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The study, which focused on California residents, is the latest of several exploring the impacts of air pollution on the incidence and severity of Covid-19 infections. And the research adds to a growing body of global research highlighting the importance of reducing air pollution for overall health.
The researchers determined that 9%, or at least 4,250 Covid-19 deaths, could have been prevented if California met national air quality standards.
The most vulnerable people in terms of air pollution exposure were likely to be Latinos and those living in low-income areas, the researchers found.
The study, published in Environmental Advances, was authored by Paul English, director of the Public Health Institute and its “Tracking California” program, along with ten other researchers, including some affiliated with the University of California San Francisco (UCSF) department of medicine and the UCSF department of epidemiology and biostatistics.
“People of color live in communities that have some of the worst air pollution, and also have greater chances of getting sick and even greater chances of dying from COVID,” English said in a release announcing the study.
“This is really concerning, especially in regions like the San Joaquin Valley where wildfires are occurring right now and contributing to greater air pollution. We can save lives by making sure families and schools have access to free and low-cost air cleaners, and that outdoor workers receive paid time off and adequate personal protection during high-pollution events like wildfires,” English stated in the release.
Vehicle emissions, including from commuters and from farm machinery in agricultural areas, were big contributors to the harmful air pollution, according to English. Dust from agricultural areas is also a factor, he said in an interview.
Farmworkers and other outdoor workers are particularly vulnerable to the dangers of the pollution, he said.
Wide range of air quality
The worst areas for air pollution were the San Joaquin Valley and the South Coast air basin. Credit: The New Lede.
The authors examined data for 3.1 million SARS-CoV-2 infections and 49,691 COVID-19 deaths in California from February 2020 to February 2021, looking at where the people infected with the respiratory disease lived.
The study found that people living in the highest quintile of long-term exposure to air pollution – defined as particulate matter less than 2.5 pm in diameter (PM2.5) – had a 20% higher risk of contracting Covid-19 compared to people living in the lowest quintile.
The researchers said that for those people living in those highest exposure areas, the risk of death from COVID-19 was 51% higher when compared to people living in the lowest exposure areas.
PM2.5 describes fine inhalable particles that can lodge in the lungs and pass into the bloodstream, potentially also impacting an individual’s heart.
English said that while conducting the research, the study team saw a striking difference in the wide range of air quality in the state.
“When you compare the areas that have the cleanest air, the air quality is up to nine times [900 percent] better than in dirty air areas,” he said. The worst areas for air pollution were the San Joaquin Valley and the South Coast air basin, he said.
Looking across the US, the ramifications literally translate to life and death.
“There’s probably 140,000 total deaths due to outdoor air pollution in the US,” said English. “If you say California is about 10% of that, that’s 14,000 deaths due to air pollution each year.”
“Already compromised”
Jose Luis Velez, founder of the southern California-based environmental justice group Comité Cívico Del Valle, said the statistics resonated with his experience of the pandemic.
“It’s a bad combination when you have a virus that attacks your respiratory system and your respiratory system is already compromised,” said Velez. “People aren’t understanding how deadly air pollution is. It’s out of control. We can’t just continue to ignore these issues. Our families, our kids, are getting sick. We have more respiratory problems than ever before.”
In Imperial County, where 85% of residents are Hispanic, there were 5,255 deaths from Covid-19 per million compared to 2,390 deaths per million statewide, according to the Centers for Disease Control and Prevention.
English said Imperial County was a “really highly polluted area with particulate matter.”
About 15.1% of Imperial County residents are affected by asthma and the county has twice as many pediatric, asthma-related emergency room visits and hospitalizations compared to the state’s average, according to a 2021 study by the University of California, Riverside, California.
In 2009, Comité Cívico Del Valle sued the EPA for its failure to hold the county accountable for federal air standards compliance. “They let the county go on and drag their feet and never put together a plan of how they’re going to get to compliance,” he said. The suit was settled in 2010.
The California Air Resources Board (CARB) commissioned the new study to get a detailed picture of the specific risks for people living in California, which ranks worst in air pollution in the nation.
The data should help inform new policies, said Bonnie Holmes, chief of the CARB health and exposure assessment branch.
“These studies underscore the critical importance of our air pollution control work, and that is the big policy implication,” she said.
California’s recent move to prohibit the sale of new gasoline-powered cars by 2035 should help reduce air pollution, but will not solve the problem.
The new study concludes with a warning: “With the growing evidence from studies worldwide that suggest there is additional risk of COVID-19 morbidity and mortality associated with air pollution, reducing concentrations of air contaminants is now even more critical to protecting public health,” the study concludes.
(This story was originally published in The New Lede)
All these issues are tragically linked by the hardening divisions in the United States over our acceptance or rejection of expertise in science, public health, and environmental protection.
