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Asthma: Has State Stalled in Regulating Breath-Robbing Big Rigs? – Part 2

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Austin Carter, 13, learns how to properly use an inhaler during his visit at the Breathmobile clinic in Oakland in May. Photo by Heidi de Marco/California Healthline.

By Ngoc Nguyen, Kaiser Health News,

California has cleaned up its diesel fleet significantly in recent years by phasing out older trucks and requiring operators to install the latest pollution-control equipment.

But local air district officials and environmental advocates say more needs to be done and that the emissions goal should be close to zero.

Efforts to get there are stalled, they say, in part because of a provision in the $52 billion road improvement law signed in April by Gov. Jerry Brown. That provision exempts most diesel trucks on the road from future emissions reduction requirements for many years.

Critics say the governor agreed to the last-minute exemption to gain the trucking industry’s support for higher diesel and gas taxes that, along with vehicle fees, are expected to raise $5.2 billion annually over 10 years to repair roads and bridges and to expand public transit.

Bill Magavern, policy director for the Sacramento-based Coalition for Clean Air, said improving infrastructure is laudable but should not come at the cost of clean air.

“There’s a lot to like in that bill, and we hated to oppose it,” but there was a “dirty deal” thrown in at the last minute, Magavern said.

Gov. Brown’s office referred questions on the truckers’ amendment to the ARB, the state’s clean-air agency.

The ARB said it can provide incentives to further reduce emissions without imposing additional requirements. And the new law, it said, will strengthen enforcement of existing rules.

Under the law, “truck operators can be denied [Department of Motor Vehicles] registration if they’re not meeting the current rules,” board spokesman David Clegern said. “Diesel pollution will be reduced by bringing 300,000 more trucks into compliance.”

Local air managers in Southern California say greater enforcement of current rules is important, but it won’t sufficiently accelerate turnover of the truck fleet. And that’s crucial to helping Southern California meet federal clean-air standards, said Philip Fine, deputy executive officer of planning and rule development at the South Coast Air Quality Management District.

The problem for local air districts and ports is that when it comes to directly regulating mobile sources of pollution like diesel trucks, the state is the boss. It approves local district plans, and the local districts more or less oversee the ports. So the most effective way to reduce trucker emissions is to set stringent policy at the state level, as California has aggressively done in the

But truckers say the state has imposed enough requirements. Chris Shimoda, vice president of government affairs for the California Trucking Association, said diesel emissions from trucks in California ports have fallen dramatically in recent years.

“This is attributable to the current $1 billion annually being invested by truckers in the cleanest available technology throughout the state,” Shimoda said.

People living near ports like the one in Oakland have benefited from the state’s efforts to clean up the truck fleet — by phasing out older models and requiring operators to install the latest pollution-control equipment. (Heidi de Marco/KHN)

He also said that being exempted from any future state emissions-reduction requirements reassures the trucking industry that it will recoup the investment it is making in new engines to meet current state standards.

Under existing state rules, owners of heavy-duty trucks must have 2010 or newer-model engines by 2023.

Those rules have dramatically improved air quality. A study by the Bay Area Air Quality Management District, among others, found that from 2009 to 2013 emissions of black carbon from trucks at the Port of Oakland dropped by 76 percent and nitrogen oxides by 53 percent.

Still, ports throughout the state rely mostly on diesel to power vessels, yard equipment, trains and trucks. Ports in Southern California remain the single-largest fixed source of smog-forming pollution in the region. And the Port of Oakland is the largest fixed emitter of diesel pollution in the Bay Area, local air managers say.

That’s why local districts were alarmed by the governor’s concession to the trucking industry, said Tom Addison, legislative and policy adviser for the Bay Area air district.

It “gives the trucking industry a get-out-of-jail-free card,” said David Pettit, senior attorney with the Natural Resources Defense Council. “It bars any kind of state regulations that might require truckers to move to a different kind of truck — natural gas-powered, electric or hydrogen fuels — when those become available in the market.”

