What do Bill Clinton and Julia Roberts know about air pollution and health in California? The answer can only be “not much,” based on their statements in support of the California ballot measure known as Proposition 8,7 which would tax oil to fund alternative energy research.
“We’re all victims of this state’s tragically poor air quality. California has the worst air pollution in the nation,” claims Roberts.
Clinton says that air pollution prevents Californians from “living out the full lives they deserve to have.”
It’s true that much of California doesn’t meet federal air quality standards. Nine of the top ten “smoggiest” counties in the nation and seven of the top ten “sootiest” counties in the nation are in California. But failure to meet federal air quality standards (called nonattainment in EPA-speak) or having the “smoggiest” and “sootiest” counties doesn’t mean that California air significantly threatens state public health.
First, the federal air quality standards are not really health-based standards – no scientific studies show that the standards (or any range around them) serve as actual demarcation points for healthy versus unhealthy air quality.
The existing standards were scientifically controversial when the Clinton-era EPA first proposed them in 1996 -- time and science have yet to validate them as improving public health. In fact, California seems to be doing quite well health-wise despite its nonattainment issues.
“What does [nonattainment] mean in the real lives of people?” Clinton asked at a speech at UCLA on Oct. 14. “It means more asthma, more bronchitis, [and] more lung cancer. It means heart disease, lung disease and premature death,” he said.
But are any of Clinton’s claims true?
The prevalence of asthma in California was below the U.S. national average (7.7 percent vs. 8.1 percent), according to the most recent data from the Centers for Disease Control and Prevention. California has a lower asthma rate than most states that fully meet (attain) federal air quality standards. California’s death rate from chronic lower respiratory disease (CLRD) -- including emphysema, chronic bronchitis and asthma -- was 20 percent below the U.S. average (34.4 vs. 42.2 per 100,000 people).
Even within the state there appears to be little correlation between air pollution and respiratory problems.
Los Angeles County has by the far the most Californians exposed to nonattainment air, yet it has a relatively low death rate from CLRD. In contrast, Humboldt County is in attainment yet has one of the state’s highest CLRD death rates.
How about lung cancer risk? For men, California ranks in the lowest quartile among states ranked by the CDC. For women, California ranks in the next-to-lowest quartile. Attainment states like Iowa, Kansas, North Dakota, Oklahoma, and Wisconsin all have much similar or much higher lung cancer rates.
By the way, a new study published in the American Journal of Epidemiology (Oct. 24) could find no support for the proposition that gasoline exhaust increases lung cancer risk.
California’s heart disease rate is also below the national average (504 vs. 536 annual deaths per 100,000 people). The rate for Los Angeles County, which supposedly has the “riskiest” air in the state, is on par with the national average. Attainment states like Arkansas, Indiana, Mississippi, and Oklahoma all have substantially higher heart disease rates than California.
With respect to premature death, California has the fourth lowest death rate among the states -- a death rate roughly one-third lower than that of attainment states.
Clinton also warned that, “At the age of two months, babies in Los Angeles have already breathed enough toxins to reach the EPA’s lifetime limit for cancer risk from dirty air.”
Putting aside the question of whether these toxins actually increase cancer risk, Clinton basically implies that California air virtually guarantees that Californians will get cancer. But according to the CDC, the cancer rates for California men and women are about 9 percent and 6 percent below the national average, respectively. California’s cancer rates are below those of attainment states such as North Dakota, Oklahoma, and Wisconsin.
So what is to be made of the fact that while most of California doesn’t meet federal air quality standards, the state’s population doesn’t appear to be adversely impacted? Moreover, Californians seem healthier than the populations of states in full attainment with federal standards.
Could it be that California’s current air pollution levels, in reality, have little, if anything, to do with its public health? If so – and the evidence certainly points to that conclusion – then it seems that Proposition 87 would have a similarly negligible impact on public health.
Yes, California should work to improve its air quality -- but success is more likely to follow from a firm grasp on the actual relationship between air pollution and health, rather than political rhetoric from know-nothing celebrities.