Droplets, smoke, and tear gas: 2020’s public health crises find cities unprepared
This is Shutdown Corners, a newsletter about how coronavirus is reshaping urbanism
My own photo of the LA sunshine on Friday
I’m writing to you from Los Angeles, one of the millions of parents on the West Coast still worrying about letting their children outside due to forest fires and clouds of horrendous smoke and ash. We still have roughly four months left in 2020—wildfire season is just getting started—and the year, true to form, isn’t going quietly.
A few days spent repeatedly checking air-quality ratings while cooped up indoors provides time to reflect. I can’t help but consider how our leaders have been reacting to these crises. Let’s give mayors and local legislators a pass for the moment—and only for the moment—on the long-term issues, and focus strictly on how they’re handling public health right now, an immediate crisis that will become exponentially worse without swift action.
For the most part, they don’t have a lot of credibility. Before 2020, city and state leaders failed, repeatedly, to take public health seriously. The system was already stretched thin and underfunded well before Covid-19: the Trust for America’s Health found that in 2017, the United States spent 2.5% of its entire health care budget, just $274 per person, on public health. That may sound like a lot, but between 2010 and 2019, the Center for Disease Control’s budget fell 10%, even accounting for the massive (and ultimately, insufficient) influx of funding for the opioid epidemic. At least 38,000 state and local public health jobs have disappeared since the 2008 recession, per an AP and Kaiser Health News analysis, and some public health workers are paid so little they qualify for public aid. To add to the fragility of our healthcare system, new Census data coming out today shows there’s also been a slight uptick in the number of uninsured Americans since 2016, reflecting years of Trump administration actions to weaken the ACA.
We were unprepared and underfunded before the year’s cascade of crises, despite the fact that public health pays off. It’s an incredible long-term investment, with an estimated ROI of 14-to-1. If you were an investor who passed up the chance to spend $1 and make $14, I imagine you’d be fired on the spot.
Local leaders also have plenty of reasons to act swiftly. We’re facing an almost unprecedented collection of health crises in addition to the pandemic, including the mental health crisis caused by lockdowns and social isolation, the stress of a season of protests, the challenges of parenting, and the displacement and despair of wildfire destruction and eco-anxiety, all which will disproportionately impact BIPOC communities. This moment will place “unprecedented pressures on health programs, especially Medicaid, at the very time these programs are needed more than ever,” and will slowly fester and bog down any recovery unless they’re taken seriously, immediately.
While there have been examples of admirable action when it comes to leadership during the lockdown era, how have we seen cities react recently? Let’s take Los Angeles and its reaction to the cloud of smoke that hung over the region this past weekend. City council members were slow to respond, not prepared with safe breathing shelters, and when they finally took action on Sunday after publicly being shamed, the response was minuscule, just four shelters for a massive region in the midst of a pandemic (a public campaign to create mutual aid sites, using the hashtag #coveringforeric, in reference to Mayor Eric Garcetti, opened the same numbers of sites themselves on Sunday). Is this not a region with annual wildfires; how could the city be caught so unprepared? San Francisco and Portland were much quicker to act. This summer, New York City sent out thousands of air conditioning units to help cool renters during the summer. LA can’t send out air purifiers? (Don’t let NYC off the hook, they’re struggling to house homeless families).
While mayors can’t stop forest fires, or change how the nation fights pandemics, they have the power to support and enact policy that can quickly improve the health and wellness of their constituents. So what can be done on a city level? Let’s start with transportation and city streets; this is the battleground where fights about air pollution, job access, pedestrian safety, and carbon emissions are fought, and where city leaders are often found lacking.
A new report released this morning by the American Lung Association, The Road to Clean Air, found that switching to electric vehicles offers broad benefits, especially in communities of color that have long paid the price of our addiction to fossil fuels. Switching to EVs, in effect cutting air pollution from cars, would provide $72 billion in health benefits by 2050, avoiding approximately 6,300 premature deaths, preventing more than 93,000 asthma attacks, and avoiding 416,000 lost workdays per year. That’s in addition to an estimated $113 billion in savings from avoiding future climate damage. Many cities have made congestion charges, low-emissions zones, and investment in charging infrastructure a reality; again, would you let an investor keep their jobs if they passed up this kind of long-term financial benefit?
Sure, give mayors a brief round of applause for new plans for al fresco dining, or committing to new bike lanes, Vision Zero plans, and exploring electrification. But in the wake of a wildfire haze literally choking the entire west coast, the bar has been raised for what should be considered responsible action and governance. We’ve known the danger of auto emissions, air pollution, and poor transportation planning for decades; for just as long, many communities of color have suffered unjust impacts. The solutions aren’t hypothetical technology, or theoretical ideas: funding transit and bus rapid transit, transitioning to electric vehicles, and making streets more walkable and pedestrian friendly are all within reach today (and in response to COVID, we’ve seen cities cut through the customary red tape and take action immediately). My former colleague Alissa Walker constantly criticized the cadre of so-called Climate Mayors for backing highway expansion despite proclaiming their green bona fides. They look even more ridiculous today when they refuse to take drastic action and make bold plans to clean our air when the skies turn orange and suns burn red in the hazy skies.
When there’s a crisis that needs to be addressed, it’s time to look at city budgets as statements of civic value. Many of the same arguments advanced by activists who want to defund the police—we’re continuing to throw most of our money at an entrenched system that has serious, and fatal, consequences, even though we know other answers and solutions improve public safety at less cost, with less side effects—can be applied to so many other aspects of municipal governance. For instance, roughly “two-thirds of Americans live in counties that spend more than twice as much on policing as they spend on non-hospital health care, which includes public health,” per AP/KHN.
This year has been a non-stop argument to reverse that disparity, and yet, with many fiscal years starting July 1 and cities and states facing budget shortfalls, there’s already been a small wave of layoffs and furloughs in public health departments that’s expected to grow. Where’s the bold action, the insightful vision, the rallying of public support around long overdue steps to clean our air and improve our health?
It’s dispiriting and downright dangerous to find that, after a multilevel failure of government to protect us, we may be headed towards a scenario where we repeat the same mistakes that landed us here in the first place.
Reading List
As a counterbalance to my upbeat writing above, America’s Pledge, the organization tasked with measuring U.S. climate progress absent federal leadership, has found in its latest report, released today, that the U.S. can still be on track to significantly cut emissions, especially with significant federal re-engagement in 2021. The time for half measures and toothless pledges is over.
Excellent, nerdy look at why digital photography wasn’t made with the climate apocalypse in mind
Some pictures of the housing market in 2020: this is a disturbing look at an abandoned motel in Orlando that makes me think a lot about The Florida Project; this piece on Zoom Towns (thanks, I hate the term, too) brings to mind a continuing failure in coverage of rural housing markets, namely, that new high-income residents pushes up housing costs for workers and pushes precarious renters and workers even further from jobs (see U.S. ski towns).
Is it a good time for community land trusts? It’s always a good time for community land trusts.
Ban or not, evictions are still taking place amid a pandemic
Finally, this graphic blew my mind when I saw it over the weekend:
Thanks for checking out Shutdown Corners, a newsletter written by me, Patrick Sisson, a freelance writer in Los Angeles covering the trends, tech, and policy shaping our cities. Please consider referring to a friend, and if you were sent this, please subscribe yourself. Send any tips, feedback, suggestions, or questions to patsisson@gmail.com.