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Asthma is a chronic health condition that affects the lungs and airways. The tubes that move air in and out of the lungs can become inflamed or narrowed, which causes breathing to be difficult.

About 1 in 13 people in the U.S. have asthma, which most often develops during childhood.

Certain environmental factors can trigger asthma attacks or make asthma worse, such as, pollen, cigarette smoke, viral or bacterial infections (like a cold), obesity and air pollution.

(National Heart, Lung, and Blood Institute, 2024)

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Program Coordinator

Peer Educators (2 A-Team)

UCSF Medical Student Doctor

UCSF Student Medical Assistant

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The Hunter's Point-Bayview neighborhood in San Francisco, has more than four times the rates of hospitalization and emergency rooms visits from asthma compared to other western parts of the city.

Children in the Hunter's Point-Bayview neighborhood of San Francisco have an asthma rate of 1 in 6, or 15.5%.

Overall, 10% of all residents living in the Hunter's Point-Bayview neighborhood of San Francisco have asthma compared to the national average of 5.6%.

(Gate, 2020)

(Ester & Harrison, 2004)

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Go Local Includes Silver Terrace and Bret Harte

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1 in 6 children residing in the Hunter's Point-Bayview neighborhood of San Francisco are affected by asthma.

86% of children living in the Hunter's Point-Bayview neighborhood of San Francisco developed severe asthma before kindergarten.

(Shao, 2021)

(Rigby, 2004)

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Parents may lack the education on the potential complications and life changes asthma can bring to children and their families.

An unclean home environment can trigger asthma because of allergens such as pets, cockroaches, mice, dust, household sprays and second hand smoke. Even the fumes from a gas stove has been linked to aggravating asthma symptoms.

(O’Connor et al., 2018)

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The Hunter's Point-Bayview neighborhood in San Francisco houses concrete plants, an animal rendering plant, data centers powered by large diesel generators, a wastewater treatment plant that treats over 80% of the city’s sewage and dozens of abandoned toxic waste sites.

Toxic waste that is released in the air, water, and even soil can irritate airways and lead to respiratory problems such as asthma.

Additionally, the Hunter's Point-Bayview neighborhood of San Francisco borders the Port of San Francisco while also being surrounded by two major freeways with heavy diesel truck traffic.

(Aldredge, 2023)

(Shao, 2021)

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A community program tracks air pollution in real time. Burdened by polluting facilities, 86 percent of Bayview's children developed severe asthma before kindergarten.

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SAN FRANCISCO-Aliyah Dunn-Salahuddin still remembers riding the bus home from elementary school and smelling fresh-baked pastries and bread from the Parisian Bread Factory near Evans Street. She also remembers how quickly that scent would turn to one of sewage and smoke as the bus pulled closer to her home.

Dunn-Salahuddin grew up two decades ago in Bayview-Hunters Point, a neighborhood in the southeastern corner of San Francisco, jutting into the bay. It's under four square miles, just 8.5 percent of San Francisco's land mass.

This relatively small parcel of the city holds a disproportionate concentration of its toxic and polluting sites. For decades, state and local agencies have tried-halfheartedly, advocates say-to monitor and clean up the polluted air in Bayview. These ineffectual efforts have sown deep distrust among the residents for the polluters, and the government.

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So, advocates launched their own community-owned air monitoring program in September to do what government agencies haven't been able to.

"It will put power in the hands of the people," said Bradley Angel, executive director of Greenaction, the nonprofit that helps run the air monitoring program.

The Marie Harrison Bayview Air Monitoring Project, named after a beloved community activist who died in 2019 of lung disease, consists of 10 air monitors placed in and around Bayview-Hunters Point. The final monitor will be installed next week, Angel said.

The Dylos air monitors are encased in white boxes, which also hold fans and a data chip, and they upload data in real-time to a website where residents can check the air quality and learn about the harmful pollutants they might be exposed to.

Angel said he hopes the project will hold government agencies and officials accountable for their inaction, since they're the ones who are supposed to be tracking and responding to the pollution crisis.

"All of these agencies, well, they're supporting the air monitoring projects we do," Angel said. But when it comes to perpetuating the environmental burden of pollution in the community, "a lot of them are as guilty as can be."

