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California, USA

Misria

In this poster, we share preliminary reflections on the ways in which hermeneutic injustice emerges and operates within educational settings and interactions. Hermeneutic injustice is a type of epistemic injustice that occurs when someone’s experiences are not well understood by themselves or by others, either due to unavailability of known concepts or due to systemic barriers that produce non-knowing (Fricker 2007). In 2021, we entered into a collaborative project to design a high school curriculum on environmental injustice and climate change for California’s K-12 students. Although the project convenors aspired to support the diversity of California’s K-12 student population through representational inclusivity across the program participant, they reproduced essentialized notions of what it means to be an “included subject”. In our first inperson meetings, activities intended to invite difference in the curriculum writing and design community were encountered by participants as an opportunity to point to the margins of that community. Who was in the room and who was not? Initial counts excluded some writers whose identity was not readily apparent by race, ethnicity, or age. Some individuals who, to their consternation, were assumed to be white, revealed themselves as people of color. The project chose the “storyline model” of curriculum design to bring coherence across the teams. The model was developed by science educators to promote student agency and active learning. Lessons start with an anchoring phenomenon, which should hook students and produce enough questions to sustain inquiry cycles that culminate in consensus making. As a result, each grade-level unit of our curriculum was intended to focus on a single environmental phenomenon, like wildfire. However, informed by Gregory Bateson’s theory of learning, we sought to foreground complexity by recursively analyzing environmental injustice through case study analysis of many hazards, injustices, and places. It took multiple meetings over several months to arrive at an articulation of environmental injustice as our central phenomenon that recognizes the compounding impacts of both climate change and toxic pollution. It also required restructuring the working relationships between the project's administrative arm, the curriculum consultants, and the writing team. The image we include is a photograph of an exercise done together with another HS team as we were tasked to clarify the aims and goals of our imagined lessons. As is evidenced in the photograph, each writing team found it difficult to articulate learning outcomes as a series of checklists, or goals, separate from skill-development that represented the dynamic need for curriculum capable of examining climate change and the environmental justice needs for California’s students.

Tebbe, Margaret, Tanio, Nadine, and Srigyan, Prerna. 2023.  "Reflections on Hermeneutical Injustice in K-12 Curriculum Development." In 4S Paraconference X EiJ: Building a Global Record, curated by Misria Shaik Ali, Kim Fortun, Phillip Baum and Prerna Srigyan. Annual Meeting of the Society of Social Studies of Science. Honolulu, Hawaii, Nov 8-11.

1. WHAT IS THIS DATA RESOURCE CALLED AND HOW SHOULD IT BE CITED?

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Public Health Alliance of Southern California. California Healthy Places Index. 2019. https://healthyplacesindex.org.

 

© 2018 Public Health Alliance of Southern California

Permission is hereby granted to use, reproduce, and distribute these materials for noncommercial purposes, including educational, government and community uses, with proper attribution to the Public Health Alliance of Southern California including this copyright notice. Use of this publication does not imply endorsement by the Public Health Alliance of Southern California.

© 2018 California Department of Public Health (CDPH)

Permission is hereby granted to use, reproduce, and distribute these materials for noncommercial purposes, including educational, government, and community uses, with proper attribution to the CDPH, including this copyright notice. Use of this publication does not imply endorsement by the CDPH.

8. How has this data resource been critiqued or acknowledged to be limited?

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The index does not include certain neighborhood characteristics critical to health because they did not meet the criteria for inclusion (described in question 3). For instance, this included physician ratios (the number of physicians per 100,000 population) because data was missing for a majority of census tracts. In fact, the steering committee was unable to locate much data on health care access or quality at the census-tract level (only data on health care insurance coverage was available).  

 The index was previously critiqued in ways that led to a shift from framing data in terms of “disadvantage” towards a framework of “opportunity”. This led to not only a renaming of the index (from “the Health Disadvantage Index to the Healthy Places Index) but also a shift in reporting of data (e.g. highlight the percentage of the population with a BA degree or higher rather than the percentage of population without a college degree). 

The HPI is also limited in terms of the effects of confounding, with some indicators with strong evidence of health effects showing contrary associations with life expectancy at birth by census tract. The steering committee has also acknowledged that the HPI might not be accurate for census tracts undergoing rapid population change (e.g. due to immigration, rapid gentrification, or other changes).

The HPI notably does not correlate strongly with CalEnviroScreen, which the steering committee for the HPI noted failed to identify one-third of census tracts with the worst conditions for population health. The HPI is ultimately more centered on considering environmental factors as a part of overall health, rather than as a central determinant. However, this disconnect between CalEnviroScreen and the HPI may also be a reflection of the challenges environmental injustice advocates have faced in linking environmental factors to health outcomes (which might not be as visible and geographically direct as the links between health and other indicators).

