“I Can’t Breath”: Negligence of Minority Children’s Public Health in the Bronx

In 2020, the haunting words “I can’t breathe” became synonymous with the tragic death of George Floyd, who uttered the phrase more than 20 times. In 2021, New York (NY) Governor Kathy Hochul signed a package of bills declaring racism a public health crisis, establishing a working group to promote racial equity throughout the state, and requiring a health equity assessment to be filed with an application for any project that will affect a hospital's health care services. However, despite a wave of immense public support within New York and increased pressure to effectively condemn racial injustice, recent legislative efforts to address public health injustices for low-income, predominantly minority children have not been matched with the same verve.

NYC Department of Health’s most recent data indicates that the asthma-related Emergency Department (ED) visit rate among Bronx children ages 5 to 17 was 2.9 times the rate of all other NYC boroughs combined, with some neighborhood rates nearly 20 times higher compared to even other low-income neighborhoods. State lawmakers from the Bronx in particular have sponsored numerous bills with low success rates. One such example is the Lydia Soto Law, named after a child from the South Bronx who died of asthma complications. This bill would establish a Minority Coordinating Council on Asthmatic Affairs within the Department of Health to assess asthma risk factors for minorities, identify barriers to treatment with corresponding action steps, and launch a state-wide asthma awareness campaign. 

Hochul vetoed the bill on Nov. 23, 2022, following its passage through the state Legislature, citing budget constraints that would make the bill more suitable for the state budget process instead. Environmental justice advocates see her veto as disdainful, and a steep departure from Hochul’s 2021 bill declaring racism a public health crisis. Reflecting an organized hypocrisy, activists like those at South Bronx Unite suggest this implies that the city’s breath is better spent elsewhere. Nonetheless, Hochul did ultimately reject this bill, along with 38 others, that would create studies or commissions. State Assembly Member Karines Reyes who sponsored the Lydia Soto Law said that its rejection was “heartbreaking” and called Hochul’s budget reasoning an “excuse.” 

While Hochul did sign a 2020 bill requiring schools, summer camps, sports facilities, and ambulances to have rescue inhalers, activists note that it took her three years to sign, and, consequently, left a wealth of public health racism brought on by COVID-19 unaddressed. Additionally, Hochul did not sign the Schools Impacted by Gross Highways Act (SIGH) Act, which was passed by the Legislature and prevents new construction of school buildings within 500 feet of a controlled-access highway unless otherwise unable to be built. The frame of mind that pushes legislators to provide treatment rather than taking proactive measures to avoid risk still leaves many children vulnerable to developing asthma or worsening their condition. “The hospitals put a bandaid on your asthma by giving you an inhaler. We should be fixing the root cause of this problem – the environmental inequality,” South Bronx Unite activist Mychal Johnson said.

In March 2019, a PNAS study not only recognized the pollution inequity, but measured how pollution is “disproportionately caused by consumption of goods and services mainly by the non-Hispanic white majority, but disproportionately inhaled by black and Hispanic minorities.” The report also acknowledged that many close to the issue would find this correlation “intuitive,” echoing the voices of many like Bronx native and “Asthma Alley” victim Daniel Chervoni: “They are the reason for our pain, this is why the lungs of Mott Haven’s residents are suffering,” he said. Lead author of the report Christopher Tessum said, “What our research did was reinforce what communities of color have been claiming for years,” he said. However, despite the clear indication of the severity and disproportionality, politicians left the documented risk unaddressed in what many consider a glaring case of negligence given the inaction displayed during the COVID-19 crisis.

COVID developments only compounded the risk for low-income minorities and increased the complications of asthma risk, thereby compromising children who, theoretically, should be the party least at-risk. Harvard University data confirms that an increase in fine particulate matter PM 2.5, a major component of air pollution, is correlated with higher mortality rates from the disease. Additionally, social inequities place additional burdens on minority communities because they are more likely to be essential workers (where telework is not possible), less likely to have health insurance and access to paid sick leave, and live in the most polluted, historically red-lined areas – ones that would have been easy to designate as at-risk populations at the start of the pandemic. As dependents, children also share these risks and are unable to support themselves in the event that a parent or guardian becomes compromised. Given the wide body of research linking inequities that have resulted from inequitable access to healthcare which persists because of structural racism in healthcare policy, the ignored prospects for disparate COVID cases and deaths ultimately reflect a political deprioritization and organized hypocrisy where New York only nominally heralds equitable healthcare outcomes across all races and ethnicities.

While data indicated how Black people were literally suffocating under this oppression, Surgeon General Jerome Adams spoke out to the Black community advising them to take individual responsibility for their families against what public health experts have deemed systemic issues. This behavior furthers a harmful culture of poverty myth and ultimately impedes a path towards actionable measures that could have worked to alleviate these burdens. 

Many recognize Floyd as what inspired the Black Lives Matter movement phrase “I can’t breathe,” but New Yorkers often think back to Eric Garner saying those words in their home city back in 2014. Still, he was hardly the first either. A New York Times article found a record of at least 70 people who have died in law enforcement custody after saying the same words — “I can’t breathe.” If politicians are unwilling to pass legislation to transgress health disparities for children, they unequivocally impede policy measures that could protect their cities’ youth instead of stifling them. Their congestion fosters anoxic conditions, then they blame generations of Black people for their inability to breathe.

Margo Donohue is a sophomore at Brown University studying Environmental Studies (Inequality) and IAPA (Policy and Governance). She can be reached at margo_donohue@brown.edu and welcomes any questions or conversations!