The air monitoring project did receive state funding and support from the California Air Resources Board through California Assembly Bill 617, legislation passed in 2017 that charged the air board and local air districts with supporting air quality tracking programs in low-income communities of color across California.

But a lot of these funding efforts have been mired in slow, bureaucratic processes that have resulted in little or no actual regulation, according to a report from the grassroots advocacy group California Environmental Justice Alliance.

The report describes a pattern-replicated across other "fenceline" communities that are adjacent to polluting facilities-that is familiar to Bayview residents. State and local agencies will identify a community as vulnerable to negative health outcomes linked to polluted air, and may even participate in outreach and engagement events. But these efforts rarely lead to "quantifiable, permanent, and enforceable emissions reductions," the report says.

A view overlooking Bayview-Hunters Point's industrial facilities and concrete plants is seen on Oct. 28, 2021. Credit: Elena Shao

California has publicly identified Bayview as a community "disproportionately burdened by multiple sources of pollution" in a 2021 environmental analysis.

The neighborhood is also considered an "overburdened community" by the U.S. Environmental Agency's definitions, meaning that Bayview residents may experience greater vulnerability to environmental harms and health hazards due to socioeconomic conditions. Bayview is home to over 21 percent of the city's Black population, according to the latest census data for Bayview's zip code 94124. Close to 19 percent of residents live below the poverty line, which is double the rate of the city at large.

"The issue is not awareness," said Raymond Tompkins, a Bayview resident and scientist. It's not that the city doesn't know that these polluting facilities exist, Tompkins added, it's that the city can get away with what he calls "deliberate negligence" because Bayview doesn't have the political influence other areas do.

"You don't see this in the Marina District," Tompkins said, referring to a neighborhood in northern San Francisco known for its affluence and high percentage of white residents. "They need to get some of these polluters out of Bayview and not burden this community with it."

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Bayview-Hunters Point, is precisely the kind of over-burdened community of color that led the Biden administration to put environmental justice at the center of the EPA's regulatory and cleanup efforts. The administration promised to spend 40 percent of all money appropriated for climate adaptation and resilience, and environmental remediation, to environmental justice communities under an initiative called Justice40.

With the president's $1.5 trillion infrastructure bill signed into law and his follow-on Build Back Better legislation nearing final votes in Congress, a moment could be fast approaching when the Biden administration will finally have a chance to put up or shut up on environmental justice, activists say.

Representatives from the Bay Area Air Quality Management District said in an interview that the agency takes the concerns of the community seriously and seeks to actively respond to them. For example, the air district has increased the number of air quality patrols in the neighborhood, said Simrun Dhoot, a senior air quality engineer at the air district, and it regularly sends a liaison to the neighborhood's monthly Environmental Justice Task Force meetings.

The air district has also proposed amendments to its regulatory process that would provide "an additional opportunity for the public to be able to comment on all of the projects that might be impactful in their community," Dhoot said. Specifically, the rule would require a public comment period any time a company seeks a permit to operate a facility in an overburdened community like Bayview.

Residents say they are still hesitant to trust that this will result in significant, noticeable change. They say that, over the decades, agencies like the air district have allowed Bayview to become the city's "dumping ground," despite a growing body of evidence that links polluting facilities with negative health outcomes.

Studies from as early as 1995 have pointed to higher-than-normal rates of cancer among Bayview residents. A 2006 survey from the city's own public health department found that 86 percent of babies born in Bayview developed severe asthma before they started kindergarten, and the neighborhood itself sees the highest rates of asthma hospitalizations in the city.

Living near a hazardous waste or Superfund site like the Hunters Point Naval Shipyard, located at the neighborhood's waterfront, is also linked to lower life expectancy, according to a 2021 study in Nature Communications. Lower-income, minority communities experience a disproportionate shortening of their lifespan, said Hanadi Rifai, the study's lead author and a civil and environmental engineering professor at the University of Houston.

The community-based air monitoring program is a good first step, but it's got several challenges ahead, Angel and other local activists say. The first is turning the data into "something that could influence policy, and actually reduce emissions and harmful development," said Anthony Khalil, a community organizer who helped launch the project.

But even if more robust policy does result from the project, there's no easy path to heal the relationship between Bayview and the government agencies that residents hoped would protect their health.

