Alice,

I desperately want to attend school in NYC, but have one reservation. I'm asthmatic and I'm afraid that my asthma will be worse in a big city. I traveled to NYC for a week this summer and was fine, but have heard it could be worse in the winter. Can you advise me? I so don't want to let my asthma limit my dream of going to school in NYC.

Dear Reader,

It's true that New York City (NYC), as with many urban areas, may pose some health risks for people with asthma. However, that doesn’t mean you have to give up your dream — there are ways to manage both your asthma and your college coursework in any city! In terms of your situation specifically, while you were able spend a week breathing easy in the Big Apple during the summer, it's possible that cold winter air itself may make it more difficult to breathe. Understanding what triggers your asthma, other asthma triggers you may encounter in the city, and ways to prevent them may help improve your respiratory health in NYC (or any other city, for that matter). 

In order to understand why people living with asthma have more trouble in urban areas than suburban or rural settings, it’s helpful to be aware of the environmental factors that often lead to asthma or trigger asthmatic episodes. These episodes and triggers may differ by person, but some factors include: 

  • Tobacco smoke
  • Animal dander
  • Cockroach droppings and remains
  • Dust mites
  • Pollen and mold
  • Physical activity
  • Sulfites in foods
  • Cold air

In most cases, multiple factors contribute to asthma, making it difficult to identify one specific culprit. However, being mindful of household triggers will help you choose and manage a living situation that will aid, rather than harm, your breathing. As a student, you may want to consider university housing if available, as schools often work to ensure that it's well maintained and that those triggers are reduced. If you choose to live in an apartment, look out for cockroach infestations, pests like mice and rats, lack of proper garbage sanitation, and crowded housing, all of which have been tied to asthma. Other apartment features to consider are hardwood floors — they’re not just aesthetically pleasing, they’re helpful in alleviating some of the burden caused by indoor allergens as they don't accumulate dust and dander the way carpets may. Additionally, if you're able, you may consider living further away from areas with major traffic. Emissions from traffic, such as nitrogen dioxide, have also been associated with asthma. These risk factors are more common in some neighborhoods, leading to a misconception that asthma is only an issue in big cities like NYC. However, asthma rates tend to be higher in areas that are densely populated and have poor air quality, which is possible in smaller cities and towns as well. 

Luckily, there are plenty of strategies to maintain your respiratory health no matter where you choose to settle. First, you may want to consider investing in a high efficiency particle air (HEPA) filter, which removes microscopic particles found in the air. Those whose asthma gets worse around mites may choose to purchase bed covers that are designed to keep those little pests away. The National Institute of Environmental Health Sciences also recommends using a steamer for your carpets every eight weeks (if you have them), vacuuming rugs and plush furniture weekly, and washing sheets and blankets weekly. Finally, for those who suffer from cold air induced asthma, covering the face when outside, doing physical activity indoors, or taking long-term medicine all may help prevent asthma episodes. In any case, discussing your particular situation with a health care provider will help you determine a plan for managing your asthma. Taking these steps will hopefully increase in the likelihood of breathing easier, allowing you to focus on preparing for a potential move and your new school.

In a New York state of mind,

Alice!

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