Roxana López, a a Los Angeles mother of two, is familiar with the symptoms that keep her children up at night: coughing, wheezing, chest pain and difficulty breathing. Both of López's children suffer from asthma, a disease that affects the lungs and can cause attacks. In extreme cases, it can even kill.
Latinos are especially vulnerable to asthma. Approximately 2.1 million Hispanics suffered from the disease in 2014, according to U.S. health authorities. Hispanics also tend to work in low-paying industries like agriculture and construction, which seldom offer health insurance and instead often expose them to serious respiratory diseases.
“They run a higher risk because of the places where they live and work,” said Lucia Oliva Hennely, an Environmental Defense Fund official who focuses on Hispanic communities. “Children are more likely to suffer from asthma, and Hispanics in general have a 40 percent higher chance than non-Hispanic whites of dying from the disease.”
Specialists don't know exactly what causes asthma to appear or develop, but there’s evidence that it’s hereditary and can be set off by certain environmental factors, such as poor air quality or certain household triggers.
“My children can't breathe,” said López. “They feel like fish out of the water,” she added, recalling the anguish of the nights when one of them had an attack. “It's very difficult at night.”
López lives on busy San Pedro Street, surrounded by heavy traffic, the port of Los Angeles and the refineries in the Wilmington neighborhood nearby. Two years ago, she got a knock on the door from Jessica Figueroa, an activist with the Long Beach Alliance for Children with Asthma.
“The first thing I do when I go into a home is use my nose,” Figueroa said, sitting next to López in the living room.
Figueroa said she gave López the same most important recommendation she has given to other Hispanic families in Los Angeles: move to a neighborhood with better air quality. But the answer was the same: it’s too expensive.
“We can only tell them that living here, so close to the traffic, will really affect the children,” said Figueroa.
While López said she can’t afford to move or stop the traffic, she proudly noted that she’s learned there's a lot she can do inside her home. It’s all thanks to Figueroa's nose.
“When I came in, I did an evaluation of the house. I found triggers, like dust. [López] didn’t clean the curtains, because she didn't know it had to be done. I also saw her daughter had too many stuffed animals,” said Figueroa. Other triggers include carpeting, mildew, cockroaches and strong cleaning chemicals.
“She asked me, 'Show me everything you use to clean. I showed her, and I was laughing because she was telling me, 'Not this. Not this. Not this … She took away everything I used [to clean],” said López. “All of this goes into the garbage.”
López said it was a bit of a shock to have someone examine everything in her house and tell her what to do. But it worked.
“I am very grateful she helped me,” said López, one of the many Latinas Figueroa taught about the seriousness of their children's asthma and how it can be somewhat controlled through cleaning.
Experts agree that Hispanics face health challenges that make them more vulnerable to the effects of air pollution, which in turn aggravate respiratory problems such as asthma. Economic, cultural, educational and language barriers make it harder for them to access services to alleviate health problems caused by pollution. Many have no health insurance.
Latinos who suffer from asthma are less likely to receive regular care from a doctor or a clinic, said Brian Christman, spokesman for the American Lung Association. They also are less likely to receive prescriptions for the correct medication, and have limited access to specialized care.
Elena Rios, president of the National Hispanic Medical Association, added that Hispanics also have more problems following treatment regimens, often don't know how to use inhalators and tend to receive less medical care for asthma in the long run because many don't have primary care physicians.
Without primary care, some Latinos – especially those who speak little English – resort to emergency room visits more often and suffer from a lower quality of life compared to those who speak English well. Uncertainty due to their immigration status may also increase their stress levels and limit the willingness of immigrants to seek the medical help they need.
Poverty and high stress levels can affect asthma sufferers, increasing the severity of attacks. About 21 percent of Hispanics live under the poverty line, compared to 12.5 percent of the general U.S. population.
Daily disabilities caused by asthma must be taken into consideration when evaluating the impact of the disease, said Dr. Joshua Galanter, assistant professor at the the University of California, San Francisco pulmonary and allergy program.
U.S. health data show that each year, asthma is responsible for about 10.5 million missed school days, 1.8 million emergency room visits and 439,000 hospitalizations that average 3.6 days.
There's no cure for asthma but it can be controlled. If not treated correctly, the attacks can grow worse over time and lead to even more serious respiratory diseases. Education is key, especially in the Hispanic culture, where home-grown remedies are common. Neglecting asthma can weaken pulmonary functions in the long run and lead to premature death, experts say.
Figueroa is proud of her work helping Hispanic families fight asthma in Los Angeles. But she burst into tears when she started to list the people she knows who also suffer from asthma.
“My mother, my sister, my cousins have asthma. I think my son will have asthma. Even me, because I live on San Pedro Street and work in Wilmington, feel a whistle in my chest that is really affecting me,” she said.