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Kaushal A, Karimi DM, Nazari DR, Opare K, Museru M, Reza Nikoo DM. Environmental Exposure and Respiratory Health: Unraveling the Impact of Toxic Release Inventory Facilities on COPD Prevalence. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024:124286. [PMID: 38823548 DOI: 10.1016/j.envpol.2024.124286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024]
Abstract
This cross-sectional geospatial analysis explores the prevalence of Chronic Obstructive Pulmonary Disease (COPD) concerning the proximity to toxic release inventory (TRI) facilities in Jefferson County, Alabama. Employing the fuzzy analytical hierarchy process (FAHP), the study evaluates COPD prevalence, comorbidities, healthcare access, and individual health assessments. Given the mounting evidence linking environmental pollutants to COPD exacerbations, the research probes the influence of TRI sites on respiratory health, integrating Geographic Information Systems (GIS) to scrutinize the geospatial vulnerability of communities neighboring TRI sites. Socio-demographic disparities, economic conditions, and air pollution are emphasized in the analysis. The EPA's Toxic Release Inventory serves as the cornerstone for assessing the association between TRI proximity and COPD prevalence. The analysis uncovers a notable inverse correlation between distance from TRI sites and COPD prevalence, signaling potential health risks for populations residing closer to these facilities. Moreover, factors such as minority status, low income, and air pollution are associated with higher COPD prevalence, underscoring the imperative of comprehending the interplay between environmental exposure and respiratory health. This study bridges gaps in the literature by addressing the geographical nexus between COPD prevalence and pollution exposure. By leveraging FAHP, the research furnishes a holistic understanding of the multifaceted factors influencing vulnerability to COPD. The findings underscore the necessity for targeted public health interventions and policy measures to redress environmental disparities and alleviate the repercussions of TRI facilities on respiratory health.
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Affiliation(s)
- Aishwarya Kaushal
- Sustainable Smart Cities Research Center, University of Alabama-Birmingham, Birmingham, AL, USA; Department of Environmental Health Sciences, School of Public Health, the University of Alabama at Birmingham
| | - Dr Maryam Karimi
- Sustainable Smart Cities Research Center, University of Alabama-Birmingham, Birmingham, AL, USA; Department of Environmental Health Sciences, School of Public Health, the University of Alabama at Birmingham; Department of Civil, Construction, and Environmental Engineering, School of Engineering, the University of Alabama at Birmingham
| | - Dr Rouzbeh Nazari
- Sustainable Smart Cities Research Center, University of Alabama-Birmingham, Birmingham, AL, USA; Department of Environmental Health Sciences, School of Public Health, the University of Alabama at Birmingham; Department of Civil, Construction, and Environmental Engineering, School of Engineering, the University of Alabama at Birmingham.
| | - Kofi Opare
- Sustainable Smart Cities Research Center, University of Alabama-Birmingham, Birmingham, AL, USA; Department of Civil, Construction, and Environmental Engineering, School of Engineering, the University of Alabama at Birmingham
| | - Mujungu Museru
- Sustainable Smart Cities Research Center, University of Alabama-Birmingham, Birmingham, AL, USA; Department of Civil, Construction, and Environmental Engineering, School of Engineering, the University of Alabama at Birmingham
| | - Dr Mohammad Reza Nikoo
- Department of Civil and Architectural Engineering, Sultan Qaboos University, Muscat, Oman
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Symanski E, An Han H, McCurdy S, Hopkins L, Flores J, Han I, Smith MA, Caldwell J, Fontenot C, Wyatt B, Markham C. Data to Action: Community-Based Participatory Research to Address Concerns about Metal Air Pollution in Overburdened Neighborhoods near Metal Recycling Facilities in Houston. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:67006. [PMID: 37285285 PMCID: PMC10246764 DOI: 10.1289/ehp11405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Exposures to environmental contaminants can be influenced by social determinants of health. As a result, persons living in socially disadvantaged communities may experience disproportionate health risks from environmental exposures. Mixed methods research can be used to understand community-level and individual-level exposures to chemical and nonchemical stressors contributing to environmental health disparities. Furthermore, community-based participatory research (CBPR) approaches can lead to more effective interventions. OBJECTIVES We applied mixed methods to identify environmental health perceptions and needs among metal recyclers and residents living in disadvantaged neighborhoods near metal recycling facilities in Houston, Texas, in a CBPR study, Metal Air Pollution Partnership Solutions (MAPPS). Informed by what we learned and our previous findings from cancer and