Last month, the mayors of Los Angeles and Long Beach set ambitious goals for the ports to transition to zero-emission truck and yard equipment over the next 20 years.

But the new state law calls into question whether those plans — and others in coming years — will be enforceable.

If the ports in Southern California announced that in five years they’re going to have an all zero-emissions fleet, Pettit said, “they’d be sued [by the trucking association] in a heartbeat.”

Kaiser Health News, khn.org, is a nonprofit health newsroom.

 

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Activism

Diabetes in Black California: Turning the Tide from Crisis to Control

According to the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System data, nearly 17.9% of Black adults in California have been diagnosed with diabetes — above the national Black adult average of 16.8%, and nearly five points higher than California’s overall adult rate of 12.6% across all races. California ranks 24th out of 39 states with available data for Black adult diabetes rates.

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Dr. Khadijah Lang is a family physician with a clinic in Los Angeles who specializes in several family medical practices, including prenatal care. Lang believes in family medicine. She says it is important to treat all members of a family. Thursday, June 5, 2026. Photo by Solomon O. Smith/California Black Media.
Dr. Khadijah Lang is a family physician with a clinic in Los Angeles who specializes in several family medical practices, including prenatal care. Lang believes in family medicine. She says it is important to treat all members of a family. Thursday, June 5, 2026. Photo by Solomon O. Smith/California Black Media.

By Charlene Muhammad, California Black Media

Crystal Lambert knew something was terribly wrong with her three-year-old granddaughter as she sped down the street trying to get her to the hospital.

“I thought she got a hold of some poison,” Lambert recalled.

Doctors found Lambert’s granddaughter had a blood sugar level over 800, diagnosing her with Diabetic Ketoacidosis(DKA), a state in which the body, starved of insulin, begins to shut down.

Lambert said she was born with a pancreas that was not fully functioning — it lacked the specialized cells required to produce insulin.

Her granddaughter survived and is five years old today.  Now, she gives herself insulin shots, asks endless questions about her condition, and runs like the spirited child she is. But the terror of that night transformed Lambert — and ultimately inspired her to launch the We Fight Back Organization, a mobile health and food access initiative serving underserved communities across California. Lambert is the executive director.

The Crisis by the Numbers

According to the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System data, nearly 17.9% of Black adults in California have been diagnosed with diabetes — above the national Black adult average of 16.8%, and nearly five points higher than California’s overall adult rate of 12.6% across all races. California ranks 24th out of 39 states with available data for Black adult diabetes rates.

Nationally, according to the U.S. Department of Health and Human Services, Black Americans were 24% more likely than the overall U.S. population to have diabetes in 2024. They also died from diabetes 78% more often than the general population in 2022. Black Americans are also more than twice as likely as the overall population to develop kidney failure caused by diabetes.

According to the California Health Care Foundation’s 2024 Health Disparities Almanac, Black Californians have the shortest life expectancy in the state at just 74.6 years — due in part to chronic conditions like diabetes and its devastating complications.

Leon Rock, co-founder of the African American Diabetes Association, believes statistics, though revealing, only tell part of the story.

“There are a whole bunch of Black folks that don’t tell you that they have diabetes — or don’t know,” he said.

And the disease itself, Rock is careful to note, is not what kills. “They die from the complications. That’s heart attack, that’s stroke, that’s amputations of legs, of feet. Going blind. All those complications are inherent in a system that has impacted Black folks with diabetes in California and across America.”

Crystal Lambert, creator and executive director of We Fight Back. She started the organization out of a need to learn more about diabetes on behalf of her granddaughter. Now she is looking to spread the impact of her organization to the valley. Friday, June 6, 2026. Photo by Solomon O. Smith/California Black Media.

