Analyze

On July 16th 1979, the largest by volume radioactive spill in US history took place in Church Rock (Kinłitsosinil), which is located in the southeastern “checkerboard area” of the Navajo Nation (Diné Bikéyah) and northwestern New Mexico. Due to a breach in the former United Nuclear Corporation’s uranium mill tailings dam, an estimated ninety-four (~94) million gallons of radioactive, toxic, and highly acidic effluent spilled into the Puerco River (Brugge et al. 2002; SRIC 2009).

The Church Rock Uranium Mill Tailings Spill marked the disastrous beginning of the end for the uranium mining industry in the Navajo Nation and New Mexico. Ironically, the spill occurred on the very same day as an event 34 years prior that marked the beginning of the uranium boom and the dawn of the atomic age: the Trinity Test of July 16th 1945, “the day the sun rose twice.” (Szasz 1984) Unlike the world’s first nuclear explosion in southern New Mexico, the Church Rock mill spill remains relatively underreported and has not yet registered at a national scale of collective memory.

“...Toxic Wastes and Race at Twenty (Bullard et al., 2007) revealed that communities of colour and poor communities were still being used as dumping grounds for all kinds of toxic contaminants. The authors discovered evidence that the clustering of environmental hazards, in addition to single sources of pollution, presented significant threats to communities of colour. Furthermore, the research showed that polluting industries frequently singled out communities of colour in siting decisions, countering the “minority move-in hypothesis”: the claim that people of colour voluntarily move into contaminated communities rather than being targeted in situ by dirty industries.” (122)

“Bullard (1990) has highlighted the problem of “Black Love Canals” throughout the United States, where issues of environmental injustice are deeply connected with environ- mental racism. For example, Bullard highlights the case of toxic DDT water contamination in the African American community of Triana, Alabama. In 1978, in the midst of the national media attention focused on Love Canal, residents in Triana raised complaints over ill-health effects and contaminated fish and waterfowl. Lawsuits in Triana against the Olin Corporation continued throughout the 1980s. Although the case is noted within environ- mental justice histories (see Taylor, 2014), it is not widely recognized or commemorated.” (126)

“Underpinning the slow, structural violence (see Galtung, 1969; Davies, 2019) of unequal and unjust toxic exposures is the problem of “expendability” … Pellow (2018) proposes that indispensability is a key pillar of critical environmental justice studies (alongside intersectionality, scale, and state power). This idea builds on the work of critical race and ethnic studies scholar John Marquez (2014) on “racial expendability” to argue that, within a white-dominated society, people of colour are typically viewed as expendable.” (127)

“National and international media headlines followed the Flint water crisis story as it unfolded, but, after the initial shock, Flint faded from media attention. It shifted from being a spectacular disaster to a case of slow violence. This paral- lels the dynamics of public memory surrounding many toxic disasters, struggles, and legacies.” (128)

The author’s main argument is two-fold. Acute environmental disasters (e.g., Chernobyl, BP Horizon Spill, Hurricane Katrina) that garnered public attention leave behind legacies of increased support for environmental action and legislation, although the public attention span is often too short for lasting change. At the same time, these disasters have received a disproportionate amount of public attention compared to the many more slow-moving toxicity disasters that affect people in more systematic but often less visible ways. Examples of this disparity include the contrast between the 1984 Bhopal disaster coverage, and the persistent toxicity in the area in the time since then in the form of industrial waste and infrastructure that is not maintained. It is additionally important to note that the cases that don’t receive much attention often affect marginalized groups (by race, socioeconomics) disproportionately.

The Emergency Medical Treatment and Labor Act is a law requiring that anyone coming into the emergency department will be stabilized and treated no matter what their insurance situation is. In terms of women's health, it is important to note that this means for active labors, medical treatment is necessary and required, no matter the health insurance of the patient. The purpose of this law to prevent certain patients from being turned away in an emergency situation or refused medical treatments if they are unable to pay, putting their health at risk.

EMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.

http://www.pitt.edu/~kconover/ftp/emtala-draft.pdf

This policy applies to American law and patients who are in need of emergency medical treatment and is to be followed by all emergency departments and personnel alike. 

This was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need  of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.

This policy greatly helped sculpt emergency medicine and public health. By giving the right to the patient to have emergency medical treatment required without proof of insurance or payment, astronomically influenced the amount of patients being turned away and their possibilty of developing worse illnesses or dying. In a paper I read, a young doctor in the late 70s and early 80s remembers watching a woman in labor give birth in the doorway of the hospital and proceed to borht her child in the parking lot after being turned away for not having insurance. By requiring hospitals and doctors to see that all ED patients get care, no patient was at risk of dying or complicating their baby's health and birth due to a lack of insurance, ultimately increasing public health efforts. Not all hospitals turned away their patients, but enough did to make it a public health concern and get Congress involved. EMTALA changed emergency medicine protocols but also public health expectations and actions.

http://www.hhnmag.com/articles/5010-the-law-that-changed-everything-and…

This policy was explicitly made for vulnerable populations who couldn't afford or for whatever reason did not have health insurance. The vulnerable parties that did not have health insurance were at risk of being turned away at hospitals during crucial times of need and emergency situations. This act completely absolved the worries and fears of this vulnerable population without health insurance by making it a law that these ED patients were to receive care and stabilization. This act was made for this specific vulnerable population, to prevent discrimination.