noncancer risk assessments of metal air pollution in these neighborhoods, we developed an action plan to lower metal aerosol emissions from metal recycling facilities and enhance community capacity to address environmental health risks. METHODS Key informant interviews, focus groups, and community surveys were used to identify environmental health concerns of residents. A diverse group from academia, an environmental justice advocacy group, the community, the metal recycling industry, and the local health department collaborated and translated these findings, along with results from our prior risk assessments, to inform a multifaceted public health action plan. RESULTS An evidence-based approach was used to develop and implement neighborhood-specific action plans. Plans included a voluntary framework of technical and administrative controls to reduce metal emissions in the metal recycling facilities, direct lines of communication among residents, metal recyclers, and local health department officials, and environmental health leadership training. DISCUSSION Using a CBPR approach, health risk assessment findings based on outdoor air monitoring campaigns and community survey results informed a multipronged environmental health action plan to mitigate health risks associated with metal air pollution. https://doi.org/10.1289/EHP11405.
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Affiliation(s)
- Elaine Symanski
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
| | - Heyreoun An Han
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas, USA
| | - Sheryl McCurdy
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, Texas, USA
| | - Loren Hopkins
- Department of Statistics, Rice University, Houston, Texas, USA
- Houston Health Department, Houston, Texas, USA
| | | | - Inkyu Han
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Mary Ann Smith
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA
| | - James Caldwell
- Coalition of Community Organizations (CoCo), Houston, Texas, USA
| | | | | | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, Texas, USA
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Goswami A, Adkins-Jablonsky SJ, Barreto Filho MM, Shilling MD, Dawson A, Heiser S, O’Connor A, Walker M, Roberts Q, Morris JJ. Heavy Metal Pollution Impacts Soil Bacterial Community Structure and Antimicrobial Resistance at the Birmingham 35th Avenue Superfund Site. Microbiol Spectr 2023; 11:e0242622. [PMID: 36951567 PMCID: PMC10101053 DOI: 10.1128/spectrum.02426-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/23/2023] [Indexed: 03/24/2023] Open
Abstract
Heavy metals (HMs) are known to modify bacterial communities both in the laboratory and in situ. Consequently, soils in HM-contaminated sites such as the U.S. Environmental Protection Agency (EPA) Superfund sites are predicted to have altered ecosystem functioning, with potential ramifications for the health of organisms, including humans, that live nearby. Further, several studies have shown that heavy metal-resistant (HMR) bacteria often also display antimicrobial resistance (AMR), and therefore HM-contaminated soils could potentially act as reservoirs that could disseminate AMR genes into human-associated pathogenic bacteria. To explore this possibility, topsoil samples were collected from six public locations in the zip code 35207 (the home of the North Birmingham 35th Avenue Superfund Site) and in six public areas in the neighboring zip code, 35214. 35027 soils had significantly elevated levels of the HMs As, Mn, Pb, and Zn, and sequencing of the V4 region of the bacterial 16S rRNA gene revealed that elevated HM concentrations correlated with reduced microbial diversity and altered community structure. While there was no difference between zip codes in the proportion of total culturable HMR bacteria, bacterial isolates with HMR almost always also exhibited AMR. Metagenomes inferred using PICRUSt2 also predicted significantly higher mean relative frequencies in 35207 for several AMR genes related to both specific and broad-spectrum AMR phenotypes. Together, these results support the hypothesis that chronic HM pollution alters the soil bacterial community structure in ecologically meaningful ways and may also select for bacteria with increased potential to contribute to AMR in human disease. IMPORTANCE Heavy metals cross-select for antimicrobial resistance in laboratory experiments, but few studies have documented this effect in polluted soils. Moreover, despite decades of awareness of heavy metal contamination at the EPA Superfund site in North Birmingham, Alabama, this is the first analysis of the impact of this pollution on the soil microbiome. Specifically, this work advances the understanding of the relationship between heavy metals, microbial diversity, and patterns of antibiotic resistance in North Birmingham soils. Our results suggest that polluted soils carry a risk of increased exposure to antibiotic-resistant infections in addition to the direct health consequences of heavy metals. Our work provides important information relevant to both political and scientific efforts to advance environmental justice for the communities that call Superfund neighborhoods home.
