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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

 

I looked into how EMS operates in situations that are beyond protocols, standing orders, and medical control. I also looked into how story cases are used by other medical professionals. Further I looked into how “evidence” based approaches are formulated for studies and research.

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seanw146

1) “…what would happen if race and insurance status no longer determined who had access to the standard of care?

…in addition to removing some of the obvious economic barriers at the point of care, the clinicians and researchers considered paying for transportation costs and other incentives as well as addressing comorbid conditions ranging from drug addiction to mental illness. They also implemented improvements in community-based care, conceived to make AIDS care more convenient and socially acceptable for patients. The goal was to make sure that nothing within the medical system or the surrounding community prevented poor and otherwise marginalized patients from receiving the standard of care.

The results registered just a few years later were dramatic: racial, gender, injection-drug use, and socioeconomic disparities in outcomes largely disappeared within the study population [35].”

2)            “This model [PIH’s model], with conventional clinic-based (distal) services complemented by home-based (more proximal) care, is deemed by some to be the world's most effective way of removing structural barriers to quality care for AIDS and other chronic diseases.”

3)            “While some interventions are straightforward, we also have to recognize that there is an enormous flaw in the dominant model of medical care: as long as medical services are sold as commodities, they will remain available only to those who can purchase them.”

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seanw146

1) “The current concern with new microbial threats has developed in at least four overlapping but distinct domains: emerging infectious disease; bioterrorism; the cutting-edge life sciences; and food safety”

2) “’Global health’ is a second field in which health threats have been problematized in new ways.”

3) “The regulation of what Ulrich Beck calls “modernization risks” comprises a third field in which biosecurity has been newly problematized.”

4) “Although there is a great sense of urgency to address contemporary biosecurity problems— and while impressive resources have been mobilized to do so — there is no consensus about how to conceptualize these threats, nor about what the most appropriate measures are to deal with them.”

 

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seanw146

With over 80 citations, and a wide variety of sources (few of which are repeated), we know that this research article was infer that a good deal of time and care was spent on this article. There are lots of citations to steel investigation, structural and architectural references, government building standards, similar historical disasters, and news articles reporting on 9/11. Without even reading the article, one can suppose a good deal about the article and how it was produced.