Rachel Morello-Frosch | University of California, Berkeley (original) (raw)

Papers by Rachel Morello-Frosch

Environmental Health Perspectives

BACKGROUND: Prior research has reported disparities in environmental exposures in the United Stat... more BACKGROUND: Prior research has reported disparities in environmental exposures in the United States, but, to our knowledge, no nationwide studies have assessed inequality in noise pollution. OBJECTIVES: We aimed to a) assess racial/ethnic and socioeconomic inequalities in noise pollution in the contiguous United States; and b) consider the modifying role of metropolitan level racial residential segregation. METHODS: We used a geospatial sound model to estimate census block group-level median (L 50) nighttime and daytime noise exposure and 90th percentile (L 10) daytime noise exposure. Block group variables from the 2006-2010 American Community Survey (ACS) included race/ethnicity, education, income, poverty, unemployment, homeownership, and linguistic isolation. We estimated associations using polynomial terms in spatial error models adjusted for total population and population density. We also evaluated the relationship between race/ethnicity and noise, stratified by levels of metropolitan area racial residential segregation, classified using a multigroup dissimilarity index. RESULTS: Generally, estimated nighttime and daytime noise levels were higher for census block groups with higher proportions of nonwhite and lower-socioeconomic status (SES) residents. For example, estimated nighttime noise levels in urban block groups with 75% vs. 0% black residents were 46.3 A-weighted decibels (dBA) [interquartile range (IQR): 44:3-47:8 dBA] and 42:3 dBA (IQR: 40:4-45:5 dBA), respectively. In urban block groups with 50% vs. 0% of residents living below poverty, estimated nighttime noise levels were 46:9 dBA (IQR: 44:7-48:5 dBA) and 44:0 dBA (IQR: 42:2-45:5 dBA), respectively. Block groups with the highest metropolitan area segregation had the highest estimated noise exposures, regardless of racial composition. Results were generally consistent between urban and suburban/rural census block groups, and for daytime and nighttime noise and robust to different spatial weight and neighbor definitions. CONCLUSIONS: We found evidence of racial/ethnic and socioeconomic differences in model-based estimates of noise exposure throughout the United States. Additional research is needed to determine if differences in noise exposure may contribute to health disparities in the United States.

Environmental …, 2011

... the first-ever voluntary guidelines to protect the school environment (Collaborative for High... more ... the first-ever voluntary guidelines to protect the school environment (Collaborative for High ... Steel Workers Local 620, and various community and environmental organizations organized a November ... stewardship, and use the EJ and sustainability approach as an economic and ...

Journal of Health and Social Behavior, 2011

This article examines participants' responses to receiving their results in a study of household ... more This article examines participants' responses to receiving their results in a study of household exposure to endocrine disrupting compounds and other pollutants. We study how the "exposure experience" -the embodied, personal experience and understanding of chronic exposure to environmental pollutants-is shaped by community context and the report-back process itself. In addition, we investigate an activist, collective form of exposure experience. We analyze themes of expectations and learning, trust, and action. The findings reveal that while participants interpret scientific results to affirm lay knowledge of urban industrial toxics, they also absorb new information regarding other pollutant sources. By linking the public understanding of science literature to the illness and exposure experience concepts, this study unravels the complex relationship between lay experience and lay understanding of science. It also shows that to support policy development and/or social change, community-based participatory research efforts must attend to participants' understanding of science.

Science Technology & Human Values, 2006

There are challenges to the dominant research paradigm in breast cancer science. In the United St... more There are challenges to the dominant research paradigm in breast cancer science. In the United States, science and social activism create paradigmatic shifts. Using interviews, ethnographic observations, and an extensive review of the literature, we create a three-dimensional model to situate changes in scientific controversy concerning environmental causes of breast cancer. We

