Air Pollution Disproportionally Affects People of Color, Lower-Income Residents in DC

The rates of death and health burdens associated with air pollution are borne unequally and inequitably by people of color and those with lower household income and educational attainment in Washington, D.C., according to a new study.

Air pollution is considered the leading environmental risk factor to health, and recent efforts have successfully brought down levels of fine particulate matter, or PM2.5, in the air in the D.C. region.

The new study found that while deaths and health burdens associated with PM2.5 halved between 2000 and 2018 in the D.C. area, disparities and geographical segregations in health effects persist.

Most impacted by PM2.5 air pollution are people living in wards five, seven and eight in the District’s east and southeast regions. Researchers found in southeast wards, baseline disease rates are five times higher for chronic obstructive pulmonary disease, lung cancer and stroke, up to nine times higher for all-cause mortality and coronary heart disease, and over 30 times higher for asthma emergency department visits, compared to northwest neighborhoods.

In these most impacted neighborhoods, residents have 10% lower education and employment rates, 10% more residents are living in poverty, their median household income is $61,000 lower than households in the rest of the city, and residents have about 10 fewer years of life expectancy. The top 10 impacted neighborhoods have a 54% higher proportion of Black residents and a 44% lower proportion of white residents.

This study highlights the importance of detailed health and air quality data, and the researchers hope it can guide future policymaking to address environmental health disparities and serve as a model for addressing air pollution health assessments elsewhere. The research was published in GeoHealth, AGU’s journal investigating the intersection of human and planetary health for a sustainable future.

“We knew that concentrations were higher in the east [of D.C.], and we knew that people were getting sicker in the east, but I don’t know if we were able to tell before that they were getting sicker because of pollution,” said lead study-author Maria Castillo, a graduate student in City Planning at MIT. “Now that we apply all these calculations, all these concentration response functions, we’re able to tell people, ‘Air pollution is the cause of some of the morbidity outcomes that you are seeing in this area.’ Making that connection between pollution and health impact outcomes I think is very powerful.”

Unequal health outcomes can be attributed to two main drivers, according to study co-author Susan Anenberg, an environmental health expert at George Washington University. First, air pollution concentration differs by neighborhood. Infrastructure such as highways or bus depots can release significant pollution into a neighborhood, negatively affecting residents.

The second driver is an individual’s health status, independent of air pollution. Rates of underlying disease persistently differ by neighborhoods, with lower life expectancy and greater rates of asthma, health endpoints and emergency visits seen in D.C.’s southeastern neighborhoods. Those underlying health issues can make residents more vulnerable when exposed to pollutants and result in higher levels of poor air pollutant-related health outcomes.

“You can’t think about air pollution in isolation. When it comes to health risks and environmental justice, we have to think of the total lived experiences that people are having,” Anenberg said. “If folks don’t have adequate access to quality healthcare, that means when they are exposed and have health effects as a result of that air pollution exposure, they may have worse outcomes because they’re not getting the treatment that they need.”

Focusing on Fine-Resolution Data

Researchers worked with new exposure assessment tools to measure the impacts of air pollution in the nation’s capital. To evaluate air pollution, Castillo and her co-authors used pollution estimates that combined information from on-the-ground air monitors with satellite data to capture some of the spatial differences in pollution levels across the city.

For health outcome data, they looked at both Centers for Disease Control data as well as administrative disease rate data obtained from the D.C. Department of Health, which provided health data in greater detail on a local scale.

Researchers aim to take advantage of the unique position of D.C. as a city with thought leaders in environmental justice and policy, and with more granular health data than other states, to make scalable solutions applicable in other regions. They hope this study can be used as a model to not just bring down overall air pollution but create targeted policy.

“I think one of the strengths of the study is that it really laid out a road map that could be done other places,” said Jonathan Levy, an expert in Environmental Health at Boston University who was not involved in the study. “The air quality data they used, that’s universally available every place across the U.S. … there are real opportunities to take this kind of approach and do it much more widely.”

