Waiting to Inhale 

It's a killer we seldom hear about, discriminating by race and locale and afflicting more people every year. So why don't we even know what causes asthma?

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Jordon Davis neither knows nor cares about such matters. He's too busy decorating a playmate's face with stickers as Amy Sholinbeck gingerly quizzes the three-year-old's mother, Letrice Harris.

"Does his school have his inhaler?"

"Oh yes, they know all about it."

"Does he play in the dirt?"

"He loves dirt," says Letrice. "Should he wear a mask?"

"No, but make sure it's wet so there's less dust."

"He loves it wet because that's where he finds worms," mom says with a smile.

Sholinbeck, an asthma coordinator from the Alameda County Public Health Department, is trying to solve a mystery: Why does Jordon cough and spit up mucus more since he and his mother moved from an apartment to a house in East Oakland?

Jordon has had asthma ever since he was born, but Letrice didn't recognize it at first. She thought her son had a bad cold, maybe pneumonia. When Jordon was eight months old, she took him to Children's Hospital Oakland. They kept him overnight and sent him home with a nebulizer, a machine that dispenses medicine as a mist that can be breathed in. This past Fourth of July was the first holiday of his life that Jordon didn't spend in the emergency room.

Through another program Letrice, a single parent, learned of Asthma Start, run by the hospital and county health department. It provides in-home asthma education to families with children up to age five. The first time Sholinbeck visited Letrice, she discussed common triggers for asthma: dust mites, cockroaches, cigarette smoke, mold, and sometimes perfume and cleaning products. On a subsequent visit she brought a specialized vacuum cleaner and dust-mite-proof bedcovers, free of charge.

The asthma epidemic has not gone unnoticed by local health departments and organizations, who in recent years have developed various programs to fight back. This year California Endowment, a health foundation, announced the launch of a three-year statewide program called Community Action to Fight Asthma that will distribute $12 million in grants. Contra Costa Health Services received some of that money, plus other grants -- a total of more than $1 million over three years -- to pay for outreach workers, asthma coalitions, and improvements to clinical care.

The Ethnic Health Institute also received money from California Endowment to develop an education program for middle- and high-school students. Because deteriorating homes can develop mold and other problems, the Alameda County Lead Poisoning Prevention Program plans to fix up homes in West Oakland with funds from the Department of Housing and Urban Development. And the year-old West Oakland Asthma Coalition, funded by RAMP and housed at the Prescott-Joseph Center on Peralta Street, offers educational classes twice a week. Its director, retired physician Washington Burns, hopes to see an asthma treatment clinic open in this community.

On her latest visit, Sholinbeck teaches Letrice a breathing exercise to teach to Jordon. She tells her to encourage him to breathe from his nose, not his mouth. She explains the diet theory, and asks how often they eat at McDonald's. (Twice a week.) Maybe she should cook at home more often, the health worker suggests.

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