A Plague for the Young Homeless

A startling study of children entering the New York City homeless shelter system in 1998 and 1999 found that half of them were asthmatic. An overwhelming percentage of the worst stricken were not receiving regular care. The rate of affliction seems to have remained constant since the study was completed, while the number of children in city shelters has nearly doubled to 16,000.

While New York's numbers are the highest documented, the chronic illness is on the rise in other cities. The New York study, published in the March issue of The Archives of Pediatrics and Adolescent Medicine, underscores the vulnerability of urban populations that lack housing and access to primary health care. Low-income living environments are often the perfect hosts for lung-irritating particles, like dust, sooty air and the waste of household pests. Unhealthy nutrition is a co-conspirator.

New York has worked to reduce hospitalizations for asthmatic children in high-risk neighborhoods, but the special needs of children without the stability of a home have been harder to address. The illness — whose attacks can be triggered by a mere whiff of tobacco smoke or a passing feline — is harrowing for any victim, but most lethal to children without access to the medications that help them breathe normally again.

The only care these youngsters may get is in an emergency room, which does little to prevent future attacks and further strains an overwhelmed health system. Often ignored as unwanted burdens, young and homeless asthma patients have the added misfortune of being the canaries in the coal mine for this illness. Helping them breathe should be a priority on every urban agenda.