How partnerships with community organizations helped me see the truth behind data

I thought about the idea for this project on Sept. 9, 2020. I remember because the sky was orange. It came after days of smoke from wildfires burning miles away had sent Bay Area locals — who could socialize only outdoors for fear of contracting COVID-19 — back inside to ride out another wildfire. This event made me think of how Oakland children, many of whom are asthmatic, were left with two bad choices: Play outside and breathe in wildfire smoke or play inside and risk COVID-19. 

My goal was to investigate health and environmental data to see if the uptick in smoky days from more California wildfires had any bearing on the number of times children in Oakland visited the hospital for asthma. In the end, I learned the factors contributing most to the childhood asthma burden in Oakland were closer to home. 

I worked with Danielle Fox, the Center for Health Journalism engagement editor at the time, and Aaron Williams, a senior data fellow and former Washington Post data journalist, to develop a dual data reporting and community engagement strategy for this project. While the data had a huge bearing on our reporting, we couldn’t have told this story or done the data analysis without community engagement. 

As the first step of our community engagement strategy, we connected with local organizations and agencies, and we listened. Four were particularly helpful: Communities for a Better Environment (CBE) in East Oakland, the West Oakland Environmental Indicators Project (which, while not quoted in the story, connected us with many scientists who were) and two Alameda County programs: the public health department’s Asthma Start program and the Healthy Homes Department. These organizations connected us with the families who became our sources and with multiple datasets that shaped our understanding of what families in East Oakland were breathing. 

It took only a few conversations to realize that children weren’t visiting the hospital because of wildfire smoke, but rather because of substandard housing and exposure to outdoor air pollution from industry and highway truck traffic. We updated the reporting plan to be two longer features, one about health problems stemming from outdoor air pollution and the other about the impact of substandard housing conditions on children’s health. 

'When home makes you sick'

We learned from listening sessions and interviews that in many families vulnerable to substandard housing, the adults are recent immigrants or do not speak English fluently. We recognized that we needed help reaching this community. We partnered with El Tímpano, a platform serving the information needs of Latino and Mayan immigrants in Oakland, and with Bay Area journalist Adriana Morga. El Timpano was working on a related reporting project on substandard housing in East Oakland. We recognized the benefits of this partnership and eagerly signed the engagement grant over to the organization.

The Asthma Start program connected us with Guadalupe Muñoz and her daughter, Carla, who became the central focus of this piece. Carla was enrolled in the county health program because of her frequent visits to the hospital for severe asthma. Guadalupe knew the mold in her apartment was the underlying cause of her daughter’s health problems but has struggled for more than eight years to get her landlord to remedy the problem. 

We worked with the experts at Healthy Homes to ensure the healthy housing tips we shared by SMS were accurate, and we worked with Madeleine Bair, founder of El Tímpano, to ensure our call-outs could be readily translated and shared via SMS. The three call-outs were translated from English to Spanish and disseminated to more than 4,000 people. We received about 50 replies from the El Tímpano community. Most were a simple “thank you” but Madeleine translated the more substantial responses from Spanish to English. Potential sources were identified in this way. With interpretation help from El Tímpano’s health and housing fellow, Héctor Arzate, we spoke with three families and included information from one of those interviews in our story.

We used two original data sources in this story. The first was code enforcement complaints for mold or moisture intrusion in Oakland between March 2020 and March 2021. To analyze this, I simply downloaded the complaints for the date range in a Google Sheet and searched for the number of times “mold” or “moisture intrusion” was mentioned. Housing experts and attorneys warned us this is likely an undercount of the mold burden because Oakland’s code enforcement system relies on tenants complaining. Many who live in substandard housing conditions risk illness rather than complain for fear of eviction, deportation or other repercussions. 

The second source was data on asthma-related hospital visits among children ages 17 and younger in Oakland from 2016 to 2019, sorted by zip code. We obtained this data via record request from the Alameda County Department of Public Health. We used the data in this story to see the number of hospital visits among children living in Carla’s zip code and in the East Oakland community featured in the other article.

The health department didn’t have 2020 data on asthma hospital visits available yet. I predicted there would be a spike during that lockdown year, when kids were not attending in-person school or participating in sports but staying inside homes filled with asthma triggers. Instead, health workers observed that hospital visits for asthma had declined.

“Our number of visits for asthma has just plummeted,” said one pediatric nurse practitioner. “Where are all the kids? Where are the coughing kids?’”

It will probably take years to know for sure, but health experts told us that even though the home environment is often substandard, it is stable, whereas school is where dust, germs and other potential asthma flares loom.

'Air-polluting industries face scrutiny in East Oakland'

For the project’s other story, we aimed to answer the question: are Oakland children visiting the hospital more frequently when the air quality is bad? We used two data sources. The first was four years of data about ozone, nitrogen dioxide and particulate matter (PM 2.5) levels collected by three Environmental Protection Agency (EPA) air quality sensors in Oakland, which are managed by the Bay Area Air Quality Management District (“the Air District”). We chose these pollutants because of their correlation with asthma and because experts told us they are the most common ones in the Bay Area. 

The second source was Alameda County Public Health Department data on hospital visits for asthma-related health problems by Oakland children. The data was rolled up into 4-month intervals and masked by the health department, meaning that zip codes with fewer than 10 hospital visits were marked as (<10) instead of the exact number. This made it impossible to see if the air quality and asthma visits were correlated, but we were able to use these simple counts in other ways. 

The results of our analysis were striking. Despite heat waves, wildfires and ambient air pollution, the EPA data showed just five days from 2016 to 2019 when the air in Oakland was “very unhealthy” and zero days when the air was deemed “hazardous.” These findings would seem to indicate that overall, the air quality in Oakland is not a major factor contributing to health problems. I knew from connecting with people living in East and West Oakland and interviewing scientists that the air in Oakland was far from fine. 

Evidence showed the three EPA monitors, which the Air District uses to design policies that impact our air, have shortcomings. A 2018 study showed that air pollution levels are highly dispersed and vary widely between city blocks, suggesting that the EPA sensors shouldn’t be the only source of air quality monitoring in the area. And a 2021 study showed communities in Oakland with more pollution have higher levels of death and disease. Residents of these neighborhoods are more likely to be people of color due to redlining and other racist land use policies. These studies and conversations with researchers confirmed what people in East Oakland have known for years: The air is making them sick. 

Community engagement was central to reporting this article as well. For example, Brian Beveridge with the West Oakland Environmental Indicators Project connected us to the researchers and data scientists who did the air quality studies mentioned above. Angela Scott, organizer with CBE, connected us to the key community voices in our first article: the teachers at Acorn Woodland Elementary School and Esther Goolsby, former organizer at CBE. Goolsby took me and The Oaklandside’s photographer on a “toxic tour” of her Acorn Woodland neighborhood, leading us from her home to Acorn Woodland Elementary and the many industrial facilities that pollute the air. This article wove testimony of teachers, organizers and families in East Oakland with new science and agency reports about the East Oakland air — all voices and reports that we identified through community engagement. 

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