Ashley Fogarty, Program Manager of the RI Asthma Control Program
Ashley: My name is Ashley Fogarty and I’m the Program Manager of the RI Asthma Control Program. I’ve worked in this position for six years. We get funding from the CDC to provide services to primarily pediatric asthmatic patients in RI. We focus on low income families, especially those living in the poor cities, Providence, Pawtucket, Central Falls, and Woonsocket.
Olivia: Is the asthma program just you?
A: It’s just me right now. I have two contractors, a data manager, and Dr. Deborah Pearlman is our epidemiologist. We’re trying to hire another person.
O: Yeah, that’s a lot of heavy lifting for one person. Tell me more about your programs.
A: We contract with agencies like Hasbro Children’s Hospital and other health centers like Thundermist Medical Center and St. Joseph Health Center to provide asthma services. They’ll go out into the homes and provide programs to the kids. The programs are home-based and school-based. The Home Asthma Response Program (HARP) is an intensive in-home visit intervention with a certified asthma educator and community health worker. They’ll go into the home and provide education as well as an environmental walk-through. So they’ll look at things like if the child is sleeping with ten cats in their room or several stuffed animals. Are there harmful cleaning products exacerbating a kid’s asthma? They’ll also work with providers to make sure there is an asthma action plan in place and the parents understand how to use the medications properly, so everyone is on the same page. One of the less common programs is the Breathe Easy at Home (BEAH) project, which is based on an intervention in Boston. It’s a last resort program. If kids who have done our other programs like HARP still have poorly controlled asthma, they’ll do BEAH. It’s for kids in rental housing and they believe that the home itself is making their asthma worse. We see this a lot with landlords that don’t want to fix certain things in the home like ventilation problems, a neighbor smoking in a big apartment complex, anything really. So we’ll have code enforcement go in and site for code violations which could be related to asthma. The thing I like about that program is it connects the healthcare provider with the Department of Health, Code Enforcement, and legal support if needed. It really empowers the family.
As far as projects, we have HARP and BEAM. We work with Hasbro and they also have a school-based program called Project CASE (Controlling Asthma in Schools Effectively). They provide education to schools including the students, parents, and staff. They cover managing asthma and having an asthma-friendly-and-safe school. We are hoping to get funding from the EPA for that outdoor/indoor study. We also work closely with the Providence Housing Authority.
O: So it sounds like this is a little more focused on indoor air quality.
A: We applied for an EPA grant that would be an outdoor and indoor air quality focused project, so I hope we get funding for that. We’re working with the American Lung Association (ALA) to promote the connection between outdoor air quality and health issues, especially asthma. For example, on a bad air quality day we’ll do alerts. We’re trying to do a lot of that, such as outreach through social media and letters to families in schools. We’re trying to connect climate change, the environmental health public tracking program, and asthma.
O: My environmental science teacher in high school would always say when you tug on one thing you find it connected to everything else. That sounds like really important work, especially empowering people, so it’s not just a band-aid — we’re also empowering you with information.
A: Exactly. We also have a program called Cool It Off, which is pretty new. We’re in our third year. With that, we provide air conditioners to low income families, primarily living in Providence Housing Authority [public housing] because high temperatures have been shown to exacerbate asthma. The AC also filters out some of the poor air quality coming in. With that program though, we’ll not only provide the AC, we’ll also provide education.
“I was preaching something for so long and now I’m living in that. I understand the importance of promoting better air quality, for everyone and especially for people with asthma. ”
O: Where do you live?
A: I’m originally from Vermont. When I went home recently I was saying to my friends, “Wow the air is so clean here.” I was also living in Coventry (RI) for several years and the air quality was actually great there too. And then recently I moved to Providence and I’ve noticed the air quality is not the best. There’s so much traffic and construction. I was preaching something for so long and now I’m living in that. I understand the importance of promoting better air quality, for everyone and especially for people with asthma.
O: What motivates you?
