A LO N G and H E A LT HY LIFE
Two children with asthma may experience their shared illness quite differently depending upon the asthma triggers in their homes and neighborhoods, for example (see BOX 1 ). People in good physical and mental health not only have greater freedom to direct their life course and pursue the objectives that matter . to them; they are also better able to weather shocks and setbacks than are people in poor health.
BOX 1
California’s Poor Air Quality Costly for Human Health
California’s poor air quality, especially its levels of ozone and particulates, harms human health. California leads the nation in the number of counties that exceed EPA guidelines for ozone levels, and those California counties exceed the guidelines by greater margins than in other states. Major metro areas, including Los Angeles, Sacramento, San Francisco, and San Diego, all have higher ozone levels than recommended, with levels in the southern part of Los Angeles one and a half times greater than the recommended 75 parts per billion. Of the counties with the highest levels of particulates in the nation, the top three are located in California’s Central Valley: Kern, Fresno, and Tulare. The particulate count in Kern, the highest in the country, is double what the EPA deems acceptable for human health. Ozone is a natural part of the earth’s stratosphere, forming a protective layer against the sun’s rays. However, ozone can also be created at the ground level from car exhaust or industrial emissions, where it becomes a main component of smog. Particulates are very small articles in the air, such as soot, dust, smoke, and pollen. California’s many industries either emit large amounts of particulates or rely on other industries (such as transportation) that do so. Excessive levels of particulates and ozone are harmful to the environment and human health. They can either exacerbate or trigger heart and lung-related illnesses, such as asthma, bronchitis, and emphysema, particularly among children and older adults. Cardiovascular disease. One study found that residents of Los Angeles living within 330 feet of a freeway experienced a hardening of the arteries twice the normal rate. This condition, also known as known as atherosclerosis, drastically increases the chances of heart disease and stroke—the leading causes of mortality in California as well as the nation. Air pollution is associated with more heart attacks than risky behaviors like using cocaine.
Asthma, one of the nation’s most widespread chronic diseases, can be caused and worsened by dirty air. It is an expensive disease for the state—in 2005, hospitalizations in California for asthma alone cost $763 million—in addition to creating serious burdens for sufferers and their families in the form of missed school and work, curtailed activities, frightening attacks and emergency room visits, and even death. In California, children are disproportionately affected by asthma, as are African Americans. Although the prevalence of asthma is similar across income groups, low-income people are much more likely to have severe symptoms and are hospitalized more frequently than middle- or high-income people; for instance, asthma sufferers from households with incomes under $20,000 are seven times more likely to experience severe symptoms than those from households with incomes above $100,000. Low-income people are exposed to more environmental triggers for asthma, such as poorly maintained housing and proximity to highways and polluting industries; they are also less likely to use the daily preventative medications that keep severe asthma in check. Air pollution from traffic and industry affects first and foremost local residents, but particulates travel with the wind; heavy emissions in one area can thus mean heavy air pollution in another. Air pollution is practically impossible to contain, so efforts to improve air quality need to be similarly farreaching. Air quality standards have improved tremendously with the introduction of automobile emissions regulations in California since the 1960s. However, there is still far to go— most Californians (up to 93 percent) continue to live in areas that fall short of EPA standards for human health. Sources: Milet et al. 2007; Cox et al. 2009; U.S. Environmental Protection Agency 2010; Nawrot et al. 2011; Yip et al. 2011.
A P O R T R A I T O F CA L I FO R N I A 2 0 1 1
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