Asthma Boulevard

J

o Franco still remembers the moment she realized that her nose worked. Growing up in Wilmington, a Los Angeles neighborhood dotted with oil refineries and next to one of the largest port complexes in the country, she’d always assumed she had a fever, or allergies: “I could never breathe through my nose at all,” she told me. But when she moved away from the city for college, her breathing suddenly got easier. “It was this wonderful surprise,” she said. “I could smell lemons.”

Franco can still map Wilmington’s refineries, and still remembers the chemicals they’d release into the sky. At 28, after moving back to California, she was diagnosed with cervical cancer. When she was in her 30s, former high-school classmates started dying. Then Franco developed another cancer: acinic cell carcinoma, a rare cancer of the salivary glands. Doctors sliced open the skin on the right side of her face to remove a tumor the size of a golf ball. Two years later, the tumor came back, and Franco underwent aggressive radiation treatment that made her feel like she got “punched in the jaw.” She was in her mid-50s.

Jo Franco, 57, is a cancer survivor who grew up in Wilmington, California, next to a refinery.
Shipping containers looming in the distance from the Wilmington Cemetery in Wilmington, Calif., the second oldest cemetery in Los Angeles that was established in 1857. Pablo Unzueta/ Magnum Foundation
Shipping containers can be seen in the distance from Wilmington Cemetery, one of the oldest in Los Angeles.
According to analysis by the South Coast Air Quality Management District scientists, the ports and surrounding communities experienced record-breaking freight movement at the end of 2021, which contributed to elevated levels of PM2.5 throughout the region. Other experts attribute air inequality to PM10—corse dust that can also be coated with chemicals. Pablo Unzueta/ Magnum Foundation
A truck drives past a storage company a block away from the Pacific Coast Highway. According to the South Coast Air Quality Management District, the region—which includes parts of the Inland Empire and Orange County—experienced unprecedented freight movement as 2021 ended.

In 2020, after a childhood spent in Los Angeles County and several adult years in Long Beach, I embarked on documenting what longtime residents like Franco had been experiencing for generations in this industrial-port belt. I dodged 18-wheelers in between errands, saw fine dust lingering in the air, and biked along the trash-clogged Los Angeles River. I could see smokestacks pummeling the sky. Even inside, I could sometimes smell the rotten-egg odor from the oil wells, where tens of thousands of barrels of crude were produced every day, to be shipped around the world.

These photographs speak to this place, through which much of the nation’s oil and many of its goods pass on their way to their final destination. More than 300,000 people live in communities near the Ports of Los Angeles and Long Beach, the first- and second-busiest in the country, and their neighborhoods are defined by the machinery of Big Industry. The I-710 routes thousands of diesel trucks through low-income areas; in 2023 alone, those trucks transported 8.6 million containers. The Wilmington Oil Field is the third-largest in the contiguous United States, and the seven refineries in Los Angeles County can produce 1 million barrels a day total, 60 percent of California’s total oil-refining capacity. Recently, a warehouse and logistics boom throughout Southern California has transformed residential streets into commercial roads.

Hilary Landreaux, 80, stands in front of his home as 18-wheeler trucks from the Los Angeles ports roar down the street in Wilmington, Calif., a Los Angeles neighborhood notoriously known to have five oil refineries, including the Wilmington Oil Field, the third largest in the United States, and a higher than average cancer risk. Landreaux has lived in this home for 50 years and worked at a steel plant and an auto repair shop throughout his life, he says. Landreaux lost his wife to cancer in the early 2000s. Pablo Unzueta/ Magnum Foundation
Hillary Landreaux, 80, stands in front of his home as 18-wheelers pass in Wilmington. Landreaux, now retired, has worked at a steel plant and an auto-repair shop throughout his life, and has lived in this home for about 40 years. His neighborhood is in the 90744 zip code. According to the South Coast Air Quality Management District, it ranks in the top 2 percent in the South Coast Air Basin for “air toxics cancer risk,” which is attributed to diesel particulate matter, benzene, arsenic, and other chemicals. Landreaux lost his wife to cancer in 2004. “We didn’t know what it was, or what caused it,” Landreaux told me. “After so many years here, you just get used to everything.”
A portrait of Hilary Landreaux’s wife who died from cancer in the early 2000s. Landreaux and his wife lived here for five decades, which is short walk from the Marathon refinery. “We didn’t know what it was, or what caused it,” Landreaux said. “After so many years here you just get used to everything.” Landreaux lives in Wilmington, Calif., a Los Angeles neighborhood notoriously known to have five oil refineries, including the Wilmington Oil Field, the third largest in the United States, and a higher than average cancer risk. Landreaux worked at a steel plant and an auto repair shop throughout his life, he says. Pablo Unzueta/ Magnum Foundation
A portrait of Landreaux’s late wife hangs in the home they shared, a short walk from the Marathon refinery.
Jose Ulloa, 58, is a 25-year resident of Wilmington, Calif. In 2019, his neighborhood was converted into a main truck route from the ports. During the pandemic truck traffic had increased, citing an increase in pollution and safety hazards. Ulloa developed bronchitis in 2020, and has had severe asthma for almost three years now—at the start of the truck traffic around the neighborhood. Ulloa has a persistent cough and says it gets worse when he returns back home from work. Pictured here, Ulloa has trouble talking and holding a conversation without coughing profusely, so he uses an asthma inhaler for relief. Pablo Unzueta/ Magnum Foundation
Jose Ulloa, 59, a 27-year resident of Wilmington, developed acute bronchitis in 2020, and has had severe asthma for more than two years now. He has trouble holding a conversation without coughing, so he uses an asthma inhaler for relief.
A cross hangs above Jose Ulloa’s bed in Wilmington, Calif. Ulloa struggles with severe asthma and a lingering cough. Pablo Unzueta/ Magnum Foundation
A cross hangs above Ulloa’s bed at his home in Wilmington.
Triptych of inhalers from residents of Wilmington, California
Left: Ulloa’s well-used inhaler. Center: An inhaler used daily by 66-year-old Carlos Ovalle, who was diagnosed with asthma in 2010. Right: The inhaler that Franco, who has had trouble breathing for years, uses every day.

