Air Pollution and Health Care Utilization

Did the Goods Movement Plan in California improve air quality and health outcomes?

California has the world’s eighth-largest economy and is home to one of eight Americans. The state also has four major ports, with three of them among the top five in the United States. The adjacent Los Angeles and Long Beach ports are the two busiest container ports in the United States and the fifth busiest in the world, moving more than $260 billion in goods each year. Moving these goods to and from the ports to their ultimate destinations across the United States and the world involves diesel-powered vehicles and equipment at each step of transport. Goods movement thus creates high air pollution exposures and worsens health in nearby communities, especially for those living in the goods movement corridors.

In 2006, the California Air Resources Board (CARB) and local air quality management districts implemented an Emission Reduction Plan for Ports and Goods Movement program comprising approximately 200 actions with an estimated investment of $6 to $10 billion. These actions targeted the major sources and polluters related to Goods Movement, such as highways, ports, railyard trucks, ship fuel, shore power, cargo equipment, and locomotives.

The UCLA Center for Health Policy Research was awarded a $1 million grant by the Health Effects Institute (HEI) to examine the impact of the goods movement policy actions on reductions in ambient air pollution and subsequent improvements in health outcomes of Medi-Cal fee-for-service beneficiaries with chronic conditions in 10 counties in California that contained dense urban areas and three major ports.  

The research team, led by Ying-Ying Meng, DrPH, director of research and co-director of the Chronic Disease Program at the UCLA Center for Health Policy Research, also assessed whether there were greater decreases in emergency room visits and hospitalizations for enrollees with chronic conditions who lived in the goods movement corridors than for those who lived in other areas.

Studying an existing cohort of 23,000 adult Medi-Cal beneficiaries (California’s Medicaid health care program for low-income individuals) with at least one of the following chronic conditions: asthma, chronic obstructive pulmonary disease (COPD), diabetes, and heart disease, researchers found that there were statistically significant reductions in NO2 and PM2.5 concentrations across all 10 counties in the post-policy period.

Results from this study released in 2021 showed that actions to reduce emissions related to the goods movement may be effective in improving local air quality levels and health care use among lower-income, disadvantaged, and underserved communities.