This study could also be used as a model help ensure policymaking is driven by health data that accurately reflects racial diversity and health outcome disparity in populations — something that was not historically the case, according to Kelly Crawford, study co-author and Associate Director of the D.C. Department of Energy and Environment.

“Doing further studies that at the very least acknowledge the disparity or lack of diversity in data sets… I think that is the role of government and research in addressing racism,” Crawford said.

What the U.S. Government Can Do to Address Energy Insecurity

By Sanya Carley and David M. Konisky

Energy insecurity—defined as the inability to pay one’s energy bill or avoid utility disconnection—is a pervasive and growing problem in the United States. Approximately 4.7 million low-income households were unable to pay an energy bill over the past year, 4.8 million received a notice for utility disconnection, and 2 million were disconnected from the electric grid, according to a recent study. Energy insecurity is disproportionately borne by people of color, as well as households including small children or individuals that rely on electronic medical devices.

Without access to electricity and other energy services, people cannot maintain adequate body temperatures, keep perishable food or refrigerable medicines cold, and power electronics like e-learning or medical devices. People experiencing energy insecurity face impossible tradeoffs between paying their utility bills and purchasing other necessities, such as food or healthcare services, and may resort to risky financial decisions (like using payday lending) or dangerous heating behaviors (like burning trash, using ovens for space heating, and relying on space heaters).

In the early months of the COVID-19 pandemic, Congress and state governments provided some protection for U.S. families from the worst consequences of energy insecurity. The CARES Act provided financial support through direct cash assistance and enhanced unemployment to many Americans facing material hardship. At the same time, almost 30 states banned energy utilities from disconnecting their customers due to a lack of payment. These protections, however, have largely been diminished as the pandemic continues. As of the start of February, only seven states and the District of Columbia still had emergency utility disconnection protections in place—with five set to expire before April. And while these critical supports fade, our research shows energy insecurity is deepening across the country, and likely to get even worse.

Energy Insecurity is Pervasive—But Cash Assistance Helps

Since the onset of the pandemic, we have conducted surveys of a nationally-representative sample of 2,000 households with incomes at or below 200 percent of the federal poverty line. Their responses reveal that millions of low-income Americans are struggling to pay their energy bills and avoid electric utility disconnection. From May through August, 21% of the households we have surveyed reported not being able to pay at least one monthly electricity bill, nearly 15% received a shutoff notice, and 6% had their service disconnected. There are also large racial disparities in energy insecurity. When compared to low-income white households, Black and Hispanic households are about 2 times more likely to be unable to pay their energy bills and between 3 and 8 times more likely to have their electricity shut off, respectively.

During the summer months, our survey further revealed that nearly one in five low-income households had to forgo other basic necessities such as buying groceries or accessing medical care to pay an energy bill. Others chose to delay payments to energy utilities, which means deferring payments (often with late fees) to the future. Nearly 40% of respondents indicated that they have at least some utility debt. In cases where utility disconnection protections are lapsing, consumers that carry debt may face immediate disconnections, which are typically accompanied by steep disconnection fees and subsequent reconnection charges.

Importantly, our analysis of the survey responses shows that households that received cash assistance from the federal government had lower rates of energy insecurity. For example, recipients of emergency assistance from the federal Low-Income Home Energy Assistance Program (LIHEAP) and people that received a CARES Act check were less likely to miss paying a bill or face the risk of service disconnections. These programs, therefore, effectively reduced energy insecurity in our sample of low-income households.

What Can Government Do Now?

