Raising Chicago’s Failing Air Quality Grade

This week the American Lung Association released their annual State of the Air report, which grades cities and counties nationally on the quality of their air. Cook County received an F grade. Among the contributing factors were very high pollution rates, high asthma rates, and high poverty rates.

No one should be surprised by the grade Cook Country was given, but we ought to be alarmed. Poor air quality causes long-term breathing problems and drives up the burden on the local health care system. Additionally, while poor air quality impacts every Chicago resident, its affects are especially harsh in low-income areas where high air pollution is paired with a lack of access to medication and health care. Respiratory illnesses like asthma and COPD, which have been linked to poor air quality, are estimated to affect 25% of low-income residents. These diseases are costly, debilitating, and can even fatal when they aren’t regularly treated.

High air pollution and low access to medical care end in what we’ve seen: asthma as the number one cause of hospitalization in Cook County, asthma as the number one cause of school absenteeism in Chicago, and Illinois with one of the highest asthma fatality rates in the country. These statistics are especially frustrating because they are preventable.

Here are a few items to consider in our discussion of what can be done to improve Cook County’s grade:

1. Expand access to proper health care in low-income neighborhoods.
While 25% of low-income residents have asthma or COPD, most either don’t know they have it or don’t know what to do about it. Many rely on emergency care as a primary health provider, which can’t adequately control their disease and isn’t meant to. As a result, there are costly repeat hospitalizations and fatalities from a disease that can be controlled. Consider that asthma hospitalizations cost $15,155 per asthmatic patient annually, while care on an Asthma Van costs less than $900 annually.

2. Encourage community health workers through insurance reimbursement.
Studies on Chicago’s Westside show that community health workers reduce asthma hospitalizations by 81% and ER visits by 64%. Though these services have an outstanding impact on overall health, they aren’t reimbursable by insurance and therefore aren’t used by the majority of hospitals. If community health workers were able to canvas the whole city, it would cost less than 15% of asthma hospitalizations.

3. Insist on clear and enforceable air quality standards in Chicago schools.
Children spend the majority of their time either at home or at school. If community health workers could do home environmental inspections, that would mitigate the impact of triggers in the home. But schools are the other half of the equation. Many cities have air quality standards in their schools that are measured and reviewed every year. The state of Illinois does not currently have the school air quality standards recommended by the Asthma & Allergy Foundation of America as well as the EPA:

A. State mandates that all schools must have indoor air quality (IAQ) management policies
B. State has adopted a policy requiring that districts and schools conduct periodic inspections (of HVAC system and other items important in asthma/allergy management)
C. State has IAQ policies that include specific components important in asthma/allergy management (HVAC, HEPA, carpeting, pesticide use)

Passing and enforcing these policies would give schools a universally understood standard they could aspire to, and would ensure a safe environment for all children.

These recommendations are not meant to be comprehensive (I‘ve left off pollution action items, though there are a good number), but acting on these items would undoubtedly make a safer, cleaner city for all of us.