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Affiliation(s)
- Anuradha Goswami
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sarah J. Adkins-Jablonsky
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Alabama College of Osteopathic Medicine, Dothan, Alabama, USA
| | | | - Michelle D. Shilling
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alex Dawson
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sabrina Heiser
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Aisha O’Connor
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Melissa Walker
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Qutia Roberts
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - J. Jeffrey Morris
- Department of Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Tee Lewis PG, Chiu WA, Nasser E, Proville J, Barone A, Danforth C, Kim B, Prozzi J, Craft E. Characterizing vulnerabilities to climate change across the United States. ENVIRONMENT INTERNATIONAL 2023; 172:107772. [PMID: 36731185 PMCID: PMC10214772 DOI: 10.1016/j.envint.2023.107772] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/22/2022] [Accepted: 01/20/2023] [Indexed: 05/28/2023]
Abstract
Climate change will cause a range of related risks, including increases in infectious and chronic disease, intensified social and economic stresses, and more frequent extreme weather events. Vulnerable groups will be disproportionately affected due to greater exposure to climate risks and lower ability to prepare, adapt, and recover from their effects. Better understanding of the intersection of vulnerability and climate change risks is required to identify the most important drivers of future climate risks and effectively build resilience and deploy targeted adaptation efforts. Incorporating community stakeholder input, we identified and integrated available public health, social, economic, environmental, and climate data in the United States (U.S.), comprising 184 indicators, to develop a Climate Vulnerability Index (CVI) composed of four baseline vulnerabilities (health, social/economic, infrastructure, and environment) and three climate change risks (health, social/economic, extreme events). We find that the vulnerability to and risks from climate change are highly heterogeneous across the U.S. at the census tract scale, and geospatially cluster into complementary areas with similar climate risks but differing baseline vulnerabilities. Our results therefore demonstrate that not only are climate change risks both broadly and variably distributed across the U.S., but also that existing disparities are often further exacerbated by climate change. The CVI thus lays a data-driven, scientific foundation for future research on the intersection of climate change risks with health and other inequalities, while also identifying health impacts of climate change as the greatest research gap. Moreover, given U.S. government initiatives surrounding climate and equity, the CVI can be instrumental in empowering communities and policymakers to better prioritize resources and target interventions, providing a template for addressing local-scale climate and environmental justice globally.
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Affiliation(s)
| | - Weihsueh A Chiu
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, TX, USA.
| | - Ellu Nasser
- Environmental Defense Fund, Austin, TX, USA.
| | | | | | | | - Bumsik Kim
- Texas Transportation Institute, Texas A&M University, College Station, TX, USA.
| | - Jolanda Prozzi
- Texas Transportation Institute, Texas A&M University, College Station, TX, USA.
| | - Elena Craft
- Environmental Defense Fund, Austin, TX, USA.
