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Asian American Medical Society

Environmental injustice arises when minority or low-income communities are disproportionately exposed to environmental hazards. The United States perpetuates a negative cycle between environmental injustice and health disparities, as represented in the South Bronx, a neighborhood of New York City. The neighborhood is known as the “asthma valley” due to high local asthma rates: residents face detrimental air pollutants, which significantly debilitate their respiratory tract (Kilani).

Asthma is the respiratory tract’s inflammatory response against pollutants, such as ozone and particulate matter. Pollutants cause the tract’s wall to swell and produce mucus, eventually blocking the airway and impeding gas exchange. As a result, asthmatic patients suffer from “coughing, wheezing, shortness of breath[,] and chest tightness” (“Asthma”). The disease is usually a result of long-term exposure to pollutants, and the symptoms may incubate for weeks or years until they sharply worsen—resulting in an asthma attack. Severe asthma is life-threatening, for with insufficient oxygen supply, the human body cannot generate enough energy to function properly. Asthmatic patients must receive emergency care; the frequency of asthma-related visits to an emergency department not only reflects the local population’s asthma rates but also indicates the severity of air pollution in the community.

Figure 1. “Asthma-related emergency department visits among children ages 5 to 17 years old were highest in the South Bronx compared with all other New York City neighborhoods” (“Disparities among Children with Asthma in New York City”). South Bronx belongs to District 15.

Figure 2. “Asthma emergency department (ED) visits rate (per 10,000 population) by age group and year,” in which children are individuals aged 17 years and younger (Asthma-related Emergency Department Visits 2010–2018”).

Among New York City and its neighborhoods, the South Bronx has an abruptly high asthma-related ED visits rate among its young residents aged 5-17 years: 372.9-578.4 out of 10000 children in 2016 (3.729%-5.784%). This rate is “nearly 20 times higher than” that of Bayside-Little Neck (0.224%-0.525%), a “low-poverty neighborhood in Queens”; it is approximately 5-7.7 times higher than the U.S. national child asthma rate in the same year (approx. 0.75%), as presented in figure 2, and 3.7-5.8 times higher than the average child asthma rate from 2010 to 2018 (approx. 100). Children in the South Bronx are far more likely to develop asthma than most peers in their neighborhoods and even throughout the U.S. The same may pertain to other age groups in the Bronx.

Figure 3. The Cross-Bronx Expressway traverses the most populated areas in the Bronx County (“Map of Cross Bronx Expressway.”).

Figure 4. Aerial view of part of the Cross-Bronx Expressway (Gupta).

The high asthma rates in the South Bronx may be attributed to localized environmental factors. For instance, traffic on the Cross-Bronx Expressway could contribute to increased respiratory issues among residents. As one of the most congested roads in New York—“where the average [vehicle] speed barely exceeds 15 [mph],” according to a New York Times article—the expressway traverses the South Bronx’s most populated residential areas (Hu et al.). The vehicles constantly release exhaust gas, bringing residents a considerable amount of pollutants: nitrogen oxides (NOx), volatile organic compounds (VOC), carbon monoxide, particulate matter, etc. NOx and VOC react under sunlight to form ozone, the major factor in the development of asthma (“Ground-level Ozone Basics”). Both carbon monoxide and particulate matter, including PM2.5, have been proven to exacerbate asthma as well. A study by the New York City Department of Health confirms that most asthma cases in the city are attributable to PM2.5 levels (Kheirbek et al.). If other toxic release inventories, stationary point sources, and major truck routes are taken into account, about 85% of the South Bronx’s land mass is subject to heavy air pollution (Maantay).

Figure 5 (Maantay).

Figure 6. “White families have more wealth than Black, Hispanic, and other or multiple race families in the 2019 [Survey of Consumer Finance]” (Bhutta).

Figures 7-9. Demography of the Bronx in 2022

(“Census Profile: Congressional District 15, NY”).

Figure 10. New York City neighborhood poverty rates (%) vs. local childhood asthma ED visits (per 10,000) (“Why Asthma Is a Social Justice Issue”). Mott Haven, Port Morris, Melrose, and Concourse are neighborhoods in the South Bronx.

The Bronx’s population is predominantly Hispanic (56%) and Black (29%), races that possess the least wealth in American society (“Census Profile: Congressional District 15, NY”). Indeed, the South Bronx is the poorest congressional district in the U.S., with 31.2%±2.1% of its population below the poverty line and 60.2% below 185% of the poverty line. (“Number and Percent of People Below Poverty by Congressional District, 2017”). A 2023 report from the New York City Government collected data from around the city and constructed a scatterplot chart (Figure 10) to prove the positive correlation between a neighborhood’s poverty rate and the number of its local childhood asthma ED visits (“Why Asthma Is a Social Justice Issue”). Strikingly, the number of visits in the South Bronx’s neighborhoods consistently exceeds values predicted by the best-fit line (“Why Asthma Is a Social Justice Issue”). Because most residents are in the lower socioeconomic stratum, they may be unable to take costly measures to reduce pollution, such as buying air purifiers; they may also lack access to medication at hand or immediate treatment.