Sociology of Health & Illness, 2004

Social movements organised around health-related issues have been studied for almost as long as t... more Social movements organised around health-related issues have been studied for almost as long as they have existed, yet social movement theory has not yet been applied to these movements. Health social movements (HSMs) are centrally organised around health, and address: (a) access to or provision of health care services; (b) health inequality and inequity based on race, ethnicity, gender, class and/or sexuality; and/or (c) disease, illness experience, disability and contested illness. HSMs can be subdivided into three categories: health access movements seek equitable access to health care and improved provision of health care services; constituencybased health movements address health inequality and health inequity based on race, ethnicity, gender, class and/or sexuality differences; and embodied health movements (EHMs) address disease, disability or illness experience by challenging science on etiology, diagnosis, treatment and prevention. These groups address disproportionate outcomes and oversight by the scientific community and/or weak science. This article focuses on embodied health movements, primarily in the US. These are unique in three ways: 1) they introduce the biological body to social movements, especially with regard to the embodied experience of people with the disease; 2) they typically include challenges to existing medical / scientific knowledge and practice; and 3) they often involve activists collaborating with scientists and health professionals in pursuing treatment, prevention, research and expanded funding. This article employs various elements of social movement theory to offer an approach to understanding embodied health movements, and provides a capsule example of one such movement, the environmental breast cancer movement.

Journal of Health and Social Behavior, 2008

We report on interviews conducted with participants in a novel study about environmental chemical... more We report on interviews conducted with participants in a novel study about environmental chemicals in body fluids and household air and dust. Interviews reveal how personal and collective environmental history influence the interpretation of exposure data, and how participants fashion an emergent understanding of environmental health problems from the articulation of science and experience. To the illness experience literature, we contribute a framework for analyzing a new category of embodied narratives-"exposure experience"-that examines the mediating role of science. We update social scientific knowledge about social responses to toxic chemicals during a period in which science alters public understanding of chemical pollution. This article is among the first published accounts of participants' responses to learning personal exposure data, research identified as critical to environmental science and public health. Our findings raise the importance of reporting even uncertain science and underscore the value of a community-based reporting strategy.

Environmental Science & Technology, 2008

Environmental Health, 2010

Background: We report on the challenges of obtaining Institutional Review Board (IRB) coverage fo... more Background: We report on the challenges of obtaining Institutional Review Board (IRB) coverage for a communitybased participatory research (CBPR) environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods: We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results: We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership.

Environmental Science & Technology, 2010

Interest in the health effects of potential endocrine-disrupting compounds (EDCs) that are high p... more Interest in the health effects of potential endocrine-disrupting compounds (EDCs) that are high production volume chemicals used in consumer products has made exposure assessment and source identification a priority. We collected paired indoor and outdoor air samples in 40 nonsmoking homes in urban, industrial Richmond, CA, and 10 in rural Bolinas, CA. Samples were analyzed by GC-MS for 104 analytes, including phthalates (11), alkylphenols (3), parabens (3), polybrominated diphenyl ether (PBDE) flame retardants (3), polychlorinated biphenyls (PCBs) (3), polycyclic aromatic hydrocarbons (PAHs) (24), pesticides (38), and phenolic compounds (19). We detected 39 analytes in outdoor air and 63 in indoor air. For many of the phenolic compounds, alkylphenols, phthalates, and PBDEs, these represent some of the first outdoor measures and the first analysis of the relative importance of indoor and outdoor sources in paired samples. Data demonstrate higher indoor concentrations for 32 analytes, suggesting primarily indoor sources, as compared with only 2 that were higher outdoors. Outdoor air concentrations were higher in Richmond than Bolinas for 3 phthalates, 10 PAHs, and o-phenylphenol, while indoor air levels were more similar between communities, except that differences observed outdoors were also seen indoors. Indoor concentrations of the most ubiquitous chemicals were generally correlated with each other (4-t-butylphenol, o-phenylphenol, nonylphenol, several phthalates, and methyl phenanthrenes; Kendall correlation coefficients 0.2-0.6, p < 0.05), indicating possible shared sources and highlighting the importance of considering mixtures in health studies.

Over the last decade, a growing number of social scientists have turned their attention to the st... more Over the last decade, a growing number of social scientists have turned their attention to the study of activism around health issues. Health social movements (HSMs) have pressed the institution of medicine to change in dramatic ways, embracing new modes of healthcare delivery and organization. Health activists have also pushed medicine to evolve by connecting their health concerns to other substantive issues such as social and environmental justice, poverty, and occupational or environmentally induced diseases. HSMs therefore serve as an important bridge, connecting the institution of medicine to other social institutions. In similar fashion, the study of HSMs has motivated medical sociology to develop new tools and theoretical perspectives to understand these alterations in the medical landscape. Medical sociologists stand to learn a great deal about the institution of medicine by observing it as it comes into conflict with patients and activists around issues of health care delivery, science and policy, and regulatory action. This broad sweep of interests must be systematized, which is our project here.