"It won't get rid of the past," Khalil added. "We have to live with that pain for our whole lives."

Thank you,

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In San Francisco's Bayview-Hunters Point Neighborhood, Advocates Have Taken Air Monitoring Into Their Own Hands - Inside Climate News

# data[].attributes.attachment_link.description
SAN FRANCISCO-Aliyah Dunn-Salahuddin still remembers riding the bus home from elementary school and smelling fresh-baked pastries and bread from the Parisian Bread Factory near Evans Street. She also remembers how quickly that scent would turn to one of sewage and smoke as the bus pulled closer to her home.

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Asthma has been shown to be triggered by strong emotions, both positive and negative.

As children develop through different stages of play they interact more both indoors and outdoors, at friend's and family homes, in parks, and outside in the neighborhoods they live in.

(National Heart, Lung, and Blood Institute, 2024)

(Plaza-González et al., 2022)

(Pathways, 2019)

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As children grow and play with their friends, they learn to explore and react to emotions. Since asthma attacks can be triggered by strong emotions, it is possible that a child diagnosed with asthma may experience an attack trigger.

Children tend to play at their friends' homes and may be exposed to allergens that aren't in their own home. This exposure may trigger an asthma attack and while also not having access to an adult who would know how to respond.

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The Hunter’s Point-Bayview neighborhood of San Francisco once housed a large, naval base where hazardous materials were used for nuclear weapons development, following the establishment of the Naval Radiological Defense Laboratory in 1946.

Additionally, the Atomic Energy Act of 1954 allowed for disposal of radioactive materials in the Hunter’s Point-Bayview neighborhood of San Francisco, thus contributing to air and soil contamination.

Exposure to air and soil contamination can worsen existing asthma symptoms while also being a possible key factor in new cases of asthma.

(Hunter’s Point Naval Shipyard, n.d.)

(Tiotiu et al., 2020)

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Historical Redlining Affects Children's Asthma

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Historical Redlining Affects Children's Asthma

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African Americans make up 31% of the population in the Hunter's Point-Bayview neighborhood of San Francisco.

This statistic reflects the policies of redlining that took place in the Hunter's Point-Bayview neighborhood of San Francisco post-WWII.

Large amounts of air pollution and disproportionately high asthma rates among children suggests that historical housing policies have negatively affected lung health in the Hunter's Point-Bayview neighborhood of San Francisco.

(Chen, 2020)

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Asthma leads to an increase in flare-ups, sleep deprivation. and the narrowing of airways. Increases in emergency room visits and hospitalizations for asthma in turn increases healthcare costs.

Currently, asthma remains as one of the main reasons for children missing school, thus impacting learning and development.

(Asthma - Symptoms and Causes, n.d.)

(About Asthma Management in SFUSD Schools | SFGOV, n.d.)

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1. Decrease in the number of asthma cases amongst children ages 5-17 in the Hunter's Point-Bayview neighborhood of San Francisco in 2 years.

2. Decrease levels of air pollution in Hunter's Point-Bayview neighborhood of San Francisco to lower asthma rates in 2 years.

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Short Term: Increase the number of parents in the Hunter's Point Bay-View neighborhood in San Francisco who know what causes asthma and what triggers attacks within 6 months (knowledge)

Medium Term: Increase the number of parents in Hunter’s Point-Bayview neighborhood in SF who have an asthma action plan for their child in order to effectively treat an asthma attack within 10-12 months (skill)

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Short Term: Increase the number of parents living in the Hunter's Point-Bayview neighborhood in San Francisco who know how to decrease asthma attacks by effectively reducing allergens like pet dander and dust within 6 months (knowledge)

Medium Term: Decrease the number of homes in the Hunter's Point-Bayview neighborhood in San Francisco who have indoor allergens by 10-12 months (circumstance)

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About asthma management in SFUSD schools | SFGOV. (n.d.). https://www.sfgov.org/sfc/asthma/about-asthma-management-sfusd-schools

Aldredge, P. (2023a, July 4). The silent killer: How hazardous waste is slowly poisoning our planet. Lone Star Hazmat. https://lonestarhazmat.com/the-urgent-need-to-address-hazardous-waste-pollution/

Asthma - Symptoms and causes. (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653#:~:text=Complications,used%20to%20stabilize%20severe%20asthma

