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Once a month Sonia Diaz says she would take her sixteen-year old daughter, Kassandra Rodriguez, to the hospital due to asthma.  “It sounded like a whistle in her chest, she would start wheezing, and sometimes she couldn’t breathe,” says Diaz, 41, a mother of two. 

Along with her daughter, Diaz, and her son, Nicholas, 19, all suffer from asthma. 

As residents of East Harlem, Diaz’s family health problems are not unusual. 

In East Harlem the rate of hospitalization for asthma in children 0-14 years of age is doubled compared to children overall in New York City.  According to the NYC Department of Health in 2005, for every five children who were hospitalized for asthma in New York City, over ten children were hospitalized for asthma in East Harlem.

Dr. Betty Perez-Rivera, director of the East Harlem Asthma Center of Excellence set to open its doors in the winter of 2009, says East Harlem has the highest rate of hospitalization for asthma in all of New York City. 

She adds that bordering neighborhoods, the Upper East Side and Gramercy, located directly south of East Harlem have the lowest rates of hospitalizations for asthma.

To account for the health disparities between the two neighborhoods, Dr. Perez-Rivera says one must look at the socio-economic backgrounds of the two communities.

 “South of 96^th street there are high risers and people that are middle to high income,” says Dr. Perez-Rivera, “in East Harlem north of 96^th street  . . . we probably have the greatest number of housing projects, immigrant populations, people with everything from housing issues, to issues around health literacy and language barriers.”

She says, “It’s definitely a very different population even though we are located so close together and that could be a very big component on why we have the difference in hospitalization rates.”

Environmental health worker, Eric Hinderlie, from Little Sisters of the Assumption, a community organization that provides public heath services to residents of East Harlem, agrees and sees many housing factors that directly complicate someone’s asthma. 

He explains, a high prevalence of pests, cockroaches, dust, molds, and structural damages in homes of East Harlem residents often trigger a person’s asthma.

“There will be places that we go into with just tons of mold and people are breathing that in that in everyday,” says Hinderlie.

“But there is not a law that says landlords have to get rid of mold or have to call someone to get rid of the mold right away,” he says.  “A lot of times it just sits there and if there is an asthmatic child breathing it in everyday, it’s a horrible mix.” 

Sonia Diaz says cockroaches and mold affected her daughter’s asthma and she reached out to Little Sisters to help control the problem. 

Little Sisters works with families to arrange and maintain a healthy home environment, by cleaning cockroach residues, contacting someone to seal cracks in cabinets and walls, and isolating small concentrations of mold, says Hinderlie.

For larger structural damages and high concentrations of mold, Hinderlie says the problem is more difficult to address.

“A lot of times you have to get New York City Housing Authority to do the work, you put in a compliant and someone will come and check it out usually within a week,” says Hinderlie.  “But then there’s no follow up, or it varies, its too inconsistent.  I think it depends on the building and each building has a different managerial staff.”

To remove the mold around her bathtub, Diaz says the NYC Housing Authority took about two months to complete the process.  

Since improving her housing conditions, Diaz says her daughter has not been back to the hospital for asthma.  

Dr. Perez-Rivera says not only do molds, pests, cockroaches, dust and the need for home repairs add to hospitalizations for asthma, but that 30% of households with an asthmatic childhood, also have an adult smoker.    

Although the rate of hospitalization for asthma has significantly declined since 1994, Dr. Perez-Rivera says rates in East Harlem have reached a plateau. 

 The East Harlem Asthma Center for Excellence aims to reduce hospitalizations rates of the community down to the norm in line with the rest of New York City, says Dr. Perez-Rivera.  

 The center plans on forming and combining a number of resources, utilizing hospitals, clinics, educational and environmental services, to create one standard to address the issue of asthma in East Harlem.

 “We want to focus on one chronic illness, in one community to see how we are able to impact it through our different programs,” says Dr. Perez-Rivera, “if it works well we will expand our model to other areas in the city.”