Environmental Health Inequalities Research Articles

Breaking free from siloes: intersectionality as a collective action frame to address toxic exposures and reproductive health

ABSTRACTThere has been increasing interest in collaborative approaches between the environmental justice (EJ) and reproductive justice (RJ) movements to address the higher burden of toxic exposures and associated reproductive health outcomes in vulnerable communities. This study examined the collective action frames (CAFs) of advocates at the EJ/RJ nexus. CAFs highlight how advocates identify problems and solutions, and motivate action. The use of intersectionality was identified as a main CAF used in three key ways: breaking free from identity-based, issue-based, and movement-based siloes. First, interviewees described breaking free from identity-based siloes by identifying risks of toxic exposures that result from intersecting social locations (e.g. gender, race/ethnicity, income, immigration status) and by equally prioritizing multiple aspects of their identities as they engage in advocacy. Second, they described breaking free from issue-based siloes by developing multi-issue agendas that address a complex web of interrelated problems impacting health. Third, they described breaking free from movement-based siloes by developing cross-movement collaborations to address issues of mutual concern. Among multiple reasons given for cross-movement collaborations, advocates perceived them as valuable in order to disrupt social, political, and economic power imbalances that shape environmental reproductive health inequities, as well as other health and social inequities. Based on these findings, we suggest that intersectionality is a master frame, and thus may be useful to advocates in other social movements addressing intersectional issues. Understanding an intersectionality frame can help to inform advocacy approaches to promote health and health equity, particularly those focused on policies and structural drivers of health.

Characterization of Environmental Health Inequalities Due to Polyaromatic Hydrocarbon Exposure in France.

Reducing environmental health inequalities has become a major focus of public health efforts in France, as evidenced by the French action plans for health and the environment. To evaluate environmental inequalities, routine monitoring networks provide a valuable source of data on environmental contamination, which can be used in integrated assessments, to identify overexposed populations and prioritize actions. However, available databases generally do not meet sufficient spatial representativeness to characterize population exposure, as they are usually not assembled for this specific purpose. The aim of this study was to develop geoprocessing procedures and statistical methods to build spatial environmental variables (water, air, soil, and food pollutant concentrations) at a fine resolution, and provide appropriate input for the exposure modelling. Those methods were designed to combine in situ monitoring data with correlated auxiliary information (for example, atmospheric emissions, population, and altitude), in order to better represent the variability of the environmental compartment quality. The MODUL’ERS multimedia exposure model developed by INERIS (French Institute for industrial Environment and Risks) was then used to assess the transfer of substances from the environment to humans, through inhalation and ingestion pathway characterization. We applied the methodology to a carcinogenic Polycyclic Aromatic Hydrocarbon substance, benzo[a]pyrene(B[a]P), to map spatialized exposure indicators, at the national scale. The largest environmental contribution corresponded to the ingestion pathway. Data processing algorithms and calculation of exposure will be integrated into the French coordinated integrated environment and health platform PLAINE (PLteforme intégrée d’Analyse des INégalités Environnementales) which has been developed to map and analyze environmental health inequalities.

Africana womanism as an extension of feminism in political ecology (of health) research

A feminist perspective within political ecology and political ecology of health considers gender dynamics in the use of environmental resources, labor division, and health inequalities. However, a feminist perspective may not adequately engender the perspectives of Africana women as many embrace their roles of the nurturer, protector and provider of their families. Africana womanism, an African theoretical perspective that is family-centered and focuses on women’s concerns only after the community’s needs are met, provides a different lens by which to conduct research in sub-Saharan Africa. However, in today’s (post-colonial) reality, Africana womanism cannot remain isolated. This forum paper focuses on the importance of including Africana womanist perspectives in political ecology and political ecology of health research by integrating African feminism and Black feminism, which are grounded in the multiple oppressions that Africana women historically and currently face. These multiple perspectives from Africana women will enable a better understanding of gender dynamics in sub-Saharan Africa and will enable Africana womanism to be used as an extension of feminism to account for a uniquely Africana perspective in future political ecology and political ecology of health research.

Socio-economic inequalities in blood mercury (Hg) and serum polychlorinated biphenyl (PCB) concentrations among pregnant Inuit women from Nunavik, Canada.

