EIJ CONCEPT: Addressing Social Determinants of Health and Health Inequity
A closer look into how to address social determinants of health and analyze community level impacts
A closer look into how to address social determinants of health and analyze community level impacts
Studie provides visual representations of lead concentration in Santa Ana cross matching it with vulnerability risk.
“Also of note when interpreting our results is that this study did not take into consideration the ingestion of heavy metals through the dietary route. Had we considered this additional exposure pathway, our calculated chronic daily intake levels of heavy metals would have been greater, resulting in higher estimated risk (particularly for metals such as Pb, As, and Cd which have been widely documented in various foods)” (Marsi et al. 2021)
“Both cancer and non-cancer risk at the Census tract level exhibited positive correlations with indicators of social as well as physiological vulnerability” (Marsi et al. 2021)
Exposure to heavy metals has been associated with adverse health effects and disproportionately impacts communities of a lower socio-economic status.
This study used a community-based participatory research approach to collect and analyze a large number of randomly sampled soil measurements to yield a high spatially resolved understanding of the distribution of heavy metals in the Santa Ana soil, in an effort to exposure misclassification. This study looks into average metal concentrations at the Census tract level and by land use type, which helps map potential sources of heavy metals in the soil and better understand the association between socioeconomic status and soil contamination (Marsi et al. 2021).
In 2018, soil samples of eight heavy metals including lead (Pb), arsenic (As), manganese (Mn), chromium (Cr), nickel (Ni), copper (Cu), cadmium (Cd), and zinc (Zn) were collected across Santa Ana. These were analyzed at a high resolution using XRF analysis. Then, metal concentrations were mapped out and American Community Survey data was used to assess the metals throughout Census tracts in terms of social and economic variables. Risk assessment was conducted to evaluate carcinogenic risk. The results of the concentrations of soil metals were categorized according to land-use type and socioeconomic factors. “Census tracts where the median household income was under $50 000 had 90%, 92.9%, 56.6%, and 54.3% higher Pb, Zn, Cd, and As concentrations compared to high-income counterparts” (Marsi et al. 2021). All Census tracts in Santa were above hazard inder >1, which implies non-carcinogenic effects, and almost all Census tracts showed a cancer risk above 104, which implies greater than acceptable risk. Risk was found to be driven by childhood exposure.
It was concluded that the issue of elevated soil contamination relates back to environmental justice due to overlap between contaminated areas and neighborhoods of lower socioeconomic status. Marsi et al. (2021) found there needs to be more community-driven recommendations for policies and other actions to address disproportionate solid contamination and prevent adverse health outcomes.
Published in May 2021, amid the coronavirus pandemic where in-person community workshops and meetings turned into weekly virtual meetings.
-> Authors:
Shahir Masri: Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine; air pollution scientist.
Alana M. W. LeBrón: Department of Health, Society, and Behavior, University of California, Irvine; Assistant Professor, Chicano/Latino Studies; Interests: structural racism and health, health of Latina/o communities, community-based participatory research.
Michael D. Logue: Department of Chicano/Latino Studies, University of California, Irvine
Enrique Valencia: Orange County Environmental Justice, Santa Ana
Abel Ruiz: Jóvenes Cultivando Cambios, Santa Ana; CRECE Urban Farming Cooperative member
Abigail Reyes: Community Resilience, University of California, Irvine
Jun Wu: Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine
This book builds on environmental justice research and concepts. In a reflection over the 1984 Bhopal gas tragedy, Kim Fortun (2012) proposed the beginning of a “late industrialism” era where disasters would be normalized as a result of conflicting information from the media and “experts” making it impossible for individuals to make informed decisions on politics and to demand environmental regulation. Bullard and Wright (2009) and Pellow (2018) proposed ethnic minorities and groups from lower socio-economic status are disproportionately burdened by toxic pollution; polluted communities face an uphill environmental justice battle against powerful corporations and local politicians to prove this disproportional toxic exposure. Brown (1993) and Allen (2003) proposed “popular epidemiology,” where communities would upkeep with their own health research, as an important way to include the community in research that would benefit them; with the benefit of having multiple different perspectives addressing one issue. Citizen science, coined by Alan Irwin (1995) is a popular concept that enforces community-based participatory research. Pellow (2018) proposed “critical environmental justices,'' defining it in four pillars: (1) “intersectional forms of inequality and oppression,” (2) “the role of scale in the production and possible resolution of environmental injustices,” (3) “recognition that social inequalities are deeply embedded in state power,” (4) “indispensability, arguing that “excluded, marginalized, and othered populations, beings, and things ... must not be viewed as expendable but rather as indispensable to our collective futures'' (Pellow 2018, 26).
Thom and Mah (2022) build on the importance of community inclusion in research. Although there are scholars interested in coming up with solutions on social-environmental problems. The community rarely benefits from the results of that research because there’s a huge disconnect between academia and neighborhoods with limited resources. Often, individuals of lower socio-economic status are left uninformed and underrepresented, even in cases of research. This book uses case studies of community-based participatory environmental health and justice research to show different ways to understand environmental injustice, political strategies, and ways to expand citizen science engagement and environmental literacy around the world.
Text focuses on questions about the production and spread of knowledge, and the role science plays in society. Thom and Mah introduce the term “post-truths” that is defined by the Oxford Dictionary as “denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.” Which factors into how the intersection of science, politics, and values around the world determine a population’s attitude towards environmental justice. They argue for the importance of “science, knowledge, and data that are produced by and for ordinary people living in environmental risks and hazards” (Thom and Mah 2022). In doing so, they recognize data isn't sufficient to solve environmental injustice, especially since issues of environmental pollution are so deeply intertwined with structures that perpetuate social inequalities. Instead, they suggest an interdisciplinary approach that integrates “legacies of environmental justice movement, participatory citizen science,” and “experts” to come up with holistic questions on how to overcome environmental inequality and advance the environmental justice movement amid challenges on the salience of environmental expertise.
Thom and Mah use four case studies of community-based participatory environmental health and justice research to show the importance of including citizens in scientific research. Citizen science refers to public engagement with science, from data sensing and crowdsourcing to design, collection, analysis of research. Although citizen science is not the only answer - with Catree (2016) pointing out that citizen-led processes have become a “lucrative business,” which creates a conflict of interest - this book redefines the meaning of “justice” within the environmental justice movement and explores “role and interpretation of citizenship within citizen science research (Thom and Mah 2022). They recognize there’s tension in balancing a community’s subjective experience and contextual knowledge with rigorous, scientifically appropriate research.
To tackle environmental injustice in a post-truth era, Thom and Mah (2022) argue there needs to be political change. An interdisciplinary approach is used to study local and global environmental justice challenges with a range of “qualitative and quantitative social science methods, including community-based participatory research (CBPR), epidemiology, ethnography, visual methods, and other innovative methods of participatory environmental justice and citizen science research” (Thom and Mah 2022).
"Health is one of our most precious resources. People everywhere want their families and communities to be healthy and to thrive. But what does it really take to make that vision a reality?