Noteworthy Asthma Efforts in a Tribal Air Program: Interview with Tony Basabe, Air Quality Analyst, Swinomish Indian Tribal Community

THHN: You’ve said that your goal is to lead a health-based tribal air program. What does this mean in practice?

Tony:    “I look at asthma trends in our community and use that data as one way to monitor indoor air quality. If I see that there is an uptick in asthma rates, then I start looking around for clues as to what the causes may be. We partner with our health clinic to get this data, which has been important to support our work. For example, during the years we implemented a woodstove change out program, I saw the asthma rates decline. Currently I’m working with our clinic to try and capture inhaler use rates to further identify asthma trends that potentially could be addressed.”

 Tell us about your home assessment program. How does your referral process work?

“I perform home IAQ assessments and also assess public buildings like our daycare. The referrals come multiple ways – an occupant can ask directly; the housing authority will call me in when needed; and sometimes our health clinic will encourage a patient to contact me if they are a new case of asthma or a repeated case. I try to respond quickly to these calls because I know that every day, exposure to an asthma trigger only makes things worse.

If I find a structural issue during a home assessment, I go to housing immediately if appropriate and try to turn it into a work order. If I am helping a homeowner, I try to recommend a low-cost way to fix the problem.

A big key to success in solving IAQ issues is getting down and dirty – you have to look into contaminants in crawl spaces and attics. Often, you find hidden things that may be affecting resident health. In my experience about half of the problems are in crawl spaces and attics.”

What advice would you share with other tribal staff incorporating healthy home activities into their work?

“When starting out, as opposed to identifying a specific target or trigger – spend some time getting to know your housing stock. This is paramount – every tribe will have unique circumstances that impact the indoor environment. It could be water issues due to the lay of the land, the age of the buildings, construction problems, or woodstove situations. Knowing what you’re dealing with lets you know where to focus.”

Can you give a specific example of how knowing the housing stock has informed your IAQ work?

“We found out we had a group of homes built in the 90s and those bathroom fans were never vented properly to the exterior. This unfortunately produced a lot of mold in our attics. Once we knew this was an issue we could coordinate the effort to change the fan venting, address the mold, and improve the air quality in those homes.”

 What kind of outreach does your program do?

“We take a multi-pronged approach to outreach. We’ve made Earth Day an annual event – bringing tribal members together at a community lunch and giving out green cleaning kits. We publish articles in our tribal newspaper, for example reminding folks we can do free home assessments, or that it’s time to start thinking about safe wood-burning ahead of the burn season. I also teach college level indoor air quality courses to the community, as well as train our housing authority, and public works employees.”

How do you know if the outreach is working?

“It’s important to have patience with this work – you have to wait till the community takes the information as their own. Over time you’ll hear the community giving advice: “Mom don’t hang that blanket against the window, it gets wet”. Maybe you only get a few hits every time you do a project, but those few hits grow over time and you can really make an impact.”