Environmental Justice, Science, and Public Health

Article excerpt

Since coalescing in the 1980s, the environmental justice movement has become one of the many forces influencing public health conditions and environmental health science. Shaped by principles of civil fights, democracy, and opposition to colonialism, environmental justice advocates echo an older and broader push to consider population health an issue of social justice, not merely the absence of disease in individuals. Linking American Indian and other non-European cultures' respect for a natural world in which the human species is only a dependent part, with principles of sustainability, self-determination, and cultural integrity, environmental justice advocates have insisted that environmental quality itself is an issue of social justice (Bullard 1993).

Knowledge in environmental science and medicine reflects the needs, interests, and perspectives of professionals, the business community, and government agencies that support research (Wing 2002). These institutions shape the choice of questions, research designs, and cultural norms regarding interpretation of data and public health implications (Wing 1998). Facing the routine use of science by institutions that create and regulate environmental hazards, the environmental justice movement has sought scientific documentation about exposures and health conditions that reflects the values and needs of affected communities. Environmental, social, and medical scientists have responded with empirical research that is driven by community concerns related to contamination, health, and justice. The development of partnerships and programs of support by private and government agencies, notably the National Institute of Environmental Health Sciences (NIEHS) Environmental Justice: Partnerships for Communication extramural grant program, started under the leadership of Dr. Kenneth Olden, brings prospects both for positive transformation of science and health and for retrenchment and reinforcement of existing inequities.

In this article, I argue that what has been called "a science of environmental justice" (U.S. Environmental Protection Agency (U.S. EPA) 2004), a science that can serve as a knowledge base for public health advocacy, cannot develop without revolutionary changes in both science and society. The developing science of environmental justice could become accommodated to production and maintenance of global environmental injustice, or it could promote efforts to reduce injustice and promote sustainability. A historical perspective on the determinants of public health and research about improvements in public health helps to place prospects for a science of environmental justice in perspective. I begin by considering inattention to popular struggles for health and justice in scientific accounts of the causes of declines in mortality and improvements in life expectancy in Europe and the United States during the 19th and 20th centuries.

The Role of Popular Movements in Epidemiologic Transition

Although the environmental justice movement emerged recently, the social relations that create racial and economic disparities in health and environmental conditions, the struggles against those disparities, and the scientific study of the causes of determinants of health have a long history. Prospects and challenges for creating a science of environmental justice that can contribute to improved public health are evident in this history.

The term "epidemiologic transition" was introduced at about the time when the 20th century epidemic of coronary heart disease (CHD) was near its peak in the United States, cancer rates were increasing, and new and re-emerging infectious diseases were not yet widely recognized as public health problems in the West (0mran 1977). Epidemiologic transition was proposed as a description of the West's shift from a health profile dominated by infectious diseases to one dominated by noninfectious diseases.

Mortality studies formed the basis for documenting epidemiologic transition and evaluating its potential causes. …