Cayden Dillon, 7 years old, was playing with kindergarten students in February 2022.
“His gym teacher had started to notice that he was having trouble breathing,”Tracy Dillion, his mother, said the following: “They ended up calling 911 because they just didn’t know what was happening or if it was something bad.”
Cayden was rushed by ambulance to the emergency room.
“They gave him some kind of steroid to keep his airway [open] so it wasn’t so hard for him to breathe,”Dillon, who called it the ordeal, said: “very scary.”
Cayden was officially given asthma when he arrived at the hospital.
Dillion and her children live in Slavic Village on Cleveland’s southeast side, in the same five-bedroom home where she was raised in the 1990s.
The home has been in Dillion’s family for nearly 50 years, and she has lived there her entire life. Now, she’s raising her own kids — Tavion, 10, Cayden, 7, and Neveah, 6 — in the same house.
The Dillons are familiar with asthma. All three of their children have it. They are not the only ones struggling to breathe.
Children who live in Slavic Village are subject to some of the following: Asthma rates among children are the highest in the nation — regardless of Race or ethnicity. However, there are other Northeast Ohio communities where asthma rates for children are almost as high.
Brenda Lee Elkins-Wylie was born in Cleveland’s Hough neighborhood. In the 1960s, she watched children play outside the apartment she shared with her mother. She said that her asthma symptoms were so severe that she was often forced to stay indoors.
“One year, I missed two months of school,”She said. “It was really hard at times.”
Tee Tee Bonnie, a 30 mile south, grew in Akron’s North Hill neighbourhood. Tee Tee Bonnie sometimes wakes up in mid-night wheezing and reaching to her inhaler.
Before moving to Akron’s Summit Lake neighborhood, Bonnie, who is now in her 30s, lived with her mother in a century-old house in North Hill, where dust, cigarette smoke and lack of ventilation triggered “terrifying”Asthma symptoms.
“I started getting chest pains and real shortness of breath,”Bonnie recalled a frightening asthma attack that she suffered in middle school. “It was hard to breathe, and I started wheezing.”
People who live in Hough and Slavic Village in Cleveland and North Hill in Akron are more likely to suffer from asthma than the national average — which is About 8%According to data from the University of RichmondThe Centers for Disease Control and Prevention.
However, the asthma rates in different neighborhoods are not equal. Parts of each were likely redlined over a century back. Home Owners Loan CorporationMaps show.
Redlining, a discriminatory lending technique that was first used in the 1930s to refuse home loans and insurance to neighborhoods deemed to be high risk, is still in use today. Redlining was a practice that devalued neighborhoods where Black people lived and other people of color. This led to a lack in resources for immigrant and predominantly Black neighborhoods.
Ultimately, HOLC’s maps were not used to deny people mortgages based on race — but they informed real estate practices at the Federal Housing Authority and private banks and mortgage lenders that did, historians say.
At least two studies, at minimum one in CaliforniaAnd another in PittsburghThere is a connection between living near redlining areas in the past and an increased chance of suffering from asthma today, according to some researchers.
About 28% of Black childrenAsthma has been confirmed in residents of Broadway-Slavic Village. That’s more than twice the Average national Black child mortality rate, according to U.S. Department of Health and Human Services’ Office of Minority Health and More than 3.5 times the CDC’s national average.
The Pittsburgh study also concluded redlining was a contributing factor to long-term environmental-related inequities and asthma-related inequalities that disproportionately affected Black residents.
“We directly link racist loaning practices more than 80 years ago to the maintenance of poor environmental quality in the most redlined neighborhoods today,”Alexander Schuyler, a M.D., is the lead author. Alexander Schuyler, a M.D. and Ph.D. student in Pitt’s Medical Scientist Training Program. “Our data, in turn, connects the higher pollution exposures to worsened asthma outcomes. In short, institutional racism — not race-based biology — is why many Black Pittsburghers experience severe asthma.”
Today’s children continue to suffer from yesterday’s problem
Elkins-Wylie, a native of Hough, lives now in a single-family home in Slavic Village with her cat and two dogs. Dr. David Margolius is the director of Cleveland Public Health. He used to work at a MetroHealth Clinic located on Broadway Avenue in Slavic Village. Elkins-Wylie now lives there.
“I think any visitor to Slavic Village and Broadway would be struck by the amount of industrial and commercial traffic that is all around you,”Dr. David Margolius is the director of Cleveland Public Health. He used to work at a MetroHealth Clinic in Slavic Village on Broadway Avenue, just a few blocks from Elkins-Wylie’s current home.
Margolius pointed out Recent studies have suggested thatLiving near freeways can lead to increased incidences of asthma and decreased lung function.
Margolius stated that Black children face a worse outlook, which can often lead to other health issues as they grow.
Dr. Kristie Ross, chief of the pediatric pulmonary division at University Hospitals’ Cleveland Medical Center, focuses on children with asthma and sleep apnea in her practice — conditions Ross says are “plagued”Health disparities
Families living in historically poor and redlined neighborhoods are at risk. “perfect storm”She said that environmental factors can harm their health.
