Ebony Elmore’s ZIP code has had an enormous impact on her life.
While the lifelong resident of River Rouge doesn’t have any chronic health problems herself, her 9-year-old son and four of her seven siblings have asthma and need breathing treatments. Her mom has Chronic Obstructive Pulmonary Disease (COPD), while her dad has bronchitis and has to use a breathing machine.
At her doctor’s recommendation, Elmore’s sister moved out of River Rouge to Dearborn Heights because her daughter was experiencing asthma attacks; the move improved her health.
This isn’t just coincidence or a matter of genetics. In a twist on the Realtor’s mantra, it’s all about “location, location, location.”
According to the Michigan Department of Health and Human Services, Wayne County has an asthma hospitalization rate two times higher than the entire state. The American Lung Association in Michigan also says that as of 2014, Wayne County had the highest number of pediatric asthma cases in Michigan.
Elmore sees the evidence every day. At the day care she operates, almost half of the children have asthma. Some have inhalers and can’t run because of their asthma. So her fight for better air quality is personal. In August she hosted the fourth annual event, It Takes a Village, to educate residents about asthma prevention and treatment and how to combat pollution. “That way people can have discussions with their physicians about how the environment might be contributing to their poor health,” she says. “I want people in my community to have a voice.”
Elmore isn’t the only one voicing concerns. A growing number of environmental groups and politicians are joining the chorus to address air pollution issues — as well as a push for doctors to get training to identify environmental-related diseases.
“There is a much stronger will by our political leaders to address environmental concerns than ever before,” says Regina Strong, the Sierra Club’s Michigan Beyond Coal campaign director. “Now everyone is paying attention to the environment and its importance.”
Dr. Michael Harbut, a physician at St. John Providence Health System and an international expert in the treatment and diagnosis of environmentally related diseases, says income level and where someone lives will impact a person’s health.
“You are not going to see industrial plants in places like Bloomfield Hills or Birmingham,” he says, adding that the people in the most affected areas “are poor and don’t have a lot of political muscle so the forces of greed often triumph.”
Wayne County has a host of refineries and heavy industries that make it home to some of Michigan’s most polluted ZIP codes. Residents in these low-income communities — including several Detroit neighborhoods, Dearborn’s south end, and parts of Melvindale, Ecorse, Wyandotte, Lincoln Park, and River Rouge — say their health has suffered as a result.
Some studies show air pollution in Wayne County is negatively impacting residents’ health, such as respiratory problems and asthma.
No single company is solely responsible. In 2014, some 182 regulated facilities in the county reported emissions to the Michigan Air Emissions Reporting System. Marathon Oil Refinery neighbors the Detroit Salt Company and is located in Detroit’s 48217 ZIP code. According to a 2010 Detroit Free Press report based on EPA data and analysis by University of Michigan environmental scientists, it’s Michigan’s most polluted ZIP code. DTE’s River Rouge Power Plant is near Zug Island and 4 miles away from AK Steel in Dearborn’s south end. Other nearby facilities include U.S. Steel, a Detroit Water and Sewerage Plant, and Carmeuse Lime and Stone.
An Epicenter of Asthma
Asthma is a chronic lung disease that affects the airways, causing them to become inflamed and making it difficult for air to move in and out. Causes of asthma are unknown, but one trigger is air pollution. There’s also no cure for asthma, but it can be managed — and attacks can be prevented by avoiding triggers.
About 1 in 12 U.S. adults have asthma and 1 in 10 children do, according to the CDC. Detroit has been deemed as the epicenter of asthma burden by the Michigan Department of Health and Human Services. It says the prevalence of asthma in Detroit among adults is 29 percent higher compared to Michigan as a whole. The hospitalization rate for asthma was three times greater for Detroiters than their counterparts around the state, while the rate among white people was 35 percent less than the rate among blacks.
“Reasons for the high asthma rate in Detroit (or anywhere) are currently unclear,” says Jennifer Eisner, a public information officer at the MDHHS. “Research is being done to investigate potential factors such as genetics, diet, and environmental concerns. … Triggers like tobacco smoke and air pollution from traffic have been shown to increase asthma risk.
“The ‘hygiene hypothesis’ is getting new attention with a recent study that showed exposure to germs from traditional farming may protect against asthma,” she says. “Having asthma in Detroit is compounded and aggravated by barriers like lack of transportation and other access-to-care issues, use of the emergency department for primary care, and shortage of pulmonary specialists.”
In 2014 the nonprofit Clean Air Task Force examined the link between air pollution in Wayne County and deaths and diseases. It found that fine particle air pollution from power plant emissions resulted in 1,400 asthma attacks as well as 70 deaths, 110 heart attacks, 47 hospital admissions, 43 cases of chronic bronchitis, and 98 asthma ER visits.