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Stephens C, Kim YI, Ramachandran R, Baskin ML, Antony V, Bae S. Disparities in Healthcare Utilization: Superfund Site vs. Neighboring Comparison Site. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159271. [PMID: 35954629 PMCID: PMC9367949 DOI: 10.3390/ijerph19159271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023]
Abstract
Inequities in pollution-attributable health disparities are similar in most urban areas throughout the United States, and appear to encompass racial and socio-demographic differences, thereby suggesting increased health risks for those living in these areas. Individuals residing in close proximity to Superfund sites, predominantly people of color, are increasingly stricken with lung diseases. The prevalence of chronic lung diseases, such as chronic obstructive pulmonary disease (COPD), asthma in children, and lower respiratory tract infections (LRTI), is significantly higher in the affected area compared to the neighboring control area, irrespective of smoking, socio-economic status, or demographics. We conducted a retrospective analysis using data collected from patients who obtained healthcare from the University of Alabama at Birmingham (UAB) Health System. The data were procured from the Enterprise Data Warehouse (UAB Informatics for Integrating Biology and the Bedside (i2b2)). We evaluated healthcare utilization and classification of disease (defined by ICD-10 codes) of patients residing in zip codes: affected (35207, 35217) and neighboring comparison (35214). The results of the analysis may provide evidence that can be used for risk mitigation strategies or outreach education campaign(s) for those who live in the affected area.
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Affiliation(s)
- Crystal Stephens
- Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (C.S.); (V.A.)
| | - Young-il Kim
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (Y.-i.K.); (R.R.); (M.L.B.)
| | - Rekha Ramachandran
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (Y.-i.K.); (R.R.); (M.L.B.)
| | - Monica L. Baskin
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (Y.-i.K.); (R.R.); (M.L.B.)
| | - Veena Antony
- Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (C.S.); (V.A.)
| | - Sejong Bae
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (Y.-i.K.); (R.R.); (M.L.B.)
- Correspondence:
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Felgentreff ES, Cochius D, Nehls T, Quandt JHW, Roesch EJ. Quantifying potential contributions of green facades to environmental justice: a case study of a quarter in Berlin. Urban Ecosyst 2022. [DOI: 10.1007/s11252-022-01235-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AbstractThe potential of green facades (GFs) to enhance environmental justice (EJ) has not been quantified so far. EJ in Berlin, Germany is assessed by the core indicators (1) noise pollution, (2) air pollution, (3) bioclimatic stress, (4) provision of green space and (5) social status. Most of the inner city is rated “poorly” in one or multiple indicators. Based on literature and spatial data, status quo and target values are determined for indicators (1)-(4) for an exemplary, highly burdened quarter in Berlin. It is assessed if and how much GFs could potentially improve current EJ levels. The improvements due to GFs to reach target values are assessed in % for day/night and indoor/outdoor settings. It can be shown that installing GFs would improve statuses of the four indicators to different extents, with the biggest enhancement found regarding indicator (3) for indoors at daytime: 52%. Determining factors for the EJ improvement potential of GFs need to be further assessed. This feasible method for increasing the amount of urban green can be helpful for improving life in highly burdened quarters. Therefore, from the point of view of EJ, large-scale implementation of GFs in urban areas is recommended.
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Jiang Y, Yang Y. Environmental Justice in Greater Los Angeles: Impacts of Spatial and Ethnic Factors on Residents' Socioeconomic and Health Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095311. [PMID: 35564705 PMCID: PMC9105631 DOI: 10.3390/ijerph19095311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/17/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023]
Abstract
Environmental justice advocates that all people are protected from disproportionate impacts of environmental hazards. Despite this ideal aspiration, social and environmental inequalities exist throughout greater Los Angeles. Previous research has identified and mapped pollutant levels, demographic information, and the population’s socioeconomic status and health issues. Nevertheless, the complex interrelationships between these factors remain unclear. To close this knowledge gap, we first measured the spatial centrality using sDNA software. These data were then integrated with other socioeconomic and health data collected from CalEnvironScreen, with census tract as the unit of analysis. Finally, structural equation modeling (SEM) was executed to explore direct, indirect, and total effects among variables. The results show that the White population tends to reside in the more segregated areas and lives closer to green space, contributing to higher housing stability, financial security, and more education attainment. In contrast, people of color, especially Latinx, experience the opposite of the environmental benefits. Spatial centrality exhibits a significant indirect effect on environmental justice by influencing ethnicity composition and pollution levels. Moreover, green space accessibility significantly influences environmental justice via pollution. These findings can assist decision-makers to create a more inclusive society and curtail social segregation for all individuals.