5. What can be demonstrated or interpreted with this data set?

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The HPI draws data about 25 community characteristics into a single indexed HPI score. The includes sub-scores for 8 “Policy Action Areas”: Economic, Education, Housing, Health Care Access, Neighborhood, Clean Environment, Transportation, and Social Factors. These scores are meant to be used to evaluate health geographically. Each policy action area includes the following individual indicators and weights:

ECONOMIC (0.32)

  • Poverty
  • Employment
  • Income

EDUCATION (0.19)

  • Pre-school enrollment
  • High school enrollment
  • Bachelors attainment

HEALTHCARE (0.05)

  • Insured adults

HOUSING (0.05)

  • Severe cost burden low income
  • Homeownership
  • Kitchen and plumbing
  • Crowding

NEIGHBORHOOD (0.08)

  • Retail jobs
  • Supermarket access
  • Parks
  • Tree canopy
  • Alcohol establishments

CLEAN ENVIRONMENT (0.05)

  • Diesel PM
  • Ozone
  • PM2.5
  • Drinking water

SOCIAL (0.10)

  • Two parent household
  • Voting

TRANSPORTATION (0.16)

  • Healthy community
  • Automobile access

*The steering committee for the HPI sought to include race/ethnicity as a 9th policy action area, but they were prohibited from doing so by state law which does not allow California state agencies to use race as a basis for public contracting.

 

The primary HPI Index is designed to align with life expectancy at birth as a predictive measure of community health status. However, the Healthy Places mapping tool can also be used to create custom scores using different indicators. The mapping tool includes detailed definitions of each indicator.

Each indicator is linked to a policy guide, which outlines concrete actions (e.g. best practices, emerging policy options) that local jurisdictions can take to improve HPI indicators. These actions are sometimes aimed at addressing direct links between policy and an action area, and other times aimed at addressed the root causes of an action area. The mapping tool also enables filtering results by “Decision support layers” like health outcomes, health risk behaviors, race/ethnicity, climate change effects, and other layers that the alliance identifies as important for advancing “resilient, equitable communities in California”. Geographies (e.g. census tracts) can also be compared by indicator using a ranking tool. The pool function can be used to create customized aggregations of data to map (e.g. adding several census-tracts together).

4. What scales (county, regional, neighborhood, census tract) can be seen through this data resource?

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Data is available at several different scales: census-tracts, congressional districts, state assembly districts, state senate districts, cities, core based statistical areas, elementary school districts, metropolitan planning organization and medical service study areas.  

10. What steps does a user need to take to produce analytically sharp or provocative data visualizations with this data resource?

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Creating maps by different combinations of indicators or geographic aggregations could be tinkered with to produce provocative data visualizations. Ranking scores can be used to draw distinction between different census tracts. However, clear inequities are evident even without these adjustments, with the HPI index score clearly demonstrating noticeable differences across geographies. 

2. Who makes this data available and what is their mission?

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The California Healthy Places Index is made available by the Public Health Alliance of Southern California. Their mission is to “make health equity and racial justice a reality” through collaboration and data (https://www.thepublichealthalliance.org/). They engage in advocacy and mobilization to generate this change. They are composed of a coalition of executives representing 10 local health jurisdictions in Southern California (including Long Beach, Los Angeles, Orange, and Riverside, among others), an area they highlight as representing 60% of California’s population (with which they blur the boundaries between “California” and “Southern California”).

The alliance emphasizes pursuing equity using publicly available data and collaboration (with government agencies, legislators, hospitals, health plans, philanthropy, and community advocates). They present the Healthy Places Index (HPI) as a tool for exploring how life expectancy is impacted by community conditions.

More specifically, the HPI was created by a steering committee made up of epidemiologists and 3 public health coalitions led by the alliance.

7. HOW HAS THIS DATA RESOURCE BEEN USED IN RESEARCH AND ADVOCACY?

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This data has been used for assessments, decision making, and planning on a state, regional and local level in California by a wide range of actors, which include:

·  California Department of Public Health

·  Governor’s Office of Planning and Research

·  California Environmental Justice Alliance

·  the Hospital Association of Southern California

·  County Public Health Departments

·  Local/regional healthcare providers

 

For instance, Kaiser Permanente used the HPI in conducting a community health needs assessments for several areas in southern California (to comply with federal tax law requiring them to conduct a health needs assessment at least once every three years). They used the tool to identify the most under-resourced geographic communities and identify the factors that are most predictive of negative health outcomes. 

For this community health assessment, researchers also consulted residents, community leaders, government and public health department representatives through surveys, stakeholder interviews, and focus groups. The assessment identified several health needs that needed to be prioritized: access to healthcare, economic security, mental health, stroke, and suicide. This was used to guide implementation strategies in partnership with community-based organizations, hospitals and groups (e.g. identifying reducing food insecurity as a strategic priority and designing/implementing food benefits programs).

Other reports using the HPI include the Solano County Public Health Departments’ report entitled “Maternal and Child Verification of Cumulative Health Impacts from Social Factors,” the Los Angeles County Department of Public Health city and community health profiles, and the California Environmental Justice Alliance’s SB 1000 Toolkit.