“The impact of the poor air quality (is) clear,” Harbut says. “On Ozone Action Days … hospital admissions rise dramatically.”
Dr. Adnan Hammad was the director of the ACCESS Community Health and Research Center for nearly 20 years and helped lead studies on the impact of air pollution in Dearborn’s south end. Pulmonary health of Arab-Americans living there is impacted by poor air quality, according to a 2014 Wayne State University study. Nearly 150 Arab-Americans who participated reported having worse asthma symptoms in the winter than the summer, which coincided with higher levels of air pollutants.
“Air pollution is one of the worst triggers for airway health and the worst trigger for asthma,” Hammad says. “People in the south end used to hang their clothes up to dry and they would become dirty really fast because of the air.”
While asthma is a top concern, other health issues — including cancer — are also being raised.
Theresa Landrum, a cancer survivor and lifelong resident of southwest Detroit, has spent almost 20 years fighting for environmental justice. She’s pushing for doctors to be trained how to identify environmentally related diseases and believes the environment directly impacted her family’s health. Her mother and father both died of complications from lung cancer. She is concerned that too often doctors attribute cancer to lifestyle and genetics.
“Right now I don’t think doctors have the expertise to treat patients correctly because they don’t know whether certain diseases are related to the environment,” Landrum says.
A few years ago Harbut received a grant to teach doctors how to identify environmentally related cancers. “What we did was train the physicians on how to identify the conditions (where) these cancers occur and how to intervene and remove the patient from the exposure,” he says.
Dr. Bengt Arnetz, chair of the Department of Family Medicine at Michigan State University’s College of Human Medicine, says the treatment plan of a doctor could vary depending on whether a disease is directly related to the environment. “Right now a lot of people do not respond to the treatment for asthma because the chemicals they are inhaling in the air actually make it harder for the drugs to function and treat the asthma,” he says.
There are also links between some of the toxins emitted by industrial sources and certain diseases. “With higher particle air pollution you are more at risk for getting a stroke. Nitrogen oxide for example is linked to cardiovascular disease,” Arnetz says.
Arnetz says that poverty is another factor. According to census figures, 24 percent of the county’s population lives in poverty, compared to 16 percent at the state level. In the 48217 ZIP code, 40 percent of the population lives in poverty.
Another concern is over the impact of air pollution on children who attend schools located near industrial sources.
A 2011 study conducted by researchers at the University of Michigan found air pollution from industrial sources potentially jeopardizes children’s health and academic success. According to the study, schools with the lowest attendance rates and highest number of students who failed to meet Michigan testing standards were located in areas with the highest air pollution levels.
Agents for Change
State Rep. Stephanie Chang, D-Detroit, has been pushing to get studies conducted that would examine the “cumulative impact” of all toxins collectively, as opposed to one source. Her predecessor, Rashida Tlaib, introduced 30 pieces of legislation to combat pollution while in office, but none passed. One would have made the state examine the impact of all toxins collectively.
This year, the fight against air pollution in Wayne County gained momentum. When Marathon was seeking a permit to increase sulfur dioxide emissions by 22 tons a year, Detroit Mayor Mike Duggan and Dr. Abdul El-Sayed, executive director of the Detroit Health Department, publicly spoke out against it. In a Detroit Free Press editorial, El-Sayed called the proposal “unacceptable.”
“We have residents who feel forced to sleep with surgical masks, others who have to take their children with asthma to the emergency room on a monthly basis,” he says. “We have a responsibility to protect our community from these diseases. And that largely means making sure the air they breathe is as clean as the air any of us would like to breathe.”
Duggan and El-Sayed met and partnered with concerned residents to pressure Marathon to reconsider the permit. This was the first time in 20 years that a Detroit mayor had publicly spoken out regarding environmental issues. Wayne County Executive Warren Evans was also vocal about the permit.
As a result, Marathon submitted a new permit that would yield lower emissions. In May, the DEQ approved the permits.
DTE has been addressing concerns, as well. In a response to a March 2016 Newsweek article titled “Choking to Death in Detroit,” Skiles Boyd, vice president of environmental management and resources for DTE, wrote: “DTE has cut its emissions in half over the last 10 years, and, over the next 15 years, plans to transform two-thirds of its coal plants to cleaner generation sources, such as wind, solar, and natural gas. In fact, the company … will retire generating units at two plants in the Southwest Detroit area, further reducing emission levels.”
The recent developments are signs of progress, but the work is far from over. “While there is still much more we need to do to approach environmental justice in Detroit, these are important steps in the right direction,” El-Sayed says.
Lexi Trimpe contributed reporting to this article.