The Breath We Choose, and the Air We Don’t.

There is something remarkable about the human lungs. We rarely think about it until breathing becomes difficult, yet every minute of every day our lungs are quietly working to keep us alive.

With every breath, air travels through the airways and into millions of tiny air sacs called alveoli. It is here that oxygen passes into the bloodstream and carbon dioxide moves in the opposite direction, ready to be breathed out. The diaphragm and other muscles of respiration create the movement that allows air to flow in and out. It is an extraordinary system, and most of the time we are completely unaware of it.

Perhaps even more remarkable is that the lungs are still developing throughout childhood and into early adulthood. The number and size of the airways and alveoli increase as the lungs grow, and lung capacity develops alongside the growing body. This means that the environment in which a child grows is also part of the environment in which their lungs develop.

This brings me back to a recent BBC report about children’s lung function in London, which I read whilst I was away.

Researchers followed more than 3,400 children in London and Luton over five years. Before London’s Ultra Low Emission Zone was introduced, the London children had poorer lung function. As exposure to nitrogen dioxide fell following the introduction of the ULEZ, the researchers found that lung growth accelerated. By the end of the study, the difference in lung function between the children in London and those in Luton had essentially disappeared.

What fascinates me about this is not simply that air pollution affects the lungs. We already know that it does. It is the fact that when the environment changed, the children’s lungs responded.

The children did not need to make a lifestyle change. They did not need to become more motivated or disciplined. They did not need to make better choices. Something around them changed, and their bodies responded.

That makes me wonder about the way we talk about health. So much of modern health advice is focused on what we can do for ourselves. We are encouraged to take responsibility for our wellbeing and there is certainly value in that. Understanding our bodies, becoming more physically active, eating well, sleeping adequately and finding ways to manage stress can all support health.

This is also where I see an important place for Yoga Therapy, breathing is fascinating because it happens automatically, yet it is also something we can consciously influence. Through Yoga Therapy we can become more aware of the breath, notice patterns of tension or effort, explore how movement affects breathing and develop practices that may help us experience greater ease and regulation.

But there is an important distinction., we can change how we breathe - yet we cannot always change what we breathe!

A breathing practice can alter our experience of breathing, but it cannot remove pollution from the air outside our home. Yoga can help us develop awareness of the body, but it cannot remove damp and mould from poor housing. We can encourage movement and time outdoors, but that assumes there is somewhere safe and accessible to go.

And this is where I think the question of poverty becomes difficult to ignore, a child’s lungs do not develop in isolation. They develop in a home, in a neighbourhood and within a particular social and economic environment.

Some children will grow up with access to clean air, green spaces and good housing. Others may grow up beside busy roads, in poorly maintained homes or in neighbourhoods where there are fewer safe places to play and exercise. Their parents may have very little choice about where they live because housing costs determine what is possible.

We often describe health as a matter of lifestyle, but lifestyle can disguise the circumstances in which choices are made.

It is very different to tell someone to live somewhere with cleaner air when they cannot afford to move. It is different to recommend fresh food when the cheapest and most accessible food is highly processed. It is different to suggest taking time to relax when someone is working long hours simply to keep their family housed and fed, at some point, the language of personal choice becomes inadequate.

This does not mean that individual choices are unimportant. It means that they exist within a much larger context.

The science of the lungs makes that difficult to ignore. These are living organs that develop in response to their surroundings. They need oxygen, but they are also exposed to everything else that enters the air we breathe. During childhood, when the lungs are still developing, that exposure can have consequences that may reach far beyond the moment of each individual breath.

The London research gives us something hopeful to think about because it suggests that the body can respond when its environment improves. Cleaner air was not simply an abstract environmental benefit. It was reflected in the developing lungs of children.

Perhaps this is an important lesson for the way we think about health.

Yoga Therapy can help us work with the individual. We can explore the breath, movement, awareness and the relationship between body and mind. But there is also a responsibility to look beyond the individual and ask what surrounds them, we cannot breathe our way out of polluted air, unfortunately we cannot meditate our way out of poverty. Just as we cannot ask a child to take responsibility for the conditions in which their lungs are developing.

Perhaps the question is not simply how we can teach people to breathe better, perhaps we also need to ask whether we are creating the conditions in which everyone has the opportunity to breathe well.

The breath is very personal, however the air is something we share and need to thrive.

Naomi Hurst (she/her)