Chinese.Ling-Mei Wong wrote this story with support from the New America Media Climate Change in Communities of Color Fellowship Program. This post is also available in:
Boston’s Chinatown neighborhood has welcomed immigrants for over 150 years, from Syrians to the Chinese. For newcomers coming from congested megacities like Beijing, Boston’s blue skies seem positively bucolic.
But for Chinatown’s 6,000 residents, the picture is not so clear. The neighborhood lies next to the Mass Pike and I-93 highways meaning, residents breathe in some of the city’s most polluted air: a toxic mix of car exhaust and other particulates that can have significant health impacts.
These health risks are most severe for people with respiratory conditions, elderly people and especially children. Irritants in air pollution can trigger asthma attacks, causing tiny airways to constrict and fill with mucus. And asthma is just one impact of pollution, says Doug Brugge, professor of public health and community medicine at Tufts University.
“Air pollution does not just affect your lungs,” says Brugge. “It also has cardiovascular effects, which are much greater than respiratory effects such as asthma or lung cancer.”
Doug Brugge, professor of public health and community medicine at Tufts University. (Image courtesy of Ling-Mei Wong.)
Respiratory issues among Chinatown’s kids are getting worse. The prevalence of asthma at the Josiah Quincy Elementary School in the heart of Chinatown went from 18 percent to 25 percent from 2009 to 2013, according to May Chin of the Asthma Prevention and Management Initiative at Tufts Medical Center. Statewide, the prevalence of asthma was 12.4 percent among students in grades K-8 in 2013, according to Massachusetts Department of Public Health data.
Tufts Medical Center pulmonologist Scott Schroeder, William Wu and May Chin. (Image courtesy of Ling-Mei Wong.)
In addition to polluting the air and harming public health, emissions from cars and trucks also drive climate change. In Boston and globally, one of the primary impacts of climate change is increased heat, according to the Climate Ready Boston report released last December.
Boston’s average summer temperatures and number of days with extreme heat are rising. The average summer temperature in Boston from 1981 to 2000 was 69 degrees Fahrenheit — it may climb as high as 76 degrees by 2050 and 84 degrees by 2100. And the number of days per year over 90 degrees could top 40 by 2030, compared with today’s average of 11 days.
Extreme heat isn’t just uncomfortable; it’s also the leading cause of weather-related mortality in the United States. “Consequences of heat are some of the most well-understood, measurable, and preventable impacts of climate change on human health,” the Climate Ready report says.
Heat waves and air pollution: a harmful combination
While hotter days will bring increased risk of health issues to all Bostonians, Chinatown’s kids may be among the worst affected due to their neighborhood’s air pollution.
“Proximity to highways is associated with an increased risk of developing asthma and of having asthma symptoms,” says Dr. Jay Portnoy, director of the allergy, asthma and immunology division at Children’s Mercy Hospital in Kansas City, MO. “Hotter weather and proximity to highways does combine to increase the risk of asthma and allergies, and is something that we should be aware of.”
According to the “How Climate Change Affects Asthma” report published by Moms Clean Air Force, a national advocacy group working to improve children’s health and combat climate change, “hot weather can trigger asthma attacks.” Air pollution from car exhaust, ozone or other irritants are added trigger, the report says.
Overall, kids are more vulnerable to pollution than adults because their lungs are not fully developed and they breathe more rapidly.
Rising temperatures directly affect cardiopulmonary (heart and lung) mortality, according to the “Climate Change and Cardiopulmonary Health” report issued in 2015. In Chinatown, this means that vulnerable kids could see worsening health issues associated with pollutants.
And in addition to having some of the worst air, Chinatown and Downtown Boston are particularly hot parts of the city due to the urban “heat island” effect, which describes how tree cover and increased pavement cause city centers to be hotter than surrounding areas.
This increasingly hot air, combined with air pollution from highways and other sources, fuels a vicious cycle.
Brugge’s work on the Tufts Community Assessment of Freeway Exposure and Health project focuses on ultrafine particles, which are thinner than a strand of hair and affect cardiovascular health. His team collected emissions data on Chinatown and Somerville neighborhoods close to highways.
“The problem here is invisible, tasteless and odorless,” Brugge says. “The cardiovascular effects are silent too.”
