Pervasive structural racism in environmental epidemiology

Abstract

Background Epistemological biases in environmental epidemiology prevent the full understanding of how racism’s societal impacts directly influence health outcomes. With the ability to focus on “place” and the totality of environmental exposures, environmental epidemiologists have an important opportunity to advance the field by proactively investigating the structural racist forces that drive disparities in health. Objective This commentary illustrates how environmental epidemiology has ignored racism for too long. Some examples from environmental health and male infertility are used to illustrate how failing to address racism neglects the health of entire populations. Discussion While research on environmental justice has attended to the structural sources of environmental racism, this work has not been fully integrated into the mainstream of environmental epidemiology. Epidemiology’s dominant paradigm that reduces race to a mere data point avoids the social dimensions of health and thus fails to improve population health for all. Failing to include populations who are Black, Indigenous, and people of color (BIPOC) in health research means researchers actually know very little about the effect of environmental contaminants on a range of population health outcomes. This commentary offers different practical solutions, such as naming racism in research, including BIPOC in leadership positions, mandating requirements for discussing “race”, conducting far more holistic analyses, increasing community participation in research, and improving racism training, to address the myriad of ways in which structural racism permeates environmental epidemiology questions, methods, results and impacts.

What Is “Socioeconomic Position (SEP),” and How Might It Modify Air Pollution-Health Associations? Cohering Findings, Identifying Challenges, and Disentangling Effects of SEP and Race in US City Settings

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The association between neighborhood obesogenic factors and prostate cancer risk and mortality: the Southern Community Cohort Study

“…However, evidence suggests that social inequities, such as structural racism and mistrust, including a history of segregation and mistreatment within the healthcare system, could impact Black men’s access to screening and treatment for prostate cancer, as well as their participation in clinical research, ultimately influencing prostate cancer outcomes and survival ( 21 – 23 ). Further evidence shows that structural racism is one of the major barriers to health equity ( 24 , 25 ). In our analysis, race designations are evaluated as social rather than biological constructs.…”

Multilevel Community Engagement to Inform a Randomized Clinical Trial

“…The rapid analytic approach coupled with the use of CFIR was largely a deductive process; however, the open-ended nature of our focus groups allowed the team to uncover more "hidden phenomena" that one may associate with traditional, inductive, qualitative methods. 25 Our entire research team contributed to the development of our five-step data-analysis process. The multistep process used a systematic, team-based approach that resulted in the identification of commonly occurring themes.…”