Environmental Health, 2009

Background: Exposure assessment has shifted from pollutant monitoring in air, soil, and water tow... more Background: Exposure assessment has shifted from pollutant monitoring in air, soil, and water toward personal exposure measurements and biomonitoring. This trend along with the paucity of health effect data for many of the pollutants studied raise ethical and scientific challenges for reporting results to study participants.

Environmental Health Perspectives, 2007

BACKGROUND: The field of risk assessment has focused on protecting the health of individual peopl... more BACKGROUND: The field of risk assessment has focused on protecting the health of individual people or populations of wildlife from single risks, mostly from chemical exposure. The U.S. Environmental Protection Agency recently began to address multiple risks to communities in the "Framework for Cumulative Risk Assessment" [EPA/630/P02/001F. Washington DC:Risk Assessment Forum, U.S. Environmental Protection Agency (2003)].

Risk Analysis, 2000

Of the 188 hazardous air pollutants (HAPs) listed in the Clean Air Act, only a handful have infor... more Of the 188 hazardous air pollutants (HAPs) listed in the Clean Air Act, only a handful have information on human health effects, derived primarily from animal and occupational studies. Lack of consistent monitoring data on ambient air toxics makes it difficult to assess the extent of low-level, chronic, ambient exposures to HAPs that could affect human health, and limits attempts to prioritize and evaluate policy initiatives for emissions reduction. Modeled outdoor HAP concentration estimates from the U.S. Environmental Protection Agency's Cumulative Exposure Project were used to characterize the extent of the air toxics problem in California for the base year of 1990. These air toxics concentration estimates were used with chronic toxicity data to estimate cancer and noncancer hazards for individual HAPs and the risks posed by multiple pollutants. Although hazardous air pollutants are ubiquitous in the environment, potential cancer and noncancer health hazards posed by ambient exposures are geographically concentrated in three urbanized areas and in a few rural counties. This analysis estimated a median excess individual cancer risk of 2.7E Ϫ 4 for all air toxics concentrations and 8600 excess lifetime cancer cases, 70% of which were attributable to four pollutants: polycyclic organic matter, 1,3 butadiene, formaldehyde, and benzene. For noncancer effects, the analysis estimated a total hazard index representing the combined effect of all HAPs considered. Each pollutant contributes to the index a ratio of estimated concentration to reference concentration. The median value of the index across census tracts was 17, due primarily to acrolein and chromium concentration estimates. On average, HAP concentrations and cancer and noncancer health risks originate mostly from area and mobile source emissions, although there are several locations in the state where point sources account for a large portion of estimated concentrations and health risks. Risk estimates from this study can provide guidance for prioritizing research, monitoring, and regulatory intervention activities to reduce potential hazards to the general population. Improved ambient monitoring efforts can help clarify uncertainties inherent in this analysis.

Environmental Research, 2006

Environmental health researchers, sociologists, policy-makers, and activists concerned about envi... more Environmental health researchers, sociologists, policy-makers, and activists concerned about environmental justice argue that communities of color who are segregated in neighborhoods with high levels of poverty and material deprivation are also disproportionately exposed to physical environments that adversely affect their health and well-being. Examining these issues through the lens of racial residential segregation can offer new insights into the junctures of the political economy of social inequality with discrimination, environmental degradation, and health. More importantly, this line of inquiry may highlight whether observed pollution-health outcome relationships are modified by segregation and whether segregation patterns impact diverse communities differently.

