The health disparities that have long plagued our city, state and nation are now more obvious than ever, with COVID-19 shining a bright light on the historic and ongoing structural racism that for too long has resulted in woefully disparate health outcomes among people of color. The latest statistics show the novel coronavirus is disproportionately impacting people of color and people who live in areas with more air pollution.
Here in Louisville, those populations tend to overlap. Local and state officials have publicly recognized the need for increased testing in these communities, but we know that increased testing is not enough. In order to make sustainable change, we must do more to address the root causes that lead to increased deaths in these communities.
According to published research, increased long-term exposure to fine particulates is associated with more lethal outcomes for COVID-19 patients. Historically, and still today, our largest local sources of fine particulates, coal-fired electricity generating units, have been in the west and southwest portions of our community. Adding to that is increased exposure from highways and from concentrations of industry that in the past relied heavily on coal for fuel.
Further, a recent “Life at the Fenceline” report by the Environmental Justice Health Alliance, in partnership with Coming Clean, showed that residents living within three miles of high-risk chemical facilities (fenceline communities) have access to fewer hospitals and healthcare facilities. They are also areas of lower income, with less access to healthy food.
In Louisville, the neighborhoods surrounding the Rubbertown cluster of chemical plants and fuel terminals are clear examples of the cumulative impacts of these factors. Currently, air emissions from industrial operations in Rubbertown add a 5 to 10 in a million risk of cancer to those living in the shadow of those operations. That disparity today must be recognized, but moreover, just 20 years ago that added risk was as high as 355 in a million, leaving a legacy of health impacts. The residents of these neighborhoods, mostly people of color, are not dying due to personal behavioral choices, they are dying because of the systematic racism that has been built into policies for generations.
This is an environmental justice issue. This is a health justice issue. This is a justice issue. And we can change.
Louisville Metro Government, community leaders, and all Louisvillians must give strong, consistent support for current and future environmental and land use regulations that remove these inequities. Locally, we’ve seen incredible improvements in air quality, but disproportionate risk remains among those living near industry and highways. So even as we continue to fully enforce the laws we have, we must seek further reductions from our local industries, including our use of coal-based energy.
As a city, our government and our community must advocate for stronger regulations at the federal level, where over the past three years we’ve seen weakened rules to reduce air pollution ranging from carbon dioxide to mercury and, most recently, a rollback of Obama administration fuel economy standards for cars. This represents a rollback of public health protection, as proven by EPA’s own analyses, which identify the increase in health impacts, including deaths.
We must recognize those communities in Louisville who have been subject to the worst of our past and current environmental conditions. Mapped data showing health risk from air pollution, tree canopy coverage, urban heat concentrations, contaminated industrial properties and other indicators of environmental quality have strong correlations with health outcomes, including asthma, heart disease and cancer.
The Louisville Metro Department of Public Health & Wellness’ Center for Health Equity’s “2017 Health Equity Report” outlines a number of recommendations to help mitigate these harms, including targeting communities with concerted resources to provide equitable health infrastructure and ensure everyone can easily receive preventative medical services, as well as treatment for mental health, trauma and substance use disorder. We need to increase outreach about these health resources and ensure more opportunities for wealth-building, education, and employment among those who need it most. Finally, we must promote land-use policies and development opportunities that protect health and enhance quality of life. Infrastructure investments should improve environmental quality, not further degrade these neighborhoods.
While COVID-19 is spotlighting the injustice of the system, it is also presenting us with an opportunity to truly become an even more “compassionate” city. As we rebuild, we need to make sure we adopt a health and justice for all policy approach to urban design, public health, and environmental protection.
Residents in The East End have done nothing to deserve longer lives, just as residents of The West End have done nothing to deserve shorter lives. We have the opportunity to do better. We must do better.
Monica E. Unseld, Ph.D, MPH is an environmental justice advocate and founder of Data for Justice.
Michelle King, J.D., MPA, is Director of Program Planning and Executive Administrator at the Louisville Metro Air Pollution Control District.