California Department of Public Health. (2022). California Breathing County Asthma Data Tool. www.cdph.ca.gov. https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/EHIB/CPE/Pages/CaliforniaBreathingCountyAsthmaProfiles.aspx

Chen, K. (2020). Bayview-Hunters Point Briefing Book. Nuclear Insecurity in the Bay Area and Beyond. https://nuclearbayarea.home.blog/br-subcategory/

Ester, T., & Harrison, M. (2004). A toxic inventory of Bayview Hunters Point, San Francisco. https://greenaction.org/wp-content/uploads/2019/06/thestateoftheenvironment090204final.pdf

Gate, G. (2020). CONCRETE PRODUCTION AND THE REGULATORY ROLE OF THE CONCRETE PRODUCTION AND THE REGULATORY ROLE OF THE BAY AREA AIR QUALITY MANAGEMENT DISTRICT BAY AREA AIR QUALITY MANAGEMENT DISTRICT. https://core.ac.uk/download/pdf/352000584.pdf

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Hunter’s Point Naval Shipyard. (n.d.). NRC Web. https://www.nrc.gov/info-finder/decommissioning/complex/hunters-point-naval-shipyard.html?utm_source=chatgpt.com

National Heart, Lung, and Blood Institute. (2024). What Is Asthma? www.nhlbi.nih.gov; National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/asthma

O’Connor, G. T., Lynch, S. V., Bloomberg, G. R., Kattan, M., Wood, R. A., Gergen, P. J., Jaffee, K. F., Calatroni, A., Bacharier, L. B., Beigelman, A., Sandel, M. T., Johnson, C. C., Faruqi, A., Santee, C., Fujimura, K. E., Fadrosh, D., Boushey, H., Visness, C. M., & Gern, J. E. (2018). Early-life home environment and risk of asthma among inner-city children. Journal of Allergy and Clinical Immunology, 141(4), 1468–1475. https://doi.org/10.1016/j.jaci.2017.06.040

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Pathways. (2019). The 6 Stages of How Kids Learn to Play | Child Development. Pathways.org. https://pathways.org/kids-learn-play-6-stages-play-development

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Plaza-González, S., Zabala-Baños, M. del C., Astasio-Picado, Á., & Jurado-Palomo, J. (2022). Psychological and Sociocultural Determinants in Childhood Asthma Disease: Impact on Quality of Life. International Journal of Environmental Research and Public Health, 19(5), 2652. https://doi.org/10.3390/ijerph19052652

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Rigby, T. (2004). Struggling for breath / Asthma hits children hard in Bayview-Hunters Point area of S.F. SFGATE. https://www.sfgate.com/health/article/struggling-for-breath-asthma-hits-children-hard-2746153.php

‌

Shao, E. (2021). In San Francisco’s Bayview-Hunters Point Neighborhood, Advocates Have Taken Air Monitoring Into Their Own Hands. Inside Climate News. https://insideclimatenews.org/news/27112021/air-pollution-bayview-hunters-point-san-francisco/

Tiotiu, A. I., Novakova, P., Nedeva, D., Chong-Neto, H. J., Novakova, S., Steiropoulos, P., & Kowal, K. (2020). Impact of air pollution on asthma outcomes. International Journal of Environmental Research and Public Health, 17(17), 6212. https://doi.org/10.3390/ijerph17176212

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Breathe Easy

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Parents and their children living in the Hunter's Point-Bayview neighborhood of San Francisco.

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Building on Cultural Wealth of Hunter's Point-Bayview Residents

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Building on Cultural Wealth of Hunter's Point-Bayview Residents

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The 'Breathe Easy' program and all of its components were developed with Tara Yosso's cultural wealth theory in mind. The program recognizes that parents, caregivers, and guardians have familial capital that has nurtured their beliefs around health and the well-being of their children. It is for this reason that we are using a peer-to-peer model to leverage the expertise and wealth of residents in the Hunter's Point-Bayview neighborhood of San Francisco. Furthermore, this program aims to improve the lives and health of the residents, specifically pertaining to asthma, in the Hunter's Point-Bayview community of San Francisco through increased knowledge and skills.

