(August 2001) West Harlem Environmental Action (WE ACT), a community-based environmental health and justice organization, has been working since 1988 to reduce childhood asthma in the highly burdened neighborhoods of northern New York City. Several area neighborhoods have the highest rates of childhood hospitalizations for asthma in a city that leads the nation for childhood asthma morbidity.

WE ACT promotes actions that people can take in their own homes as well as addressing the larger policy issues of where industry is located and its effects on the health of neighborhood residents. Currently, WE ACT’s promotora de salud, or health educator, provides bilingual outreach and education at day care centers, schools, clinics, and after-school programs. This outreach focuses on empowering parents to recognize the symptoms of asthma, to develop personal management plans with their children, and to take actions to reduce children’s exposure to asthma triggers and respiratory irritants in the environment.

These efforts have led to changes. One parent stated that: “I never realized that there were things in our home and in the environment that were affecting my son’s asthma, such as the carpet, roaches, cold weather, and cigarette smoke. Now that I know, I will try to change things around the home to see if they help my son.”

The director of one Head Start center has commented on the value of the promotora de salud/health educator: “Many of our parents don’t have access to the basic information on asthma that WE ACT is providing, either because they are working so much, or because of a language barrier. By coming in to the classroom for free and speaking directly with the parents in their own language, the health educator has really built trust with the parents and overcome a barrier to provide them with very valuable information.”

WE ACT also works with researchers at the Columbia University Mailman School of Public Health to create healthier indoor environments and reduce asthma symptoms and attacks through “structural” interventions. The strategy is to reduce the exposure of asthmatic children to cockroach allergen, without resorting to heavy use of toxic pesticides. This is done through a physical intervention that repairs leaks, cracks, and holes in the walls, and intensive one-on-one education in integrated pest management methods. The results and outcomes of this new program will be known in 2002.

WE ACT has been working for over a decade to address the issue of the number and types of polluting facilities located in the region. At a recent conference, WE ACT’s executive director Peggy Shepard outlined the factors affecting the neighborhood’s air quality: “Northern Manhattan houses over one-third of the city’s 4,200 buses and the Port Authority’s 630 diesel buses. The area is bounded on the west by the heavily-trafficked Westside Highway and the George Washington Bridge, with 50 million truck crossings per year. On Harlem’s west side is the North River Plant … (and) on Harlem’s east side, the aging Wards Island sewage treatment plant. … It is no wonder that these are the same communities experiencing an asthma epidemic. … Outdoor air pollution and indoor air allergens, molds, and pesticides combine to impact a vulnerable, stressed population.”

WE ACT is developing actions that the community and individuals can take in their own homes as well as addressing the larger policy issues of where facilities are located, how they function within the neighborhoods, and ways to effect greater public involvement in public decisionmaking.

Joy E. Carlson, MPH, is co-founder and former director of the Children’s Environmental Health Network. She is currently a principal of J. Carlson Consulting. Carol Stroebel is president of Coalition Resources, Inc., a policy consulting firm specializing in health and injury prevention issues.

For More Information

For more information about WE ACT, visit their website at www.WEACT.org or contact Swati R. Prakash, environmental health director by e-mail at swati@weact.org, or at West Harlem Environmental Action, Inc. (WE ACT), 271 West 125th St., Suite 303, New York, NY 10027.