SARAH VERBIEST

Looking Forward , Sarah Verbiest, founder of Every Woman Southeast, reflects on the new year and what it holds.
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11People of all income levels, employment categories, races, ethnicities, and locations in the United States are exposed to environmental toxins and toxicants. Such exposure is thought by many to occur primarily through the intake to food, water and air, but what some fail to realize is that the clothes they wear, detergent they use, housing they inhabit, furniture in their homes, or transportation they take are all sources of environmental contaminants. Unfortunately, exposure to toxic chemicals is an increasingly common part of everyday life.

Today more than 84,000 chemicals are in use in the US, the majority of which have yet to be tested for toxicity to human health and the environment. Of the chemicals that have been tested, most have only been evaluated for their acute consequences to adult males in industrial settings. Toxic chemicals that enter the environment pose health problems for women – especially women of color – that are unique from those for men, because women and minorities are more likely to work in lower-status, lower-wage jobs. They tend to be disproportionately exposed to a myriad of hazardous chemicals, including agricultural pesticides, home cleaning products, industrial cleaning products, and chemicals used in hair and nail salons. And as such, they bear a greater burden of the diseases and conditions associated with these exposures.

  • Breast cancer: Repeated exposure to toxic environments is related to an increased risk for breast cancer. While this form of cancer is diagnosed 10% less frequently in African American women than White women, the former are 40% more likely to die from the disease. Disproportionate environmental exposures, socioeconomic status, and inadequate access to quality health care all contribute to this higher rate of morbidity.
  • Asthma: The disparity in asthma prevalence and severity provides a striking example of the effect of disproportionate exposures and health outcomes. The prevalence of asthma is highest among multi-racial Americans, Hispanics of Puerto Rican descent and non-Hispanic blacks, and is also higher among those living in poverty.
  • Birth Outcomes: African American women have consistently had higher rates of preterm and low birth weight babies, in spite of prenatal care usage, behaviors during pregnancy, and socioeconomic status. A growing number of studies have associated certain environmental contaminants with these poor birth outcomes.

12People of color now comprise a majority in neighborhoods with poor air quality, disproportionate exposure to toxic hazards, unhealthy housing conditions (e.g., mold, dampness and pest infestation), and lack of safe areas for physical activity. Race and socioeconomic status are highly correlated with living near harmful sources of pollution (e.g. commercial hazardous waste facilities); in fact, 46% of low-income housing units sit within about a mile of factories that report toxic emissions to the EPA. These poor environmental conditions have led to higher-than-average rates of asthma, lead poisoning, and exposure to contaminated water, pesticides and mercury, especially among women and children living in these areas.

Environmental racism – the disproportionate impact of environmental hazards on people of color – is the reason so many people, especially women, have become involved in the environmental justice movement. This movement seeks to abolish environmental harms by improving environmental conditions, identifying and mitigating structural inequalities, and finding solutions to empower traditionally marginalized people. While there is plenty of work yet to be done, the fact that these issues are being taken into account indicates that the environmental health of minority women is becoming a national priority.

To ensure your environmental health and to help protect that of minority communities:

  • Recognize that women suffer unique effects of environmental hazards and advocate for policies that improve reproductive health and pregnancy outcomes.
  • Push for stricter regulation through legislation such as the Toxic Substances Control Act that establishes health and safety testing, bans the most toxic chemicals, and protects the most vulnerable populations.
  • Support the equitable distribution of green space, walking and biking trails, and playgrounds in low-income communities.
  • Urge regulatory protections and safer labor practices for those exposed to toxic chemicals in industries dominated by low-income workers and women of color.

Health inequities have persisted in this country for decades – in health care, housing, education, and even in the environment. But the fact of the matter is that they are and always have been avoidable. Poor communities and women of color are systematically and unjustly exposed to environmental contaminants that hinder them from being the healthiest individuals they can be. And until the environmental health of these populations is accounted for, the generations that follow will never know what it feels like to be truly free from environmental contamination.

Amanda Zabala is a graduate intern at the Center for Maternal and Infant Health. She is currently attending the University of North Carolina at Chapel Hill, Gillings School of Global Public Health, and majoring in Maternal and Child Health.

On June 13, 2014, I had the opportunity to attend Tulane University’s 2nd Biennial Black Women’s Health Conference (BWH) in New Orleans, Louisiana, representing the Every Woman Southeast Coalition (EWSE), and connecting with one of our coalition members in Louisiana. The full conference agenda can be accessed here and click here to view the recorded highlights from the conference sessions.

1As an exhibitor, I had the opportunity to connect and speak with different conference attendees, sharing resources and information about Every Woman Southeast. People truly appreciated our newsletters’ topic areas, which prompted a few attendants to speak about their own health experiences as it related to the newsletter themes. Additionally, it was great to connect with other organizations and agencies that were represented at the conference. Many professionals in the health, social work, and criminal justice fields were very interested in learning more about EWSE, and were appreciative of the fact that we were represented there with useful and informative resources to share. Everyone LOVED the Birth Control after Baby and the Taking Care of You: Your Post-partum Health and Visit Booklets.

