Ying-Ying Meng is a Center senior research scientist and a co-author of the new report, Income Disparities in Asthma Burden and Care in California. In this short interview, she discusses why asthma is increasing in California, the impacts on low-income residents and society at large, as well as tips for policymakers on how to reduce asthma in their communities.
Q: Asthma prevalence appears to be increasing in California, what are some of the causes of the disease?
As with many other chronic diseases, multiple genetic and environmental factors interact to cause the disease. Environmental causes are particularly important since many are modifiable. They’re all around us. In the trucks rumbling by our homes or schools on a freeway built too close to residential neighborhoods. In the toxins we inhale, if we live near a polluting facility, or the second-hand smoke we breathe, if we are close to a smoker. And in the asthma allergens, such as house-dust mite, mold and cockroaches, we find in substandard housing common in low-income communities. Because many of these environmental causes are modifiable, they are a good place to consider state and local policy and program intervention. For example, California Senate Bill 352 establishes a distance requirement regarding school locations near major roadways. California’s Air Resource Board has identified environmental smoke as a Toxic Air Contaminant.
Q: Lack of insurance – more frequent among those with low incomes – often forces people with asthma into the emergency room or causes them to miss work. Is there a broader impact on society?
Yes, low-income Californians suffer the adverse effects of asthma disproportionately, and this impacts society as whole through lost productivity and higher health care costs. Asthma is one of the five most costly illnesses in the United States. It costs the nation approximately $15.6 billion each year in direct health care costs –- this includes expenditures for hospital care, physician services and prescription drugs. Indirect costs from such things as lost productivity add another $5.1 billion, bringing the total to $20.7 billion a year. Fortunately, these costs can be brought under control. But that will take a serious commitment to expanding health care coverage to all Californians. Health insurance can help remove obstacles low-income Californians face in getting the quality of health care that can help prevent and appropriately manage asthma. Expansion of benefits to include home- or community-based asthma education is important since we need to educate people about asthma and raise awareness about the importance of controlling environmental triggers for the disease.
Q: Low-income Californians often live in unhealthy environments that can trigger asthma. What do policymakers need to know in order to build healthy communities?
New policies aimed at reducing exposures and creating asthma-friendly environments are needed. Prohibiting smoking indoors –- even in apartment complexes -- and in all public spaces –- both indoors and outdoors -- can help. Regulations to reduce pollutant emissions must be strengthened across the state. Efforts to reduce idling of diesel buses and trucks and increase retrofitting and replacement of diesel buses and trucks could also provide important protection for vulnerable populations. Local authorities can do a lot for asthma control. For instance, community planners should strive to ensure that schools, day care centers, work places, subsidized housing and parks are located away from pollutant sources, such as busy ports and major roadways, especially for low-income communities.
Read the report: Income Disparities in Asthma Burden and Care in California