In the shooting and killing fields of Chicago there is a new concern: asthma. Violence, it turns out, is now widely believed to trigger the disease, which can cause a shortness of breath and in some cases lead to death.
Even before someone is born, a violent act can lead to asthma.
"We are beginning to see evidence that stressors (including violence), even as early as utero, may actually affect the development of asthma," said Dr. Victoria Persky, Professor of Epidemiology at the University of Illinois' School of Public Health.
In the past, poverty, pollution and genetics were believed to be among the principal causes of asthma. Now add violence.
Just going outside or going to the doctor can cause enough stress to trigger an asthmatic attack Dr. Persky says.
As we talked, outside the Beloved Community Family Wellness Center in Englewood, sirens wailed continuously.
The center sits in the heart of Englewood, a South Side neighborhood marked by poverty and violence. According to one study there were 141 homicides here between 2010 and 2012.
Englewood is where Michelle Anderson lives and Beloved Community is where she works.
"When you come home every day you have to worry about am I going to get shot and you stay in the house all day," she said.
And inside that house?
"There's mold and allergies. You can't step outside to get a breath of fresh air," said the 25- year old medical assistant who has had asthma since she was 8.
"It feels like there is an elephant on your chest," she said, "You just want to breath normally but you can't."
According to experts, September is the month with the highest number of asthma incidents. And September 19th is the single worst day of the year.
On September 19th in Chicago, 13 people were shot in the Back of the Yards neighborhood.
Katrese Minor understands the connection. She is the Executive Director of the Mobile CARE Foundation, a non-profit whose van criss-crosses the city providing medical attention to students with asthma.
This year the van will serve 1,100 Chicago school kids in under served neighborhoods, including 12-year old Javielys Montanez, who has trouble breathing when she runs.
"My throat tightens and my lungs, it, it hurts," she said just after being weighed, measured and having to blow as hard as she can into a tube.
The checkup at the van has meant she won't need to miss a day of school. Or go to the hospital.
A decade ago, over 9,000 Chicagoans were hospitalized annually for asthma. In 2011 that number had dropped to 7000. But even with the decline, Chicago still leads the nation when it comes to asthma statistics.
"In hospitalizations, ER visits, missed school days, Chicago still tops the charts as far as those, those records unfortunately," said Minor. (Hospitalizations by Zip code)
Add to that this alarming statistic: In Chicago "black residents are nearly eight times more likely to die than… white residents" from asthma, according to a recent study.
Then factor in the violence that permeates some gang-infested neighborhoods.
Or Michelle Anderson put it when it comes to both asthma and violence.
"It's no walk around the park in Englewood, no," she said.