Read Part 1, Part 2, Part 3 Part 4, Part 5, Part 6 and Part 7 of the Special Report.
EAST ST LOUIS, Ill ? On a clear spring day, the four-year-olds laughed as they ran out on the playground at the start of morning recess. Within minutes, one boy stopped, a terrified look on his face. Brenda Crisp and her staff immediately realized what was happening: Asthma attack.
?He escalated from zero symptoms to a severe attack in no time at all,? said Crisp, director of the Uni-Pres Kindercottage daycare center. ?It came out of the clear blue.?
An ambulance rushed the boy to the hospital, where it took him two days to recover. Two years later, he still suffers unexpected asthma attacks and must take his nebulizer, a device that delivers a dose of corticosteroids and oxygen, wherever he goes.
This wasn?t the first ? or the last ? near-deadly attack Crisp and her staff have witnessed at the daycare center. When it comes to asthma, the children of their community are at high risk.
Nearly all are African American and living in poverty. Incinerators, metal producers, power plants, chemical manufacturers and other industries ring the city. Exhaust from cars and trucks on nearby highways blankets the area, as well.
This socioeconomic profile and long history of environmental hazards have left East St. Louis with what experts suspect is one of the highest asthma rates in the nation.
Seven million American children -- nearly one out of every ten -- have asthma, and the rate has been climbing for the past few decades, reaching epidemic proportions. For black children, it?s even worse -- one out of every six -- and the reported rate has risen 50 percent between 2001 and 2010,?according to data from the Centers for Disease Control and Prevention.
?We are seeing higher asthma numbers in emergency departments, and we?re realizing it's on the rise,? said Anna Hardy, a public health nurse at the East Side Health District in East St. Louis.
What is it about this city ? and other poor, African American cities across the nation -- that leaves children with a disproportionate burden of respiratory disease? Is it the factories? The traffic exhaust? The substandard housing? For two decades, medical experts have struggled to unravel the mysterious connections between inner-city life and asthma, and while they have reached no conclusions yet, they suspect they know the answer: All of the above.
Crippling poverty
Located across the Mississippi River from St. Louis, Mo., East St. Louis is on the wrong side of the tracks, so to speak.
Of its 27,000 residents, 15 percent are unemployed, almost 44 percent are below the poverty line and the median family income is around $22,000, according to census reports. Its violent crime and murder rates are consistently among the nation?s highest. Eighty-two percent of East St. Louis children depend on food stamps, 28 percent of births are to teen mothers and 22 percent of mothers receive no or inadequate prenatal care, according to the nonprofit group Vision for Children at Risk.
Housing in the city ranges from, at best, small homes that often house multiple families to crowded, low-income apartment complexes. Some people live in burned-out buildings and tents.
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