Residents lead charge toward health, environmental sustainability


Earlier this fall, the New York Times’ lead food writer Mark Bittman visited the San Joaquín Valley. In a recent piece for the Times’ magazine, ‘Everyone Eats There,’ Bittman said he came here to explore big farming, small farming, food politics and sustainability – as well as the industry’s impact on natural resources, people, and animals.

During his five-day visit, Bittman experienced the environmental conditions that many of us endure here. He writes:

The air, trapped between mountain ranges, stinks, and the pollution is consistently ranked among the most severe in the country. Worse, there are so many cows nearby in megadairies and feedlots that the air contains microscopic particles of dried dung, enough so that you can taste it. I smelled it on my clothes when I unpacked each night and even brought it home with me. I have never carried Visine in my life, but there I was using it every half-hour.

After visiting huge farming operations and an organic farm, and meeting a Hmong farmer, Bittman lands on this issue:

There must be, I thought (or fantasized) as I traveled through the valley, some movement toward pushing farmers, big and small, to produce decent food sustainably. Because if there’s not, the valley’s problems will only worsen, and we’d be complicit in destroying one of the country’s greatest resources, one that has served us amazingly well until now.

Well, I have an answer for Bittman: There IS a movement pushing for better, more sustainable environmental conditions in the San Joaquín Valley, and it’s bubbling up from the people who are most impacted by these problems.

 Yesterday, I participated in an environmental justice bus tour, as part of the launch of the new Fresno Environmental Reporting Network. The network allows residents to report health and environmental hazards in their community, via telephone, text message, e-mail, or the website,

During the tour, we visited a farm labor camp in Huron, where residents have to leave their small, cream-colored buildings to use the bathroom or shower. Just down the road, we visited another apartment complex, located next to a “stinky stream,” that turns brownish-red during the tomato harvest. Resident Leonarda Soto told us that when her grandchildren come in contact with the water, they break out in rashes across their bodies.

In Lanare, an unincorporated community surrounded by dairies and chicken farms, we heard about the community’s ongoing struggle for clean drinking water. The community has a water treatment plant, to deal with the high levels of arsenic in the water, but residents can’t afford to operate it, resident Isabel Solorio told us.

With the Fresno Environmental Reporting Network, residents like Soto and Solorio can now report these problems and violations, and get a response from government officials. A task force of community members and government officials will meet monthly to follow up on the concerns and ensure the reports are addressed.

Tracey Brieger, co-director of Californians for Pesticide Reform, said this network represents a movement toward realistically quantifying cumulative health impacts in the Valley, or all the unhealthy elements to which residents are exposed.

“When a farmworker is exposed to pesticides, they’re not exposed to just one, they’re exposed to dozens – on top of smog, on top of water contamination, on top of particulate matter, so it’s not just one thing,” she said. “The way you think about these things, and the way you regulate all of this pollution, isn’t the way a community member in a real human body experiences it.”

The new network, she said, will empower community members to report health and environmental hazards to government agencies, and ensure their concerns are addressed. The model, she said, represents a new trend in government accountability and transparency, when it comes to health and the environment.

“I think this is going to be the cutting edge issue: How to get regulators and government agencies to start regulating in a way that represents communities’ lived experiences,” Brieger said.

“We’re far from that, but as with so many of these issues, it’s directly affected people who are taking the lead – it is community members, it is  farmworkers, it is all the people who experience it saying, ‘Hey, you need to look at this differently.’”

Environmental reporting, previously on Harvesting Health:

Nitrate Problems, by the Numbers

A new report, ordered by the state Legislature, examines the causes of nitrate groundwater contamination and identifies potential solutions to the widespread issue.

Below is the report – ‘Addressing Nitrate in California’s Drinking Water,’ prepared by UC Davis researchers – in numbers.

  • 254,00: People in California’s Tulare Lake Basin (the southern San Joaquín Valley) and Salinas Valley currently at risk of nitrate contamination of their drinking water
  • 96: The percentage of nitrate pollution connected to cropland. This occurs when nitrogen is applied to crops, but not removed by harvest, air emission, or runoff, and then leaches from the root zone to groundwater.
  • 57: The percentage of the current population in the study area that depend on a community public water system with untreated nitrate concentrations that have exceeded the maximum contaminant level for nitrate in drinking water between 2006 and 2010.
  • 80: The percentage of the population that could be affected by 2050, if nitrate groundwater concentration trends continue.
  • $20 to $36 million: The estimated cost, per year, for short- and long-term safe drinking water solutions for the two regions.

