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Subscribe to PrintBy Barbara Anderson / The Fresno Bee
The price tag for cleaning the air runs into the billions.But there's another expense that's harder to calculate -- the cost of not cleaning the air. Experts say Valley residents pay for dirty air in the loss of "human capital" -- skilled workers the region needs to prosper.Some of the Valley's most valuable employees, fed up with waiting for better air, are leaving. Among them are doctors, dentists, nurses and other educated workers who are already in short supply.Smog also hurts the Valley's reputation and discourages skilled workers from taking jobs here.A lack of educated workers, in turn, hurts Valley businesses and causes others to look elsewhere for office and plant locations."What you're losing are people who have resources and talent that we need to help grow the economy," said John Quiring, owner of CMQ Associates, a Fresno company that specializes in economic development planning.Among those who have left is Dr. Brian Shaw. And smog was a big factor in his decision to close his Fresno pediatric orthopedic practice after 13 years and move to Colorado in 2004.Shaw said he had developed asthma in Fresno and "it just got progressively worse." His four children also had breathing problems.The family now lives in Colorado Springs, where the air is clean year-round, Shaw said: "You can see 80 to 100 miles most days. We live at 6,800 feet. The air is a little thin -- but it's clear."No one tracks how many people flee the Valley for cleaner air. But from 1995 to 2000, according to the Public Policy Institute of California, the region from Madera to Bakersfield had a net loss of 3,000 college graduates while gaining 13,000 adults without high school diplomas. The Valley can ill afford to lose educated workers. Only 12% of adults here have bachelor's degrees, compared to 24% statewide.The most prosperous cities boast large skilled-labor pools, said Perry Wong of the Milken Institute, a Santa Monica think tank. Nationwide, professionals are 13% to 14% of the labor force. In the Valley, they are 9% to 10%, he said.Higher-paid professionals contribute to the economy not only with their skills, but through their spending. They buy large homes and expensive goods and services. Their sales and property taxes support schools and public safety.Economists say the Valley should be appealing: It's an affordable place to live. And a population of nearly 4 million is big enough to sustain a skilled work force.But it takes more to draw and keep educated workers. The Valley has to be an attractive place to live -- and smog is not a selling point."Air quality is part of a package of what communities have to offer to attract professional and other highly skilled workers," said Stephen Levy, director of the independent Center for Continuing Study of the California Economy in Palo Alto."Things like adequate housing and good schools and air quality become important, because people -- not just businesses -- have a choice of where they live and work," Levy said.Many business leaders in the Valley know that bad air is a problem."There is no doubt among the business community that air quality is an issue" in luring and keeping knowledge workers, said Pete Weber, co-chairman of the Regional Jobs Initiative, a public-private partnership aimed at expanding and diversifying the Valley's jobs base.Nowhere is the skilled-worker shortage more apparent than in the Valley's medical community, which has struggled for years to recruit professionals. The Valley has the lowest doctor-to-patient ratio of any area in the state.Seeing a specialist often means waiting weeks or leaving the area. Hospitals and medical groups are forced to create new incentives to lure doctors and nurses.Air quality "is a black eye" for the Valley, said Matthew Craven, manager of recruitment at Saint Agnes Medical Center in Fresno.At recruiting conferences, Craven said people tell him they would never move to the Valley because of what they've heard about the air.It is the No. 1 reason specialists refuse offers to join lucrative Valley medical practices, said Fresno cardiologist John Telles, who interviews potential doctors for a large cardiology office.Doctors interested in practicing medicine in California are attracted to the Valley by the low cost of housing and the Sierra. Medical groups also offer doctors a lot of money to move here, Telles said.But air quality becomes a sticking point. Doctors and nurses know the risks, such as heart and lung illnesses, that come with polluted air.Highly trained specialists are in short supply nationwide. They can pick anywhere in the country to practice medicine, said Dr. Jim Davis, chief of trauma at Community Regional Medical Center in downtown Fresno."If the money is relatively equivalent, then you get to lifestyle issues -- health, family," said Davis, who helps recruit surgeons for the teaching staff at the UC San Francisco-Fresno Medical Education program.Davis has seen a change over the years in the priority doctors place on air quality. Surgeons he interviewed in the 1990s asked a lot of questions about crime in Fresno. They now ask about air quality first.One doctor who fled the Valley's poor air quality said the slow pace of change drives people out.Dr. Fred Williams said he might have considered remaining in Fresno at his neurosurgery office. But he didn't have confidence that those charged with cleaning the air would be able to reduce the smog and soot that affected wife Nessie Williams' lungs."My wife was just becoming more and more unhealthy," Williams said. "Whenever we would travel away from Fresno, her breathing would improve and when we came back, her breathing would deteriorate."The couple left Fresno three years ago for cleaner air in Hillsboro, Ore., a city west of Portland, where there are only a handful of bad-air days each year. Since the move, Nessie's asthma symptoms have eased.Said Williams, 53, of the decision to leave Fresno: "I had to make a move -- I didn't have a choice."The departure of one doctor might not sound like much, but his decision to leave Fresno compounded a problem.More brain surgeons have closed offices and moved or retired in the past few years than have come to the Valley, said Dr. John Bonner, a neurosurgeon who closed his practice in 2003 after a 31-year career in Fresno.Replacing a professional in a highly competitive field such as neurosurgery is neither easy nor cheap.Recruiting, interviewing and hiring a new employee -- not to mention paying substitutes to fill in until a person is hired -- can cost up to three times a replaced professional's salary, said John Sullivan, a professor of management at San Francisco State University."When you lose health-care professionals in any city, it's millions of dollars," he said.And one decision to leave has a ripple effect, said Sullivan. Colleagues also begin thinking about a move. "If a top person leaves, five to 10 people follow them."Air quality officials say they recognize there are economic consequences from air pollution chasing professionals away. They cite the problem when asking for federal and state money to help clean the air."Now the health consequences and the economic consequences of air pollution have been given equal consideration" when considering clean-air regulations, said Seyed Sadredin, executive director of the San Joaquin Valley Air Pollution Control District.But those who flee the Valley for cleaner air say that concession may be too little and too late.Fresno dentist Bob Claypool, 52, sold his dental practice in 2005 and moved to San Diego for healthier air.Claypool said he spent a decade relying on two asthma medications, antihistamines and steroids to try and keep his lungs open. For the past year in San Diego, he hasn't needed them.He gets sick when he returns to the Valley for any length of time.Claypool had expected to keep filling cavities at his Fresno office for another decade or longer. "I loved my patients," he said. But he hated being ill."I was getting sicker and sicker," Claypool said. "I knew if I didn't make a change, I was probably going to end up in the hospital -- or dead."