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Know Your Rights
Source: City Limits
Subject: Health Justice & Access
Type: Media Coverage

Tenants with Asthma Fight to Breath Easy

Tenants and organizers want home-based sources of asthma irritation – like roaches and mold – to be granted more enforcement power by the city.  By Kate Pastor

Elizabeth Mendoza, a 32-year-old Mexican immigrant, has lived in a two-bedroom basement apartment inSunset Park, Brooklyn, for seven years. Her 14-year-old daughter and her 6-year-old niece both have asthma.

Alysha Lewis Coleman, 37, lives on the Lower East Side with her husband and two children. All three of them have asthma, too – a chronic disease that constricts the airways, especially when irritated by allergens, and makes it difficult to breathe.

 Both women think their housing conditions are to blame for their families’ compromised health, and despitecomplaints to their landlords and the city, have been left to deal on their own with the ongoing presence and problems of roaches, rodents and mold – all triggers for asthma. Under the banner of the newly-formed Coalition for Asthma-Free Homes, they were among the advocates who, along with City Councilmember Rosie Mendez, gathered last week outside Coleman’s building at 10 Stanton Street to demand the city do more to control indoor triggers of asthma.

 The Coalition and others are pointing to ever-clearer patterns that correlate cockroach and rodent infestation and the presence of mold with low-income households – and all of those things with residents having asthma. A 2005 report by the city Department of Health (DOH) said vermin are most common in homes in northern Manhattan, south and central Bronx and central Brooklyn, and disproportionately affect minorities at every income level. DOH also says childhood asthma hospitalizations were highest in east Harlem, central Harlem, Williamsburg-Bushwick in Brooklyn, and Highbridge-Morrisania, Crotona-Tremont, and Hunts Point-Mott Haven in the Bronx.

 "New York City has pockets, enclaves, that are high in asthma and they overlap with high poverty rates," said Ginger Chew, assistant professor of environmental health sciences at Columbia University’s Mailman School of Public Health.

 A recent report by the Fifth Avenue Committee, along with an affiliated new immigrant worker organization called La Union de la Communidad Latina, concludes that for the largely immigrant community of low-income renters in Sunset Park, their homes are hurting their health. The experiences of Mendoza, a member of La Union de la Communidad Latina, formed one of several case studies highlighted in the report, which found that the most common chronic health problems were asthma and other respiratory ailments. In one-third of surveyed households, at least one household member suffered. Among that third, nine out of 10 households reported that housing conditions exacerbated their illnesses. The DOH says that citywide, 17 percent of all children have had asthma at some point in their lives, while 4.4 percent of adults have had an episode in the past year.

The Coalition for Asthma-Free Homes – formed around the same time as La Union’s report was issued – last week proposed changes to the city’s policies in dealing with asthma triggers. A major recommendation was for the department of Housing Preservation and Development (HPD) to reclassify mold, mildew and infestations of  vermin as class C violations – the most serious category – up from the class B status they receive in most cases. B violations, though considered hazardous, carry a 30-day window for correction, while class C violations are immediately hazardous and the owner has 24 hours to respond.

The way enforcement works now, according to HPD spokesman Neill Coleman, is that tenants who can’t get their landlords to make repairs can call 311 to contact HPD and get HPD inspectors to write up violations. If that doesn’t get the owner to repair the problem, a Voluntary Repair Agreement (VRA) sets out conditions to be corrected and a timetable for repair. After re-inspection, if an owner is not in compliance, HPD’s Housing Litigation Division can bring a case against the owner in housing court. In some of the most serious cases HPD can ask the court to appoint an administrator to collect rents, maintain the building and make necessary repairs.

Advocates for asthma policy change – which include such groups as the American Lung Association of the City of New York, New York City Aids Housing Network and the New York Immigration Coalition in the Coalition for Asthma-Free Homes – are asking that guidelines for proper mold and pest removal be turned into enforceable regulations in the city’s health code, as is the case with lead – which has been known for centuries to cause a variety of serious health problems. Right now, there are guidelines, but no provision for HPD to enforce best practices for dealing with mold and mice, rats and roach violations.