Learn more about Valley residents’ fight for clean drinking water:

Learn more about the study:

Report: Place, Zip Codes Matter

Consider these facts, from a new study out this week:

  • Life expectancy varies by as much as 21 years in the San Joaquín Valley depending on zip code. Zip codes with the lowest life expectancy tend to have a higher percentage of Latino and low-income residents.
  • Areas of the Valley with the highest levels of respiratory risk have the highest percentage of Latino residents, while areas with the lowest levels of respiratory risk have the lowest percentage of Latino residents.
  • The health status of first-generation Latino immigrants is similar to the white population, but on average health deteriorates for second and subsequent generations of Latinos, largely due to economic vulnerabilities, inadequate educational opportunities, and a lack of political power relative to whites.

These new statistics are highlighted in ‘Place Matters for Health in the San Joaquín Valley: Ensuring Opportunities for Good Health for All,’ a report prepared by the Joint Center for Political and Economic Studies, in conjunction with the Center of Human Needs at Virginia Commonwealth University.

The report underscores the strong correlation between income and educational attainment, and premature mortality. As the income level and educational attainment of an area decrease, premature mortality generally increases, according to the study.

This information is hardly surprising. You only need to spend time in some of the Valley’s poorest communities, talking to people about their health and environmental concerns, to know there is great inequity in our region.

What struck me about this report, though, is how it frames the Valley’s health disparities in a larger social context. The report describes how the Valely is bolstered by agribusiness; neighborhoods are shaped by waves of immigration and patterns of class and racial segregation; and the region has been the home of national movements for human rights.

The report concludes:

“In this context, this study adds to the growing and consistent literature showing how the region’s striking social class and racial/ethnic health inequalities are at least partly explained by historical forces and current policies that concentrate low-income people, people of color, and recent immigrants in urban neighborhoods and rural settlements that lack many of the most fundamental supports for health and well-being.”

Read the full report here.

More from Harvesting Health on health disparities in the Valley: 

Would ‘mission-focused medicine’ make an impact in the Valley?

Could San Joaquín Valley health clinics and hospitals lure more doctors to the region if they focused more on “mission-based medicine?”

I couldn’t help but wonder that when I heard a story today on NPR’s ‘Morning Edition’ about how one hospital in rural, southwest Kansas is recruiting doctors.

Facing a medical professional shortage that threatened to close down the tiny Ashland Health Clinic, the facility’s CEO developed an innovative pitch: Medical candidates who joined the clinic could take eight weeks off each year to do missionary work overseas.

This quote, from CEO Benjamin Anderson, explains why a mission-focused provider would be attracted to working in a rural region of the country:

“When you recruit a mission-focused provider, they want to see the ghettos,” he says. “They want to know that there’s no Spanish-speaking provider in more than a one-hour drive. They want to see houses that are falling down, widows that are uncared for. They want to know that there’s need and that by them coming there, they would fill a disparity that would otherwise not be filled. So we reversed it.”

So, would this work arrangement work in the Valley? The region has fewer primary-care physicians and specialists than are recommended by nationally recognized benchmarks, according to the California Health Care Foundation. Of Valley physicians, just 6 percent are Latino.

It could certainly help fill positions at individual clinics in the region. But I suspect that pipeline programs like the high school Doctors Academy, medical school programs – like the new UC Merced San Joaquín Valley Program in Medical Education - that train doctors to address the region’s unique medical needs, and the proposed medical school at UC Merced, will more effectively fill the critical doctor and specialist shortage in the region, over the long term.

What do you think? Listen to the Harvest Public Media story, and then chime in!

Above, Agustín Morales, a student in the UC Merced San Joaquín Valley PRIME program, rallies in support of health care. Below, Selma High School student Karen Vásquez shadows nurses. By Héctor Navejas and Daniel Cásarez.

Residents to EPA: “We’re simply telling you our reality”

On the second day of his two-day tour through the San Joaquín Valley, EPA regional administrator Jared Blumenfeld visited the east Tulare County communities of East Orosi and Seville.

Standing in the driveway of an East Orosi home, Blumenfeld listened to the personal stories of community residents like Berta Díaz, in pink, who has fought for more than a decade for clean drinking water.

“I have fought with mis compañeros for eleven years, and we have not seen any change in this very contaminated water,” Díaz said.

“We are not complaining, we’re simply telling you our reality,” said Jesus Quevedo, pictured at right, as he described the health struggles of family and friends who have been sickened by the poor water.

“I’ve been having to growing up not being able to drink my tap water, which I think is something that’s not really right,” said Jessica Mendoza, 16, pictured above, at left. “All I’m asking for is just a change, because it is not just for my generation, but generations that are yet to come.”

From there, Blumenfeld traveled to Stone Corral Elementary School, where he addressed residents, including Rebecca Quintana, pictured below.

