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Environmental Justice Through the Lens of Gulf Coast Transdisciplinary
Research
Maureen Lichtveld, MD, MPHProfessor and Chair
Director, Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives
PRESENTATION OBJECTIVES
• Describe the transdisciplinary characteristics of Environmental Justice
• Demonstrate the role of public health science and policy in addressing Environmental Justice
• Assess the implications of a holistic approach to environmental Justice for curriculum development and learning delivery
CORE ENVIRONMENTAL HEALTH TENET
The health of the environment is inextricably linked to the health of the
community
ENVIRONMENTAL HEALTH
Those aspects of human health, disease, and injury that are determined by these factors in the environment:• Physical• Chemical• Biological• Social• Psychosocial
www.who.int/phe/en
HEALTH AND THE BUILT ENVIRONMENT
CDC recognizes the following problems:1. Children’s Health2. Elderly Health3. Gentrification4. Home Environment5. Community Design6. Injury7. Physical Activity8. Mental Health9. Respiratory Health10.Water Quality
PRINCIPLE OF ENVIRONMENTAL JUSTICE
“The need for urban and rural ecological policies to clean up and rebuild our cities and rural areas in balance with nature, honoring the cultural integrity of all our communities, and provide fair access for all to the full range of resources.”
ETHICS OF ENVIRONMENTAL HEALTH POLICY
• Where does the burden lie?
• Where should the burden lie?
“WHERE DOES THE BURDEN LIE?”HEALTH DISPARITIES
• “A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage” (Healthy People 2020)
• Directed at people who experience greater health obstacles based on their
• Race/ethnic group• Religion• SES• Gender• Age
• Mental Health• Disability• Gender Identity• Geographic Location
“WHERE DOES THE BURDEN LIE?” GEOGRAPHY
Woolf et al 2012; Robert Wood Johnson Foundation
“WHERE DOES THE BURDEN LIE?” SOCIAL DETERMINANTS OF HEALTH
DISPARITIES
• Differential Susceptibility (at-risk groups)• Differential Exposure• Differential Health Behavior• Differential Health Access
All interact to cause differences in health
A NEXUS OF DISPARITIES- CANCER ALLEY, LOUISIANA
• The area known as Cancer Alley is located within a 100 mile stretch between Baton Rouge and New Orleans
• The area is home to up to 300 industries
* Cancer Alley Slides adapted from Randall Garchar Urbs 515: Race, Poverty, and the Environment Professor Raquel Pinderhughes, Urban Studies & Environmental Studies Programs, San Francisco State University Spring2004
CANCER ALLEY LOUISIANA
CANCER ALLEY LOUISIANA
• Have a 55% higher percentage of people of color than the national average
• Have a 48% higher percentage of people of color below the poverty line
• Have a 9% lower household income than the national average
• Have a 24% lower per capita income than the national average
ETHICS OF ENVIRONMENTAL HEALTH POLICY
• Who bears the burden?
• Who SHOULD bear the burden of environmental exposures?
ENVIRONMENTAL JUSTICE
ENVIRONMENTAL JUSTICE
“The fair treatment and meaningful involvement of all people regardless of
race, color, national origin, or income with respect to the development,
implementation, and enforcement of environmental laws, regulations, and
policies.”(EPA, 2013)
ENVIRONMENTAL XXX:WHAT’S IN A NAME?
• E Justice• E racism• E equity• E equality
CASE STUDY:AGRICULTURE STREET LANDFILL
Demographics:• Location: located in New Orleans
• Population: 1990 Census identifies 390 residential units (some 1,000 people) on the site - community is predominantly (97% +) African-American, with middle-to-low income levels
• Setting: the 95 acre former city disposal area that has been partially redeveloped
• 47 acres of the site have private and public housing: the Press Park Community Center; a recreation center; retail businesses, and the Morton Elementary school
• The remainder of the site is undeveloped and covered by dense vegetation
CASE STUDY:AGRICULTURE STREET LANDFILL
• The city dump was opened from 1909 to the late 1960s
• The 190 acre dump received waste from households, construction debris, ash from municipal waste incinerators, and debris from the devastation of Hurricane Betsy in 1965
• No documents were kept as to what materials were dumped into the landfill but anything from household garbage to service station oil waste was dumped, and the landfill was often on fire and commonly referred to as Dante’s Inferno
• Covered by a light layer of sand
CASE STUDY:AGRICULTURE STREET LANDFILL
• In 1969, the city and federal government supported and financed the building of a low-income community on the landfill
• Part of the landfill was developed into three subdivisions, Press Park and Gordon Plaza, a housing complex for the elderly, and a small business complex
• Part of the landfill was left as undeveloped land
CASE STUDY:AGRICULTURE STREET LANDFILL
• 1912-1948: area was used as a dump by the city of New Orleans.