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Affiliation(s)
- Yuliang Jiang
- Landscape Justice Initiative, School of Architecture, University of Southern California, Los Angeles, CA 90089, USA;
- Stillwater Sciences, Los Angeles, CA 90013, USA
| | - Yufeng Yang
- Space Syntax Laboratory, The Bartlett School of Architecture, University College London, London WC1H 0AY, UK
- Correspondence:
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Adkins-Jablonsky SJ, Akscyn R, Bennett BC, Roberts Q, Morris JJ. Is Community Relevance Enough? Civic and Science Identity Impact of Microbiology CUREs Focused on Community Environmental Justice. Front Microbiol 2020; 11:578520. [PMID: 33424782 PMCID: PMC7793635 DOI: 10.3389/fmicb.2020.578520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/30/2020] [Indexed: 11/13/2022] Open
Abstract
Course-based undergraduate research experiences (CUREs) often involve a component where the outcomes of student research are broadly relevant to outside stakeholders. We wanted to see if building courses around an environmental justice issue relevant to the local community would impact students' sense of civic engagement and appreciation of the relevance of scientific research to the community. In this quasi-experimental study, we assessed civic engagement and scientific identity gains (N = 98) using pre- and post-semester surveys and open-ended interview responses in three different CUREs taught simultaneously at three different universities. All three CURES were focused on an environmental heavy metal pollution issue predominantly affecting African-Americans in Birmingham, Alabama. While we found increases in students' sense of science efficacy and identity, our team was unable to detect meaningful changes in civic engagement levels, all of which were initially quite high. However, interviews suggested that students were motivated to do well in their research because the project was of interest to outside stakeholders. Our observations suggest that rather than directly influencing students' civic engagement, the "broadly relevant" component of our CUREs engaged their pre-existing high levels of engagement to increase their engagement with the material, possibly influencing gains in science efficacy and science identity. Our observations are consistent with broader community relevance being an important component of CURE success, but do not support our initial hypothesis that CURE participation would influence students' attitudes toward the civic importance of science.
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Affiliation(s)
| | - Rob Akscyn
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Brad C Bennett
- Department of Biological and Environmental Sciences, Samford University, Birmingham, AL, United States
| | - Qutia Roberts
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - J Jeffrey Morris
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
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Clougherty JE, Rider CV. Integration of psychosocial and chemical stressors in risk assessment. CURRENT OPINION IN TOXICOLOGY 2020. [DOI: 10.1016/j.cotox.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Johnston J, Cushing L. Chemical Exposures, Health, and Environmental Justice in Communities Living on the Fenceline of Industry. Curr Environ Health Rep 2020; 7:48-57. [PMID: 31970715 PMCID: PMC7035204 DOI: 10.1007/s40572-020-00263-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE OF REVIEW Polluting industries are more likely to be located in low-income communities of color who also experience greater social stressors that may make them more vulnerable than others to the health impacts of toxic chemical exposures. We describe recent developments in assessing pollutant exposures and health threats posed by industrial facilities using or releasing synthetic chemicals to nearby communities in the U.S. RECENT FINDINGS More people are living near oil and gas development due to the expansion of unconventional extraction techniques as well as near industrial animal operations, both with suggestive evidence of increased exposure to hazardous pollutants and adverse health effects. Legacy contamination continues to adversely impact a new generation of residents in fenceline communities, with recent studies documenting exposures to toxic metals and poly- and perfluoroalkyl substances (PFASs). Researchers are also giving consideration to acute exposures resulting from inadvertent industrial chemical releases, including those resulting from extreme weather events linked to climate change. Natural experiments of industrial closures or cleanups provide compelling evidence that exposures from industry harm the health of nearby residents. New and legacy industries, coupled with climate change, present unique health risks to communities living near industry due to the release of toxic chemicals. Cumulative impacts from multiple stressors faced by environmental justice communities may amplify these adverse effects.
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Affiliation(s)
- Jill Johnston
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Lara Cushing
- Department of Health Education, San Francisco State University, San Francisco, CA, USA
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