Crystal Lambert, creator and executive director of the We Fight Back Organization, started out of a need to learn more about diabetes on behalf of her granddaughter. Now she is looking to spread her organization to the valley, on Friday, June 6, 2026 Photo by Solomon O. Smith/ California Black Media

An Information Gap Fuels the Crisis

For Rock, part of the solution is diagnosis. He says the medical and public health systems are failing Black Californians by the absence of information designed for them.

“That is the bottom line. We need good information. Information that is culturally specific,” said Rock.

Telling people to eat healthy or exercise, he added, falls short when culturally specific alternatives are not provided, and when many residents of urban communities do not feel safe exercising in some neighborhoods – or outside at night.

Dr. Khadijah Lang, a family medicine physician and president of the Golden State Medical Association, agrees that the roots of the crisis run deeper than individual behavior — and blaming patients misses the point.

“We are not genetically predisposed to diabetes,” Lang said. “But the system under which we live increases the likelihood that we will develop it.” 

What the Body Needs — What Communities Are Denied

Type 2 diabetes, which accounts for 90 to 95% of all diabetes cases, according to the CDC, develops when the body can no longer use insulin effectively to regulate blood sugar. Left unmanaged, it damages nerves, kidneys, eyes, and the cardiovascular system. The hemoglobin A1C test is a blood draw that reveals how the body has processed sugar over the previous three months — not just at the moment of the test. It is the standard tool for both diagnosis and ongoing monitoring.

That distinction matters, Lang emphasized, because patients cannot manipulate three months of blood sugar history the way they might fast for a day before a single blood draw.

“The pill is not meant to undo or control a sugar level that’s being constantly stressed,” Lang said. “It’s meant to work in conjunction with a low-carbohydrate diet and exercise.” She recommended at minimum 30 minutes of physical activity five days a week — breakable into 10-minute sessions for those who need it.

Lang stressed that education must be delivered in language people recognize and can relate to. The goal is to inform them of the choices that serve their health best, she said.

But for many Black Californians, even those informed choices remain out of reach, Lambert said.

“They need access to healthy foods and medication, too” she said.

California has made some critical policy advances. The state has expanded access to the Continuous Glucose Monitor (CGM), which has transformed diabetes care for state residents. Assembly Bill 365, introduced in 2024, proposed requiring Medi-Cal to cover the costs of CGM and other related medical equipment but it failed in the State Senate. Since then, the California Department of Health Care Services (DHCS) reports that the core Medi-Cal CGM benefit now available to eligible patients was solidified through previous budget actions and pharmacy policy updates.

These measures, while meaningful, have not closed the gap for the communities most at risk, according to advocates.

Control Through Community

Health care advocates conclude that the solution must be communal, culturally grounded, and sustained — not a fad, not a celebrity moment, not a single clinic visit. For example, observed Lang, lifestyle shaped by shared values and collective accountability can move the needle where individual prescriptions have not.

Rock is building infrastructure to match the urgency, establishing local chapters of the African American Diabetes Association across the country, with California next.

“We have to do for self, period,” he said. “Health is wealth. We have to eat to live.”

And Lambert, whose granddaughter unknowingly started all of this for her, keeps showing up.

“Diabetes advocacy is about dignity, education, prevention, and hope,” she said.

Video: Diabetes Disparity Exposed in California

This article is supported by the California Health Care Foundation 

(CHCF). Visit www.chcf.org 

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Commentary

Doctors Seeing More Cases of Preventable Childhood Illnesses

OAKLAND POST — Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

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By Stacy M. Brown

Doctors across the United States say they are treating children for illnesses that routine vaccinations once made increasingly uncommon, raising concerns that years of declining immunization rates are beginning to reverse decades of public health progress.

Pediatricians have described seeing more cases of whooping cough, rotavirus infections, bacterial pneumonia and other potentially life-threatening illnesses that vaccines have long helped suppress. Some physicians reported treating conditions they had rarely encountered during their careers, while others said that growing vaccine hesitancy is changing how emergency rooms and hospitals care for children.

