Environmental Health Disparities and the Roles and Responsibilities of Researchers

Editor’s note: Much of our research at the Duke Superfund Research Center is done in the laboratory, under controlled conditions, with single chemical exposures. Outside of the laboratory, people are exposed to many different chemicals with each passing minute, and we don’t live in carefully controlled environments. To understand these “real life” exposures, our researchers are beginning to explore how exposure to chemical mixtures such as household dust may impact health. We’re also beginning collaborations with colleagues across Duke and Durham to explore the impact of these and other chemical exposures in our community, their implications for later life health, and health equity concerns in Durham more broadly. We have ongoing discussions with Duke’s School of Nursing on how best to collaborate on this effort, and continue to build partnerships with others across Durham.

As we consider this new area of work, we also want to consider the role of structural and systemic forces that help shape environmental health disparities in Durham and elsewhere. In that spirit, we are proud to share the writings of Amy Yoon, a Duke Undergraduate with whom we have collaborated with on blog posts exploring these topics.

By Amy Yoon, Undergraduate Student, Duke University

The COVID-19 pandemic has exposed and exacerbated the systems and structures that cause inequities. Many marginalized groups, including Black, brown, and Indigenous; poor and working class; unhoused and incarcerated people, have been disproportionately affected by the virus. But these disparities highlighted by COVID-19 are not new, nor are they due to individual differences in biology or behavior. They are the effects of institutionalized oppression from the systems of white supremacy and anti-Blackness, racial capitalism, patriarchy, colonialism and imperialism.

The effect of these systems of oppression on environmental health can be seen through environmental health disparities (EHDs). The EPA defines EHDs as “inequities in illnesses that are mediated by disproportionate exposures associated with the social, natural and built environment.” These disparities often exist along racial, ethnic, and socioeconomic lines. Underlying EHDs are differences in social determinants of health (SDOHs), or factors in the places people live, learn, work, and play that can impact health risks and outcomes.

Both EHDs and SDOHs are constituted by systems and structures of oppression. Negative SDOHs, such as poverty and lack of access to housing, healthcare, and food, are produced by racial capitalism and, as Ruth Wilson Gilmore explains racism as “state-sanctioned and/or extralegal production and exploitation of group-differentiated vulnerability to premature death.” We see this, for example, in substandard minimum wage or lack of universal healthcare, food apartheid, housing discrimination, terrorization by police, immigration forces, and prisons that have compounding effects on the livelihoods of especially poor and working class and Black, brown, and Indigenous peoples. These vulnerabilities are extremely racialized and classed, and in the same way, negative SDOHs compound on marginalized groups, causing and entrenching EHDs.

This is especially evident in environmental racism, defined by Dr. Robert Bullard as “any policy, practice, or directive that differentially affects or disadvantages (whether intended or unintended) individuals, groups, or communities based on race or color.” Environmental racism is a function of white supremacy and settler-colonialism, and it causes and exacerbates EHDs and undermines communities’ self-determination, health, and wellbeing. For example, inequitable siting of pollution sources in low-income communities of color and/or “willful neglect” by the state disproportionately exposes many Black, brown, and Indigenous peoples to environmental contaminants. With the pandemic, Black people and other people of color who are more likely to live in areas with high levels of air pollution also have greater health risks and impact from a respiratory illness like COVID-19.

In the 1970s and 80s, the environmental justice (EJ) movement in the U.S. formed in response to the many environmental injustices. The movement has been led by Black and Indigenous peoples committed to eliminating systems of oppression, including racism, and their environmental harms, and creating sustainable relations between people and with the Earth. This is evident in “The Principles of Environmental Justice,” written by leaders of the EJ movements at the First National People of Color Environmental Leadership Summit in 1991. Their principles extended beyond policy reform to the sacredness of the earth, self-determination, right to “ethical, balanced and responsible uses” of land and resources, and opposition to “military occupation, repression, and exploitation” of land and life. These principles continue to ground EJ work today.

Environmental health scientists have to be explicit about the root causes of EHDs and should be committed to not just studying but ending these unjust systems. Black, Indigenous, and other people of color and the poor and working class are subject to EHDs because this country is structured by white supremacy, capitalism, and colonialism. EHDs can only be eliminated with an end to these systems. Environmental health scientists must be led and guided by Black and Indigenous leaders of the EJ movement to end environmental harms, dismantle systems of oppressions, and work to build a better world.