We examined the relationships between socio-economic characteristics and mercury (Hg) and polychlorinated biphenyl (PCB) concentrations among pregnant Inuit women from Nunavik. We used biomonitoring data from 208 pregnant Inuit women recruited in the 14 villages of Nunavik between September 2011 and December 2013. Blood samples were collected to monitor levels of blood Hg and serum congener PCB-153 (surrogate of total PCB concentration). Ratio of omega 3/omega 6 polyunsaturated fatty acids, a validated biomarker of marine country food consumption, was also measured in red blood cell membranes to determine maternal dietary profile. Data on socio-economic characteristics (income and education), health-related lifestyles, and reproductive history were collected through questionnaires. Association between socio-economic characteristics and contaminant concentrations was assessed using linear regressions. We observed a significant inverse relationship between education and Hg levels. Lower concentrations of Hg were observed among women who had completed high school compared to women who had not completed high school. However, no association was observed between level of education and concentration of PCBs. Socio-economic disparities in maternal exposure to Hg exist in Nunavik. Further research is needed to determine whether environmental health inequalities also exist in other subgroups of the Nunavik population and in other Indigenous communities in Canada.

Towards equity-focused intersectoral practice (EquIP) in children\u2019s environmental health and housing: the transformational story of RentSafe

SettingThis paper chronicles the transformational process through which a national intersectoral collaboration, the Canadian Partnership for Children’s Health and Environment (CPCHE), came to embrace a more upstream, equity-based focus in its mandate to advance children’s environmental health.InterventionAfter 15 years of working within a conventional, evidence-informed approach to health promotion and policy advocacy, in 2010–2013, CPCHE had the opportunity to collaborate on the development of equity-focused knowledge translation (EqKT). EqKT is a relational approach to knowledge practices that challenges intersectoral actors to work to uncover biases and limitations within their own institutional paradigms and professional practices that constrain their capacity to address population health inequities.OutcomeThe ensuing transformation towards equity-focused intersectoral practice led CPCHE to create an intersectoral initiative called RentSafe. Conceptually and operationally, RentSafe provides an intersectoral space within which the grounded expertise of people with experience of unhealthy and undignified housing provides a roadmap for public health and other practitioners to critically explore professional and institutional blind spots and barriers. With RentSafe as its watershed moment, CPCHE is shifting from a top-down “for whom” orientation to an authentically engaged “with whom” approach that seeks to work integrally with community partners to expose and challenge systemic roots of health inequity.ImplicationsThe transformational story of CPCHE underscores the competencies needed for public health professionals to acknowledge the sources of our own biases and limitations as a necessary first step in equity-focused intersectoral practice (EquIP). It also affirms the value of working in partnership with those who experience the environmental health inequities that such efforts seek to address.

Informal Recyclers' Health Inequities in Vancouver, BC.

We explore informal recyclers' perceptions and experiences of the social determinants of health in Vancouver, Canada, and investigate the factors that contribute to the environmental health inequities they experience. Based on in-depth interviews with 40 informal recyclers and 7 key informants, we used a social determinants of health framework to detail the health threats that informal recyclers associated with their work and the factors that influenced their access to health-related resources and services. Our analysis reveals that the structural factors influencing environmental health inequities included insufficient government resources for low-income urbanites; the potential for stigma, clientization, and discrimination at some health and social service providers; and the legal marginalization of informal recycling and associated activities. We conclude that Vancouver's informal recyclers experience inequitable access to health-related resources and services, and they are knowledgeable observers of the factors that influence their own health and well-being.

HEALTH ACTIVISM FROM THE BOTTOM UP: PROGRESSIVE ERA IMMIGRANT CHICAGOANS’ VIEWS ON GERM THEORY, ENVIRONMENTAL HEALTH, AND CLASS INEQUALITY