All findings strongly suggest racism in New York City’s planning, which severely disadvantages residents in the South Bronx. New York urban planner Robert Moses directed the construction of the Cross-Bronx Expressway around 1950. In the meantime, minority communities, such as African Americans and Puerto Ricans, were moving into the Bronx; 91% of them settled in the South Bronx. The expressway sliced straight through these communities, divided them, and has since then afflicted them with social, economic, and health crises. Robert Caro, a political journalist contemporary to Moses, commented that the expressway was “among the most racially integrated in the country” (Susaneck); in his biography The Power Broker: Robert Moses and the Fall of New York, he noted an alternative route for the expressway that needed additional costs but would not break communities down (Caro). Still, Moses was firmly against the plan and preferred saving money over saving the lives of marginalized citizens. Moreover, while the New York City Government encouraged old Irish and Jewish residents “to the newly built, racially-restricted suburbs” by providing them with mortgages, it prevented minority communities from relocation by redlining the South Bronx and establishing racist residential policies (Susaneck). Until recently, the government has remained inactive and allowed systemic racism to grow by the expressway, in the form of life-threatening pollutants, for 70 years.

Regardless of their perspective, individuals should recognize the South Bronx health crisis’s environmental, social, economic, and moral threats to humanity. City planners have put communities that are already grappling with socioeconomic hardships into unhealthy conditions, depriving them of their basic rights to enjoy hygienic lives. The uneven share of environmental privileges between racial groups and economic strata exemplifies injustice; it may lead to societal division—tension and hostility. In addition, it is crucial to acknowledge that environmental pollution is not confined to the South Bronx. Exhaust gas pollutants have impacted other regions, such as Brooklyn (Figure 1; Kheirbek et al.). Without effective vehicle exhaust regulations, all New Yorkers’ health conditions will deteriorate with the air quality. Ironically, as the “center of culture . . . commerce . . . [and] everything,” New York City currently fails to play a role model in preventing environmental injustice (“Why NYC”). The consequences are immense: the city may set a global trend of inadequate attention to such issues; ultimately, all citizens’ quality of life will deteriorate.

The New York City Government has recognized the “burdens that were ignored when [it] constructed the city”. It has launched an Asthma-Free Bronx program to “address pediatric asthma in a comprehensive, coordinated manner between a child’s home, school and health providers” (“De Blasio Administration Launches Asthma-Free Bronx”). It also establishes laws for drivers to turn off idling engines, in an effort to reduce exhaust gas (“Idling Laws”). In the future, increased use of electric vehicles may also reduce air pollution. As we anticipate a drop in asthma rates through these actions, we should all learn from the “Asthma Valley” health crisis and do our best to mitigate environmental injustice worldwide, such as voicing our concerns and rejecting pollution.

Works Cited

“Asthma-related Emergency Department Visits 2010–2018.” Center for Disease Control and Prevention, 9 April 2021,

“Asthma.” World Health Organization, 4 May 2023,

Bhutta, Neil. “Disparities in Wealth by Race and Ethnicity in the 2019 Survey of Consumer Finances.” Board of Governors of the Federal Reserve System, 28 Sept. 2020,

Canova, Cristina, et al. “Carbon Monoxide Pollution Is Associated With Decreased Lung Function in Asthmatic Adults.” The European Respiratory Journal, vol. 35, no. 2, Aug. 2009, pp. 266–72.

Caro, Robert A. “The Power Broker—III.” The New Yorker, 5 Aug. 1974,

“Census Profile: Congressional District 15, NY.” Census Reporter,

“De Blasio Administration Launches Asthma-Free Bronx.” The Official Website of the City of New York, 31 July 2019,

“Ground-level Ozone Basics.” US EPA, 2 June 2023,

Gupta, Mike. “Loving the Bronx.” New York City News Service, https://www.nycitynewsservice....formation-by-capping.

Hu, Winnie, et al. “NYC Traffic: How Neighborhoods Outside of Manhattan Are Feeling the Pain.” The New York Times, 28 Dec. 2021,

“Idling Laws.” NYC Department of Environmental Protection (DEP).

Kilani, Hazar. “‘Asthma Alley’: Why Minorities Bear Burden of Pollution Inequity Caused by White People.” The Guardian, 4 Apr. 2019,

Maantay, Juliana. “Asthma and Air Pollution in the Bronx: Methodological and Data Considerations in Using GIS for Environmental Justice and Health Research.” Health & Place, vol. 13, no. 1, Mar. 2007, pp. 32–56.

“Map of Cross Bronx Expressway.” Wikimedia Commons, 20 March 2014,

“Number and Percent of People Below Poverty by Congressional District, 2017.” Food Research & Action Center, 2017,

Susaneck, Adam Paul. “The South Bronx — SEGREGATION BY DESIGN.” Segregation by Design,

“Why Asthma Is a Social Justice Issue.” Environment & Health Data Portal, 24 Oct. 2019,


Zhang, Yue, et al. “The Relationship Between PM2.5 and the Onset and Exacerbation of Childhood Asthma: A Short Communication.” Frontiers in Pediatrics, vol. 11, Aug. 2023,

Kheirbek, Iyad, et al. “Air Pollution and the Health of New Yorkers: The Impact of Fine Particles

and Ozone.” City of New York,


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