ASTHMA
May 17, 2007

New Ideas on Allergies and Asthma

Well-intentioned efforts to protect us from our environment may, in fact, have contributed to a modern epidemic of allergies and asthma.

In a new book, professor Gregg Mitman of the University of Wisconsin at Madison writes that that part of the problem is our inability to look at the big picture.

"We narrowly focus our attention on what promises to be the next magic bullet that holds the promise of a cure-all for every ill," Mitman says. No magic bullet, however, has been found. Despite many advances in drug and other treatments, asthma and allergies seem to be affecting more and more Americans each year, a trend that goes back more than a century.

Artificial outdoor environments — public parks filled with non-native plant species or mostly one kind of planting — may be contributing to the problem. Indoor environments may be even worse. "The creation of artificial indoor climates through air-conditioning, for example, together with the trend toward more airtight, energy-efficient buildings, increased the risk of exposure to dust mites and mold, secondhand tobacco smoke and other indoor allergens," Mitman says.

According to professor Mitman, real relief from allergies and asthma can come only from changing how we interact with the environment.

"Allergies are not things, like bacteria, to be eliminated by drugs from our bodies. An allergy is instead the result of complex interactions that our bodies have with physical, chemical, biological and social factors in the environment," he says. One common example — the urban asthma epidemic that began after World War II and continues today.

"Asthma disproportionately affects people of color living in impoverished inner-city communities. In East Harlem, for example, hospitalization rates for asthma are 10 times the national average. Close to 25 percent of children there suffer from the disease. It is a product of the ecology of injustice that structures urban life — a disproportionate share of bus depots and polluting industries are in inner city neighborhoods. In addition, high levels of indoor exposure to cockroach allergens and pesticides, plus inadequate access to medical care combine to make impoverished urban residents vulnerable to asthma," he says.

As an asthma sufferer, Mitman speaks from personal experience. "My son and I both take an inhaled steroid every morning. As consumers, we buy into the idea of escape. Drugs let us get on with our lives without regard to the environment. Taking the drug is much easier than moving to the mountains or lake shore or desert — and much easier than addressing issues of land use, or rethinking building construction or structural inequities in housing or health care."

Professor Mitman's book is called "Breathing Space: How Allergies Shape Our Lives and Landscapes" and was published by Yale University Press in May, 2007.

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