Poverty, the Built Environment, and Asthma: A recipe for environmental injustice in the South Bronx and low-income communities globally
Every year, around 4 million children are diagnosed with asthma globally [1]. Asthma is a non-communicable chronic disease characterized by difficulty breathing due to the lungs becoming inflamed from an asthmatic trigger with no known cure [2]. But if asthma is non-communicable, how are there 4 million cases being diagnosed each year? Although it cannot be passed from case-to-case, asthma may develop in response to various factors, from genetics to the environment [3]. As mentioned previously, many of these new childhood cases (around 64%) were reported in urban areas [1]. A 2017 review of several international studies on asthma prevalence found that low-income areas in cities were more likely to develop asthma than higher-income areas [4]. While many of these cases occur in the Global South, the Global North isn’t exempted. A prime example of a low-income area in an urban setting with high asthma rates would be the South Bronx located in New York City [5]. Neighborhoods like the South Bronx are often located near highways like the Bruckner Expressway, which increases inhabitants’ exposure to air pollutants that could trigger and exacerbate asthma symptoms [4, 6]. Other communities built near similar conditions, such as heavy traffic centers or factories, have also reported alarmingly high asthma rates [7]. It could simply be an unfortunate coincidence that these communities located near heavy industry or highways are often low-income. But we can also ask whether this is a form of environmental injustice.
Original illustration by Cassandra Seal.
It is well known that poverty and social discrimination go hand in hand. This overlap of factors has led to poorly built environments with dense populations trapped by expressways, poor housing conditions, rampant industry, and subpar waste treatment facilities [8]. While there are many scenarios that create environmental injustice, I return to the case of the South Bronx as it is one of the most well-documented. The Bronx is the borough, one of the five semi-autonomous divisions of the city, with the highest amounts of asthma, hospitalizations for asthma, and asthma-related deaths in all of New York City [10]. For the South Bronx, the intersection of social discrimination and poverty has created environmental injustice that closely mimics the aftereffects of redlining, which occurred in the 1930s. During the Great Depression, the Home Owners Loan Corporation (HOLC) was tasked with creating maps that would help banks figure out which neighborhoods would be ‘safe’ to give out loans to. They would map neighborhoods by color; where blue indicated the safest neighborhoods to provide loans to while red was deemed high risk [11]. HOLC considered neighborhoods densely populated with African Americans, racial minorities, and historically disenfranchised groups as “too high risk” [11]. The South Bronx, both back in the 1930s and the present day, has a large population of racial minorities, with 30% of the borough being made up of African Americans and 54% of the borough being Hispanic [10]. Due to this, the South Bronx was red-lined, rendered as a slum on the city, and became the target of urban renewal policies that sought to completely clear these areas for development [12]. These policies caused a mass panic of middle-class white citizens and encouraged them to move to the suburbs as they were eligible for HOLC loans [11]. This mass migration, in turn, led to a massive economic hole that caused a general disinvestment in the area [13]. So, with the South Bronx now rebranded as a “blight” on the city, legislators had justification to clear the area, displacing hundreds, for infrastructure development such as the Major Deegan and Bruckner Expressways [14]. Since many of these displaced disenfranchised groups had nowhere else to go to, they began to overcrowd into the remaining buildings, which created a high density in the area [14]. In response to overcrowding, housing projects for low-income residents were created but they were placed close to these highways [14].
