Save Money! Stay Healthy!

710 freewayOK, that headline may not garner as many hits as Sarah Palin or Charlie Sheen, but maybe it will bring in more readers than “Cumulative Environmental Impacts in Los Angeles: Public Health’s Role in Emerging Policy Solutions.” I’m trying to put into practice something I learned at Wednesday’s conference by that name where I also got enough facts to delight any data junkie. But speaker Dr. Tony Iton, senior vice president of the California Endowment said the public health community has put “too much emphasis on facts and data” out of the belief that “once people know the truth, things will change.” But they don’t change. So if you want data, I’ll tell you later where you can go to access some. Right now, I’d rather tell a story about two neighborhoods.

My story starts with a friend who lived in Pasadena years ago when smog obscured the view. When she returned more recently for a visit, she looked around in shock and said, “Were those mountains always there?” An air quality success! Then the story goes on to tell of the children, K-8th grade, who attend the Hudson School in West Long Beach and study and play next to the road on which 500 trucks an hour travel from the port up to the Union Pacific railyard, emitting carcinogenic diesel exhaust. Andrea Hricko of the USC Environmental Health Sciences Center told us that the Air Quality Management District has measured the highest level of toxic particulates anywhere in the region right at the site of the school. Now Union Pacific wants to double the size of their yard. Burlington Northern Santa Fe proposes to build a new one nearby.

Andrea Hricko of the USC Environmental Health Sciences Center

Andrea Hricko of the USC Environmental Health Sciences Center

What story do you imagine those little kids tell about themselves and their lives?

Being Poor is Expensive

Dr. Iton told a story too, about two universes co-existing in the same city, in this case, Baltimore, where there’s a 30-year difference in life expectancy between people in a high-income neighborhood and people in a low-income neighborhood. (Guess which universe boasts longer-living residents?) “There’s a cost to being poor,” he said, “and you can measure it in death.” In the Bay area where Dr. Iton served as director of the Alameda County Public Health Department and also as a physician for the San Francisco Dept of Public Health, the gap between life expectancy for white males and black males increased between 1960 to 2005. (In case you’re wondering, deaths attributed to homicide and HIV/AIDS were statistically insignificant. The disparity was based on chronic conditions such as heart disease, cancer, and stroke).

“We can’t regulate one facility and one chemical at a time,” said Dr. Rachel Morello-Frosch of the UC Berkeley School of Public Health, because of the cumulative impact of “multiple hazards and greater vulnerability due to social stressors.” Particulates, for example, affect all people who are exposed and lead to lowered birth weights, but the effect is strongest on African American babies. Similarly, there are higher rates of pre-term deliveries for all people living in heavy traffic corridors, but the rate is highest in poor neighborhoods.

boy with inhaler

Waste Sites in Low Income Communities

Land use and planning has allowed toxic release industries and waste sites to concentrate in LA’s low-income communities of color near homes, churches, senior centers, daycare centers and schools. Pesticide factories. Chrome-plating factories. Railway yards. Metal recyclers. Auto-body paint shops. Many of these businesses are small so they are unregulated or entirely unknown to regulators while structural inequality makes poor people more vulnerable to toxins and chronic disease as they cope with bad schools, low-wage jobs, violence on the street and at home, discrimination, substandard housing, inadequate nutrition, and chronic stress.

“Health care,” said Dr. Iton, “is only a small part of overall health.” He told us studies showed “every additional $12,500 in household income buys another year of life.”

I get it. I’m convinced. But, I wondered, when people who’ve done well in life feel they’ve earned that greater income and therefore earned those extra years, what do you say to convince them something is wrong with this picture? Call them names?

We need to “construct a new narrative,” Iton said, one “that speaks to the values of the dominant society.” Then, we can hope, more people will get on board, participating in solutions.

Dr. Richard Jackson of the UCLA School of Public Health, an expert on effect of the environment on health, especially on children, offered an example. For years, he fought to regulate or ban one pesticide after another and always lost–as long as he kept focusing on the harmful effects on farmworkers and their children. When he started to talk about the dangers that pesticide residue on foods pose to all Californians and their children, the cause got traction. I could get mad at the people who cared only about their own families but maybe it makes more sense to seek common ground and alliances with them (while, of course, continuing to organize in low-income communities of color to challenge the structural conditions that generate health disparities).

Can we create the narrative in which everyone–regardless of income and neighborhood–has a stake in healthy communities? Cont’d

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