Relatively little is known about the spectrum of health effects, and the scope and level of ambie... more Relatively little is known about the spectrum of health effects, and the scope and level of ambient air concentrations of those pollutants regulated under the Clean Air Act as "hazardous air pollutants." The U.S. Environmental Protection Agency's (USEPA) Cumulative Exposure Project uses currently available emissions inventories, from a variety of source types, and an atmospheric dispersion model to provide estimates of ambient concentrations for 148 hazardous air pollutants (HAPs) in over 60,000 census tracts for the year 1990. This paper uses currently available hazard information for those pollutants and provides a database of potential regulatory threshold concentrations

Environmental Research, 2006

On May [24][25] 2005 in Ann Arbor, Michigan, the US Environmental Protection Agency, the National... more On May [24][25] 2005 in Ann Arbor, Michigan, the US Environmental Protection Agency, the National Institute of Environmental Health Sciences, and the University of Michigan sponsored a technical workshop on the topic of connecting social and environmental factors to measure and track environmental health disparities. The workshop was designed to develop a transdisciplinary scientific foundation for exploring the conceptual issues, data needs, and policy applications associated with social and environmental factors used to measure and track racial, ethnic, and class disparities in environmental health. Papers, presentations, and discussions focused on the use of multilevel analysis to study environmental health disparities, the development of an organizing framework for evaluating health disparities, the development of indicators, and the generation of community-based participatory approaches for indicator development and use. Group exercises were conducted to identify preliminary lists of priority health outcomes and potential indicators and to discuss policy implications and next steps. Three critical issues that stem from the workshop were: (a) stronger funding support is needed for community-based participatory research in environmental health disparities, (b) race/ethnicity and socioeconomic position need to be included in environmental health surveillance and research, and (c) models to elucidate the interrelations between social, physical, and built environments should continue to be developed and empirically tested. Published by Elsevier Inc.

Environmental Health Perspectives, 2005

This study examines links between racial residential segregation and estimated ambient air toxics... more This study examines links between racial residential segregation and estimated ambient air toxics exposures and their associated cancer risks using modeled concentration estimates from the U.S. Environmental Protection Agency's National Air Toxics Assessment. We combined pollutant concentration estimates with potencies to calculate cancer risks by census tract for 309 metropolitan areas in the United States. This information was combined with socioeconomic status (SES) measures from the 1990 Census. Estimated cancer risks associated with ambient air toxics were highest in tracts located in metropolitan areas that were highly segregated. Disparities between racial/ethnic groups were also wider in more segregated metropolitan areas. Multivariate modeling showed that, after controlling for tract-level SES measures, increasing segregation amplified the cancer risks associated with ambient air toxics for all racial groups combined [highly segregated areas: relative cancer risk (RCR) = 1.04; 95% confidence interval (CI), 1.01-107; extremely segregated areas: RCR = 1.32; 95% CI, 1.28-1.36]. This segregation effect was strongest for Hispanics (highly segregated areas: RCR = 1.09; 95% CI, 1.01-1.17; extremely segregated areas: RCR = 1.74; 95% CI, 1.61-1.88) and weaker among whites (highly segregated areas: RCR = 1.04; 95% CI, 1.01-1.08; extremely segregated areas: RCR = 1.28; 95% CI, 1.24-1.33), African Americans (highly segregated areas: RCR = 1.09; 95% CI, 0.98-1.21; extremely segregated areas: RCR = 1.38; 95% CI, 1.24-1.53), and Asians (highly segregated areas: RCR = 1.10; 95% CI, 0.97-1.24; extremely segregated areas: RCR = 1.32; 95% CI, 1.16-1.51). Results suggest that disparities associated with ambient air toxics are affected by segregation and that these exposures may have health significance for populations across racial lines.

Environmental Justice, 2009

ABSTRACT Analyses on the equity issues associated with climate change and the mitigation strategi... more ABSTRACT Analyses on the equity issues associated with climate change and the mitigation strategies that aim to attenuate it tend to focus on the international scale. These analyses tend to cite developing countries as the most vulnerable and disproportionately affected, and thus, the most likely to benefit from sound policies. However, fewer studies focus on the intra-national context within industrialized countries and the potential disparate impacts and benefits of climate change mitigation on lower socioeconomic groups and communities of color. In this article we investigate the costs and benefits of climate change mitigation strategies-some of which have been specified in the Scoping Plan for the implementation of the California Global Warming Solutions Act of 2006 (AB 32). We discuss: (1) the environmental equity concerns regarding certain forms of climate change mitigation; (2) the health co-benefits of AB 32 GHG mitigation policies; (3) the economic implications of different climate change policies on households of low socioeconomic status; and (4) future steps and research needs to leverage GHG mitigation as a health and economic opportunity for vulnerable communities that face disproportionate exposures to social stressors and environmental hazards.