• 1948-1958: dump is converted and used as a sanitary landfill.
• 1958-1959: landfill closed• 1965: landfill is reopened to receive debris
created by Hurricane Betsy• 1976-1986: portion of the site was redeveloped to
support housing
CASE STUDY:AGRICULTURE STREET LANDFILL
• 1986: EPA completed a site investigation Under the old Hazardous Ranking System, which excluded ingestion, the site did not qualify for placement on the National Priorities List (NPL)
• 1993: community leaders requested EPA to re-evaluate the site; EPA collected samples
• 1994: EPA initiated an“accelerated remedial investigation” integrated with removal actions
• May 1994: fieldwork completed and fence built around the undeveloped area and removal of highly contaminated soils at children’s play area
CASE STUDY:AGRICULTURE STREET LANDFILL
• August 23, 1994: site was proposed to the NPL
• December 16,1994: site was formerly added to the NPL
• April 27, 2001: EPA completes cleanup project: 99% of the site has the first two feet of soil replaced
• The remaining 1% of the site belongs to 9 private homeowners in the community who elected not to participate in the removal action
CASE STUDY: CHEF MENTEUR LANDFILL
CASE STUDY: DEEPWATER HORIZON OIL SPILL
ENVIRONMENT AND COMMUNITY HEALTH:WHO MUST PLAY “NICELY” IN THE SANDBOX?
Clean Air, water
Safe seafood
Vulnerable Populations
Communitycapacity building
Industry
Economy
Environmental policies
policymakers
Public Health
Ecosystem
GULF COAST COMMUNITY HEALTH THREATS
Environmental Health
Health Disparities
Disaster Preparedness
Gulf Coast Community Health
TRANSDISCIPLINARY RESEARCH CONSORTIUM FOR GULF RESILIENCE ON WOMEN’S HEALTH
(GROWH)
Addresses three community-driven questions:• “Is the seafood safe?”• “Can I breathe the air?”• “Is my baby safe?”
www.growhgulfsouth.com
GROWH
Goal: to identify individual and community health effects potentially stemming from the Deepwater Horizon oil spill and enhances community resiliency to potential disasters through population-based and laboratory research, and community outreach.
• Research Projects 1, 2 & 3• Community Outreach and Dissemination Core• SAMHSA Supplement (2 projects)
GROWH AIMS
• Determine the effects of the DWH disaster, combined with the other adversities faced by the area, on mental health and reproductive outcomes among pregnant women and women of reproductive age living in affected parishes in Louisiana.
• Characterize exposures of pregnant women and women of reproductive age to selected contaminants through exposure routes of concern to communities - specifically seafood consumption and air.
• Examine the interactions of environmental and social disparities on the health of pregnant women and women of reproductive age.
• Utilize community-based participatory research and outreach strategies to strengthen community resilience in vulnerable Gulf Coast populations.
BUILDING COMMUNITY RESILIENCE THROUGH DISASTER MOBILE HEALTH
• Community-based participatory research• Target population of pregnant women and women
of reproductive age living in SE Louisiana• Develop a community-driven disaster mobile health
platform• Train WIC-affiliated CHWs to serve as disaster
interventionists• Examine the effect of disaster mobile health
www.growhgulfsouth.com
STUDY POPULATIONINCLUSION CRITERIA
• 18-45 years old• Resident of six parish
region at the time of DHW spill
• Pregnant and in first trimester with first child
• Recruited at Women, Infant, and Children (WIC) clinics• Had to be eligible
for WIC assistance
Study Demographics (n=112)
N(%)
Mean Age 25.32 (sd 4.65)
Race/Ethnicity White Black Latina Other
27 (24.1)64 (57.1)17 (15.2)4 (3.6)
Income Under 10k 10-29k Over 30k
59 (56.7)29 (27.9)16 (15.4)
Education High school dropout ≥ High school degree
19 (17.0)93 (83.0)
BUILDING COMMUNITY RESILIENCE THROUGH DISASTER MOBILE HEALTH
PSYCHOSOCIAL HEALTHSAMSHA SUPPLEMENT
Define the biological and psychosocial pathways linking maternal prenatal and postnatal health
Aim: Extend an anthropological model of psychosocial stress and maternal and child wellness that focuses on the modifying effect of cultural context
Influencing Health Needs and Vulnerabilities
He
alth
Dis
pa
ritie
s
Impact on Health
Disparities
Improving the Living Environment: Surveillance of Health Determinants
Poverty
Education
Access to Healthcare
Perceived Discrimination
Environmental Pollution
Housing/Shelter Quality
Workplace Health Hazards
Insurance
Culture
Culturally Competent Providers
INFLUENCERS OF HEALTH DISPARITIES
A COGNITIVE THEORY OF CULTURE
•Culture is the information needed to act appropriately in a given context
•Information is learned and shared by social networks
•Range of factors can influence the information absorbed, and therefore, a person’s culture
(original photo credit Heide Benser/Corbis)
STUDY POPULATIONINCLUSION CRITERIA
• 18-45 years old• Resident of six parish
region at the time of DHW spill
• Pregnant and in first trimester with first child
• Recruited at Women, Infant, and Children (WIC) clinics• Had to be eligible
for WIC assistance
Study Demographics (n=112) N(%)Mean Age 25.32 (sd
4.65)Race/Ethnicity White Black Latina Other
27 (24.1)64 (57.1)17 (15.2)4 (3.6)
Income Under 10k 10-29k Over 30k
59 (56.7)29 (27.9)16 (15.4)
Education High school dropout ≥ High school degree
19 (17.0)93 (83.0)
Region Orleans WB Orleans EB Suburban WB Suburban EB SW Rural SE Rural
9 (8.1)23 (20.7)35 (31.5)9 (8.1)16 (14.4)19 (17.1)
FREELISTING RESPONSES
Stratified sample were asked: • “What are the things in the
environment that threaten mothers and children in your community?”