Drawing on Chicago immigrant communities’ archives, memoirs, and native-language newspapers, this article advances our understanding of Progressive Era environmental politics by delving into cross-class immigrant communities’ views on and activism concerning health. Everyday ethnic Chicagoans—medical and journalistic professionals alongside working-class immigrants—displayed a sophisticated understanding of health. Well versed in medical and scientific germ theories, they embraced a mixture of germ and environmental theories that made them, in effect, “disease ecologists,” revealing a widespread health ecology orientation not limited to the educated white professionals and reformers about whom scholarship has revealed much more. Such perspectives contribute to reinterpretations of earlier scholarly assumptions that germ theory largely displaced environmental analyses. Moreover, ethnic communities’ interpretations of health as ecological underpinned some of their political activism in pursuit of greater environmental parity. Many ethnic activists from across Chicago's class spectrum fought alongside white reformers to rectify environmental health inequities. They sometimes even initiated efforts, displaying an early version of environmental justice activism. At the same time, other cross-class ethnics at least partly blamed individual or ethnic communities’ habits and failures, mirroring to a degree the condescension visible among many Anglo reformers and professionals.

Cumulative Risk Assessment in the Lorraine Region: A Framework to Characterize Environmental Health Inequalities.

The study explores spatial data processing methods and the associated impact on the characterization and quantification of a combined health risk indicator at a regional scale and at fine resolution. To illustrate the methodology of combining multiple publicly available data sources, we present a case study of the Lorraine region (France), where regional stakeholders were involved in the global procedures for data collection and organization. Different indicators are developed by combining technical approaches for assessing and characterizing human health exposure to chemical substances (in soil, air and water) and noise risk factors. The results permit identification of pollutant sources, determinants of exposure, and potential hotspot areas. A test of the model’s assumptions to changes in sub-indicator spatial distribution showed the impact of data transformation on identifying more impacted areas. Cumulative risk assessment permits the combination of quantitative and qualitative evaluation of health risks by including stakeholders in the decision process, helping to define a subjective conceptual analysis framework or assumptions when uncertainties or knowledge gaps operate.

Relationship between neighbourhood socioeconomic position and neighbourhood public green space availability: An environmental inequality analysis in a large German city applying generalized linear models.

The environmental justice framework states that besides environmental burdens also resources may be social unequally distributed both on the individual and on the neighbourhood level. This ecological study investigated whether neighbourhood socioeconomic position (SEP) was associated with neighbourhood public green space availability in a large German city with more than 1 million inhabitants. Two different measures were defined for green space availability. Firstly, percentage of green space within neighbourhoods was calculated with the additional consideration of various buffers around the boundaries. Secondly, percentage of green space was calculated based on various radii around the neighbourhood centroid. An index of neighbourhood SEP was calculated with principal component analysis. Log-gamma regression from the group of generalized linear models was applied in order to consider the non-normal distribution of the response variable. All models were adjusted for population density. Low neighbourhood SEP was associated with decreasing neighbourhood green space availability including 200m up to 1000m buffers around the neighbourhood boundaries. Low neighbourhood SEP was also associated with decreasing green space availability based on catchment areas measured from neighbourhood centroids with different radii (1000m up to 3000 m). With an increasing radius the strength of the associations decreased. Social unequally distributed green space may amplify environmental health inequalities in an urban context. Thus, the identification of vulnerable neighbourhoods and population groups plays an important role for epidemiological research and healthy city planning. As a methodical aspect, log-gamma regression offers an adequate parametric modelling strategy for positively distributed environmental variables.

Environmental and Socioeconomic Health Inequalities: a Review and an Example of the Industrial Ostrava Region.

According to the World Health Organization (WHO) more than 2 million premature deaths and 7 million of total deaths each year can be attributed to the effects of air pollution. The contribution of air pollution to the health status of population is estimated to be about 20%. Health is largely determined by factors outside the reach of healthcare sector, including low income, unemployment, poor environment, poor education, and substandard housing. The aim of the paper was to review a current knowledge of relationships among air pollution, socioeconomic health inequalities, socio-spatial differentiation, and environmental inequity. The relationships were demonstrated on an example of the Ostrava region. Also basic approaches to health valuation were reviewed. Social differences are reasons both for health inequalities and spatial patterns of unprivileged area housing. In urban environments with poor air quality there is also a large concentration of low income residents. Less affluent population groups are more often affected by inadequate housing conditions including second-hand smoking and higher environmental burden in their residential neighbourhoods. Environmental injustice is highly correlated with other factors that link poverty with poor health, including inadequate access to medical and preventive care, lack of availability of healthful food, lack of safe play spaces for children, absence of good jobs, crime, and violence. The theoretical background and also results of the studies brought evidence that population health is affected by both socioeconomic and environmental inequalities. Air pollution is unevenly distributed in Ostrava and is related to distribution of socially disadvantaged environment and social exclusion as well.