Journal of Urban Affairs, 2005

Environmental justice advocates have recently focused attention on cumulative exposure in minorit... more Environmental justice advocates have recently focused attention on cumulative exposure in minority neighborhoods due to multiple sources of pollution. This article uses U.S. EPA's National Air Toxics Assessment (NATA) for 1996 to examine environmental inequality in California, a state that has been a recent innovator in environmental justice policy. We first estimate potential lifetime cancer risks from mobile and stationary sources. We then consider the distribution of these risks using both simple comparisons and a multivariate model in which we control for income, land use, and other explanatory factors, as well as spatial correlation. We find large racial disparities in California's ''riskscape'' as well as inequalities by other factors and suggest several implications for environmental and land use policy.

Environmental Health Perspectives

BACKGROUND: Prior research has reported disparities in environmental exposures in the United Stat... more BACKGROUND: Prior research has reported disparities in environmental exposures in the United States, but, to our knowledge, no nationwide studies have assessed inequality in noise pollution. OBJECTIVES: We aimed to a) assess racial/ethnic and socioeconomic inequalities in noise pollution in the contiguous United States; and b) consider the modifying role of metropolitan level racial residential segregation. METHODS: We used a geospatial sound model to estimate census block group-level median (L 50) nighttime and daytime noise exposure and 90th percentile (L 10) daytime noise exposure. Block group variables from the 2006-2010 American Community Survey (ACS) included race/ethnicity, education, income, poverty, unemployment, homeownership, and linguistic isolation. We estimated associations using polynomial terms in spatial error models adjusted for total population and population density. We also evaluated the relationship between race/ethnicity and noise, stratified by levels of metropolitan area racial residential segregation, classified using a multigroup dissimilarity index. RESULTS: Generally, estimated nighttime and daytime noise levels were higher for census block groups with higher proportions of nonwhite and lower-socioeconomic status (SES) residents. For example, estimated nighttime noise levels in urban block groups with 75% vs. 0% black residents were 46.3 A-weighted decibels (dBA) [interquartile range (IQR): 44:3-47:8 dBA] and 42:3 dBA (IQR: 40:4-45:5 dBA), respectively. In urban block groups with 50% vs. 0% of residents living below poverty, estimated nighttime noise levels were 46:9 dBA (IQR: 44:7-48:5 dBA) and 44:0 dBA (IQR: 42:2-45:5 dBA), respectively. Block groups with the highest metropolitan area segregation had the highest estimated noise exposures, regardless of racial composition. Results were generally consistent between urban and suburban/rural census block groups, and for daytime and nighttime noise and robust to different spatial weight and neighbor definitions. CONCLUSIONS: We found evidence of racial/ethnic and socioeconomic differences in model-based estimates of noise exposure throughout the United States. Additional research is needed to determine if differences in noise exposure may contribute to health disparities in the United States.

Environmental …, 2011

... the first-ever voluntary guidelines to protect the school environment (Collaborative for High... more ... the first-ever voluntary guidelines to protect the school environment (Collaborative for High ... Steel Workers Local 620, and various community and environmental organizations organized a November ... stewardship, and use the EJ and sustainability approach as an economic and ...

Journal of Health and Social Behavior, 2011

This article examines participants' responses to receiving their results in a study of household ... more This article examines participants' responses to receiving their results in a study of household exposure to endocrine disrupting compounds and other pollutants. We study how the "exposure experience" -the embodied, personal experience and understanding of chronic exposure to environmental pollutants-is shaped by community context and the report-back process itself. In addition, we investigate an activist, collective form of exposure experience. We analyze themes of expectations and learning, trust, and action. The findings reveal that while participants interpret scientific results to affirm lay knowledge of urban industrial toxics, they also absorb new information regarding other pollutant sources. By linking the public understanding of science literature to the illness and exposure experience concepts, this study unravels the complex relationship between lay experience and lay understanding of science. It also shows that to support policy development and/or social change, community-based participatory research efforts must attend to participants' understanding of science.

