Avoidance of racism in environmental health epidemiology

A body of environmental health research has for decades linked the disproportionate impact of environmental health problems born by Black, Hispanic and disadvantaged communities to structural racism and societal factors that put communities of color at greater risk. A new commentary recently published in Environmental Health concludes that outside of the environmental justice context the term "racism" has rarely been mentioned in prominent environmental health journals.

The George Washington University Milken Institute School of Public Health Professor Melissa Perry co-authored the commentary with GW students and research staff in the Department of Environmental and Occupational Health. The research team reviewed environmental health literature dating back to the 1970s to identify any studies related to structural racism in environmental epidemiology.

Dr. Perry and her colleagues defined structural racism "as societal forces, policies and institutions that interact to produce and maintain racial and ethnic inequities" and characterized it as "insidious." "Often we as scientists pose the question of where the worst air pollution might be, where the highest exposure to pesticides might be," Dr. Perry said, "but we often think that exposures are equally distributed throughout a population when in fact that is not the case. All too often, those hazardous exposures are happening based on socio-demographic, race and ethnicity factors that we often ignore when we are investigating environmental health problems.

"All too often when we measure race, we find differences and that is as far as we go, we never seek to understand what might be driving those differences," she said.

When race is addressed, she said, the white experience becomes the standard or default scenario through which all other experiences are compared. In one example, male fertility studies that have set the worldwide "normal" sperm values are for the most part based on samples from men seeking assisted reproduction treatment. Such clinics are more likely to see men from higher economic backgrounds and who tend to be white rather than including diverse patient populations.

For years environmental studies have shown that communities of color have disproportionately endured the burden of environmental hazards and pollution whether it is the exposure of Black children to lead and other heavy metals, the impact of mining on Native Americans or toxic waste sites near communities of color. Epidemiologic studies have established neurologic, respiratory, cardiovascular and health problems caused by exposure to toxins and pollutants in the environment.

When the environmental health movement raised concerns and awareness about the deleterious effects of pollutants to health, communities of color were overlooked. It was the environmental social justice movement that emerged out of the modern Civil Rights Movement in the 1970s that challenged the failure to address the environmental conditions leading to health problems in Black and Hispanic communities.

The commentary observed that not investigating the impact of structural racism in environmental health can be misleading and historically has given rise to biological determinism, the implication that racial differences may be biological rather than societal. This occurred early in the COVID pandemic when for a time there was the implication that genetic differences accounted for the disproportionate number of cases among Black Americans.

The underrepresentation and underfunding of scientists of color in environmental research has compounded the problem, the authors said.

Dr. Perry and her colleagues offered several recommendations, the first being to acknowledge that racism is influencing the relationship between environmental hazards and health. She said it is also important to ask why the most highly polluting industries are placed in poor neighborhoods and what impact that may have had on these communities.

Dr. Perry said the paper seeks to make recommendations of things that could be done to change the field, including being intentional about the measurement of race and racism, intentional about training environmental epidemiologists to recognize these factors, and also to ensure that scientists of color are prominently featured throughout the scientific enterprise.