The health inequities appear most acute for asthma. California Department of Public Health statistics show that residents of all ages in Richmond are 1.5 times more likely than those in the rest of the county to go to hospital emergency departments for asthma attacks. Again, African Americans are especially hard-hit, with asthma emergency visits and admissions about four times that of other racial groups in the county.
The same pattern holds true nationally. Blacks are much more likely to die of heart disease and stroke than their white counterparts, and black children are more likely to have asthma. The reasons include diet, stress, access to medical care and other factors. The role of environmental pollutants is unclear, but many health experts say they do contribute.
Around the country, numerous health studies, including a decade-long study by the South Coast Air Quality Management District in the Los Angeles basin, have shown that people near major roadways and ports suffer more severe health problems than people elsewhere. Children have a greater risk of impaired lung function, and babies are more likely to be born prematurely or with lower weights. Near major transportation routes, the risk of cancer is higher due to diesel exhaust and other air contaminants. Around the world, fine particles generated by vehicles and industry have been linked to increased deaths from heart attacks and lung diseases.
Richmond’s estimated cancer risk is higher than nearby cities, based on a combination of pollution exposures and demographic factors, according to a 2007 University of California, Santa Cruz report on environmental justice in the Bay Area.
Eric Stevenson, director of technical services at the Bay Area Air Quality Management District, said his agency is often asked how it can let people live next door to a refinery. "The question is," he said, "what is the impact and what is the danger of the impact?"
Health effects near industries in Richmond have not been well studied. It can be difficult for epidemiologists to prove a connection between exposures and diseases because of confounding factors, such as smoking and diet, and how frequently people move around.
Some people living near Richmond’s industrial backbone complain of problems like headaches, breathing difficulties and fatigue. Others see high rates of autoimmune disorders, such as psoriasis, among their family and friends.
"I'm the only one in my family who doesn't have asthma," said Johnny White, 58, whose family settled in North Richmond in the 1930s. "Out of my bedroom window, I could see Chevron flaring and fire coming out of the stacks. My mother and grandmother would go around and shut all the windows. We'd have to take my niece, Tracy, to the hospital and get her on a breathing machine.
"As kids, we used to play basketball in Shields-Reid Park, a few blocks from the refinery,” he said “We'd actually know what hour they would start flaring. Your nose would start running. We'd say let's take a break and go inside."
Outdoors, indoors, everywhere
But what starts outdoors doesn’t stay there. It moves inside people’s homes, too.
A team of scientists came to Richmond in 2006 to conduct a new kind of study, one that would try to answer residents' questions of which outdoor pollutants were coming indoors. At 40 homes in Richmond and 10 in nearby Bolinas, which has no heavy industry, equipment monitored pollution levels outdoors and indoors.
The results were striking. The outdoor levels around Richmond homes were almost double the levels around Bolinas homes, and the chemicals moved indoors. Vanadium and nickel in outdoors air were among the highest in the state.
"In Richmond, we see high correlations indoors and outdoors for pollutants that come predominantly from industrial sources," such as sulfates and vanadium, said Rachel Morello-Frosch, an associate professor in the UC Berkeley School of Public Health and an author of the study.