Asthma in Diné children: Addressing elevated rates through community collaboration and education

By Robert Bettis
Navajo Times

WINDOW ROCK – Asthma rates among children in the Navajo Nation are significantly higher than the national average, posing serious health challenges for families across the region.

Experts point to environmental and socioeconomic factors as key contributors, emphasizing the need for long-term community-based solutions. One such solution, the Community Asthma Program, is working to spread awareness and reduce asthma for children in Diné Bikéyah.

Bruce Bender, a pediatric neuropsychologist from the National Jewish Health, has spent over a decade collaborating with Navajo Nation health care providers to address childhood asthma. He noted that economic hardships and limited access to health care play a significant role in the elevated rates. “Anywhere there’s increased poverty, asthma seems to be worse,” Bender explained. He highlighted indoor air pollution from wood stoves, livestock exposure, and mold in homes as major triggers, along with dust from unpaved roads.

In response to these challenges, a long-term health study focusing on asthma prevention and management recently concluded after nearly 10 years of work in multiple Navajo communities. Funded in 2013, the project aimed to reduce asthma rates in children by working closely with schools, health care centers, and families to provide education and improved care strategies.

The study began in Tuba City in 2016 before moving to Chinle, where it remained for four years because of pandemic-related logistical challenges. Chinle served as a central hub, allowing the research team to reach surrounding communities, including Piñon, Hard Rock, and Black Mesa. The primary focus was to educate and support Diné children aged 7 to 17 through partnerships with local schools and Indian Health Service facilities.

A critical component of the study was the implementation of the American Lung Association’s Open Airways curriculum, which provided asthma education to students and trained school staff, bus drivers, and even janitors on recognizing and responding to asthma symptoms. “The goal is to get treatment to them,” Bender emphasized, explaining that proper education helps ensure children receive care before emergencies arise.

The project also partnered with Navajo Technical University, where engineering students built and installed air filtration systems in homes with asthmatic children. These systems, designed under the guidance of Engineering Professor Peter Romine and NTU President Elmer Guy, resulted in reported improvements in children’s breathing.

Additional key figures in the project included Lynn B. Gerald, a research professor of medicine at the University of Illinois at Chicago, and Dr. Wayne Morgan, a respiratory physiologist from the University of Arizona, both of whom have extensive experience serving Navajo communities. The research team also worked closely with the Navajo Department of Health, the Navajo Department of Education, and the Navajo Nation Council to ensure local collaboration and sustainability.

Peter Nez, a member of the Community Asthma Program team, underscored the importance of community involvement. “We made it a priority to work with families directly, understanding their experiences and making sure they felt heard throughout the process,” Nez said.

Though the study has concluded, its impact remains visible through the Community Asthma Program. Increased asthma awareness expanded health care training, and better access to resources like NavajoCAP.org, a website offering asthma education materials, have all contributed to long-term improvements.

Bender expressed optimism for the future, emphasizing the continued importance of collaboration with the community. “It’s not a competition between traditional medicine and modern medicine. It’s a collaboration. We’re all searching for the same goal—to help children be less sick.”

The study’s findings and community-centered approach offer a hopeful path forward, with families, health care providers, and educators working together to ensure healthier futures for children in the Navajo Nation.