As such, the case of the South Bronx illustrates how social discrimination and poverty gave way to displacement, overcrowding, the construction of highways, and the placement of low-income housing close to these air pollution sources. Presently, the placement of high traffic areas near schools and housing has exposed inhabitants to a high amount of air pollutants [14]. While most individuals in North America are exposed to traffic-related air pollution (TARP), people living and going about their daily lives near South Bronx expressways (which are considered some of the most congested traffic centers in the United States) have been unprecedentedly exposed to TARPs. Considering that long-term exposure to TARPs is a strong predictor of asthma development in children [15], this explains why the South Bronx experiences high asthma rates. But the poor built environment of the South Bronx is not just in what is there, but also in what is not there. Despite the Bronx being dubbed the “greenest borough,” many South Bronx residents lack easy access to green spaces [16]. Green spaces have been found to buffer air pollution and decrease the amount of pollutants in the air, potentially decreasing the number of asthma cases [17]. They have also been shown to improve asthma control by reducing the stress of pollutants [18]. Unsurprisingly, it has been found that green spaces can help lessen the chances of asthma developing in adolescents [9]. Green spaces have also been linked to a decrease in asthma prevalence if a higher density of trees were present [19]. All these physical features, or lack of certain features, lead to poorer air quality conditions. They produce higher rates of harmful air pollutants, which are known to trigger an asthmatic response [6, 8].
“the case of the South Bronx illustrates how social discrimination and poverty gave way to displacement, overcrowding, the construction of highways, and the placement of low-income housing close to these air pollution sources”
There are hundreds of other cases similar to the South Bronx throughout the world, documenting social injustice, poverty, and poorly built environments in urban centers like the South Bronx. The most-reported childhood incidents of asthma cases were in low-to-middle-income nations [1, 20]. Many low and middle-income such as those in industrializing nations like China, Mexico, Brazil, and India, are reporting increased health risks from deteriorating air quality [21]. So, what are the general factors these nations have dealt with that have made them victims to environmental injustice like the South Bronx?
Similarly, but not quite the same as the South Bronx, many of the poor environmental conditions these nations like China, Mexico, Brazil, and India are results of social discrimination bringing about poverty. Firstly, these nations were subject to being colonies of the Global North, where they lacked autonomy over their governments and economies. The justifications for colonization of these nations were based on racist ideology such as the idea of Social Darwinism, that these nations could not govern themselves because they were “not sufficiently advanced.” Colonization made them entirely subject to their colonizers as the colonizers extracted resources that enriched themselves only [22]. As industrialization moved from the Global North, they began to take hold in the Global South that had just gained control of their economies. Presently, the Global South covers most of the world’s manufacturing production. The factories and highways that are being rapidly built are massive sources of air pollutants that can trigger asthma attacks [6, 23]. With the industrialization of these countries, there has been a rapid expansion of urbanization, and it has been occurring at a larger scale [24]. Urbanization has been informal in many of these countries as low-income communities have sprung up around the edges of these cities where industrialization occurs [20]. Also, many of these communities construct the housing themselves [25], and due to the informality of these communities, there are usually no green spaces. A study focusing on Juárez, Mexico, found that these types of low-income communities were the most vulnerable to the hazards of industrialization [20]. Colonization and the recent industrialization of the Global South explain many of the high rates of asthma and other respiratory diseases in these nations today. Air pollution disproportionally affects the Global South, taking on 91% of air pollutants [7]. For example, Andean Latin America has the largest burden of childhood asthma cases due to nitrogen dioxide emissions, and Indonesia has some of the highest incidents of childhood asthma [1]. These high asthma rates result from the combination of historical injustice combined with the enduring abysmal conditions of built environments, thus illustrating the detriments of environmental injustice.
“Colonization and the recent industrialization of the Global South explain many of the high rates of asthma and other respiratory diseases in these nations today”
The South Bronx, the Global South, and various low-income communities throughout the world have been victims of environmental injustice. These communities were discriminated against historically, and that discrimination is what led to the poverty and poorly built structure these communities face, and it has taken its toll in the form of 4 million children being diagnosed with asthma annually [1, 8]. Cities and nations must recognize that and begin to fix the built environment as it is essential to ensuring the prosperity and the overall health of their populations, especially their most vulnerable.
Eileen is a second year undergraduate student majoring in Global Health and minoring in French Language. She also plans to add a second minor in Urban Studies. She hopes to use her education to one day give back to her own community. Eileen is part of the 2021/2022 Juxtaposition Staff.
References
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