Around the start of the pandemic, Jose Ulloa, a 27-year Wilmington resident, saw his street turned into a truck route. Parts of the neighborhood were quickly covered in thick layers of dirt, he told me, while dust and fumes hung in the air as trucks roared down the street. Some residents began to complain about their respiratory health. Ulloa was diagnosed with acute bronchitis, which eventually developed into a severe case of asthma that lingers today.

“Sometimes this cough won’t let me sleep, or my family,” Ulloa said, between wheezes. “And before, the cough was so bad, it would hurt my stomach [and] my back, almost like you were doing exercise.” Our interview was cut short because he had a minor asthma attack. I watched him fumble to his bedroom and grab his inhaler for relief. “This has completely changed his life forever,” said his wife, Imelda, shaking her head from the living room.

Picture of smokestacks from the Phillips 66 refinery is seen from Figueroa Place, residential street in Wilmington, California
Smokestacks from the Phillips 66 refinery are seen from Figueroa Place, a residential street in Wilmington.
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Trash is strewn along the Dominguez Channel, a 15-mile river in the southern part of Los Angeles County. This river has become a drainage point for industrial runoff, which eventually makes its way to the Pacific Ocean.
Picture of Gustavo Hernandez, 66, sitting for a portrait in front of his home, which is adjacent to oil pipelines buried underneath the soil and the Phillips 66 refinery.
Gustavo Hernandez sits for a portrait in front of the home he has lived in since 1977, adjacent to the Phillips 66 refinery. The 50,000 people who live in Wilmington, mostly people of color, experience more pollution than up to 90 percent of California, according to a 2021 report by Grist.

Bad air is invisibly violent. Nitrogen dioxide and chemically coated particulate matter—the by-products of industrial activity—have been repeatedly linked to cancer, decreased lung function, and chronic respiratory diseases. Children who are exposed to toxic air and develop asthma may have trouble breathing for the rest of their life, Joel Ervice, the associate director of Regional Asthma Management and Prevention, told me. Paul English, who recently retired from his job as a researcher and director for the Public Health Institute, told me studies have shown that particulate matter is especially concentrated in low-income neighborhoods.

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A view from a front yard in Wilmington, with 18-wheelers going by
Juan Sandoval, 52, who lives near Drumm Avenue, a-once residential street that has been converted into a main truck route, changes the fluids to a neighbors car.
Juan Sandoval, 53, who lives near Drumm Avenue, a once-residential street that has been converted into a main truck route, changes the fluids in a neighbor’s car. “We keep the windows closed, and you can sometimes hear and see the windows shake from all of the trucks too,” he told me. The Marathon refinery is just a short walk from here.

Over the past few years, California has made efforts to regulate its dirty air. But Los Angeles has among the most ozone and particulate pollution of any U.S. city. According to new data, 41 out of the 45 reporting counties in California received an F grade for particle pollution, including most counties in Southern California.

I recently checked in with Franco. This year, another childhood friend was diagnosed with breast cancer, who recently finished radiation and begins chemotherapy this month. “It’s one thing to hear people are dying of cancer,” she told me. “But when the people are real, it goes to a whole different level.”

Near the Terminal Island freeway on the cusp of West Long Beach and Wilmington, Calif., overlooking the railroad that connects to the ports and the Valero refinery. This sector is contaminated with industrial waste. Pablo Unzueta/ Magnum Foundation
A view near the Terminal Island Freeway on the edge of West Long Beach and Wilmington, overlooking the railroad that connects to the ports and the Valero refinery

Support for this story was provided by the Magnum Foundation, in partnership with the Commonwealth Fund.