Energy insecurity is a chronic problem for millions of Americans that will require long-term solutions to alleviate material hardship, improve the energy efficiency of homes, reduce energy burdens, and carefully consider how to protect vulnerable populations from utility disconnection. The COVID-19 pandemic has indisputably made matters worse and there are several things that policymakers should immediately do to alleviate the burden of energy insecurity:

  • The federal government should impose a national moratorium on energy utility disconnections so that no Americans lose access to critical energy services until the economic disruption from the pandemic eases. A federally-mandated moratorium on disconnections can provide much needed protections while superseding the patchwork of temporary state protections. In the absence of a national moratorium, governors should put state-level protections in place.
  • Congress should more deeply invest in the Low-Income Home Energy Assistance Program to provide eligible Americans with short-term, emergency cash assistance to pay energy bills so as to avoid disconnections, and more significantly invest in the Weatherization Assistance Program to improve the efficiency of their homes for the long-term.
  • States should revisit their long-standing utility disconnection protection policies now that we have learned more about the prevalence of energy insecurity across the United States, both in general and for vulnerable populations in particular.

Age-Related Racial Disparities in Suicide Rates Among Youth Ages 5 to 17 Years

Suicide rates in the United States have traditionally been higher among whites than blacks across all age groups. However, a new study from researchers at Nationwide Children’s Hospital and collaborators published today in JAMA Pediatrics shows that racial disparities in suicide rates are age-related. Specifically, suicide rates for black children aged 5-12 were roughly two times higher than those of similarly-aged white children.

“Our findings provide further evidence of a significant age-related racial disparity in childhood suicide rates and rebut the long-held perception that suicide rates are uniformly higher in whites than blacks in the United States,” says Jeff Bridge, PhD, director of the Center for Suicide Prevention and Research at Nationwide Children’s and lead author of the publication. “The large age-related racial difference in suicide rates did not change during the study period, suggesting that this disparity is not explained by recent events such as the economic recession.”

For older children, the trend reverses back to the national average. For youth aged 13-17 years, suicide was roughly 50 percent lower in black children than in white children.

Researchers obtained data for cases in which suicide was listed as the underlying cause of death among persons aged 5-17 years from 2001-2015 from the Web-based Injury Statistics Query and Reporting System (WISQARSTM) of the Centers for Disease Control and Prevention.

From 2001-2015, for American youth aged 5-17 years, 1,661 suicide deaths in black youths and 13,341 suicide deaths in white youths occurred. During this period, the overall suicide rate was about 42 percent lower in black youth (1.26 per 100,000) than in white youth (2.16 per 100,000). However, age strongly influenced this racial difference, as seen when suicide rates among 5- to 12-year-olds and 13- to 17-year-olds were analyzed.

“The existing literature does not adequately describe the extent of age-related racial disparities in youth suicide, and understanding these differences is essential to creating targeted prevention efforts,” says Dr. Bridge, also a professor of Pediatrics, Psychiatry and Behavioral Health at The Ohio State University College of Medicine.

While the findings highlight an important opportunity for more targeted intervention, these data are limited and cannot point to the potential reasons for the observed differences.

“We lacked information on key factors that may underlie racial differences in suicide, including access to culturally acceptable behavioral health care or the potential role of death due to homicide among older black youth as a competing risk for suicide in this subgroup,” Dr. Bridge elaborates. “Future studies should try to find out whether risk and protective factors identified in studies of primarily white adolescent suicides are associated with suicide in black youth and how these factors change throughout childhood and adolescence.”

“Parents and health providers should be aware of the importance of asking children directly about suicide if there is a concern about a child,” added Dr. Bridge. “Asking children directly about thoughts of suicide will not put the idea in a child’s head or trigger subsequent suicidal behavior.”

Responsible reporting on suicide and the inclusion of stories of hope and resilience can prevent more suicides. You can find more information on safe messaging about suicide here.  If you’re feeling suicidal, please talk to somebody. You can reach the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to Crisis Text Line at 741-741.

Our Social Responsibility in Combating Oppression

As a Social Worker, I am committed to social justice. However, as I have always been on the frontline doing day-to-day work with individuals and families, I left political intervention and macro social work to others. I have spent too much time thinking and feeling that someone would come along and help improve the state of Black America, but I can not stay silent any longer.

