As the system director of thoracic surgery for the Henry Ford Health System, I see the results of lung disease on a daily basis in my patients. I realize that many of my patients suffer from both benign disease and lung cancer secondary to behavioral causes like smoking. But I also understand that many of my patients, particularly African American men and women, are exposed to high levels of air pollution and receive inadequate screening for lung cancer.

My African American patients also experience a disproportionately high rate of asthma. The prevalence of asthma among Detroit adults is currently 46% higher than in Michigan as a whole, and the hospitalization rate for asthma was at least four times greater for Detroit residents than for Michigan residents as a whole between 2016 and 2019. Detroit’s population is 80% African American.

Although the incidence of lung cancer in African American and Caucasian patients is similar, African American people (particularly African American men) are far less likely to receive treatment at an early stage and are far more likely to die of disease. Wayne County has a middling incidence of lung cancer compared to Michigan (65.52 cases per 100,000 in the county compared with 61.68 cases within the state between 2016 and 2018), but lung cancer survival in Detroit is amongst the lowest compared to other major cities. African American men have some of the lowest lung cancer screening rates of all populations.

I also know that air quality, asthma and lung cancer are linked. A study I led in Texas showed wide differences in the incidence of lung cancer across Texas that seemed to be related to differences in air quality. Other studies have shown similar associations between lung cancer and air quality.  I’m working to undertake a similar analysis in Wayne County.

In this new study, we’re aiming to look at 10 to 12 major air pollutants and air quality in every area in Wayne County.  We will investigate whether poor air quality correlates with lung disease in Wayne County.

This data can be helpful to health care practitioners, who may use it to design interventions based on geographic areas with high lung cancer incidence and poor air quality. People living in these areas can benefit from targeted education and screening. 

It’s time to understand the associations between air pollution, asthma and lung cancer within Wayne County. By building this knowledge and targeting lung cancer screening efforts based on quality data, we can save many lives.

To learn more about lung cancer screening, please visit this website.

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

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Dr. Ikenna Okereke is system director of thoracic surgery for the Henry Ford Health System.

He grew up in Detroit before going to Johns Hopkins University for his undergraduate degree. He attended medical school at Washington University in St. Louis, completed residency at the Cleveland Clinic Foundation and then fellowship at Beth Israel Deaconess Medical Center in Boston.

Dr. Okereke specializes in lung and esophageal disease. He performs almost every surgery minimally invasively and has been named to the Super Doctors list for 6 consecutive years.

Dr. Okereke started the Okereke Foundation in 2013 to provide care and education to communities in need, and he has dedicated his life and career to this cause. In 2016, he began a mentorship program with underrepresented high school students, which continues today.

Dr. Okereke also performs research on disparities in healthcare in Michigan and across the country. Dr. Okereke has had nearly 100 peer-reviewed publications in his career and is one of the most-often published investigators in Detroit.