Elkins-Wylie emigrated from Hough in the late 1970s. Lakeview TerraceHOLC maps also show that a redline was also applied to the neighborhood of.
Lakeview Terrace is located between the West Shoreway freeway and the reinforced Cuyahoga River bank. It was the first federally funded public housing project in the country.
Elkins-Wylie’s asthma struggles are not isolated to Cleveland. Cleveland is the most populous of the five major cities in the country. Ohio Valley Asthma Belt — with higher asthma rates than Columbus, Dayton and Detroit, according to the Asthma and Allergy Foundation of America’s 2021 Asthma Capitals report.
Elkins-Wylie states that several of her adult children suffer from asthma today.
Nationally, Cleveland ranks sixth in the nation on the Asthma and Allergy Foundation’sListe of “asthma capitals,”It is difficult and expensive to manage asthma symptoms.
Ross explained that asthma is a result of the environment in which we grow up.
“All of those things, whether it’s toxins from air pollution or toxins from stress, that exposure impacts the way the genes are expressed at the genetic level,”She said. “Not just the DNA you’re born with, but how it gets turned on.”
How did we get here?
In the 1930s, the Home Owners Loan Corporation began to study the financial risk for bankers in Cleveland’s Slavic Village.
The environment was not very pleasant. The area was not very pleasant. “detrimentally affected by smoke, soot, fumes and dirt,”According to a description of the neighborhood, created by HOLC sometime around the 1930s.
Explore our interactive map based upon HOLC maps to find out how different Cleveland communities were described. Click on your neighborhood for the original HOLC description card.
The description cards also listed the types of people who lived in the area.
According to the card, about 70% of the Slavic Village neighborhood were Polish immigrants. The residents maintained their lawns, trimmed their shrubbery and kept their yards clean, however. “limited income of these residents leaves much to be desired in the renovation.”
The neighborhood received a D rating from HOLC. The area was “hazardous”It was a determination for banks and mortgage lenders.
On HOLC’s maps, neighborhoods fall in one of four categories: Neighborhoods that were coded green for “Best,”They were awarded an A rating. B neighborhoods are blue “Still Desirable,”Yellow neighborhoods are C. “Definitely Declining”Red for the D and D neighborhoods “Hazardous.”
Many times, immigrant and black neighborhoods were deemed unacceptable. “hazardous”According to The, risks were the reason for decades of disinvestment. University of Richmond.
Black Americans are still a significant part of the American population today. More likely than white AmericansData journalists found that it is difficult to live in historically-redlined areas. Public health experts have found that these areas in Northeast Ohio and across the nation are often plagued from aging homes and high levels of air pollution, which can make asthma and allergen triggers like mold and dust nearly impossible to manage.
White Clevelanders began to move out of the city’s core in the middle of the 20th century, sometimes heading further east to the suburbs. Maple Heights, Shaker HeightsBoth codes are coded blue and green “Best” and “Still Desirable” on the HOLC maps, historians say.
However, black residents grew to be more concentrated in older neighborhoods. By the mid-1960s About 90% of Black Clevelanders lived in a cluster of redlined neighborhoods on the city’s East Side, according to Cleveland Historical, a project by Cleveland State University.
Many of the Black residents of Cedar Central were driven to their deaths by a highway in the 1940s. Hough. According to the Hough Daily News, as Hough’s population exploded city officials failed to enforce housing regulations meant to keep residents safe. Cleveland Historical:
“Vacant homes deteriorated, becoming hazards to the community and breeding grounds for vermin. Even as Hough’s physical condition declined, residents were regularly charged high rents due to the limited housing options available to the Black community in Cleveland and the refusal of suburbs to accept Black residents.”
Elkins-Wylie, a Hough native who now has asthma, recalls the apartment she lived in falling apart and being overrun by pests and rodents.
“I remember seeing the rats come out from a hole under the sink,” she said. “I was so scared. I used to cover my face, but once I felt something run across me. I was absolutely terrified.”
Today, she said doctors have linked her childhood exposure to pest and rodent droppings, mold and other household environmental factors to many of her lifelong allergies — which often trigger or intensify asthma symptoms, making the diagnosis more difficult to treat and manage over time.
“The allergies upset the asthma,” Elkins-Wylie said. “When you’re around mold, dampness, rats, mice or roaches, that’s going to affect it.”
Elkins-Wylie stated before signing the lease for her current home at Slavic Village that she had checked for rodents and cockroaches everywhere.
The same pattern of white flight was observed in the Slavic Village neighborhood. The former Polish enclave is today a predominantly Black neighborhood — about 50% of residents are Black and 8% Hispanic, according to the Center for Community Solutions. Around two-fifths of all residents live in poverty.
The pattern also played out in Akron’s Summit Lake neighborhood, where summer cottages for the wealthy have now become year-round homes for people with lower incomes.
“In terms of air quality, we’re doing great,”Sam Rubens is a long-standing laboratory analyst for the Akron Regional Air Quality Management District. The aging housing stock poses serious health risks.
“The houses in Summit Lake were never meant to be year-round,” Rubens said. “They were all just summer houses for the rich. When everybody moved on and the rich people moved out to the west side and they stopped using Summit Lake because it became too polluted, [the houses] became year-round residences for people with low incomes.”
