I don’t have asthma, but my sister Marta does, and so do at least 20 other people I know, most of whom take medication to control it. We all live in East Harlem, which has the highest rates of asthma in New York City – and the children in New York City were nearly twice as likely to have asthma in 2000 as kids in the United States as a whole, according to a report by the New York City Department of Health and Mental Hygiene.

Asthma is actually the most common chronic disease of childhood throughout the United States, and is the country’s number one cause of school absences each year. But kids in New York City have an especially difficult time with the condition, which causes a person’s airways or windpipes to narrow, resulting in difficult breathing, including wheezing, shortness of breath, chest tightness, and coughing. Over the last 20 years, the number of people in New York City diagnosed with asthma has increased and so has the severity of the illness, according to Dr. Beverley J. Sheares, associate clinical professor of pediatrics at Columbia University.

It is the kids living in low-income neighborhoods, like mine, that make the numbers so high. Hunts Point-Mott Haven and the High Bridge-Morrisania sections of the Bronx, East Harlem in Manhattan and Bedford Stuyvesant-Crown Heights in Brooklyn all have some of the most severe rates of asthma in the city. New York City children age 4 and younger who lived in low-income neighborhoods like these in the year 2000 were more than four times more likely to be hospitalized for asthma than those in wealthier areas. In my neighborhood, East Harlem, 435 children age 14 and younger were hospitalized for asthma in one year. (My sister Marta once stayed in the hospital for a whole week because of her asthma). Compare that to the wealthy Upper East Side, where only 40 children in that age range got hospitalized, less than one-tenth of the number in the neighborhood right next door.

Experts are a bit uncertain why asthma is so prevalent in low income areas, but many attribute it to pollution. “Communities like East Harlem are burdened with polluting facilities, like a multi-storied diesel bus depot operated by the New York City Transit Authority, a sanitation truck depot, and a sewage treatment plant on Ward’s Island,” said Yolande Cadore, organizing director of the environmental justice group West Harlem Environmental Action, Inc. ( WE ACT), in an email. “These communities bear the burden of high asthmas rates, lung and heart disease, obesity and diabetes.”

In the past five years, there has been some decrease in hospitalizations for asthma in New York. Dr. Sheares says this is at least partly due to groups that work in communities to keep asthma at bay. Harlem Children’s Zone Asthma Initiative is one of these groups. It has significantly reduced the need for emergency room visits for children with asthma involved in the program, and the program nearly eliminated their overnight hospital stays, the New York Times reported last year.

Harlem Children’s Zone focuses on working directly with children and their families. Its doctors and nurses visit the homes of children with asthma regularly, and lawyers help families deal with the housing problems common in low-income areas that are believed to contribute to asthma attacks, including mold, dust mites, and rodent infestation.

WE ACT takes a broader approach to alleviating asthma: They fight to keep pollution out of poor neighborhoods. Cadore says that city planners often build sewage treatment plants and bus depots in poor neighborhoods of color because they assume the community will not protest as much as a rich, white community might. Cadore said this is because historically minority communities have been less politically active, less likely to vote, and have had less money to sue.

Riverbank State Park, located in West Harlem between 137th and 145th Streets along the Hudson River, was built on top of the North River Wastewater Treatment Plant, which processes 170 million gallons of sewage each day. It handles the sewage of the entire western half of Manhattan and Riverdale in the northwest Bronx.

At one point, the plant was going to be built on 72nd Street. But developers saw the spot as a potential high-income area (it is where the Trump condos are now, so someone figured right), so the plant was built in Harlem.

The location was a bad choice for a sewage plant. Since it was up on a hill, the city had to spend additional money to install pumps to carry the sewage up from underground. When it opened in 1986, the putrid smell was overpowering. “The first summer it opened no one could open their windows or stand to breathe the air for extended periods of time,” said Cadore.

And the plant’s smoke stacks spewed diesel exhaust, which can trigger asthma attacks. Since West Harlem already suffered from high asthma rates, the plant was most likely harming those residents, said Cadore.

Peggy Shepard, who would eventually become the executive director of WE ACT, organized community residents to speak out. After they chained themselves across the street from the plant, the city installed proper odor and air pollution controls and built the park. Now locals can enjoy the park without the horrid smell that once came from the sewage plant.

As a means of fighting asthma, Cadore urges us to organize to protect our community against pollution. “It’s a right, not a privilege, to breathe clean air,” she said.

Additional reporting by Gamal Jones. Natalie Olivero, 17, and Gamal Jones, 20, are writers for New Youth Connections.