“I really wanted him to visually see what really exists,” Quintana said after the short community forum. “There is a difference between hearing and seeing. I actually wanted him to see with his own eyes what communities and their infrastructure look like.”

Hearing about residents’ personal struggles to access clean drinking water, and seeing their determination to bring potable water to their communities, seemed to leave an impact on Blumenfeld, pictured below.

“You can read statistics,” he said. “But when you meet someone with a name and a face and a child and a house – it is definitely why we all do this job. Our job is to protect human health and the environment.”

That was the reaction María Herrera, of the Community Water Center, was hoping for.

“Anyone can read about the problem… but it is one thing to read it, and it is another thing to be able to come to the actual communities that are impacted by the issue and hear directly from residents,” she said. “That makes a huge difference.”

Read more about Blumenfeld’s tour:

All photos by Daniel Cásarez, Vida en el Valle.

‘The Forsaken Five Percent’

UPDATE: ‘Valley is lagging behind’ ran in the Oct. 26 edition of Vida.

Welcome to the San Joaquín Valley, which a recent report dubbed ‘The Forsaken Five Percent’ of California.

Here, a Latino resident lives an average of 81.2 years – about a year longer than the average Californian, but less than Latinos in other areas.

Here, 28.4 percent of adults have never completed high school, and just 16 percent have a bachelor’s degree.

Here, the median personal earnings for Latino adults is $18,000, more than $10,000 less than the state’s median personal earnings, of $30,000.

These facts – and many more – are available in ‘A Portrait of California,’ a report published in May by the American Human Development Project. (They are the authors of ‘The Measure of America,’ which found that the country’s 20th Congressional District – located here in Valley – ranked last among the country’s 435 districts in terms of well-being.)

The report takes 233 neighborhoods and counties in the state, and analyzes them by life expectancy, access to knowledge, and median personal earnings. It shows disparities throughout the state, but also within regions like the Valley.

To many residents, grassroots advocates, and reporters like me, this type of information, sadly, is no longer shocking. But it certainly underscores the need for continued collaboration, advocacy, and – in my case – reporting.

Read more about ‘A Portrait of California’ – and its implication for Valley Latinos – in next week’s edition of Vida.

Reforming health in the Valley

Thanks to the Affordable Care Act, federal funds have been funneled into San Joaquín Valley clinics and health organizations this summer.

In fact, it’s dizzying to keep track of the different grants that Valley agencies have received recently. Starting today, I’ll try to keep a running log here of these funds.

This week, the Fresno County Department of Public Health ($499,695 per year,) Stanislaus County Health Services Agency ($293,899,) and Sierra Health Foundation ($499,229,) which serves Sacramento County, all received Community Transformation Grants from the U.S. Department of Health and Human Services.

Also, the Oakland-based Public Health Institute received a Community Transformation Grant of almost $6 million to implement projects in the state’s 42 smaller counties, including Madera, Merced and Tulare counties.

The awards — made possible through the Affordable Care Act’s Prevention and Public Health Fund — will allow counties and agencies to work toward reducing chronic diseases in local communities by focusing on three priority areas: Tobacco-free living, active living and healthy eating, and evidence-based quality clinical services and other preventative services.

Earlier this month, a Merced organization was one of 129 organizations nationwide, and 14 organizations in California, to receive grants from the U.S. Department of Health and Human Services to become future health centers.

Horizons Unlimited, from Merced, received an $80,000 Health Center Planning Grant Award to support community-based groups seeking to provide a more comprehensive range of primary health care services or expand their services to the larger community.

In August: A number of San Joaquín Valley community health clinics earned grants from the U.S. Department of Health and Human Services to establish new health delivery sites.

Of the 67 community health centers across the county that received $28.8 million through the Health Centers New Access Points grants, four were from the Valley: Family HealthCare Network in Visalia ($333,342,) Livingston Medical Group, Inc. in Livingston ($316,562,) United Health Centers of the San Joaquin Valley in Parlier ($817,714,) and Valley Health Team, Inc. in San Joaquín ($503,930.)

Will these funds help to reduce health disparities in the San Joaquín Valley, and improve access to medical care? We’ll have to wait and see.

‘The Youngest Parents’ series

For the past six weeks, between Mother’s Day and Father’s Day, Vida en el Valle has run a multiple-part series called ‘The Youngest Parents’ about teen pregnancy. In case you missed any of the stories, they are listed below.

Profiles of teen moms:


Have you been following this series? What do you think could be done to lower the teen pregnancy rate among Latinas in the Valley? Do you have a teen pregnancy experience you would like to share?

 Top two photos by Daniel Cásarez. 

Petition: Do you want to know how polluted the air is near roadways?