Science Technology & Human Values, 2006

There are challenges to the dominant research paradigm in breast cancer science. In the United St... more There are challenges to the dominant research paradigm in breast cancer science. In the United States, science and social activism create paradigmatic shifts. Using interviews, ethnographic observations, and an extensive review of the literature, we create a three-dimensional model to situate changes in scientific controversy concerning environmental causes of breast cancer. We

Sociology of Health & Illness, 2004

Social movements organised around health-related issues have been studied for almost as long as t... more Social movements organised around health-related issues have been studied for almost as long as they have existed, yet social movement theory has not yet been applied to these movements. Health social movements (HSMs) are centrally organised around health, and address: (a) access to or provision of health care services; (b) health inequality and inequity based on race, ethnicity, gender, class and/or sexuality; and/or (c) disease, illness experience, disability and contested illness. HSMs can be subdivided into three categories: health access movements seek equitable access to health care and improved provision of health care services; constituencybased health movements address health inequality and health inequity based on race, ethnicity, gender, class and/or sexuality differences; and embodied health movements (EHMs) address disease, disability or illness experience by challenging science on etiology, diagnosis, treatment and prevention. These groups address disproportionate outcomes and oversight by the scientific community and/or weak science. This article focuses on embodied health movements, primarily in the US. These are unique in three ways: 1) they introduce the biological body to social movements, especially with regard to the embodied experience of people with the disease; 2) they typically include challenges to existing medical / scientific knowledge and practice; and 3) they often involve activists collaborating with scientists and health professionals in pursuing treatment, prevention, research and expanded funding. This article employs various elements of social movement theory to offer an approach to understanding embodied health movements, and provides a capsule example of one such movement, the environmental breast cancer movement.

Journal of Health and Social Behavior, 2008

We report on interviews conducted with participants in a novel study about environmental chemical... more We report on interviews conducted with participants in a novel study about environmental chemicals in body fluids and household air and dust. Interviews reveal how personal and collective environmental history influence the interpretation of exposure data, and how participants fashion an emergent understanding of environmental health problems from the articulation of science and experience. To the illness experience literature, we contribute a framework for analyzing a new category of embodied narratives-"exposure experience"-that examines the mediating role of science. We update social scientific knowledge about social responses to toxic chemicals during a period in which science alters public understanding of chemical pollution. This article is among the first published accounts of participants' responses to learning personal exposure data, research identified as critical to environmental science and public health. Our findings raise the importance of reporting even uncertain science and underscore the value of a community-based reporting strategy.

Environmental Science & Technology, 2008

Environmental Health, 2010

Background: We report on the challenges of obtaining Institutional Review Board (IRB) coverage fo... more Background: We report on the challenges of obtaining Institutional Review Board (IRB) coverage for a communitybased participatory research (CBPR) environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods: We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results: We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership.

Environmental Science & Technology, 2010

Interest in the health effects of potential endocrine-disrupting compounds (EDCs) that are high p... more Interest in the health effects of potential endocrine-disrupting compounds (EDCs) that are high production volume chemicals used in consumer products has made exposure assessment and source identification a priority. We collected paired indoor and outdoor air samples in 40 nonsmoking homes in urban, industrial Richmond, CA, and 10 in rural Bolinas, CA. Samples were analyzed by GC-MS for 104 analytes, including phthalates (11), alkylphenols (3), parabens (3), polybrominated diphenyl ether (PBDE) flame retardants (3), polychlorinated biphenyls (PCBs) (3), polycyclic aromatic hydrocarbons (PAHs) (24), pesticides (38), and phenolic compounds (19). We detected 39 analytes in outdoor air and 63 in indoor air. For many of the phenolic compounds, alkylphenols, phthalates, and PBDEs, these represent some of the first outdoor measures and the first analysis of the relative importance of indoor and outdoor sources in paired samples. Data demonstrate higher indoor concentrations for 32 analytes, suggesting primarily indoor sources, as compared with only 2 that were higher outdoors. Outdoor air concentrations were higher in Richmond than Bolinas for 3 phthalates, 10 PAHs, and o-phenylphenol, while indoor air levels were more similar between communities, except that differences observed outdoors were also seen indoors. Indoor concentrations of the most ubiquitous chemicals were generally correlated with each other (4-t-butylphenol, o-phenylphenol, nonylphenol, several phthalates, and methyl phenanthrenes; Kendall correlation coefficients 0.2-0.6, p < 0.05), indicating possible shared sources and highlighting the importance of considering mixtures in health studies.