Environmental health inequalities in contaminated industrial areas in Brazil

Environmental health inequalities in contaminated industrial areas in Brazil

Use of geographic indicators of healthcare, environment and socioeconomic factors to characterize environmental health disparities.

BackgroundAn environmental health inequality is a major public health concern in Europe. However just few studies take into account a large set of characteristics to analyze this problematic. The aim of this study was to identify and describe how socioeconomic, health accessibility and exposure factors accumulate and interact in small areas in a French urban context, to assess environmental health inequalities related to infant and neonatal mortality.MethodsEnvironmental indicators on deprivation index, proximity to high-traffic roads, green space, and healthcare accessibility were created using the Geographical Information System. Cases were collected from death certificates in the city hall of each municipality in the Nice metropolitan area. Using the parental addresses, cases were geocoded to their census block of residence. A classification using a Multiple Component Analysis following by a Hierarchical Clustering allow us to characterize the census blocks in terms of level of socioeconomic, environmental and accessibility to healthcare, which are very diverse definition by nature. Relation between infant and neonatal mortality rate and the three environmental patterns which categorize the census blocks after the classification was performed using a standard Poisson regression model for count data after checking the assumption of dispersion.ResultsBased on geographic indicators, three environmental patterns were identified. We found environmental inequalities and social health inequalities in Nice metropolitan area. Moreover these inequalities are counterbalance by the close proximity of deprived census blocks to healthcare facilities related to mother and newborn. So therefore we demonstrate no environmental health inequalities related to infant and neonatal mortality.ConclusionExamination of patterns of social, environmental and in relation with healthcare access is useful to identify census blocks with needs and their effects on health. Similar analyzes could be implemented and considered in other cities or related to other birth outcomes.

Perception of environmental quality of nearby localities to the Petrochemical Complex of Rio de Janeiro, Brazil.

Resumo O artigo tem por objetivo verificar a diferença da percepção de residentes sobre a qualidade ambiental de duas localidades próximas à área de construção do Complexo Petroquímico do Rio de Janeiro. Nove aspectos da qualidade ambiental (serviços de abastecimento de água, esgotamento sanitário e coleta de lixo; áreas de lazer; segurança pública; serviços de saúde; ruas; ar; rios) foram avaliados. Estudo transversal realizado com 240 residentes de Porto das Caixas e Manilha, ambos situados no município de Itaboraí-RJ, Brasil. A análise estatística envolveu o teste do qui-quadrado e exato de Fisher. Área de lazer foi o fator percebido igualmente pelos participantes das duas localidades do estudo com pior qualidade. A percepção da qualidade dos serviços de saúde, segurança e saneamento diferiu significativamente entre os moradores das duas localidades estudadas. A piora da qualidade ambiental foi relacionada por 51% dos residentes de Porto das Caixas à ausência de medidas mitigatórias após a ocorrência de um acidente químico local em 2005. A priorização de intervenções deve ser baseada na percepção de grupos populacionais específicos como estratégia que possa permitir a redução de iniquidades em saúde ambiental em contextos de instalação e construção de indústrias de petróleo e gás.

A cross-disciplinary approach to global environmental health: the case of contaminated sites.

Cross-disciplinary approaches to Global Environmental Health are essential to address environmental health threats within and beyond national boundaries, taking into account the links among health, environment and socio-economic development. The aim of this study is to present a cross-disciplinary approach where knowledge and findings from environmental epidemiology and social research are integrated in studying environmental health issues, focusing on environmental health inequities, public and environmental health literacy, and international scientific cooperation. In the case of contaminated sites, environmental epidemiology can contribute investigating the multidimensionality of equity for sustainable development practices. These practices entail a better understanding of environmental contamination, health effects pathways and improved capacities of different stakeholders to identify policy options for environmental risk prevention, remediation and management that will foster informed participation in decisions influencing communities. International scientific cooperation frameworks adopting equity principles shared by scientific community, populations and decision-makers may be of valuable support to this task.

