Over the last several decades, community-based groups and research organizations have documented how low income and minority communities have been disproportionately affected by environmental hazards. In response, the environmental justice (EJ) movement is advocating for equal and fair treatment of all people when environmental decisions are made.

A Disproportionate Risk
Low-income communities and communities of color often face multiple potential sources of contamination in their neighborhood such as industrial facilities, waste management facilities, and landfills. In addition, low-income communities sometimes have older housing, which may contain lead-based paint. If stress, poor nutrition, smoking, and limited access to healthcare are present, along with greater exposure to environmental contaminants, an increase in rates of illness occurs.

Communities facing disproportionate risk to environmental contaminants may also be facing other challenges, such as making ends meet on low wages. Environmental contaminants may not be the dominant issue for community members - even though they may be at greater risk of exposure to contaminants.

The goal of public health is to prevent disease and promote health. Epidemiologists and other public health officials have a responsibility to further investigate the risks faced by people in communities that are known to be at disproportionate risk of exposure, even if community members are not actively advocating for environmental public health. Epidemiologists can play an important role in reducing disproportionate burdens of exposure and illness by documenting inequitable patterns of disease among communities with environmental hazards. Some public health professionals suggest that epidemiologists have a responsibility to expand beyond data collection to policymaking and public health advocacy.

The Environmental Justice Movement
The environmental justice movement that occurred in the United States in the 1970s and 1980s has historical roots, from the colonization of Native Americans, to issues surrounding nuclear testing in the 1930s, and the development of pesticides after World War II. The impetus for the movement we know today is complex; numerous events and campaigns played active roles. A few of many important events and publications are summarized below:
Applying Environmental Justice Principles:
A Gradual Process for Government Agencies
In light of the grassroots EJ movement, government agencies have gradually incorporated these principles into their work. In 1992, the report Environmental Equity: Reducing Risks for All Communities released by the U.S. EPA found clear differences in exposure to contaminants among people of different racial and economic backgrounds, with minority and low-income communities experiencing a greater burden. As a result of the documentation and advocacy of environmental justice issues, President Clinton signed Executive Order 1298 in 1994 to address environmental justice in minority and low-income populations. Among other things, it outlined specific responsibilities and implementation of environmental justice strategies for the U.S. EPA; it advocated for continuing surveillance of issues of inequality; and it called for access to information and public participation for the incorporation of environmental justice principles into federal agency programs or policies. In relation to environmental epidemiology, the order advocated for the inclusion of diverse segments of the population whenever possible when conducting studies.

Applying environmental justice principles requires collaborative, inclusive approaches that seek to address the unequal burden of environmental contamination and resulting health effects. Because agencies often operate under very specific legal mandates, institutional resistance to change, and the slow pace of bureaucracy, it is often a challenge for scientists and government agencies to apply principles of environmental justice, but over time, more and more agencies have adopted them. The U.S. EPA's Environmental Justice website provides a good overview of current efforts to promote environmental justice at the federal level.

Continuing Environmental Justice Challenges
A 20-year follow up to the 1987 United Church of Christ study was released in 2007. The study, Toxic Wastes and Race at Twenty, 1987-2007: Grassroots struggles to Dismantle Environmental Racism in the United States, found that communities of color are still disproportionately more likely to live near hazardous waste sites and are not equally protected by environmental laws.

Moving forward to improve environmental public health in communities facing a disproportionate burden of exposure and illness will require scientists, public health professionals, and the communities themselves to gather strength from their shared goals, engage in genuine collaborative relationships, and take deliberate steps to avoid unwittingly creating more environmental health disparities.