Over the last decade, a growing number of social scientists have turned their attention to the st... more Over the last decade, a growing number of social scientists have turned their attention to the study of activism around health issues. Health social movements (HSMs) have pressed the institution of medicine to change in dramatic ways, embracing new modes of healthcare delivery and organization. Health activists have also pushed medicine to evolve by connecting their health concerns to other substantive issues such as social and environmental justice, poverty, and occupational or environmentally induced diseases. HSMs therefore serve as an important bridge, connecting the institution of medicine to other social institutions. In similar fashion, the study of HSMs has motivated medical sociology to develop new tools and theoretical perspectives to understand these alterations in the medical landscape. Medical sociologists stand to learn a great deal about the institution of medicine by observing it as it comes into conflict with patients and activists around issues of health care delivery, science and policy, and regulatory action. This broad sweep of interests must be systematized, which is our project here.

Environmental Health, 2009

Background: Exposure assessment has shifted from pollutant monitoring in air, soil, and water tow... more Background: Exposure assessment has shifted from pollutant monitoring in air, soil, and water toward personal exposure measurements and biomonitoring. This trend along with the paucity of health effect data for many of the pollutants studied raise ethical and scientific challenges for reporting results to study participants.

Environmental Health Perspectives, 2007

BACKGROUND: The field of risk assessment has focused on protecting the health of individual peopl... more BACKGROUND: The field of risk assessment has focused on protecting the health of individual people or populations of wildlife from single risks, mostly from chemical exposure. The U.S. Environmental Protection Agency recently began to address multiple risks to communities in the "Framework for Cumulative Risk Assessment" [EPA/630/P02/001F. Washington DC:Risk Assessment Forum, U.S. Environmental Protection Agency (2003)].

Risk Analysis, 2000

Of the 188 hazardous air pollutants (HAPs) listed in the Clean Air Act, only a handful have infor... more Of the 188 hazardous air pollutants (HAPs) listed in the Clean Air Act, only a handful have information on human health effects, derived primarily from animal and occupational studies. Lack of consistent monitoring data on ambient air toxics makes it difficult to assess the extent of low-level, chronic, ambient exposures to HAPs that could affect human health, and limits attempts to prioritize and evaluate policy initiatives for emissions reduction. Modeled outdoor HAP concentration estimates from the U.S. Environmental Protection Agency's Cumulative Exposure Project were used to characterize the extent of the air toxics problem in California for the base year of 1990. These air toxics concentration estimates were used with chronic toxicity data to estimate cancer and noncancer hazards for individual HAPs and the risks posed by multiple pollutants. Although hazardous air pollutants are ubiquitous in the environment, potential cancer and noncancer health hazards posed by ambient exposures are geographically concentrated in three urbanized areas and in a few rural counties. This analysis estimated a median excess individual cancer risk of 2.7E Ϫ 4 for all air toxics concentrations and 8600 excess lifetime cancer cases, 70% of which were attributable to four pollutants: polycyclic organic matter, 1,3 butadiene, formaldehyde, and benzene. For noncancer effects, the analysis estimated a total hazard index representing the combined effect of all HAPs considered. Each pollutant contributes to the index a ratio of estimated concentration to reference concentration. The median value of the index across census tracts was 17, due primarily to acrolein and chromium concentration estimates. On average, HAP concentrations and cancer and noncancer health risks originate mostly from area and mobile source emissions, although there are several locations in the state where point sources account for a large portion of estimated concentrations and health risks. Risk estimates from this study can provide guidance for prioritizing research, monitoring, and regulatory intervention activities to reduce potential hazards to the general population. Improved ambient monitoring efforts can help clarify uncertainties inherent in this analysis.

Environmental Research, 2006

Environmental health researchers, sociologists, policy-makers, and activists concerned about envi... more Environmental health researchers, sociologists, policy-makers, and activists concerned about environmental justice argue that communities of color who are segregated in neighborhoods with high levels of poverty and material deprivation are also disproportionately exposed to physical environments that adversely affect their health and well-being. Examining these issues through the lens of racial residential segregation can offer new insights into the junctures of the political economy of social inequality with discrimination, environmental degradation, and health. More importantly, this line of inquiry may highlight whether observed pollution-health outcome relationships are modified by segregation and whether segregation patterns impact diverse communities differently.