The reports come as measles outbreaks continue to spread across multiple states and vaccination coverage remains below federal public health targets.

Johns Hopkins University’s International Vaccine Access Center reported 2,077 confirmed measles cases nationwide as of May 29. Researchers warned that outbreaks reported across the country have raised concerns about continued transmission, additional hospitalizations and deaths, and the possible loss of the nation’s measles elimination status.

Public health experts have long viewed measles as a warning sign because of its ability to spread rapidly through communities with lower vaccination coverage. The New York Times reported that physicians increasingly fear the resurgence of measles may be followed by the return of other vaccine-preventable diseases.

Doctors say that is already happening.

Dr. Meghan Hofto, a pediatric hospitalist at the University of Alabama at Birmingham, said she has already treated roughly as many children with rotavirus this year as she saw during the previous decade. Rotavirus once caused tens of thousands of hospitalizations annually before vaccines sharply reduced its spread. None of the children she treated this year had been vaccinated.

Hofto also described caring for infants with pertussis, commonly known as whooping cough.

“It’s hard to know when they’re safe to go home,” Hofto told The Times.

The rise in whooping cough cases has been particularly striking. More than 28,000 cases were reported nationwide last year, compared with approximately 7,000 in 2023, according to figures cited by The Times. Many of the affected infants were too young to receive vaccinations themselves and relied on broader community protection to reduce their exposure.

Other doctors described similarly troubling cases.

Dr. Jessica Kirk, a pediatric hospitalist in Alabama, recently treated an unvaccinated toddler hospitalized with pneumonia caused by simultaneous infections of Haemophilus influenzae and Streptococcus pneumoniae. Vaccines exist to protect against both illnesses. The child required oxygen and antibiotics to recover.

Researchers at Johns Hopkins have been tracking vaccination trends nationwide and found continuing signs of vulnerability.

At the same time, vaccine policy has become increasingly contentious in state legislatures.

Johns Hopkins researchers reported that lawmakers across the country continue to introduce bills affecting childhood vaccination requirements, vaccine access and non-medical exemptions. Researchers also noted that state policies governing exemptions remain a significant factor in vaccination coverage and disease transmission risks.

Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

For doctors confronting the return of illnesses that vaccines once pushed to the margins of American medicine, the challenge is becoming increasingly personal.

“It just feels like you’re a tiny little boat with a giant tidal wave coming at you,” Dr. Erin Charles, a regional pediatric hospitalist at Seattle Children’s Hospital, told reporters. “And you might convince one family here and there.”

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Community

Asm. Isaac Bryan’s Environmental Reparations Bill Passes on Assembly Floor

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

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Asm. Isaac Bryan (D-Ladera Heights). File photo.

By Bo Tefu, California Black Media

On May 26, the California State Assembly passed legislation to provide direct financial assistance to families harmed by pollution from a major urban oil field in South Los Angeles.

Assembly Bill (AB) 1661, introduced by Assemblymember Isaac Bryan (D-Ladera Heights), cleared the Assembly floor with a 44-10 vote after lawmakers concluded debate on the measure.

The bill would direct money from a community repair fund toward families who suffered negative health effects from living near what Bryan described as the state’s largest toxic urban oil field. The repair fund was created under legislation approved two years ago that shut down the oil field and required polluters to contribute financially to community recovery efforts.

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

Bryan called the proposal “the largest environmental reparations opportunity for South LA” and told lawmakers the bill had not received opposition during the legislative process.

The legislation is part of California’s broader push to address environmental justice concerns in communities historically exposed to industrial pollution. South Los Angeles residents and environmental advocates have long raised concerns about health risks associated with oil drilling operations near homes, schools and parks.

Supporters say the measure represents a new approach to environmental accountability by ensuring that communities affected by pollution directly benefit from funds collected from responsible companies.

After debate concluded, Assembly leadership opened the roll call vote, and the measure passed with majority support from lawmakers.

AB 1661 now moves to the Senate for further review.

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