A: I really like to advocate for people who might feel like they don’t have a voice. A lot of the families that participate in our programs like BEAH, they’re worried about complaining about an issue because they don’t want to lose their housing. Landlord retaliation, especially in Providence, is a serious thing. [I am motivated by] trying to empower those people so they can take charge of their health and giving them a voice when they feel like they’re not being heard. The asthma program is a really great way to see all of that. Many think the asthma program is just about chronic disease, but it actually connects so many more things like environmental health, climate change, health equity, and social justice. It’s so eye-opening to see that low-income people are affected so much more by this than by other conditions. It’s really frustrating and it pushes me to provide more services with the resources we have.
O: What information do you wish you had about air quality?
A: Having more information, such as air quality alert days with ALA, [having air quality data] readily available and especially going out to families affected by asthma with information really knowing what we as a community can really do to make improvements. Especially with climate change…we can all do certain things like recycle, but we really want to move things forward to actually make an impact.
O: Like going beyond the individual to the institutional problems that are occurring.
A: Exactly! I think [sensor data] would be really helpful. Thinking about the families we’re serving now, making sensor data available via social media, or going to specific communities. One of the things we’re trying to do is work closely with the Health Equity Zones on the potential EPA project. The HEZs are a sort of hub for reaching many different groups in all the communities. I’d recommend [partnering] with those groups to get your data out.
O: What do you wish people knew about environmental justice or air quality in Providence?
A: I think just understanding the different issues and what’s happening. A lot of people know ‘oh yeah, the Port of Providence isn’t great’ and actually, I’ve talked to a lot of people that had no idea that there are a lot of air quality issues in that area. The 6/10 connector also poses issues. A lot of people don’t consider things beyond just traffic, such as construction and other sources of pollution. I don’t think people understand the depth of what’s happening.
O: When I walk around now, and I’m like uh-oh, I notice when the air is hazy or I’m near the highway.
A: Me too. When I was applying for the EPA grant I hadn’t previously really considered so many different factors. When I mapped out where different family housing units were, I found they are right off of I-95 and between the 6/10 connectors, which has had construction going on [since 2018]. It’s sad and frustrating.
O: I’ve been thinking a lot about how we rectify these situations where sources are highways and ports, and I doubt those things are going to go away. For me, it’s powerful to think about how electrifying vehicles not only curbs carbon emissions [impacting climate change] but also reduces emissions people are breathing in. Heavy diesel trucks come through every day. I’m imagining a Port less focused on fossil fuels.
O: What do you see as the biggest barriers to a healthy Providence and healthy air here?
A: One of the biggest issues is we have a lot of communities that are underserved and feel like they don’t have a voice, so empowering those communities makes a big difference. When watching the ALA documentary Unbreathable: The Fight for Healthy Air, those youth groups took action. Actually bringing people together to make something happen. We’re not really providing all this information to communities that we should be. I really like the idea of using the HEZ to empower those communities so they can do something.
“The DOH needs to be doing more with air quality and asthma to connect it to other issues.”
O: In my background reading, air pollution and asthma are not new issues to Providence. There was the 2014 asthma report…It’s kind of curious how it feels like there are folks in the statehouse who are clearly not aligned with climate justice goals and are not interested in protecting the people of Providence. For example, the pyrolysis ‘advanced recycling’ bill that just came up. Two senators co-sponsored it and it was approved in the Senate and then effectively killed in the House, but I was watching videos from a protest and Dwayne Keys from the South Providence Association said, ‘Why do you even think this is a good idea? Why do we have to protest on our own time in our busy lives and tell you once again, no, stop polluting our communities?’ People aren’t on the same page about what’s harming the community and who we’re here to serve.
A: I think about the Port of Providence. A lot of folks don’t consider all the traffic going in and out with the big trucks, that alone is a big issue, besides all the other things going on there.
O: What haven’t I asked that you’d like to share?
A: This conversation highlights that the DOH needs to be doing more with air quality and asthma to connect it to other issues.
