Overview:
- Detroit ranks as the third worst city in the U.S. for asthma, with high rates of asthma-related deaths and hospitalizations.
- Pollution, poverty, and lack of access to care contribute to worsening asthma and allergy issues, especially among African-American children.
- Local efforts, such as installing air monitors and advocating for cumulative impact legislation, aim to address the root causes of Detroit's air quality crisis.
Before she goes out for a run, Detroit environmental justice lawyer Liz Jacob checks the day’s air quality to determine the cleanest route, puffs her inhaler, and takes allergy medicine – a new routine since developing asthma in June, less than a year after she moved to Detroit.
“Since moving here I definitely felt tightness in my chest and difficulty breathing,” said Jacob, who moved from Connecticut. At first, she thought it might be long-COVID or allergies, but several months later she was diagnosed at Henry Ford Hospital with asthma for the first time in her life.
“I have a ton of new allergies and asthma, and both [the doctors] attributed it to pollution in the city,” she said.
Across Detroit, thousands of children and adults start their day with a puff of an inhaler or a nebulizer treatment for asthma.
This year, the Motor City was ranked the third worst city in the country to live in with asthma, according to a new report published Tuesday from the Asthma and Allergy Foundation of America. The report ranks the worst cities to live in with asthma by how common asthma is, asthma-related deaths and emergency room visits due to asthma. In one recent year, 17 people died in Wayne County from asthma. Detroit’s ranking got worse this year, moving from fifth-worst last year, in the annual “Asthma Capitals” report published by the foundation.
The worst cities in this year’s top five list are:
- Allentown, PA
- Rochester, NY
- Detroit, MI
- Springfield, MA
- Philadelphia, PA
For years, Detroit has hovered in the top five worst cities, earning top place in 2022 as the worst city in the country to live with asthma. But it’s more than just asthma that is plaguing Detroiters these days.
Garen Wolff, a Detroit Medical Center Harper Hospital Allergist Immunologist, said she was “disappointed” to see that Detroit’s asthma ranking had gotten even worse in the report, but that allergies have also been awful lately likely due to climate change.
“These past two years, allergies have been terrible – allergic conjunctivitis, which is an allergy of the eyes, has just been very hard to treat,” she said.
Making asthma worse
Nearly 28 million people living in the United States have asthma, according to the National Center for Health Statistics. It’s worse for people with low incomes – 12.5% of individuals with an income of less than $31,200 for a family of four have asthma, compared to 7.9% of families of four with at least $62, 400 annual income, according to the report.
The prevalence of asthma also changes depending on ethnicity and race. For example, Puerto Ricans have the highest rate of asthma compared to any other racial or ethnic group in the country, according to the report. African Americans are also disproportionately impacted: 11.7% of Black people in the U.S. have asthma, compared to 8.9% of white Americans.
In 2019, the rate of asthma hospitalization among Black people in Detroit was 31 per 10,000. The rate among white people in Detroit was 7.9 per 10,000.
Wolff noted several factors that create a cumulative impact that keeps Detroit ranking poorly: high poverty rates, pollution, and access to care.
“The poverty rate in Detroit is still three times higher than regular Michiganders… then air pollution, we still have the refineries. If you drive down I -75 you’ll see the marathon petroleum refineries, the US Steel refineries, and we still have schools that are next to highways and freeways,” Wolff said. “You have issues that kind of persist and have not gotten better.”
The most common demographic she sees in her office is African-American boys ages 10 and 11.
For Hamtramck mom Brea Harris, it took months of her 3-year-old son complaining of a stomach ache to realize it was actually his lungs.
“Finally, it got so bad that we just took him to the ER, and they were like, ‘oh yeah, he’s having an asthma attack,’” she said. Now, her son, who is African-American, uses a nebulizer daily to manage his asthma.
Harris isn’t surprised either that Detroit ranks so badly.
“I guess we’re the Motor City –yeah, it’s just a bummer,” she said taking the information in. “I feel like a lot of people don’t really take asthma very seriously, I know I didn’t, until I realized how scary it is.”
In 2018, Darren Riley also developed asthma after moving to Detroit, from Houston, the largest center of polluting oil refineries in the country. The report is upsetting, he said.
“It’s sad to hear that our communities continue to suffer,” said Riley, founder of Just Air, a solutions-based air quality data and monitoring organization. “The opportunity that we do have, however, is… to help reduce the risk, close the disparities and hopefully get our communities off the list.”
The mission of Riley’s Just Air is to collect accurate and specific air quality data to inform decision-making and interventions for cleaner air, like informing new air permits and helping families manage their children’s asthma with outdoor sports or playtime. The company is under contract with Wayne County to install 100 air monitors across the county.
For years, US Rep. Rashida Tlaib, D-Detroit, has tried to pass legislation that would take cumulative impact into account, re-introducing the bill in July 2023. The Cumulative Impacts Act would require the EPA to analyze the cumulative effects in permitting decisions under the Clean Air Act and Clean Water Act, and deny permit applications unless the applicant can demonstrate a reasonable certainty of no harm to the community or vulnerable groups.
As a staff attorney at the Sugar Law Center for Social and Economic Justice and the Michigan Environmental Justice Coalition, Jacob is also working on strategies for cleaner air.
“We have a lot of heavy emitting polluters in the area, and that all contributes to the kind of air pollution that we’re experiencing,” she said. “Trying to address root-cause solutions like zoning, holding polluters accountable, trying to pass legislation on cumulative impacts, things like that.”
One fight Jacob has helped Detroit residents win preliminarily is getting a primarily Black neighborhood, Schoolcraft Southfield, rezoned to prohibit heavy industry from establishing next to the residents after residents said their health and asthma have been affected by a concrete crushing operation in the area.
On Thursday, the Detroit City Planning Commission voted to downzone the parcels, prohibiting the concrete crusher from expanding. The issue will now go to city council for a vote.