Community health worker William Wu does outreach in Cantonese, English and Spanish. He currently is working with daycare workers at the Boston Chinatown Neighborhood Center for asthma management and medication.
“Asthma affects the family as well,” Wu says. “They have to take time off work, which represents a loss of income.”
In Chinatown, ‘a tangle of highways’
Reggie Wong Park in Chinatown. (Image courtesy of Ling-Mei Wong.)
Chinatown was not always locked into air pollution from surrounding highways. The construction of the Central Artery and Turnpike Extension in the 1950s and 1960s revitalized downtown Boston, but displaced hundreds of immigrant families who lost their homes to eminent domain in Chinatown and the West End, including the cramped tenements considered blighted.
And while urban renewal added affordable housing to Chinatown with more than 3,000 units today, polluting highways are an inescapable legacy.
Perhaps nowhere is this more evident than the Reggie Wong Memorial Park, an asphalt park sandwiched between two highway ramps. The park is one of the few recreational spaces in Chinatown.
“Reggie Wong Park is right in a tangle of highways,” Brugge says, adding that children and families who visit the park are exposed to a range of pollutants.
Exercise also increases the intake of pollutions due to heavier breathing.
Dr. Scott Schroeder is a pulmonologist at the Tufts Medical Center’s Floating Hospital for Children.
“We put highways in the poorest communities,” he says. “That’s what we have to fight against. Every child is important.”
The park is currently slated to be replaced due to development and local groups are pushing for the new design to address air pollution in some way, including installing air filtration systems and adding pollution barriers.
Reducing risks for kids, facing climate change
The Chinatown Park PlayCubes are on Surface Artery, which leads to highway I-93 and the Mass Pike. Children playing outdoors breathe in car exhaust and are at risk of developing cardiopulmonary issues, as seen on May 19, 2016. (Image courtesy of Ling-Mei Wong.)
While increased heat and the related respiratory risks are unavoidable climate impacts, experts say that families can take simple steps to lessen them.
These include developing an asthma action plan with a doctor, learning your child’s asthma triggers to prevent symptoms and checking the air pollution and pollen information regularly, according to the Moms Clean Air Force report.
“People who live near highways and who have asthma might consider staying indoors when the weather is very hot and when the air pollution indexes are elevated,” Portnoy says. “Ozone levels are also higher during the daytime when the sun is shining, so it is a good idea to avoid that as well by staying indoors. One can wear a mask, but it has to be a high efficiency N95 mask. The surgeon’s masks that people wear are good for reducing infection, but not good for reducing exposure to bad air quality.”
In Chinatown and surrounding areas, public health advocates already have some measures in place to combat the growing asthma crisis.
The Asthma Prevention and Management Initiative launched in 2006 after pediatric providers at Tufts Medical Center noticed a spike in the number of children with asthma-related urgent care visits.
“We see smaller kids getting respiratory problems early on,” says Schroeder, who works with the Initiative.
The Tufts team works in day care centers, schools and homes to coordinate asthma care between families and care providers. Its work over the last decade has paid off, decreasing hospital emergency visits by 21 percent.
On the research side, Brugge’s team’s investigation into freeway air pollution in Chinatown also has far-ranging implications for public health and transportation policy. For now, the next step for his team is acquiring an all-electric vehicle to monitor emissions, replacing the current gas-powered truck.
“In the long run, there have to be solutions that improve public transportation, and make cars and trucks cleaner,” Brugge says. “We ultimately need a social solution as well as individual solutions, like mandating better filters for ventilation.”
Meanwhile, the City of Boston is working to improve its climate adaptation measure, with 11 proposed “resiliency” strategies outlined. Several take increased heat and air pollution into account, including updating the city’s heat emergency action plan, launching a community engagement and education campaign and retrofitting existing buildings against climate hazards.
“We’re in a global world, so we have to make sure we do our part here as Bostonians and Massachusetts folks to push back,” Boston Mayor Marty Walsh said last December at the release of the new phase of the Climate Ready Boston report. “When I say push back, I mean reverse some of the trends we’re seeing. The environment is changing.”
Inquiries to the Asthma Prevention and Management Initiative can be made by calling (617) 636-1339.