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Op-Ed

Latinos are disproportionately affected by asthma, and Trump's policies are making it worse

Many Americans live where it is unsafe to breathe. About 40% of the U.S. population — more than 126 million people — live in areas that do not comply with national ambient air quality standards.

This public health problem poses a particular threat to Latinos, who are exposed disproportionately to high levels of the main pollutants that can aggravate asthma: ozone and fine particulate matter.

Latinos and Asian Americans are more likely than any other racial or ethic group to live in counties that don’t meet standards for particulate matter, according to a 2011 Centers for Disease Control and Prevention study, the agency’s most recent report on air quality that includes demographic information. At the time of the study, 26.6% of Latinos lived in counties that did not meet standards for particulate matter, while the same was true for only 9.7% of whites. More than 48% of Latinos lived in counties that did not meet standards for ozone.

President Trump is undermining efforts to improve air quality for Americans. His administration has attempted to delay the implementation of new ozone standards adopted by the Environmental Protection Agency in 2015, and it is seeking cuts to the EPA’s budget that would severely compromise the agency’s ability to enforce all air quality standards.

For Latinos, the Trump administration is compounding the problem even more, through its efforts to roll back healthcare and its aggressive deportation policies.

Healthcare is critically important for asthma patients, particularly children. Latino children who have health insurance are more likely than white children with insurance to visit emergency rooms or be hospitalized for asthma, according to a 2011 report by the Natural Resources Defense Council.

But Latinos have less access to healthcare than other groups. According to 2015 CDC data, Latino populations have an uninsured rate of 19.4%, compared with 6.2% of white Americans. The NRDC report estimates that two out of five Latinos are either uninsured or underinsured.

If the Trump administration and Republicans roll back any part of the Affordable Care Act, the rates of uninsured are certain to grow. Before the ACA, one out of three adult Latinos lacked coverage, according to a 2013 report by Kaiser. The enrollment rate among Latinos then grew 7.2% under Obamacare, according to a New York Times investigation. And because Latinos have comparatively high rates of asthma, diabetes and obesity, they in particular have benefited from the ACA’s protection for people with preexisting conditions.

What’s more, the Trump administration’s deportation crackdown means that Latino immigrants are already less likely to seek medical attention, as concerns mount over immigration raids at hospitals and the potential transfer of personal information from healthcare systems to immigration authorities.

Although it is Immigration and Customs Enforcement policy to avoid conducting sweeps at healthcare facilities, which are classified as “sensitive locations,” ICE agents reportedly targeted several individuals at hospitals this summer. In one case, undocumented Latino parents were intercepted at a Texas children’s hospital after they registered a child who had been transferred to a neonatal intensive care unit. In another, ICE agents moved a critically ill Salvadoran woman who was awaiting emergency surgery to a detention facility.

In recent weeks, the New York Times and Politico documented a growing trend of immigrant populations forgoing medical care due to fears of deportation. And in a June op-ed in the Washington Post, a Chicago doctor argued that immigration concerns are preventing children from getting medical care.

A number of hospital chief executives have issued open letters acknowledging the problem and encouraging immigrants to seek care. But a large body of research has shown that immigrants tend to avoid healthcare providers when fears of deportation are running high. As a result, many Latinos with asthma, among other conditions, are less likely to receive the medical attention they need.

Trump should want to protect air quality for all citizens and residents, including Latinos. His administration could do this by vigorously enforcing EPA standards and avoiding policies that directly or indirectly limit access to medical care. Instead, sadly, his policies are making things worse.

Ignacia S. Moreno is a founding principal of the iMoreno Group. She served as assistant attorney general for the environment and natural resources division of the U.S. Department of Justice from 2009 to 2013. Richard L. Revesz is a Lawrence King Professor of Law and dean emeritus at New York University School of Law.

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