Transcript Document

Environmental justice,
SES and health,
place and health,
theories of inequality
Mike Buzzelli and Gerry Veenstra
University of British Columbia
Problems with the Environmental
Justice Literature
1. The working hypothesis of
environmental justice research
2. Methodological issues
3. Where’s (the health) study?
4. Conceptualising equity and justice
Working hypothesis of
environmental justice
• Disadvantaged social groups face
disproportionate exposures to
environmental health hazards despite
benefiting least from the production and
consumption sectors that produce those
hazards
• ‘Equity’ and ‘justice’
• Process and outcome studies
Two decades of research…
Methodological problems
Lack of data
– Usually aggregated sociodemographic
data
– Reliance on proxies for environmental data
– These result in poor exposure
classification…
Methodological problems
Exposure classification
1. Proxies for environmental hazards
– Spatial coincidence (buffering)
– Proximity measures
2. Where monitoring data exist
– Plume dispersion models
– Spatial interpolation techniques
– Toxicity indexes
Methodological problems
So after two decades of research:
• Still plagued by the modifiable areal unit
problem (MAUP)
• Not always using real environmental
monitoring data
• A mixed bag of one-off cross-sectional
studies
Where’s the (health) study?
Classifying recent research (post-1995; N = 78 studies)
33
32
Health Association
Possible?
Health Association
Drawn
35
# of Studies
30
25
USA
20
9
Other
15
4
10
5
0
A way forward
• Linked social,
environmental
and health data
• Combined
process and
outcome
analyses
• Multi-level
analysis
What is needed?
• A data and methodological leap forward
• A health connection
• International, and ideally, directly
comparable research
• To build this from the ground up will also
require meaningful infusion of critical
social theory (‘justice’, ‘SES’, etc.)
1. Environmental justice
2. SES and health
3. Place and health
4. Theories of inequality
SES and health
Description:
- explores the relationship between socio-economic status and
health, and tends to focus on such issues as:
(I) direction of causality, and
(ii) neo-material versus psycho-social explanations
Methods:
- tends to use traditional statistical techniques
Health Status
Relationship between income and health
at the individual-level
Income
SES and health
Spuriousness explanation:
- that some other factor (e.g. genetically determined intellectual
ability or physical size) influences both SES and health
Drift hypothesis:
- that poor health contributes to lower SES standing
Neo-materialist explanation:
- the purchasing power of income secures those essential
material resources that subsequently influence health
Psycho-social explanation:
- the perceptions and interpretive meanings that accompany
social status influence health (perhaps via levels of stress)
SES and health
Overlap with EJ:
- both discourses explore the health effects of socio-economic
standing
Advantages of EJ:
- expressly considers the health effects of environmental
pollutants; locates health effects of SES in place/space
Advantages of SES-health:
- considers multiple measures of ‘objective’ socio-economic
standing (e.g. occupational prestige); also considers ‘subjective’
measures of social status (e.g. perceived relative standing)
Place and health
Description:
- explores the health effects of place (e.g. neighbourhood and
community), focusing specifically on aspects of the material and
socio-cultural infrastructures (i.e. the context) above and beyond
characteristics of the people living in places (i.e. composition)
Methods:
- uses traditional statistical techniques at the individual or
community level and multilevel models (at both levels) to model
the health effects of places
Place and health
Material infrastructure:
- ‘opportunity structures’ in places, socially-constructed and
socially–patterned features of the physical and social
environment that can affect health (Macintyre et al. 2002)
Examples:
- availability of healthy environments at home, work and play
(such as decent housing and safe employment)
- health, human and social services (such as education, healthcare, transport and policing)
- nature of economic industry
- social class dynamics
- community wealth
- inequality in the distribution of wealth
Place and health
Collective social functioning:
- socio-cultural and historical features of the social worlds of
communities (Macintyre et al 2002)
Examples:
- shared norms, traditions, values and interests
- political, economic, ethnic and religious histories
- levels of crime
- networks of community support
- the reputation of an area
- mobility into and out of communities
- social trust, political trust and social networks (i.e. social
capital)
Place and health
Overlap with EJ literature:
- both pay attention to the health effects of properties of places
- both use multilevel modelling to distinguish individual from
contextual effects
Advantages of EJ:
- sophisticated use of GIS
- includes environmental pollutants
- considers differential health effects of pollutants by socioeconomic position
Advantages of PH:
- considers socially-constructed attributes of places
- distinguishes individual from contextual socio-economic effects
Discussion points
Point 1:
- in EJ research, socio-economic position (i.e. income and
education) is the primary measure of inequality
Point 2:
- in SES-health research, physical and social characteristics of
places (and their differential health effects by socio-economic
standing) are seldom considered
Point 3:
- in place-health research, physical characteristics of places
(e.g. environmental toxins) are seldom melded with socioeconomic, socio-political and socio-cultural attributes of places
Points of entry for social theory
Point 1:
- SES-health relationships may interact with other dimensions
of social inequality (e.g. gender, racial/ethnic differences, sexual
orientation, disability, immigrant status, religious beliefs)
Point 2:
- SES-health relationships may be reflective of social class
dynamics, i.e. reflective of group-level dynamics based upon
control over the means of production, for example (in a Marxian
sense, at least)
Point 3:
- physical space and social space may overlap with one
another, with apparent physical space health effects actually
reflective of underlying social space health effects
Workshop participants
Environmental justice:
David Briggs, Imperial College London
Eva Rehfuess, World Health Organization
Kee Warner, University of Colorado at Colorado Springs
Michael Buzzelli, University of British Columbia
Michael Jerrett, McMaster University
Keith Warriner, University of Waterloo
SES-health:
Shona Kelly, University of Nottingham
Gerry Veenstra, University of British Columbia
Workshop participants
Place and health:
Tony Gatrell, Lancaster University
Michael Hayes, Simon Fraser University
Social determinants of health:
John Cairney, University of Toronto
Tony Blakely, Wellington School of Medicine
Workshop goals
1.
2.
3.
4.
5.
6.
7.
Learn about the different discourses
Speculate on potentially fruitful ways of conceptualizing and
measuring inequality (above and beyond SEP)
Conceptualize theoretical models that incorporate these
conceptions of inequality, their manifestations in space, and
their relationships with both environmental factors and health
Speculate on interesting ways of using funky analytical and
statistical techniques (e.g. GIS, multilevel modelling,
correspondence analysis) to test such models
Identify relevant international data sets that may facilitate
mutual empirical exploration along these lines
Build relationships with like-minded researchers, pursue
subsequent research projects
Think thoughts that have never been thought before
Environmental justice,
SES and health,
place and health,
theories of inequality
The End