Q&A about asthma and air quality with PA State Representative Sara Innamorato

Following the publication of our four-part series Breathless: Pittsburgh's asthma epidemic and the fight to stop it, we reached out to politicians and lawmakers to hear their thoughts on how we can work together to improve the air.

Sara Innamorato is the Pennsylvania State Representative-elect for District 21, which includes parts of Pittsburgh and sections of areas to the north of the city including Aspinwall, Etna, Millvale and Ross Township. She was elected in May and will take office in November.

EHN: Do you ever hear concerns about air pollution or asthma from your constituents?

Innamorato: Absolutely. Environmental issues are not a left or a right thing—they're very much community issues. I represent a district that has seen firsthand the impacts of climate change. Some neighborhoods have seen lots of flooding, so we've really been in touch about designing buildings and structures that can withstand more of the extreme weather we know we'll see moving forward as a result of climate change.

Millvale is one of the neighborhoods that from an outsider's perspective would be viewed as more conservative, but they've really led the way in bringing sustainability to residents in very real and tangible ways, along with Etna and Sharpsburg.

Innamorato: Air quality is also part of the conversation. Many people in my district lived here when you could still see the air pollution, so there's the perception that it's significantly cleaner now, but in reality we're still suffering and feeling the impact of under-regulated industry that's happening in the region and in the tristate area. That has a real impact on families. When you have families that have kids with asthma, every trip to doctor may be fifty to a hundred dollars, and prescription medications for asthma are getting more expensive.

I personally have had asthma since I was two, and I know I've had to make decisions about what bills to put off paying so I can pay for my asthma medications this month. Because now it costs fifty dollars when it used to cost five dollars. We see this industry that's profiting off essentially making us sick. Our conversations about lack of access to affordable healthcare and about environmental issues are very interconnected.

EHN: While reporting for the asthma series, we looked at a recent study of 1,200 Pittsburgh students in low-income neighborhoods. It found that more than 70% of those kids live in areas with particulate matter pollution levels above World Health Organization annual average thresholds for safety. Do you think that Pittsburgh City Council members in general are aware of the scope of this problem?

Innamorato: Air quality doesn't know neighborhood boundaries. Just because it's coming from a polluter in one neighborhood doesn't mean it isn't impacting many others. If it's bad in Millvale, it's bad in Fox Chapel, even though the median income is three times higher there. You could have all the money in the world but if you're living in an area with bad air quality, there's no way to be exempt.

But when you think about industry, we have let the people who have the least be the guinea pigs for potential public health repercussions for so long. A company wants to develop a fracking well near an elementary school in Fox Chapel, and of course the community is up in arms. That's reasonable, but if we don't want to be impacted by things like fracking, we also need to think about other people who are suffering because of fracking wells—if it isn't your backyard, it's still near someone else's back yard, near someone else's elementary school.

EHN: Pittsburgh's air quality is among the worst in the nation. As someone with a history of environmental activism, do you have any plans in the works related to tackling that problem?

Innamorato: A lot of this happens in low income neighborhoods. I have an active foundry in Lawrenceville, which is my neighborhood. It's arguably one of most gentrified and expensive places to live in Pittsburgh, and there's an active foundry. That's wild to me.

They operated without a permit from the county for several years. When they finally issued a permit, county officials came and and talked to community about the permit and they put up a list of emissions and the allowable amounts. I asked, "If I breathe those in, what does that do to my body? What does it to a child's body?" It's a very simple question. But they couldn't answer it.

Why are we going around and issuing these permits that will absolutely have an impact on public health but not having any conversations about how? You feel really helpless when you can't get answers to questions like these. I think we need to be able to talk about permitting for polluters in tandem with talking about the impacts these choices will have on public health.

EHN: Are you aware of the Allegheny County Health Department's Asthma Task Force?

Innamorato: No, I haven't heard about it.

EHN: How about the Pennsylvania State Asthma Plan?

Innamorato: No, I haven't heard anything about it.

EHN: There's a local pediatrician, Dr. Deborah Gentile, who has developed a survey that's highly effective at predicting asthma diagnoses, and she wants to make it available to school nurses for free. She hopes to see mandatory asthma screenings implemented in all public schools in the county and ultimately at the state, similar to vision and hearing screenings, on the premise that kids' ability to breathe is just as critical as their ability to see and hear. What do you think about that idea?

Innamorato: I think that's a great idea, but also one of those necessary programs that pop up because we have a system that is broken. So it's important, but it's not going to change the fundamental problem. The data can feed into a conversation around needing to change the system, but even that won't get to the root cause, which is that we have unregulated industries that feel like they can just use the environment and the people in our communities as test subjects or collateral damage to increase profits.

So I'm for it, but with the awareness that it's something we'll have to put in place as a temporary solution while we work on a plan for the bigger picture.

Editor's note: This interview has been edited for length and clarity.

If you're a politician or lawmaker and you'd like to speak with EHN about air quality and asthma, contact Kristina Marusic at kmarusic@ehsciences.org.