We have spent too much time having the same conversations ending with the same list of demands that will never be achieved; and they won’t be achieved because they are unrealistic. As a 33-year-old woman of color, I have heard these demands, but I am more concerned with creating our system of justice than I am with getting others to amend theirs to suit the needs of my community. The Black community in America should consider the following:

Stop believing anyone owes us anything

screen-shot-2010-02-01-at-16-14-521If this is true for individuals trying to succeed in a chosen career, why isn’t it true of a community? How many oppressed people sit back waiting for their oppressors to correct the system of oppression they created for their own benefit? I am aware that the government promised 40 acres and a mule.

What I am not clear on is why we continue to expect people who don’t even see us as human beings to honor a promise that was quickly repealed? It gave with one hand and took it back with the other. Have these demands for a repealed “promise” prove productive or prosperous for us? No. What it has done is keep us locked into poverty and a slave mentality. It is no longer a valid argument and we do ourselves no justice trying to change a system built to deny. We need to move on and forward.

Stop addressing each other as n***ers or any variation of the word

The argument is that by using it we take the power away from the word. The truth is that argument is a blatant lie. What we’ve done is give others not only permission but license to use that diminutive word without any context to its damaging nature. The truth is, I doubt anyone who uses this word (besides those who aren’t people of color) would feel so confident as to walk away from a Caucasian person using this word. The truth is, if they heard this shouted when they were out on their own in the middle of Mississippi, they wouldn’t bother sticking around for an explanation. As long as the word precedes an attack on my person, either physically or verbally, it is unacceptable. We need to stop using the word and stop accepting it from others. We are better than that.

Establish a national Black Caucus

I know there is a congressional caucus that is looking at the representing the interests of the African-American community. However, I am proposing an expansion or a separate entity. The remit would be calling our prominent figures that are doing things that are counterproductive to change, prosperity and/or progression within the community. We would manage public relations of national community issues – sending representatives to rally locals and improve media portrayal of the community. We would prepare local political candidates to represent the community and create local caucuses to help them address the issues prevalent in their own communities. It would be a coming together of local and national leaders.

Local lobby for fair and appropriate representation in communities where we are the majority

We need to work with our young people to help them understand and get into politics. We need to support our own who want to get into politics. We need to support those with track records of supporting or being involved in initiatives that address local concerns. We need to understand politics and the dynamics of representation on a larger scale.

Get our young people involved

We need to get our economists, political science majors, policy makers involved in local government early. Create local internships and fellowships etc so they are talking, strategizing and creating actions plans to move forward locally.

Take notes from other communities on building and circulating wealth within the community

We continue to need educating on finance. Not only on the use of money, credit and the like, but also on investments, financial planning, equity and other issues. We need to build up the work ethic and sense of community/communal assistance. We need to own more and to be educated on how to do this so that we hold on to it. We need to know more about possible tax breaks, write-offs and rebates for volunteer work, pro-bono work etc.

Take responsibility for our own wealth and prosperity

We need to stop relying on “others” to move our community forward on a local level. There are many national programs looking at the bigger picture but we need to empower the “impoverished” so they learn to help themselves. Stop being so comfortable with “others” buying in our neighborhoods when we own nothing. Stop blaming anyone except ourselves for our lack of progress because in truth we haven’t done all we can do. Start accepting the responsibility to ourselves, to each other and to our communities.

Teach and accept social responsibility

We need to help our children and young people gain work experience within their own neighborhoods first and foremost, encourage volunteerism from a young age as a means of community building, developing social skills and local pride while also developing employable skills. We need to make local investments in restorative justice and reparations to discourage crime and rebuild what has been broken. We need to, as adults, model this behaviour for our children and volunteer to help each other and each other’s children.

Understand that if we want change we have to create it. We can’t depend on our oppressors to help us progress. No one will give us anything we haven’t taken. Discussions are important but only as predecessors to action which will facilitate change.

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