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Despite decades of cleanup, respiratory disease deaths plague California county

An investigation of state data shows one out of every 37 people in Kern County died of chronic respiratory disease between 2013 and 2016—a rate 12 times higher than the state.

The fastest driving route to Sacramento from Los Angeles is the I-5 or Highway 99. On the way there, you'll drive through miles of farms, oil fields and open space.

After a couple of hours, you'll be in the heart of Kern County and San Joaquin Valley — a place that has become the state's epicenter of harmful air pollution.

The state of California has drastically reduced air pollution since the 1970s in its major cities—but an investigation of Chronic Lower Respiratory Disease (CLRD) and air pollution shows Kern County and the rest of San Joaquin Valley still have a long way to go.

In a review of deaths from Chronic Lower Respiratory Disease—which refers to a group of diseases that affect the lungs, cause airflow blockage and breathing-related problems and can be fatal—between 2013 and 2016 from the California Department of Public Health, one county stood out: Kern County, which had more than 23,000 deaths.

California Health Landscape: An interactive, county-level mapping tool

Click on any county in the map above for health, socioeconomic, and environmental information. The darker the shade, the more people who died from CLRD. You can see how counties compare to others across the state.

About one out of every 37 people in Kern County—current population 871,337—died of CLRD over that time. This is 12 times higher than the death rate from CLRD for California, which is 87,725 deaths in the same years, and 14 times higher than the rate for the U.S., which is 602,465 deaths. Kern County's residents are about 28 times more likely to die from CLRD than people in San Francisco County, which has a similar sized population.

CLRD diseases—which include asthma, chronic obstructive pulmonary disease, occupational lung diseases and pulmonary hypertension—are the third leading cause of death in the U.S. More than 11 million Americans were diagnosed in 2015.

"Reducing the air pollution in the San Joaquin Valley is far from done," Kevin Hamilton, CEO of Central California Asthma Collaborative, told EHN. "The air district would like to claim 90 percent of air pollution has been cleaned up since 1980, but we only just got better at monitoring air quality within the past 10 years."

Pollution persists 

Kern County has some of the worst air pollution in the state—the American Lung Association has rated it an F since 2006.

Kern County's Air Quality Index (AQI)—a rating of air quality that measures particulate matter, ozone, nitrogen dioxide, carbon monoxide and sulphur dioxide —is comparable to bigger counties like Los Angeles or San Diego. On average, Kern's AQI was 103.3 — which is unhealthy for sensitive populations, such as people with asthma and young children. Los Angeles County was just a few points higher at 111.2.

The region's air pollution comes from multiple sources, including oil fields, agriculture, railroads, wildfires like the ones that have ravaged the state this month, and heavy road traffic.

In 2016 the American Lung Association found Bakersfield, the county seat of Kern, had the worst air in the U.S. for both short-term and year-round particle pollution, and had the second worst air in the country for ozone pollution.

It ranges from year to year, but Kern County typically experiences around 240 unhealthy days for sensitive groups and around 60 unhealthy days for everyone a year. By comparison, Los Angeles County has 200 unhealthy days for sensitive groups and around 80 unhealthy days for everyone a year.

Pollution can spur allergies, asthma and have adverse effects on children's lung development. Symptoms are shortness of breath, coughing and a tight feeling in the chest. While the CLRD deaths cannot specifically be pinned on pollution, there's a strong link between air pollution and respiratory deaths.

After having initial symptoms, people tend to get other chronic diseases like congestive heart failure, diabetes, coronary heart disease or stroke.

"There is a health crisis in Kern County" 

Chronic respiratory diseases also pose a significant economic burden in Kern County. In 2010, it cost the county an estimated $190 million in healthcare costs and lost productivity just from people suffering from asthma —that doesn't account for other chronic respiratory diseases. "There is a health crisis in Kern County and the rest of San Joaquin Valley caused by air pollution," Bill Magaven, policy director at Coalition for Clean Air, told EHN.

Geography is another aspect making it worse for pollution. The county is in San Joaquin Valley where it's surrounded by mountain ranges, trapping air pollutants often for days or weeks at a time.

"Local sources of pollution add to the health burdens and the geography can work against cleaning up the air," Will Barrett, director of advocacy of clean air and policy analyst at American Lung Association, told EHN. "So in order to achieve clean air, we need to approach this as we need to clean up all the local pollution sources."

Cassandra Melching, San Joaquin Valley Air Pollution Control District's outreach and communications representative told EHN that a growing population and commutes are worsening the problem.

"While emissions have been dramatically reduced, the Valley's population and vehicle miles traveled continues to grow," she said.

CLRD related deaths adversely affect communities with higher poverty rates where people don't have the best health insurance or any at all. There were still about 2.8 million Californians without health insurance in 2016, according to a National Center for Health Statistics report.

The following groups were more likely to report CLRD:

● Counties with high CLRD deaths are in places of California where 20 to 25 percent of people live below the poverty level. The state's overall poverty rate is 15.8 percent.

● Californians with lower levels of education and income are more likely to report having at least one form of the disease.

● People who are over 65 years are the hardest hit from CLRD.

● Non-Hispanic white people are more likely to get CLRD.

There's no cure for CLRD, but treatment can prevent worsening of the disease.

(Data Sources: California Department of Public Health, United States Environmental Protection Agency and United States Census Bureau's American FactFinder.)

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