What can people do right now?
Sue Cummings fights asthma using vacuum cleaners, HEPA air purifiers and furnace filters, as well as mattress and pillow cover covers.
Cummings is the director of Summit County’s Management of Asthma Triggers At Home (MATH) programShe has been in public health since 1996. Her program operates in partnership with Akron Children’s Hospital and currently serves about 400 of Summit County’s most vulnerable pediatric asthma patients.
She stated that she has witnessed firsthand the impact simple asthma mitigation strategies can have on people’s lives.
Browse our interactive map based HOLC maps to find out how different Akron-area neighborhoods were described. Click on your neighborhood for the original HOLC description card.
MATH is available to help high-risk patients as well as their families for one year. They provide in-home assessments, mitigation strategies, and valuable resources such vacuum cleaners, and other appliances, free of charge.
“My families are [living in] poor housing stock. Typically, it’s older homes, and the older homes have issues,” Cummings said. “They have basements that leak that create mold or mildew. They have lead paint.”
Cummings, who is also an expert in healthy homes and lead paint risk assessment for Summit County, stated that lead often produces a fine toxic powder that can damage the brain and lung health.
“Often what we see with [lead paint] is a dust issue,” Cummings said. “As these houses fall into disrepair and you open and shut windows, you cause friction and friction creates dust [that] falls on the floor and the kid’s pacifier falls on the floor or the toys fall on the floor or they crawl on the floor and put everything in their mouth.”
Now in its third year, Cummings also said data collected via the MATH program has proven that simple asthma mitigation strategies were effective in reducing hospital visits and healthcare costs for families of pediatric asthma patients — potentially by thousands of dollars per year.
“I am actually making a difference to these kids,”Cummings noted that asthmatic kids can be able to sleep, learn, and play without being interrupted by their asthma symptoms. Their quality of life can improve dramatically.
The Cleveland Regional Nonprofit Environmental Health Watch (EHW).It is also working to create safer, healthier living environments.
Executive Director Kim Foreman said asthma mitigation has been part of EHW’s mission since the organization was founded in 1980.
EHW distributed resources such as vacuum cleaners, dehumidifiers, and mattress covers via the MATH program. Healthy Homes Assessment Service pilot program. EHW does not currently offer this program to the public. It is looking for a new managed health organization to work with and additional funds. However, Foreman stated that the program helped families identify asthma triggers as well as other health-related issues at home.
Recent $67 million contribution to the Lead Safe Cleveland Coalition from the city of Cleveland and the Cleveland Clinic may possibly help expand the Resource Center’s Work, Foreman said.
Although air purifiers can be a great way to improve your home’s environment, the U.S. must have higher air quality standards in order to address the systemic issues that are worsening asthma symptoms and shortening lives, according to Yvonka Hall (executive director of the American Asthma Society). Northeast Ohio Black Health Coalition.
Her organization recently asked the Office of Management and Budget (OMB) at the White House to raise standards to cut pollution that aggravates asthma, chronic pulmonary disease and COVID among all people — but especially among Black Clevelanders, Hall said.
“We know that the African American community faces greater health risks even when they meet standard health risks,”She said. “The standards are so low that we’re being poisoned. We have to raise the standards.”
Redlining’s legacy is certainly part of that, Hall said. The air quality problem is personal, and it affects everyone.
“When we look at the historical picture around redlining and how African Americans are dying, we have been redlined to death,”She said. “We have been put in situations that are beyond our control that have affected how long we live. We have been forced into these toxic communities that are costing our lives.”
Life expectancy has increased since 2016. All Americans are affected by the fallHall stated that African Americans had lost five years.
“When we started doing this work they said, ‘These kids are going to be the first generation that won’t live longer than their parents,'”She said. “But, hell, nobody said it was going to be me. It’s you.”
Dillion is helping her children cope while Ohio’s policymakers and public health experts work together to find systemic solutions.
After Cayden’s diagnosis, she worked with doctors to develop a care plan that includes two separate inhalers: one Cayden uses twice daily and another for emergencies — when he can feel an asthma attack coming on.
Dillion said she’s also in the process of getting the family’s home tested for mold and other allergens but had trouble accessing home inspections free of charge.
Nearly 50 years after Dillion’s grandmother purchased the home in 1975, a few storm windows are cracked in their frames. The siding has been removed at the corners to expose the layers below.
“When Cayden was born, on the papers from the hospital, they said he had issues with his lungs,”Dillion stated. “But I didn’t know that. Nobody ever told me that.”
Today, Cayden’s asthma symptoms are under control in large part because he has access to the daily medication he needs. But it’s not easy to live with asthma or to care for children suffering from the disease — and it’s not cheap either.
While Dillon’s children’s insurance covers their treatment, she has to pay out-of-pocket for her own inhalers and medicine. A $700 ambulance ride for her son can be out-of-pocket.
“Like with medical bills, yeah, they’ll give you time to pay them, but if you don’t pay them on time they’re continuing to send bills,” Dillon said. “It’s a day-to-day struggle.”