Kira Lou, Food Policy Research Intern — originally written in October, 2014
It has been a little over a month since I started my Master’s program in Public Health, and almost two weeks since I started here at CFJC. In this short amount of time I have opened my perspective of what public health, and environmental health in particular, encompasses. Not only is the field far-reaching but it is extremely interconnected. A month ago, I probably had a very limited understanding of what environmental justice was. Perhaps I thought it was the idea that certain people are exposed to environmental hazards more than others. While that may be true, it is of course so much more. Environmental justice can be thought of as an area of environmental health within public health, but I am starting to realize that it is actually pervasive across every concentration of public health. Furthermore, there often seems to be a dichotomy in the field of public health, between studying/researching on a university level, and public health practice in an action-oriented, hands-on approach. From just the beginnings of my classes and this internship, however, I have learned that in order to address the issue of environmental injustice there must be a partnership and collaboration between both ends of the public health spectrum.
The issue of environmental justice has surprisingly had a place in almost all of my classes thus far, though in none of them is environmental justice a focus. In epidemiology we are learning about methods to identify disease distributions, how to explain difference in incidence rates, and how to go about implementing programs to address those issues with the aim of improving the health status of populations. These differences in disease patterns between certain groups or populations can illuminate disparities that exist on a geographic, racial, or socioeconomic status level. It seems as though these health inequalities can often be traced back to environmental injustices, whether those be physical or social. Addressing these underlying injustices can often be instrumental in changing health outcomes.
In health policy and management, the focus has been on the changes that the Affordable Care Act will have on the health of Americans. The ACA in its attempt towards universal health care can be understood as a move to narrow health disparities by improving access and quality of care to people who in the past were left without health insurance. However, politics and ingrained institutional racism throughout the country may prove to be an enormous obstacle in achieving these goals.
In environmental health, climate change is at the forefront of conversation. The scientific community is in close to unanimous agreement on the fact that Earth is warming, resulting in a number of environmental effects including rising seawaters, extreme weather events, and especially here in California, more extreme heat days per year as we move forward. It is also clear that these changes will directly affect human health, and furthermore that there will be a disproportionate burden of climate change health effects on those who are already disadvantaged. While the environmental justice movement was largely started in response to toxic waste sites being placed in poor communities, I think that this issue of climate change being borne by underserved populations is the most pressing and distinct example of environmental justice today.
While rigorous science is essential to establish these inequalities in public health, the question becomes how do we implement strategies to eliminate them? Answering this question—and realizing that answering it is the right and just thing to do—then begins to blur the line between research and practice. For example, going into a diseased community to conduct a study on the effectiveness of a drug, then leaving without helping that community in the long run is an ethical issue. Making climate change policy without those who are most affected will only further exacerbate the already existing disparities, and implementing health care expansion without ensuring that newly covered individuals have appropriate access to medical care will not change the state of health inequalities. These are challenges that must be addressed as a priority when attempting to find a solution in public health problems, and the means of accomplishing those feats should employ collaboration between researchers and communities, and universities and organizations.
The approach of Community Based Participatory Research (CBPR) is one that strives towards this collaborative process, which ultimately works to reduce and eliminate social and environmental injustices. Research is used to inform policies and practices in communities, but just as importantly the community informs the research at the same time. This is good for the community because they are given a voice and a role in the process that ultimately will affect them. However, it is also beneficial to the research because community can inform researchers of what the most pressing issues really are, and the community can have an active and important role in data collection and organizing in order to carry out the research. This approach attacks a problem within a community from all directions, and ultimately it achieves established ethical requirements that all research must follow: respect for persons, beneficence, and justice.
While CFJC may not always conduct their own CBPR studies, they consistently use its guiding principles to inform all of the work in which they are involved. While policy may be a large aspect of their involvement, instead of falling into the often bureaucratic trappings that come with policy, CFJC encourages community oriented organizations to collaborate and communicate in order to influence policy with the genuine interest of local communities in mind. Another example of CBPR principles having a central role in CFJC’s work is their involvement with the Growing Equity from the Ground Up project. The initiative has an apprenticeship component, where a curriculum works to develop local experts and leaders in urban agriculture. However, instead of using local land and resources for implementing and advancing this apprenticeship program, the larger of aim of GEGU is in fact to encourage and support the collaboration of local food and farming groups. This will hopefully cultivate civic engagement in the community and ultimately lead to systemic change in how groups within one community communicate and work together for changes they hope to see. This idea of including community needs in research and programs is central to CBPR theory, and CFJC fosters that theory in practice.
My view of how environmental justice, policy, CBPR, and so much more is just starting to form and make sense to me. However, in just a few weeks, the theory that guides CFJC’s work has transformed my perspective on these concepts into understanding how tangible actions can be carried out in order to work towards improving the well being of communities. I am excited to see how this perspective grows during my internship here, and appreciative to have the opportunity to have a part in carrying out the methods and principles necessary to work towards environmental justice.