Since being diagnosed with severe asthma six years ago, Marco, who lives in this border town east of San Diego, has visited the hospital nearly 50 times. He has been airlifted on several occasions. The illness has affected much of his childhood, preventing him from playing sports, going to friends’ houses and attending school for days at a time. Blowing out the candles on his 8th-birthday cake this year, Marco had only one wish: “I just want to run.”
For children with asthma in California, there is no place worse than Imperial County. They are far more likely than children in any other county to end up in the emergency room or hospitalized. Kids go the emergency room for asthma at a rate three times higher than the state’s average, according to the Department of Public Health.
“Imperial stands out,” said Meredith Milet, an epidemiologist with the department. “There is obviously a disparity. . . . There is just a need for something to change. It should be possible for it to be different for the kids of Imperial.”
Severe childhood asthma is also a major problem elsewhere in California, including the smog-filled Central Valley. Heavily agricultural Fresno, Merced and Bakersfield, for example, all rank high among the nation’s worst cities for asthmatics. Imperial County is different because it leads the state for asthmatic children going to the ER and being hospitalized, but experts are unable to pinpoint the cause.
Doctors and public health officials said that a combination of whipping winds, pesticide-tinged farmland dust and large numbers of low-income families lacking health insurance contribute to high rates of asthma hospitalizations and ER visits. Whatever the reason, uncontrolled asthma and frequent hospital visits aren’t an issue just for those with the disease; many children are covered by Medi-Cal, meaning taxpayers often pay the tab for care.
In Imperial County, about 63 percent of asthma-related ER visits and 67 percent of the hospitalizations, for both children and adults, are paid through Medicare and Medi-Cal. Each hospitalization costs, on average, about $16,600. The county spans nearly 4,600 square miles of mostly desert in the southeastern corner of California, just north of Mexico and west of Arizona. The county is hot and dry and depends largely on agriculture.
One in five of Imperial County’s children ages 5 to 17 has been diagnosed with the chronic respiratory disease, which cannot be cured but can be managed with medication. Uncontrolled asthma can lead to hospitalization and in rare cases, death. In 2009, a 16-year-old girl died after an asthma attack.