As a conference participant, I had the chance to listen to the dynamic keynote speaker, Dorothy Roberts, and had a chance to get her to sign a copy of her latest book, Fatal Invention: How Science, Politics, and Big Business Re-Create Race in the Twenty-first Century. Dorothy Roberts delivered a powerful presentation, illustrating the thread of inhumane historical medical practices (e.g. “the father of gynecology”, J. Marion Sims), the racial stereotypes and racist structural policies that impact black women and their families, and the connections to current poor maternal health outcomes of black women. I was also able to attend a couple of breakout sessions that focused on black infant and maternal health disparities, factors that influence black women’s decisions to pursue counseling, and understanding the historical exploitation of black women’s bodies and its effect on black women’s health.

2Earlier in the week, I attended a week-long training as part of my professional development with the CDC’s Public Health Prevention Service Fellowship. A half-day was dedicated to topics in health disparities, which included keynotes from former CDC Medical Officer Dr. Camara P. Jones MD, MPH, PhD, who presented on levels of racism and health disparities, and from Environmental Justice Officer at the CDC, Dr. LaToria Whitehead, PhD, MPH, who presented on environmental justice and her work with the CDC. One of the points that stood out to me most was how Dr. Jones defined health equity and described “achieving health equity.” She stated:
…Health equity is assurance of the conditions for optimal health for all people. Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying historical injustices, and providing resources according to need. Health disparities will be eliminated when health equity is achieved…” (Source: Jones CP 2010, adapted from the National Partnership for Action to End Health Disparities).
Another highlight of the training was that I had the opportunity to co-facilitate a discussion during a breakout session for the viewing of the Unnatural Causes Episode Two: When the Bough Breaks documentary.

I mention the above experiences because it ties back into my participation in the roundtable discussions during the BWH Conference roundtables session on racism-based stress and pregnancy outcomes of African-American women. During this session, the presenters also showed a video clip from the Unnatural Causes documentary and led a discussion as well. The most poignant component of both discussions was when audience members shared their personal stories about their pregnancy, experiences with healthcare providers, and spoke about their experience with racism in general. Since we only had a short amount of time for discussion during the breakout session I facilitated, our discussions centered more on people’s reactions to the disparity of poor birth outcomes between college-educated black women and high school drop-out white women, and opportunities for public health professionals wanting to become involved in work that seeks to address these disparities.

On the other hand, the roundtable discussion during the BWH conference centered more so on ways to address the issue of infant mortality experienced 3by African Americans. This led to a very long and dynamic conversation and feedback to the facilitators. Some of the roundtable participants were very shocked at the fact that racism is a huge factor in poor birth outcomes, some believed that this was not new information and that the black community has always been aware of the overall health impact of racism and oppression, and other participants expressed criticism for how the documentary failed to leave room to show examples of how black women have organized historically and in the present-day to address such issues with poor birth outcomes.

The stories, perspectives, and solutions that were presented by participants of the roundtable discussions at the BWH conference made me reflect back on the points presented during Dr. Jones’ presentation when she pointed out the importance of being willing to talk about and address historical injustices when engaging in health equity work with communities, and the racially-gendered policies that impact black women’s health as presented by Dorothy Roberts. It also prompted me to reflect on the importance of facilitating an emotionally charged topic and having information readily available for participants.

Attending this conference was very meaningful, in terms of sharing the EWSE resources, connecting with other health professionals and organizations, and to get a pulse on how information pertaining to black maternal and infant health disparities is received by the communities most impacted.

For a few examples of black maternal health initiatives spearheaded and/or organized by black women, see below:

Mommy in Chief,” is MadameNoire’s original web series that explores the ups, downs, and everything in between of being a modern mom. The series offers a fun, inspiring, and practical take on parenting for mothers in a variety of life stages and child ages.

Black Women’s Health Imperative’s CEO and President’s Call-to-Action on Black Women’s Maternal Health

Mocha Manuel an online resource where black moms go for information and inspiration for pregnancy, parenting and beyond!

Black Women Birthing Justice is a collective of African-American, African, Caribbean and multiracial women who are committed to transforming birthing experiences for Black women.

Birthing Project USA is the only national African American maternal and child health program in this country.

The Black Maternal Health Project by Women’s eNews on Pinterest is a social media resource page with resources and information from breastfeeding to childbirth culturally geared towards African American women.

Angela D. Aina, MPH is a CDC Public Health Prevention Service (PHPS) Fellow serving her two-year field placement with UNC, Center for Maternal and Infant Health.

**The statements in this blog post  are those of the authors and do not represent the official position of the Centers for Disease Control and Prevention (CDC).**

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