Abstracts of the 27th Annual Conference of the International Society for Environmental Epidemiology (ISEE), 30 August-3 September 2015, Centro de Convenções Rebouças, São Paulo, Brazil.

The 27th annual conference of the International Society for Environmental Epidemiology was held 30 August-3 September 2015 in São Paulo, Brazil. The conference theme was "Addressing Environmental Health Inequalities." Sessions highlighted social determinants of health and how they can generate environmental health inequalities.

Building spatial composite indicators to analyze environmental health inequalities on a regional scale.

BackgroundReducing health inequalities involves the identification and characterization of social and exposure factors and the way they accumulate in a given area. The areas of accumulation then allow for prioritization of interventions. The present study aims to build spatial composite indicators based on the aggregation of environmental, social and health indicators and their inter-relationships.MethodPreliminary work was carried out firstly to homogenize spatial coverage, and secondly to study spatial variation of environmental (EI), socioeconomic (SI) and health (HI) indicators. The aggregation of the different indicators was performed using several methodologies for which results and decision-makers’ usability were compared.ResultsFour methodologies were tested: 1) A simple summation of normalized HI, EI and SI indicators (IC), 2) the sum of the normalized HI, EI and SI indicators weighted by the first principal component of a Principal Component Analysis (IC PCA), 3) the sum of normalized and weighted indicators of the first principal component of Local Principal Component Analysis (IC LPCA), and 4) the sum of normalized and weighted indicators of the first principal component of a Geographically Weighted Principal Component Analysis (IC GWPCA).ConclusionThe GWPCA is particularly adapted to taking into account the spatial heterogeneity and the spatial autocorrelation between SI, EI and HI. This approach invalidates the basic assumptions of many standard statistical analyses. Where socioeconomic indicators present high deprivation and where they are associated with potential modifiable health determinants, decision-makers can prioritize these areas for reducing inequalities by controlling the socioeconomic and health determinants.

Characterizing Environmental Health Inequalities With Spatial Environmental Database, Exposure Model And Biomonitoring Measures

Environmental health inequalities have become a major preoccupation for public health as evidenced by the emergence of the French national plans for health and environment. The third plan (2015-201...

Environmental Health Inequalities In Industrially Contaminated Sites In Europe

Early industrialization and poor environmental management practices have resulted in a multitude of sites that are heavily contaminated. In Europe, there are 340000 contaminated sites (CS) identifi...

Complex Systems Modeling Meets Community-Based Participatory Research: A Tool For Enhancing Critical Consciousness

Complex systems modeling has great potential as a tool for characterizing the environmental and social determinants underlying environmental health inequalities. Systems sciences has not been widel...

Examining The Correlation Between Environmental Cancer Risk, Incidence, And Mortality And Measures Of Environmental Justice

Introduction. This study assessed spatial variations in cancer risk and cancer outcomes (incidence and mortality) by racial and socioeconomic composition in South Carolina. Methods. Cancer risk data were ascertained from the 2005 National-Scale Air Toxics Assessment (NATA). Cancer outcomes (measured by incidence and mortality counts for 2006-2010) were retrieved from the South Carolina Central Cancer Registry. All cancer data were georeferenced to the 2000 Decennial United States Census tract boundaries in three counties. A Spearman's rank-order correlation was performed to determine the relationship between cancer risk or cancer outcomes and characteristics of environmental justice (percent Black, poverty, and low-income). Correlations were performed in SPSS 22.0. Bivariate choropleth maps were created in ArcGIS 10.2 to represent the geographic associations between cancer data and environmental justice. Results. We observed an inverse relationship between cancer risk and cancer incidence (rs = -1.90, p = .040). Total cancer risk was positively correlated with percent (%) Black (rs = .324) and % poverty (rs = .474), yet negatively related to % income (rs = -.542). Bivariate maps showed that 80% of the tracts with high cancer incidence/high percent Black population were also high cancer mortality/high Black population tracts. No high incidence or high mortality tracts were observed with simultaneously high total cancer risk. Conclusions. Our findings have implications for reducing environmental and cancer health disparities. Future studies should explore cancer risk and cancer causing risk factor clusters in diverse groups in the tri-county area assessed. With a better understanding of patterns of risk, we can develop tailored interventions and community-based environmental health programs that will inform, change, and create policies to reduce environmental health inequalities.