• “What are ways that mothers prepare or respond to these things?”
• “Who do mothers typically turn to for each of these things?”
Threats in the environment
Frequency (%)
Violence 55
Hurricanes 55
Outdoor air 45
Drugs 40
Indoor air 35
Cigarette smoke 35
Reckless drivers 30
Floods 25
Money problems 25
Risk behavior Interval (1-6)
Collapsed answer
Buy extra food & water 5.77Extremely important
Keep extra power supplies 5.68Extremely important
Watch news during season 5.58Extremely important
Make a plan of what to do 5.53Extremely important
Evacuate before the storm 5.33 Very important
Shelter-in-place 4.99 Very important
Collect important documents during the season
4.95 Very important
Avoid thinking about the threat 4.48Moderately important
Follow what other family members do
4.11Moderately important
What is important to do during hurricane season?CULTURAL MODEL OF HURRICANE RISK BEHAVIOR
Extra
Wat
er
Power
Sup
plie
sPl
an
Wat
ch_N
ews
Evac
uate
Colle
ct_D
ocs
Shel
ter
Don’t_
Focu
s
Follo
w_F
amily
5.97 5.93 5.91 5.84 5.83 5.72
4.97 4.77
4.18
5.074.84
4.29
4.83
3.7
2.73
5.01
3.633.84
Comparison of two subcultures – Risk Behavior6 (Extremely important) – 1 (Not important)
Subculture 1 Subculture 2
Risk behaviorInterval
(1-6)Collapsed
answer
Family 5.53 Extremely likely
TV News 5.51 Extremely likely
Friends 4.77 Likely
Community Leaders 4.75 Likely
Police 4.72 Likely
Internet 4.54 Likely
Government Services 4.51 Likely
People at church 4.16 Somewhat likely
Doctor 2.35 Unlikely
Which are likely sources to turn to during the season/storm?CULTURAL MODEL OF HURRICANE RISK BEHAVIOR
Family TV_News Internet Friends Police Leaders Gov_Services Church Doctors
5.61 5.58
5.15
4.74 4.59 4.584.46
4.28
2.55
5.2 5.39
2.89
4.855.1 5.2
4.63
3.84
1.99
Comparison of two cultures – Sources of support6 (Extremely likely)- 1( Extremely unlikely)
Subculture 1 Subculture 2
GULF REGION HEALTH OUTREACH PROGRAM:When studies are not the right answer
A Healthier Resilient Community
Through Regional Partnerships
Com
mu
nity
Inp
ut
Com
mu
nit
y In
pu
t
Enhanced Frontline Heath
Services
Mental & Behavioral
Health
Primary Care
Environmental Health
EMERGING SCHOLARS PROGRAMS
EJ’S INTERCONNECTEDNESS:IMPLICATIONS FOR CURRICULUM DEVELOPMENT
Environmental
Justice
science
community
policy
ecosystem
EJ’S INTERCONNECTEDNESS:IMPLICATIONS FOR LEARNING DELIVERY
• Transdisciplinary must replace discipline-specific• Problem-based, case-driven• Field-based learning• Flipped lecture• Case study as group assignment• Verbal and written communication performance
assessment• Group learning: peer expert panel debates; peer
evaluations
A HEALTHY NATURAL AND BUILT ENVIRONMENT: NOLA
“We envision a green, healthy New Orleans, a city whose beauty is rooted in the harmony between the natural and the built environment. This means protecting our wetlands and water bodies, enhancing the quality of our air, and preserving the beauty of our community. Healthy, environmentally-conscious New Orleanians will be cooler, use less energy and breathe fresher air. Our City will have fewer drainage problems, less water pollution, and more recreational opportunities. None of this will be possible without active, informed citizens, who share in the responsibility for managing our environment.”
