Poor Asthma

Poor Asthma

Today there was an article in the Washington Post that discussed a surprising new study which found that it’s not asthma and urban poverty that are linked, but instead, poverty in general. While the author of the article was able to surmise that living in poverty might possibly be a causative factor in regards to asthma, it completely missed the idea that in addition to genetic and environmental factors, the stress of living in poverty might be to blame. Unfortunately, and unsurprisingly, poverty is also linked to the educational achievement gap and a broad range of other health issues.

For more than 50 years, researchers have described childhood asthma as a plague of the inner city — urban areas where 20 percent or more of the population lives below the poverty line. But a new study by researchers from Johns Hopkins University School of Medicine suggests that isn’t true, and that race, ethnicity and poverty are more closely associated with the lung disease than location in urban neighborhoods.

It turns out that people who live in poverty in small towns and rural areas are also more likely to suffer from the effects of asthma as those who live in congested city quarters. For years, it was thought that poor people in urban settings are more prone to asthma. There’s a tacit assumption that in edition to the fact that poor people have less of the kind of political capital that might help them get trucks off their streets and trash dumps out of their neighborhoods, their homes are dirtier and more infested with vermin. This assumption is borne out in the article.

For African-Americans and Puerto Ricans, higher risk of asthma may be genetic, Keet said. For the poor, it may be stresses such as exposure to mouse and cockroach allergens, cigarette smoke, a higher rate of pre-term births and more maternal stress, she said.

The article seems to insinuate that middle class people got the memo: “smoking and teen pregnancy are bad. Make sure not to let cockroaches and mice into your homes.” All of the discussion ignores the scientific knowledge gathered by scholars like Robert Sapolsky from Stanford, who have shown that being in a “low status” position in society is inherently stressful and that this stress leads to negative health outcomes. Further, it has been shown that extreme stress, involving issues like PTSD, poverty, and institutionalized racism, can create epigenetic changes to one’s DNA. That is to say, a powerfully negative environment can change the genes that parents pass on. While it has been clearly shown, and widely accepted, that stress “exacerbates” the symptoms of asthma, the causative action of stress is rarely discussed.

Unfortunately, since the problem is poverty and poverty is a structural side effect of capitalism, no one wants to ask the really hard questions about how to deal with the full extent of this problem. What is it about poverty that makes people ill? Clearly stress is a major factor in this equation, but no one really looks at it, because in order to address this problem we have to make drastic changes to our society, so we look the other way and ignore the skinny elephant in the room.

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