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Subscribe to PrintBy Barbara Anderson / The Fresno Bee
Lisa Mitchell thinks about leaving Fresno every time her children cough and wheeze on smoggy days. [See an audio slideshow of the Mitchell family]Four years ago, Mitchell, 35, a single mother of four, thought a move to Fresno from pricey San Francisco made sense. Her parents had moved here and bought two houses. They offered to let her live in one if she paid the mortgage.Two of her children -- 4-year-old twins Malik and Monet -- had asthma. But Mitchell said she didn't know about Fresno's unhealthy air before the move: "In hindsight, if I had known about the air quality in the Valley, I would not have moved here."And now she can't afford to leave.Many working-class people face the same dilemma: They can't escape, even if they -- or their children -- face health threats from bad air.Low-income workers are more likely to live in polluted areas near freeways, industry or dairies, said Carolina Simunovic of the nonprofit Fresno Metro Ministry."These are the people who buffer the pollution for others," she said. "And they are the ones who are the most vulnerable."Mitchell said her children's health deteriorated almost immediately after the move in October 2003.The twins were born with asthma, but medications controlled the disease. They were only hospitalized once while living in San Francisco, Mitchell said.But within days of moving to Fresno, Malik had a severe asthma attack and had to be rushed to the hospital. He has had several major attacks since, Mitchell said. Daughter Monet suffers from asthma more now than before the move.Another son, 18-month-old McKinley, born after the move to Fresno, struggles the most with the chronic lung disease. He's been in the hospital more than 10 times.Only Mitchell's eldest son, Donald Willis, 16, has escaped breathing problems.Mitchell, herself an asthmatic, finds it harder to breathe since the move. She was only occasionally ill in San Francisco, but she has been in intensive care twice in Fresno."Every doctor I've seen said, 'You need to get yourself and your kids out of the Valley,' " she said.Mitchell has considered moving -- back to San Francisco or possibly to Oakhurst, which is above the smog -- but she can't afford it. Her job drawing blood at a laboratory for Kaiser Permanente provides a steady income -- and health insurance the family needs.Dr. John D. Gasman, a Kaiser pulmonologist, said he sees patients like Mitchell who should move but remain because of family, jobs or a lack of money.Mitchell hasn't given up on the idea of moving. For now, she and her children take frequent weekend trips to visit relatives in San Francisco. They all breathe easier after a few days there.Soot and smoke -- fall and winter pollutants in the Valley -- are the toughest on her children's lungs, Mitchell said.McKinley was sick most of October and November. Doctors admitted him to the hospital twice within one week in October.The hospital bill for the toddler's one-night stay on Oct. 10: $6,594.66. Insurance paid for all but a small co-payment, Mitchell said.But she exhausted her sick leave earlier this year. "So I go with no pay when we're out sick."Daily breathing treatments are part of the routine to keep the children healthy.Monet is as comfortable assisting her mother give an asthma treatment as most preschoolers are with helping put away toys. On one recent morning, she popped the cap off a small vial of lung medicine and handed it to her mother, who poured it into a machine that vaporizes the liquid. She gave her younger brother a reassuring pat on the arm as he inhaled the fine mist.Those breathing treatments are "just a daily thing -- part of living for us," Mitchell said. "It's kind of like brushing teeth -- you just get into a routine and you do it."Parents who cannot afford to leave the Valley have little choice but to give children breathing treatments to try and keep them healthy, Simunovic said."But it makes for an unhealthy community, and for people who are frustrated and sad."