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Lee argues that EJ practice has long stagnated over an inability to properly define the concept of disproportionate (environmental and public health) impacts, but that national conversations on system racism and the development of EJ mapping tools have improved his outlook on the potential for better application of the concept of disproportionate impact. Lee identifies mapping tools (e.g. CalEnviroScreen) as a pathway for empirically based and analytically rigorous articulation and analysis of disproportionate impacts that are linked to systemic racism. In describing the scope and nature of application of mapping tools, Baker highlights the concept of cumulative impacts (the concentration of multiple environmental, public health, and social stressors), the importance of public participation (e.g. Hoffman’s community science model), the role of redlining in creating disproportionate vulnerabilities, and the importance of integrating research into decision making processes. Baker ultimately argues that mapping tools offer a promising opportunity for integrating research into policy decision making as part of a second generation of EJ practice. Key areas that Lee identifies as important to the continued development of more effective EJ practice include: identifying good models for quantitative studies and analysis, assembling a spectrum of different integrative approaches (to fit different contexts), connecting EJ research to policy implications, and being attentive to historical contexts and processes that produce/reproduce structural inequities.

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seanw146
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1)            Factors affecting disease (HIV/AIDS) outcome in different biosocial settings are radically different despite similar, established “risk-factors” in lifestyles/behaviors for individuals. This is because biosocial factors play an important role that is far often overlooked by current medical systems and policies.

 

2)            mother-to-child transmission (MTCT) of HIV, antiretroviral therapy (ART) and infant formula (preventing pediatric aids transmission through mother). MTCT of HIV is driven through universal breastfeeding being mainly pushed by the existing medical structures of the local and international healthcare policy makers. They claimed that the difficulty giving access to infant formula in rural areas and stigma around signing up for an HIV project doomed it to failure; however the projects in Rwanda and Haiti proved otherwise, when the structural “violence” was addressed. This was done mainly by giving both distal and proximal support and care as well as addressing the other social-economic barriers to good medical care in these communities.

 

3)            When locals, who are much more aware of the areas biosocial setting, implications and problems, are utilized in the medical system, the results are multifold. Proximal care provided by an accompagnateur not only reduces barriers to care such as traveling to a hospital for basic medicine, but also creates jobs that contribute to raising the quality of life which is another major factor when examining structural “violence”.

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seanw146
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1)            In domains of biosecurity: bio-terrorism (smallpox, anthrax, etc.), emerging infectious diseases (AIDS, tuberculosis [TB], malaria, etc.), life science (intention production of various deadly organisms for research or otherwise), and food safety (animal borne pathogens and diseases like mad cow, E. coli, etc.)

2)            Global health and emergency response: The DOTS (Directly-Observed Treatment, Short-Course) program failed in several areas to be a service-ready anywhere in the globe for drug resistant TB in places like Georgia. The strict regulations in treatment did not account for the variance in doctor training and practices in this area of the world. Its rigidness led to the breakdown of the protocol adherence.

3)            Health security and modernization risks: As the world modernizes, we generate new risks that need to be addressed. For example, in the 20th century, the technological and system advancements in agriculture and food processing have aided in consistent and increased food supply, but also introduced new problems such as sanitation practices and diseases that led to the creation of the Food and Drug Administration and the expansion of the Department of Agriculture.

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seanw146