Why Asthmatics Struggle in the Pioneer Valley — and What Can Be Done
Dr. Matthew Sadof emphasizes something he calls the rule of twos to determine when to seek professional help for asthma.
If you wake up at night due to asthma more than twice a month, if you need to use your rescue inhaler more than twice a week, or if you need to refill your inhaler more than twice a year, then your asthma is out of control, and you need to get some help, said Sadof, a pediatrician who runs the asthma intervention program at Baystate Childrens Hospital and chairs the Pioneer Valley Asthma Coalition (PVAC).
If youre having trouble breathing, call somebody, he added. Asthma deaths are preventable for the most part.
Its true: according to the American Academy of Allergy Asthma & Immunology (AAAAI), some 3,500 Americans die from asthma-related causes every year, and up to 250,000 annual deaths worldwide may be attributable to asthma. More than 34 million Americans are living with a diagnosis of asthma at some point in their lives. On an average day, about 30,000 Americans suffer an asthma attack, and 5,000 wind up in the hospital.
Its even worse in Western Mass., said Sadof, noting that the incidence of asthma is about 18% much higher than the state average.
It has a lot to do with the geography of the area, he explained. Were in a valley, which is kind of a bowl, and the air coming up from New York and Hartford pools in the area, giving us poor air quality. Plus we have a highway, coal-fired power plants, and a lot of manufacturing in the valley.
Those elements are magnified by issues with indoor air quality that are also common to Western Mass. specifically, a multitude of old houses that dont feature modern ventilation, allowing mold and other allergens to take hold.
Considering all these factors, the asthma coalition has launched a series of educational and advocacy programs aimed at improving asthma conditions in homes, schools, and other places in the Pioneer Valley. In this issue, BusinessWest examines this ongoing health problem and why Sadof believes those goals are within reach.
Gasping for Air
Asthma is a breathing condition triggered by any number of things, from exercise and cold air to illness and allergies to plants, pets, or dust mites. And its on the rise; the prevalence of asthma has roughly doubled over the past quarter-century, according to the AAAAI.
In technical terms, asthma is a chronic respiratory condition in which the airway occasionally constricts and becomes inflamed. This airway narrowing can cause a number of symptoms, from wheezing and coughing to chest tightness and shortness of breath. It affects all ages, but young children and senior citizens have the highest incidence.
The Mass. Department of Public Health released a report recently that found that the incidence of adult asthma rose by 29.4% in the Commonwealth between 2000 and 2007. Moreover, total hospital costs related to asthma jumped by 77% over roughly the same period, from $50 million to $89 million annually and, again, Western Mass. has borne the worst of the increase.
While noting that homeowners can reduce their own asthma triggers with certain home improvements, such as better ventilation systems, Sadof conceded that this is a bad time economically for people to make those sorts of changes.
With that in mind, the PVAC continues to partner with organizations that have the resources to make a difference. We want to increase the capacity of statewide and local partnerships, and address these issues at a community level, Sadof said. Among the organizations efforts are:
The Springfield Healthy Schools Initiative, a partnership with Springfields Department of Parks, Buildings and Recreation Management, which aims to improve indoor air quality in city schools and educate students about asthma;
A project that educates school nurses in Springfield and Holyoke about asthma management, and provides asthma-related resources and materials, as well as putting together a School Nurse Asthma Conference in collaboration with the American Lung Assoc.; and
Such programs are critical to improving the health of the regions young people, Sadof said.
One school a few years back reported that more than 40% of the students had asthma, he recalled. Like other chronic illnesses, asthma requires ongoing medical assessment and self-care, and that happens not only in a medical setting, but in the home, in the community, and at school.
PVAC also focuses on healthy housing, with forums teaching people about asthma triggers in their homes, development of community resources to help homeowners minimize these triggers, and public advocacy aimed at reducing asthma triggers in public, subsidized, and private housing. The group also distributes educational material for parents of asthmatic children and pushes for legislation to improve access to medical care for individuals with asthma.
Educating asthma sufferers about how to properly administer medicine is also important, Sadof said.
Many people I see in practice, when they have an asthma attack, are often taking their medicine improperly, he told BusinessWest. And its not that people dont listen; it can be extremely complicated. People need to be reminded on a regular basis how to use their medicine properly.
Sadof is passionate about each of these points and the programs the PVAC has set up to address them because he knows that asthma doesnt have to kill.
The sad thing is, here in 2009, you can live a completely normal life with asthma, but for many people in our community, its out of reach, Sadof said. For economic reasons, they dont have access to health care, and they cant make the changes in their environment that can decrease the triggers for asthma. Its a crime.
Kids with asthma should be able to move around and play without coughing, but too often, that doesnt happen.
So he continues to spread the word, understanding that its possible, with a little knowledge and effort, for asthma sufferers even in the Pioneer Valley to breathe a little easier.
Joseph Bednar can be reached at