Breathless

But four years later, the only asthma prevention programs in the state are voluntary, pesticides are still used freely in schools, and no substantial attention has been paid to lead in drinking water.

To a lot of people, the forum goals and the governor's attention to children's health sounded great. At first, there was a lot of momentum around the project.

Megan Irwin

Jonathan Hendrix and his mom Jennifer test his lung capacity.

Mary Chick, head nurse for the Roosevelt Elementary School District, administers a breathing treatment.

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More About

• Sandy Bahr
• Janet Napolitano
• Steve Owens
• Respiratory Medicine
• Asthma

And yet, virtually nothing has happened. Attention for the program dropped off, after that first big press conference and forum. No legislation has been passed as a direct result of the project. No departmental mandates have been given to school districts to improve student health.

Sandy Bahr, conservation outreach coordinator for the Sierra Club, says the lack of attention to the program is disappointing.

"The governor has made child's issues and education a big deal," she says. "But they can't learn if they can't breathe."

One of the best asthma programs in the state, the Breathmobile, has nothing to do with Napolitano. The mobile asthma unit, operated by Phoenix Children's Hospital and funded by corporate sponsorship, serves families in the Roosevelt, Creighton and Phoenix Elementary school districts. According to Judy Harris, director of the Breathmobile program, the mobile provides complete treatment, including pulmonary function testing, medication and asthma education, for areas of Phoenix that are medically underserved and underinsured.

It does more for parents like Jennifer Hendrix than any DEQ program. Hendrix says she was delighted to discover the free service — the care and information provided to her from Breathmobile staffers and nurses has made a big difference in Jonathan's life. She'd like to see a similar program made available to more schools and families.

"Napolitano, I would say if she's talking about people's health and asthma and poor quality of air, maybe she should start a program just for asthma. Even start something like that [the Breathmobile]," says Hendrix, who adds that she did vote for Napolitano in the last election and probably will this time as well.

One of the Breathmobile's greatest virtues is that it's free for the families that use its service. Still, it currently is only able to serve 19 schools, and many parents in areas with high asthma rates do not have access to health insurance. Financial disparity between high- and low-income school districts places asthmatic kids on some very uneven ground.

Without funding, many low-income schools can't implement the program. And it's the poorest schools, like the ones in Roosevelt School District, that have the highest asthma rate. Many low-income schools sit near industrial sites and freeways and are exposed to high levels of pollution. Nurse Mary Chick feels that while more money for schools would be nice, it's not the only answer. And she'd rather not wait around for money that probably won't be coming from the Capitol any time soon. She says that what is really needed is stronger enforcement of environmental policies, and mandatory, not voluntary, programs.

"I don't think the state is doing their part at all," says Chick. "There's no enforcement. Unlike California, where they have laws mandating certain things helping asthmatics, Arizona doesn't have any laws (although Arizona's asthma rate is higher). It took something like a child dying to say, hey, we've got to do something. Make it mandatory, not voluntary, that these children are not sent outside when the air is bad."

Mandatory regulations and strict enforcement won't cure Jonathan's asthma, and they might not have saved the Rose Linda fifth-grader's life, but they would cut down on asthma attacks in schools and certainly would decrease the number of school days missed.

The Sierra Club's Sandy Bahr has worked on environmental issues like air quality and pesticide exposure for a long time, through several gubernatorial administrations. This past legislative session she helped to get a bill passed that will regulate pesticides in schools. She was at the Children's Environmental Health project's kickoff forum, and was encouraged at the time, though she says the buzz has disappeared.

"In the beginning, there was excitement about this opportunity to make a difference," she says. "Interest has waned, and I'm not sure why. People get discouraged. They think, 'The Legislature stinks so there's nothing we can do.' This is when we have to get creative."

The project's one significant success is a voluntary school-bus-idling program that requires school buses to turn off their engines — rather than idling outside schools pumping exhaust into the air children are breathing. The program started with just seven schools and has increased to 144.

Not bad for a voluntary program, but that still leaves more than 1,500 schools not participating.

DEQ has also implemented a voluntary program to cut down on pesticide use. Working with University of Arizona entomologist Dawn Gouge, the department is trying to educate schools about integrative pest management — an exterminating approach that avoids mass spraying of pesticides. Often, when dealing with a pest problem, schools will just contract with the least expensive extermination company. Gouge says this is an ineffective practice that ultimately winds up costing a lot of money (because the pests don't go away) and can harm kids.

"You need to know what pesticide to use on which organism, and that's not what usually happens when you contract with a low-bid pest management company," she says. "Integrated pest management is about resolving the reasons why pests are there in the first place as well as giving sensible remediation."