off devices which could help in situations such as waiting to load/unload or in long lines at the bridge in Detroit. We also need to think about where idling is occurring: school buses waiting for students, tour buses outside sport and concert arenas, and reduce idling there. 
  1. Electrify vehicles: Almost every type of truck and bus now has electric versions, and some of their parts will be made and/or the vehicle assembled in Michigan. This is a huge economic opportunity for our region. We need policies to encourage consumers to purchase electric vehicles. We also need to build out the infrastructure to support an electric fleet — and ideally, that will be done on a national scale, as President Biden is proposing in his infrastructure bill, not piecemeal by state. Governor Whitmer’s recent announcement of an EV charging station circuit around Lake Michigan puts our state on the map with other Midwest states to ensure our highways have adequate charging infrastructure. We should also support bills such as the Clean Commute for Kids Act, co-sponsored by U.S. Senators Debbie Stabenow and Gary Peters and U.S. Congresswoman Debbie Dingell, to expand the electrification of school buses (already 17 in MI!).
  1. Reduce vehicle miles traveled. The most straightforward way to cut air pollution from transportation is to drive fewer miles. That requires more investment in public transportation — which is crucial for several reasons. Public transit is critical for essential workers who’ve kept us going through this entire pandemic, many of whom are reliant on this service. And it’s vital because when we are serving the needs of people who don’t have cars or don’t drive, we’re also helping those who do drive. After all, we’re reducing the amount of traffic, and thus the amount of air pollution and congestion impacting those who drive their cars. 

There are also things we as individuals can do. Most important is to contact your legislators (contactmypolitician.com) and let them know you are concerned about air pollution and care about your health and that of your community — and urge them to support the policies outlined above. You can opt for an electric vehicle when you replace your car. You can remember to stop idling when in a car queue. You can urge your school district to purchase electric buses. And you can talk to your friends and neighbors about all of these things.

 Here’s a list of great ideas to get you started.


Susan Mudd is an attorney and senior policy advocate for ELPC, where she directs ELPC’s Diesel Pollution Reduction Initiative to protect children’s and community health, ELPC’s Electric School bus campaign and with ELPC’s Science Advisory Council. Susan previously served as Citizens for a Better Environment’s Wisconsin director for 15 years, consulted for the Gaylord and Dorothy Donnelley Foundation, and the Brico Fund. She lives in Chicago with her husband and daughter; all three love Lake Michigan.
For more information on the Environmental Law & Policy Center http://elpc.org; to contact Susan regarding this issue email her at  [email protected].

Kathleen Slonager is the Executive Director of Asthma and Allergy Foundation of America – Michigan Chapter, a non-profit charity dedicated to education and training for all those affected by asthma and allergies, as well as the professionals that take care of them.  

Ms. Slonager has over 30 years’ experience in health care. In 2013, she was awarded the Chapter Innovation Award from the Asthma and Allergy Foundation of America, in recognition of a home care program for families dealing with asthma and allergies.  Additionally, she is the co-author or the AAFA Wee Breathers™ and the Asthma Care for Adults™ asthma management programs. Ms. Slonager is also the author of several published papers and lectures regarding asthma education and holistic health practices, as well as co-author of a published study:   Impact of air pollution on asthma in Arab Americans, 2014.

Kathleen is a passionate patient advocate, mentor, and Board-certified asthma educator with expertise in asthma and allergy management, complementary and alternative medicine modalities, disease management, quality assurance, and health promotions.  She is passionate about providing evidence-informed health information to aid consumers and clinicians in health and wellness.  For more information on asthma and allergies in Michigan, contact the Asthma & Allergy Foundation of America – Michigan Chapter #888.444.0333 or aafamich.org

Planet Detroit’s Solving Lead & Asthma in Detroit series is underwritten, in part, by the Erb Family Foundation.

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