Nearly six decades ago, in 1963, US President John F. Kennedy told the National Academy of Sciences that science is “the most powerful means we have for the unification of knowledge.” He said it could help us “cut across boundaries,” to solve major problems. But today, COVID-19, climate change, and environmental injustice seem to have done the opposite by exacerbating the already horrific divides between rich and poor, cities and states, urban dwellers and rural residents, Democrats and Republicans, old and young, polluters and the polluted, the healthy and the immune-compromised, and last but hardly least, races and ethnicities.
It increasingly feels like our nation now stands at a precipice, teetering between truth and the consequences of denying it. The evidence is all around us. One respected recent survey, for example, found that 64% of Democrats but only 34% of Republicans have a “great deal of confidence” in the scientific community. The survey, conducted regularly for decades, found that the gap between the parties has tripled since 2018, when high Democratic and Republican confidence in science stood, respectively, at 51% and 42%. Equally notable, high confidence in science between Democrats and Republicans was essentially equal just two decades ago.
Beyond partisan politics
But before Democrats get on a high horse about being more sensible about science than Republicans, it’s important to note the critical holes in trust along racial lines. Black Democrats historically have much lower levels of trust in science than white Democrats. The mistrust is well earned after centuries during which dark-skinned people were “scientifically” judged as inferior, many decades during which they were abused in experiments, not to mention ongoing discrimination in becoming scientists themselves.
The US reaction to the COVID-19 pandemic only adds to that sordid history. The siting and signup procedures for testing and vaccines in both liberal and conservative states blatantly catered to wealthier and whiter families with access to cars and computers. Conservative governors were particularly vicious in ignoring science around COVID-19 protections, fighting against masking policies and keeping their economies open on the backs of essential workers who, in many critical occupations, were disproportionately Black and Latino.
Families of color are still paying the price for being first in line to get the virus and at the back of the bus of prevention. Two years after COVID-19 began sweeping the nation, Black, Latino, and Indigenous people are still twice as likely to die if infected. During the Omicron wave, the hospitalization rate was four times higher for Black people than white people. And decisions keep getting made that ignore that reality and bow instead to the emotions of privileged and more protected white people to get back to normal.
One example was the debate all fall and winter over when to drop indoor mask mandates and return to in-person classes in K-12 education. The call to end masking was led primarily by white medical experts, right-wing think tanks, and conservative commentators. Many health experts of color, joined by hundreds of physicians concerned about an equitable return to “normal,” said it was way too soon to drop all COVID-19 prevention measures as Indigenous, Black, and Latino children were still two to three times more likely to die if infected and were much more likely to live in homes with vulnerable elders or parents compromised by preexisting health conditions.
And now, the entire nation is dropping mask mandates and social distancing rules even though COVID-19 continues to cause some 30,000 cases a day, three times what White House Chief Medical Advisor Anthony Fauci once said was the safe rate at which to reopen the nation. We are still losing 1,000 people a day, equivalent to wiping out the undergraduate enrollment of Harvard University within a week or the University of Wisconsin-Madison within a month.
Of course, part of the problem is that the United States has one of the lowest vaccination rates among high-income economies. Its 65% rate for fully vaccinated people is lower than or equal to that of many nations such as El Salvador, Iran, Columbia, Nepal, and Cuba. The Biden administration, despite its efforts to restore respect for science throughout federal government, and its pledges to account for racial disparities, has frequently tripped over itself in bowing to political and economic pressures to drop restrictions.
The cost of dismissing science
Only 22% of Republican-leaning respondents said in a 2020 Pew poll that humans contribute “a great deal” to climate change. (Credit: Li-An Lim/Unsplash)
Mistrust and dismissal of peer-reviewed scientific experts is poisoning other mortal matters. Despite the fact that more than 99% of papers on climate science agree that humans are causing climate change, the level of urgency to stop spewing heat-trapping gases is crippled by partisan and racial divides. Only 22% of Republican-leaning respondents said in a 2020 Pew poll that humans contribute “a great deal” to climate change. Only 39% of Republicans think climate change is a serious problem, according to a 2021 Washington Post/ABC News poll.
White consumers, regardless of party, disproportionately produce global warming emissions and soot while being relatively spared the environmental injustice of fossil pollution in their communities or living in heat islands and flood zones. Even if they are hit by climate disasters, white families on average have much more access to property damage relief funds than families of color.
With this systemic buffer from the worst of climate effects, only 60% of white people in the United States said climate change is serious in the Washington Post poll. Only 40% say global warming requires immediate action by the government. Such a low number is not driven by fossil fuel company disinformation alone. It is also evidence of general white privilege.
Meanwhile, African Americans, who disproportionately breathe in fossil pollution, bear higher burdens from living in heat islands and flood zones (regardless of class because of the legacy of redlining), and face much lower chances of collecting relief payments. They don’t need to wait for scientists to tell them about climate change, as billowing carbon pollution from power plants and transportation is deeply intertwined with deadly particulates. In a study published in December in Environmental Health Perspectives, Black seniors accounted for 33,000 of the nation’s 133,000 deaths in 2014 from particulate air pollution (25%), while comprising just 9% of the nation’s senior population.
Losing elders at that rate is one reason that 93% of Black people told the Washington Post poll that global warming is serious, and 62% say it requires immediate government action. Latino communities, faced with many of the same climate risks, also have significantly higher levels of concern than white respondents.
Conversely, most white people are unaware of the disparities that define climate injustice. According to both a 2021 poll by Axios-Ipsos and a 2020 poll by West Harlem Environmental Action (WEACT) and the Environmental Defense Fund, only a third of white adults know that Black and Latino communities face more pollution than they do. Only 20% of white respondents in the WEACT poll thought that environmental justice was a serious problem in their state.
That leaves a big question: What horrible levels do COVID-19, climate change, and environmental injustice need to reach before a decisive majority of people in the United States—especially privileged white people—return to Kennedy’s notion that science can lead to a “unification of knowledge,” and unified action?
Science in the balance
We already live in a society where we tolerate far too many sources of death that science has told us are preventable. These include guns (45,000 deaths in 2020), fatty fast foods and sugary drinks (300,000 deaths a year through obesity and diabetes), and tobacco (480,000 deaths a year). Richard Keller, a medical historian and bioethics professor at the University of Wisconsin-Madison, warns that COVID-19 is becoming yet another acceptable chronic disease, because it will disproportionately afflict marginalized populations that are out of sight and mind.
“It will move out of the headlines,” Keller wrote last month, on the medical anthropology website Somatosphere, “but will remain a central lived experience and an evolving tragedy in much of the world, the US included. . . precisely in the populations that can least afford it.”
A sign that we are headed in that direction came when Rochelle Walensky, director of the Centers of Disease Control and Prevention, recently predicted that once the nation reaches “good immunity,” COVID-19 will still kill “some people,” but at levels we will “tolerate in some way.”
Will we similarly “tolerate” the forecasts of death and destruction from fossil-fueled climate disasters and pollution? We already know that 100,000 to 200,000 people die every year in the United States from air pollution. A study last year in The Lancet Planetary found that we already tolerate 5 million deaths per year from extreme temperatures, which will be exacerbated by climate change.
How much longer will people in the United States tolerate the immoral political morass around these issues? For instance, the Biden administration’s attempts to elevate climate science and environmental justice into public policy are being blunted at many turns. Sarah Bloom Raskin withdrew her nomination for a top regulatory role on the Federal Reserve after a withering attack by the fossil fuel industry and opposition by fossil fuel-backed Sen. Joe Manchin of West Virginia. She was merely following the economic science that says climate risks should be factored into lending decisions. Similar forces continue to obstruct legislation on the “Build Back Better” agenda, which includes major funding for renewable energy, addressing environmental injustices, and creating high-quality jobs.
Biden has resorted to using regulatory powers within cabinet agencies to deal with climate change, but the right-wing packing of the courts by the Trump administration threatens to slow even that to a crawl. Though the White House recently won a big federal appellate court battle against conservative states to factor in the social costs of carbon in federal rulemaking, a critical decision looms from a conservative Supreme Court on the EPA’s powers to regulate carbon.
All that is making the Biden administration pull its punches on environmental injustice. Despite the cascade of science showing that systemic racism greatly determines which communities get polluted, the Biden administration last month undercut its promises on environmental justice by unveiling a new system to identify beleaguered communities that did not include race.
In short, at this most critical juncture of public health and the fate of the planet, science and scientists have been reduced to a political punching bag. It is because the United States has forgotten—or perhaps never truly believed—that science must be accompanied by something else.
A year after Kennedy’s speech about science as a unifying force, Martin Luther King, Jr., warned that science means nothing if it is not accompanied by moral force. In his Nobel Peace Prize lecture, he said the nation’s “technological abundance” to peer “into the unfathomable ranges of interstellar space,” and build “gargantuan buildings to kiss the skies” were diminished by a “poverty of the spirit” in poverty, racial strife, and war.
That was 58 years ago. The challenge and choice remain the same, and the poverty of common sense and the common good are equally glaring. Had the nation adopted universal masking early in the pandemic, for instance, we might have saved hundreds of thousands of lives. If the nation tightened industrial soot pollution limits by only a small amount, thousands more lives could be saved. Combating climate change could preserve the livelihoods and lives of millions more people around the globe.
As the United States nears its one-millionth death from COVID-19 and lurches toward climate catastrophe, the moment offers us one more chance to match our scientific abundance with something currently elusive in our politics and public policy: compassion, equity, and a clear ethic never to “tolerate” preventable death. Only then can it be the unifying force that cuts across boundaries.
Derrick Z. Jackson is on the advisory board of Environmental Health Sciences, publisher of Environmental Health News and The Daily Climate. He's also a Union of Concerned Scientist Fellow in climate and energy. His views do not necessarily represent those of Environmental Health News, The Daily Climate or publisher, Environmental Health Sciences.
This post originally ran on The Union of Concerned Scientists blog and is republished here with permission.
Banner photo credit: Irwan iwe/Unsplash