Totally gnarly air, dude

 

What might California save if it met the EPA's current air quality standards? From 2005-'07, the figure might have been $193 million — in hospital bills alone. That's the approximate cost of about 30,000 emergency room visits and/or hospital admissions that might have been avoided if California's skies were more breathable, according to a new report by the RAND Corporation, a non-profit research institute.

The authors of "The Impact of Air Quality on Hospital Spending" identified air-pollution-associated medical cases in more than 400 hospitals throughout the state. Then, with the help of epidemiological studies that have appraised the health rewards of lower pollution concentrations, they estimated how many hospital visits could have been prevented in each California zip code if those places were  to meet the EPA's air quality standards (perhaps a pie-in-the-sky prospect, in the short-term). Reducing pollution, of course, will come at a hefty cost; but this report demonstrates "the cost of doing nothing," as Mary Nichols, chairwoman of the Californian Air Resources Board, told the San Francisco Chronicle.

According to the report, almost three-quarters of these hospital trips stem from fine particulate, bits of dust and soot less than 2.5 microns in diameter, or about 1/28th the width of a human hair — particles borne of cars, factories and chimneys that worry air quality inspectors everywhere, including in the Bay Area. The remainder of air pollution cases are linked to ozone from smog. More people in California reside where air fails to meet federal quality standards than in any other state.

Yet $193 million over three years doesn't describe nearly the full cost of California's poor air, because the study considers just three of many air pollution "endpoints": asthma-related ER visits, and hospital admissions for cardiovascular or respiratory conditions. The study doesn't touch upon the less-easily-quantifiable costs linked to premature mortality, restricted-activity days, work loss days, asthma exacerbations, or even visits to doctor's offices, except to acknowledge they exist.

But the study does tackle the (unequal) distribution of air pollution-related medical costs, in part by taking a look at five specific hospitals. They ranged from Stanford University Hospital, which might have dodged just 30 cases and $534,855 in treatment, to the St. Agnes Medical Center in Fresno, which might have avoided 384 admissions/ER visits and $2,976,116 in coverage. Why the difference? Among other factors, much of the Bay Area's air pollution blows to the Central Valley, which also suffers from the emissions of truck after truck on I-5.  In addition to the Central Valley, the worst cases of air pollution and its diseases exist at the outskirts of LA.

As for who picked up the air pollution tab, $104 million was covered by Medicare; another $28 million by Medi-Cal (the state's Medicaid program); and $56 million by private insurers. So even in a place like the Bay Area, where relatively few air-pollution health cases would have been avoided according to Rand's report, citizens are paying through the nose for related sicknesses in the form of tax money. Everyone in California, it seems, has a stake in bodacious air.

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