They also recommend better training for inspectors, landlords and supers in identifying mold hazards and their causes, along with increased education for inspectors, landlords and tenants. A report published last year by Public Advocate Betsy Gotbaum, entitled "Unhealthy Exposure: Mold In New York City Homes," made similar recommendations.

While groups are taking inspiration from the way the city deals with household lead, Coleman wrote in an e-mail that the most recent iteration of the city’s lead law "has been very expensive for building owners and the City with no evidence to show that it has had any impact on already declining rate of lead poisoning. We would see it as a very bad model for correcting other housing maintenance code violations."

The city health department does not address mold and infestation the same way it handles lead because asthma can be the result of numerous pollutants, and mold is not a hazard to the general population the way that lead is, said DOH spokesperson Sara Markt. "Some housing conditions, such as roof and plumbing leaks, floor cracks and building defects do lead to issues such as pest and mold. Landlords are required to fix these conditions regardless of tenants’ health status," Markt said. DOH calls on both landlords and tenants to do their part, and coordinates a New York City Asthma Initiative which includes training, programs in schools and daycare centers, a community integrated pest management program and more.

Although City Council created a significant new housing enforcement tool last month in the Safe Housing Act, activists say it doesn’t provide enough help when it comes to asthma. The Act targets the 200 worst buildings for increased HPD enforcement, requiring owners to correct 80 percent of hazardous and immediately hazardous violations within four months, or else the city will make repairs at owners’ expense. And yet "you might have very, very bad asthma, but you don’t live in one of the worst 200 buildings in the city," said Irene Tung, a member of Make the Road by Walking, a community group that supported the legislation and is a member of the Coalition For Asthma-Free Homes.

Georges Benjamin, executive director of the American Public Health Association, said some of the advocates’ recommendations are worth a try. "I think it would be interesting to look at and see if it would actually work," he said about modeling an asthma program on lead interventions. But Ginger Chew from the Mailman School pointed out challenges in regulating acceptable levels of mold, roaches and rodents. "We don’t know what a safe level would be for each person," she said, since sensitivity varies.

La Union de la Communidad Latina is looking for other structural changes, too. It wants to see the city move away from a complaint-driven system, which puts the burden on tenants to report substandard conditions to the city. According to Artemio Guerra, director of organizing for the Fifth Avenue Committee, occupants of affected apartments may not be named on the lease, or may think they’re breaking overcrowding laws and therefore choose to live with vermin and mold rather than complain. Even Mendoza, who now appears fearless in her leadership of La Union de la Communidad’s environmental justice committee, said, "I was afraid that the landlord would threaten me. The landlord would say, you either like it or you go." Her fear was realized when her landlord called the police and the Administration of Children’s Services on her for withholding rent, she says.

 Fifth Avenue Committee is working with Lutheran Medical Center in Sunset Park on a medical-legal partnership, a local initiative that would include housing advocacy. As it stands, when a person comes to the medical center with asthma, the patient is assigned a nurse, and sometimes a community health educator to conduct an environmental assessment of the patient’s home. What Fifth Avenue Committee is proposing is an additional step in which community educators could opt to call on housing advocates who could organize tenants, assist in mediation with the landlord, or call on a lawyer to help settle the housing issue. Then, when a doctor writes a prescription for an asthma sufferer to avoid allergens like mold, mites or roaches – as a physician recently did for Mendoza’s niece, with no result – "an enforcement mechanism will be triggered," Guerra said.

 The program would be modeled after similar public health approaches at the Medical-Legal Partnership for Children at Boston Medical Center, said Kathy Hopkins, director of community-based programs for Lutheran Family Health Centers. Hopkins said among the largely immigrant and undocumented community that her center serves in Sunset Park, "There’s a fear of losing their home. That’s why advocacy is so important."