Many of us in the San Joaquín Valley travel down Highway 99, State Route 41, or Interstate 5 on a regular basis, whizzing past agricultural land and small communities.

Have you ever paused to think what chemicals your car, and those of the other drivers on the road, are spewing into the air, and onto these roadway communities?

Catherine Garoupa White, director of the Central Valley Air Quality (CVAQ) Coalition, knows that living by a roadway can be damaging to your health. Garoupa White grew up in Madera, “within eyesight” of Highway 99, and now suffers from chronic bronchitis.

But while she knows from her own experiences that living near a busy roadway can be dangerous, Garoupa White discovered there is little long-term, scientific data to prove what types of particulate matter, and at what quantity, are impacting communities within 500 to 1,000 feet of a major roadway. (Current PM 2.5 air monitoring sites are located farther away from roadways.)

In response, Garoupa White, as part of her work with UCSF’s “Reach the Decision Makers” program, is asking the US EPA to place monitors near roadways, as part of the EPA’s revision of the National Ambient Air Quality Standard for PM 2.5. The monitors would collect critical data about the cumulative health effects of PM 2.5 on communities that live, work and play near roadways.

Under Garoupa White’s proposal, the PM 2.5 monitors would be erected along roadways throughout the United State. But the monitors would be especially effective in the San Joaquín Valley, where cities including Bakersfield, Fresno-Madera, Sacramento, Visalia-Porterville, Modesto and Hanford are ranked among the most polluted cities by 24-hour PM 2.5 in the country, according to the American Lung Association.

Particulate matter (PM) 2.5 – a combination of tiny specks of soot, dust and aerosols in the air – has been linked to coughing and difficulty breathing, and can cause irregular heartbeat, heart attacks and even premature death in people with heart of lung disease, according to the American Lung Association.

The monitors would also serve as an advocacy tool for lower-income communities of color, which tend to be located along roadways, Garoupa White said.

“It’s not just that people near roadways are being disproportionally impacted, it’s that are most vulnerable populations tend to be the ones are the ones that are living along the roadways,” she said. “Not only are they dealing with higher levels of pollution, they also have less health care access, and all the other issues that go along with that.”

Do you support the campaign to establish near-roadway monitors for PM 2.5 in the San Joaquín Valley, and roadside communities across the country? If so, you can participate in this petition.

Read more about the need for roadway monitors for PM 2.5 in an upcoming edition of Vida en el Valle.

Living with Diabetes

In recognition of American Diabetes Month, I’m working on a story about diabetes among Latinos in the San Joaquín Valley.

The story, which will run in the Nov. 24 edition of Vida en el Valle, will focus on the individual experiences of a few Latinos in the San Joaquín Valley who are living with diabetes. (UPDATE: Read the full story here.)

In the San Joaquín Valley, 11.3 percent of Latinos have been diagnosed with diabetes. Across California, more than 2 million adults have been diagnosed with diabetes, according to the UCLA Center for Health Policy Research report, “Obesity and Diabetes: Two Growing Epidemics in California.”

For now, I’d like to introduce you to a few of the people who are featured in the story.

Jesús Sánchez
: 29
Time with diabetes: 3 months
Birth place/Current home: Oaxaca, México/Madera, CA
Advice for people recently diagnosed with Type 2 diabetes: “Don’t lose heart. Do your best: pay attention to your doctor, eat healthier food, and follow the diet.”

Esperanza Aguillón
: 60
Time with diabetes: 14 years
Birth place/Current home: Mexicali, México/Porterville, CA
Advice: “You have to accept that you have this disease and you have to take care of yourself. If it’s not for you, it should be for your loved ones.
“You have to make the sacrifice. At first it is difficult, it is very difficult to become accustomed to another way of eating, but it’s worth it to take care of yourself and feel better.”

Azucena Durán
Age: 25
Time with gestational diabetes: 1.5 months
Birth place/current home: Jalisco, México/Stockton, CA
Advice for women with gestational diabetes: “It’s really all going to be worth it in the end – the dieting, the insulin. As much as it’s stressful and tedious, it really will all be worth it in the end.
“Yeah, I really want that piece of cheesecake, but then it’s not good for your baby, and ultimately your goal is to have a healthy baby. It’s all worth it in the end.”

Age: 13
Time with type 1 diabetes: 4 years
Current home: Selma, CA
Advice for kids diagnosed with type 1 diabetes: “At first it starts off bad – you don’t know what is happening. But once you start learning about it, you start to understand that it’s not your fault, it just happens. And things are going to change, but you will start getting used to it, and pretty much your life is going to go back to how it was, and diabetes is going to be another part of you, like your personality. You’re going to be a normal person like you were before, just having to do things a little differently.”

For more information about Latinos and diabetes, check out these sites: