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St. Louis may use environment efforts against asthma

This article first appeared in the St. Louis Beacon, April 8, 2011 - A working mother and her asthmatic son have become the poster family for the benefits of transforming moldy, poorly insulated housing into energy efficient, healthy homes.

Vice President Joe Biden has cited the Baltimore family -- Lekquan Young and her 8-year-old son, DeWayne -- as beneficiaries of a new public-private movement to tackle home environmental problems, such as allergens, in one fell swoop instead of working on them one at a time.

About a dozen cities, in addition to Baltimore, already have begun Green Healthy Home Initiatives. St. Louis hopes to join them, seeing this movement as a way to have city agencies work together and tackle lots of home health problems more effectively and perhaps more cheaply.

The possibility of such a St. Louis program is among the topics being discussed at a two-day Asthma Summit, sponsored by the St. Louis Regional Asthma Consortium, on Friday and Saturday at downtown's Millennium Hotel.

"The Green Healthy Homes Initiative is a process we're looking at to see if we can improve the environment," says Dr. William Kincaid, head of the consortium. "This is the next step beyond what we've been able to do with lead poisoning. The lead poisoning rate has dropped to around 3 percent because we've been able to find funding to update homes before a child is lead poisoned."

St. Louis ranks sixth in asthma nationwide, with Richmond, Va., having the nation's highest rate. Local data show that 13 black children under age 15 died from asthma between 2000 and 2007, and that more than 1,800 city residents under age 15 visited emergency rooms in 2008 due to asthma-related issues. In that same year, 427 St. Louisans were hospitalized for this chronic illness. High poverty areas in St. Louis have the highest rates of asthma.

The numbers, Kincaid says, show that "we're spending money at the wrong end of this problem. We're spending it after you're sick. We should be spending money to keep you well."

Keeping the victims well will mean paying closer attention to problems that trigger asthma. He says reasons for the high rates include St. Louis' location between two rivers, "so mold and mildew are very high." Others factors include air pollution and tobacco smoke.

Judy Riehl, head of the St. Louis Lead Prevention Coalition, praises Kincaid's effort to help set up a Green Healthy Homes Initiative in St. Louis. The partnership would include the Lead Prevention Coalition, the Maternal Child and Family Health Coalition, and other groups that coordinate anti-lead initiatives and weatherization in St. Louis.

The Lead Prevention Coalition expects that its role in the initiative would include programs and workshops to educate people about environmental triggers for asthma.

"Everybody knows some of the triggers, the pollen and mold," Riehl says. "But they may not be aware that cockroach droppings can contribute to asthma or cause attacks. People might not smoke around children, but they might not know that having the smoke linger in the air or in clothing can also precipitate asthma problems."

Another problem she and Kincaid point to is the consequence of good intentions. Making a home energy efficient has the potential in some instances of trapping bad air due to a faulty furnace or seemingly harmless chemicals.

"You have less fresh air coming in, and you just get a toxic soup of air fresheners, bleaches and personal care products. All these can exacerbate problems for a child who has asthma or an allergy," Riehl says.

Heading up the move to set up the Green Healthy Home Initiative in St. Louis is Ron Smith, former building commissioner and former director of operations in the Slay administration. He retired last year and became principal partner in SAG Consulting.

He's now helping to draft a strategic plan for the Healthy Home Initiative and also is working on identifying federal, state and foundation funding to get the program moving. The group hopes to begin a pilot project early next year for about 200 homes, Smith says. The project would include work to make the homes environmentally safe from lead, allergens and other unhealthy conditions. Others initiatives would focus on educating families about making their homes healthier and working with health providers on how to educate patients about asthma and other environmental issues.

"Groups in cities across the country are doing between 200 to 250 homes as part of their pilots," Smith says. "We're going to try to mirror that here in St. Louis."

Smith will discuss the healthy homes initiative during a Friday afternoon session at the summit. Joining him will be Patty Osman, an environmental specialist at the Missouri Department of Health and Senior Services.

Kincaid stresses that asthma continues to be among the region's most serious health problems. The summit, he says, will help St. Louis look at its medical care system to make sure it is using resources effectively to reduce triggers that cause asthma in homes and schools.

"We're looking at the medical piece and the environmental piece. We're trying to look at where we are and how can we improve our responses to asthma."

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.

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