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Program Activities Phase 1: Program Development (mos. 1-3)

# data[].attributes.subject
Program Activities Phase 1: Program Development (mos. 1-3)

# data[].attributes.body
Hire staff.

Identify spaces within the Hunter's Point-Bayview neighborhood of San Francisco to rent for the conducting of program activities (workshop & lung tests)

Promote training/workshops through the use of fliers and social media.

Develop curriculum for the Asthma & Allergies 101 workshop.

Recruit participants.

Recruit a student doctor and a medical assistant from UCSF to conduct simple spirometry asthma exams.

Train Peer Educators (A-Team) in instructing the Asthma & Allergies 101 workshop.

Purchase air purifiers and replacement HEPA filters.

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Program Activities Phase 2: Program Implementation (mos. 4-21)

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Program Activities Phase 2: Program Implementation (mos. 4-21)

# data[].attributes.body
Train staff for Asthma and Allergens 101 workshop

2 Peer Educators (Asthma Team/A-Team members) will meet 4 hours a day for 5 days a week for 2 weeks with the Health Educator for training on how to instruct on rescue breathing, slow breathing techniques, and how to change HEPA air filters on the air purifiers.

A-Team Members Conduct Asthma and Allergens 101 Workshop

A-Team members will distribute flyers and conduct street outreach to parents at schools, grocery stores, and shopping centers within the Hunter's Point-Bayview neighborhood of San Francisco to recruit participants to attend the Asthma and Allergens 101 workshop.

A-Team members conduct a two hour Asthma and Allergens 101 training once a month for 16 months.

As part of the workshop, one member from each family that attends will receive an indoor air purifier with HEPA filters and additional replacement HEPA filters to last two years after the program ends.

Training Approach

Power-point for information

Hands-on training for rescue breathing

Acting out scenarios

Training Topics

Defining what asthma is

Identifying allergens that contribute to asthma, and how to reduce indoor allergens

How to operate air purifiers/HEPA filters and how they can help.

Signs of an asthma attack

Slow breathing techniques

Performing rescue breathing

When to go to the emergency room

Simple Asthma Testing

One recruited volunteer student doctor and one student medical assistant from UCSF will come to our workshop facility once a month on the Sunday after every Asthma and Allergens 101 workshop for an 8 hour session to conduct Healthy Lungs Testing (simple spirometry asthma tests) on children.

With parental consent, physical exams will be conducted, along with a questionnaire about symptoms, and possible use of a peak flow meter to test lung capacity.

If warranted, medical referrals to nearby clinics will be given to parents for further asthma/lung testing or to have medication prescribed.

Every family that attends asthma testing will receive a $20 Visa gift card as an incentive for participating.

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Program Activity Phase 3: Closing (mos. 22-24)

# data[].attributes.subject
Program Activity Phase 3: Closing (mos. 22-24)

# data[].attributes.body
Facilitate/coordinate a block party in the Hunter's Point-Bayview neighborhood of San Francisco to highlight reduced asthma rates and reduced air pollution.

Conduct closing evaluation activities.

Develop a final report on Breathe Easy program.

# data[].attributes.body
2 certified Asthma Team Members (A-Team members)

1 curriculum to train the A-Team

1 Asthma and Allergens 101 workshop curriculum

320 parents and guardians (20 people per workshop over the course of 16 weeks) in the Hunter's Point-Bayview neighborhood of San Francisco will possess knowledge on asthma, slow breathing techniques, how to reduce allergens, and air purifiers/HEPA filters via the Asthma and Allergens 101 workshop

320 households (20 people per workshop over the course of 16 weeks) within the Hunter's Point-Bayview neighborhood of San Francisco will have an indoor air purifier with HEPA filters and 5 additional HEPA replacement filters provided by the Asthma and Allergens 101 workshop.

320 children residing in the Hunter's Point-Bayview neighborhood of San Francisco will be tested for asthma via spirometry tests.

# data[].attributes.body
Short Term: Increase the number of people who believe that indoor air quality affects asthma rates and severity in Hunter's Point-Bayview neighborhood in San Francisco with 6 months (attitude)

Medium Term: Increase the number of people who have air purifiers and HEPA filters to decrease the number of air pollutants and indoor allergens in Hunter's Point-Bayview neighborhood in San Francisco within 10-12 months (circumstance)

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Childrens health Budget Template -- Spreadsheet - Sheet1