On March 9, 1997, Notorious B.I.G. aka Biggie, real name Christopher Wallace, was murdered in a hail of bullets after an awards show in Los Angeles. On his person, authorities found, among other items, a Primatene Mist inhaler. Until this information was made available to the public by the FBI last year, most people were unaware that one of the greatest Hip Hop artists and performers of all times had, since childhood, faced an all too familiar struggle: the management of asthma.
Asthma is a chronic inflammatory illness that affects over 20 million people in the United States. It is one of the most chronic conditions that presents in young people, and almost 1 in 10 children and teens have the disease. Asthma is more prevalent in children, but more deadly in adults. In an asthmatic, the body’s airways are periodically narrowed and obstructed due to a reaction to various stimuli, such as respiratory infections, allergens like pollen or animal dander, dust, cigarette smoke, or cold air. The inflammation associated with asthma is continuous, but the illness presents in sudden “attacks” of breathing difficulty that are treated episodically. Recent studies indicate that asthma may have a specific genetic component. If it is not managed properly, asthma can be a life-long, life-threatening disease.
For various reasons, asthma disproportionately affects African-Americans living in poor, urban neighborhoods. East Harlem and the South Bronx have some of the highest childhood rates of asthma in the country. Many Hip Hop artists have talked about the prevalence of roaches and other pests that they dealt with while growing up in housing “projects” or other poor neighborhood residences. The feces and saliva of cockroaches is a common allergen and allergy trigger, and is thought to play a significant role in the prevalence of asthma in urban areas. Dust mites and mice also produce asthma triggers. The high rates of childhood obesity, smoking and consequent secondhand smoke exposure, as well as high levels of particulate matter due to vehicle exhaust, proximity to manufacturing plants, and other sources are also correlates of the high asthma rates in poor urban areas.Also, people of all ages that live in neighborhoods that are not perceived as safe may spend more time indoors and are less likely to keep windows open, which may cause them to have more exposure to indoor allergens and asthma triggers. In addition, many have pointed to casein, a milk protein, as a major contributing factor to asthma rates in poor urban neighborhoods, considering that many children in these areas consume tremendous amounts of milk as a result of participating in free breakfast and lunch programs.
There have been a number of Hip Hop artists that have publicly addressed their struggles with asthma. Tyler The Creator, who is a new addition to the Hip Hop community, is also a severe teenage asthmatic and often needs to use an inhaler while performing onstage. He also stopped taking Ritalin to treat his ADHD because it interfered with his asthma medication. Another well-known Hip Hop asthmatic is Pharoahe Monch. While he was alive, Biggie and Pharoahe Monch bonded over their struggle with asthma. Pharoahe Monch’s desire to hone his craft as a Hip Hop MC pushed him to overcome the limitations of his condition as an asthmatic, and the management of his lyric delivery in spite of his asthma allowed him to develop a very unique, critically-acclaimed flow. He addressed his struggle with asthma in the song “Evolve” on his most recent album W.A.R. (We Are Renegades). On the front cover of the W.A.R. album, he is sporting a gas mask, which represents him protecting himself from the toxicity of the environment that contributed to the development of his asthmatic condition. Some of these artists have used their fame and notoriety to directly fight the incidence and prevalence of the disease in their communities. For example, Coolio has been hospitalized due to asthma complications several times during his lifetime, and his children also have the condition. Coolio is now a spokesperson for the Asthma and Allergy Foundation of America.
Although exercise is a key aspect of health maintenance and promotion, tremendous amounts of exercise can cause a person to develop asthma or can bring about an asthma attack. This is known as exercise-induced bronchospasm (EIB), and it affects 80-90% of asthmatics. A significant percentage of Olympians are asthmatics. One of the most famous of these athletes is Jackie Joyner-Kersee. Although she won many Olympic medals, she sometimes had to wear a mask in order to compete. Another one of the most famous asthmatic athletes was her sister-in-law, the late Florence Joyner (Flo Jo). Once called “The Fastest Woman Alive”, numerous Hip Hop artists including Sir Mix-a-Lot, Fresh Prince and DJ Jazzy Jeff, Hi-Tek, and Ludacris have paid homage to Flo Jo in their music. (While it was reported that she died from seizure disorder, others have concluded that she may have died from asthmatic airway obstruction due to the consumption of casein. Ironically, Flo Jo was a spokesperson for the milk industry.) Flo Jo is quoted as saying: “I never looked at asthma as being a handicap. My attitude was to beat asthma; I wasn’t going to allow asthma to get the best of me.”
In the past, doctors encouraged children with asthma to lead more sedentary lifestyles as to not risk flare-ups. However, asthma treatments such as anti-inflammatory agents and bronchodilators have allowed people to maintain healthy levels of physical activity while effectively managing the disease, and doctors now encourage their asthmatic patients to participate in sports and other physical activities. It is very important that children with asthma are encouraged to be physically active but are also armed with the tools and knowledge to manage their condition. For example, some physical activities are less problematic for asthmatics than others, and it is important to identify which sports work best for every asthmatic individual. Also, children living in cold climates and/or areas with high levels of pollution may require a higher level of treatment than others. It is imperative that asthmatic children have access to appropriate medication, such as having a bronchodilator to use before exercising to avoid symptoms. In addition, an adequate warm-up prior to exercising as well as pacing oneself during exercise has been shown to reduce or avoid asthma symptoms in children. The GO SLOW WHOA breathing technique touted by Hip Hop F.E.E.T. (Finding Exercise Energy Thresholds) may help young asthmatics to pace themselves when engaging in physical activity, thus helping them to maintain a healthy lifestyle in spite of their condition. It is also hoped that the upcoming initiative Hip Hop Smoke will help to decrease smoking rates and consequently asthma rates by educating children to encourage their caregivers and relatives to drop the habit. Curbing the incidence and prevalence of asthma in our communities must involve culturally-relevant, grassroots interventions to arm communities with the information and resources needed to reverse the trends. Ill health will get suppressed for widespread success. The power needed is already possessed; nonetheless we must cherish every breath.