Fields are commonly burned to prepare the ground for the next crop, creating large plumes of smoke. Permits and specific burn dates are assigned to control air pollution.
Imperial County is known as Southern California’s agricultural oasis. Environmental allergens abound because of the vast desert region’s extreme climate changes, air pollution and pesticide exposure. Multiple regulations exist within the county in attempts to decrease pollutants entering the air. Farmers must water dirt roads to decrease dust, burn permits regulate the burning of fields and crop dusters have limitations on spraying near vulnerable populations, such as schools.
Despite these stringent efforts, Imperial County has a significant problem with asthma. Asthma is a chronic disease that inflames airways and causes recurrent wheezing, coughing, difficulty breathing and chest tightness. Attacks can be mild to deadly. If controlled, most affected people lead active, healthy lives. According to a 2005 Border Asthma and Allergies (BASTA) Study conducted by the California Department of Public Health, 20.2% of children in Imperial County are diagnosed with asthma. The national average is 13.7%. Imperial County consistently has the highest asthma hospitalization rates among all California counties. Health care providers realize we can’t change the environment, but more can be done to diagnose children early so that proper maintenance leads to active, healthy lives.
Both of my children have had asthma symptoms. We were fortunate to travel to San Diego for specialized care at Rady Children’s Hospital in the allergy/asthma clinic. It was interesting to learn that many of the children in the Imperial Valley may have an allergy to sugar beets, which is harvested locally. Fortunately, my children had early treatment and have now outgrown their symptoms. Unfortunately, this is not the case for most. Local school nurses and health care providers are fighting to get each child on an asthma action plan to ensure no additional deaths occur from a manageable disease.
Unfortunately, the county is plagued with a lack of health care providers, limited specialized resources and a large population of uninsured. From 2000 to 2004, ten asthma deaths occurred in Imperial County. The problem has gained recent attention with the death of a local 16 year old girl. Since 2001, public health, local hospitals, community health agencies, the Centers for Disease Control and the California Department of Public Health have all collaborated to provide all levels of prevention for asthma.
The Imperial Valley Child Asthma Program (IVCAP) is funded by the Imperial County Children and Families First Commission, and operated by El Centro Regional Medical Center in partnership with Pioneers Memorial Hospital. The program is designed to reduce health disparities, and to improve the development and school readiness of young children from birth through age five who suffer from asthma or asthma related symptoms. The IVCAP follows the National Institute of Health asthma guidelines. A free referral is provided by a local health care provider or parents can self-enroll. Community health workers and Aidee Fulton, RN, provide case management services.
Lessons include:
- What is asthma?
- asthma medications
- preparing for clinic visits and collaborating with your child’s MD
- proper use of inhaler, nebulizer and peak flow meter
- limiting asthma triggers at home
- recognizing early asthma symptoms and what to do when they worsen
- use of an asthma action plan
Currently, hospitalization rates are declining here, but still remain the highest in California. Both hospitals are leading the initiative because the majority of people in the Imperial Valley do not have access to primary care services. This means that they come to the ER with mild to life-threatening conditions. IVCAP is currently facing an uncertain future. Without additional grant funding, the program will end. Fullton is seeking additional partners and looking into expanding services to people ages 0-17, while exploring the addition of a mobile clinic to better serve outlying areas.
The American Lung Association has also been actively involved in bringing the Open Airways Program into local schools. Several school districts have looked into using a colored flag system to identify when air quality is poor, and additional measured need to be taken for those with asthma to prevent attacks.