Relatively little is known about the spectrum of health effects, and the scope and level of ambie... more Relatively little is known about the spectrum of health effects, and the scope and level of ambient air concentrations of those pollutants regulated under the Clean Air Act as "hazardous air pollutants." The U.S. Environmental Protection Agency's (USEPA) Cumulative Exposure Project uses currently available emissions inventories, from a variety of source types, and an atmospheric dispersion model to provide estimates of ambient concentrations for 148 hazardous air pollutants (HAPs) in over 60,000 census tracts for the year 1990. This paper uses currently available hazard information for those pollutants and provides a database of potential regulatory threshold concentrations

Environmental Research, 2006

On May [24][25] 2005 in Ann Arbor, Michigan, the US Environmental Protection Agency, the National... more On May [24][25] 2005 in Ann Arbor, Michigan, the US Environmental Protection Agency, the National Institute of Environmental Health Sciences, and the University of Michigan sponsored a technical workshop on the topic of connecting social and environmental factors to measure and track environmental health disparities. The workshop was designed to develop a transdisciplinary scientific foundation for exploring the conceptual issues, data needs, and policy applications associated with social and environmental factors used to measure and track racial, ethnic, and class disparities in environmental health. Papers, presentations, and discussions focused on the use of multilevel analysis to study environmental health disparities, the development of an organizing framework for evaluating health disparities, the development of indicators, and the generation of community-based participatory approaches for indicator development and use. Group exercises were conducted to identify preliminary lists of priority health outcomes and potential indicators and to discuss policy implications and next steps. Three critical issues that stem from the workshop were: (a) stronger funding support is needed for community-based participatory research in environmental health disparities, (b) race/ethnicity and socioeconomic position need to be included in environmental health surveillance and research, and (c) models to elucidate the interrelations between social, physical, and built environments should continue to be developed and empirically tested. Published by Elsevier Inc.

Environmental Health Perspectives, 2005

This study examines links between racial residential segregation and estimated ambient air toxics... more This study examines links between racial residential segregation and estimated ambient air toxics exposures and their associated cancer risks using modeled concentration estimates from the U.S. Environmental Protection Agency's National Air Toxics Assessment. We combined pollutant concentration estimates with potencies to calculate cancer risks by census tract for 309 metropolitan areas in the United States. This information was combined with socioeconomic status (SES) measures from the 1990 Census. Estimated cancer risks associated with ambient air toxics were highest in tracts located in metropolitan areas that were highly segregated. Disparities between racial/ethnic groups were also wider in more segregated metropolitan areas. Multivariate modeling showed that, after controlling for tract-level SES measures, increasing segregation amplified the cancer risks associated with ambient air toxics for all racial groups combined [highly segregated areas: relative cancer risk (RCR) = 1.04; 95% confidence interval (CI), 1.01-107; extremely segregated areas: RCR = 1.32; 95% CI, 1.28-1.36]. This segregation effect was strongest for Hispanics (highly segregated areas: RCR = 1.09; 95% CI, 1.01-1.17; extremely segregated areas: RCR = 1.74; 95% CI, 1.61-1.88) and weaker among whites (highly segregated areas: RCR = 1.04; 95% CI, 1.01-1.08; extremely segregated areas: RCR = 1.28; 95% CI, 1.24-1.33), African Americans (highly segregated areas: RCR = 1.09; 95% CI, 0.98-1.21; extremely segregated areas: RCR = 1.38; 95% CI, 1.24-1.53), and Asians (highly segregated areas: RCR = 1.10; 95% CI, 0.97-1.24; extremely segregated areas: RCR = 1.32; 95% CI, 1.16-1.51). Results suggest that disparities associated with ambient air toxics are affected by segregation and that these exposures may have health significance for populations across racial lines.

Environmental Justice, 2009

ABSTRACT Analyses on the equity issues associated with climate change and the mitigation strategi... more ABSTRACT Analyses on the equity issues associated with climate change and the mitigation strategies that aim to attenuate it tend to focus on the international scale. These analyses tend to cite developing countries as the most vulnerable and disproportionately affected, and thus, the most likely to benefit from sound policies. However, fewer studies focus on the intra-national context within industrialized countries and the potential disparate impacts and benefits of climate change mitigation on lower socioeconomic groups and communities of color. In this article we investigate the costs and benefits of climate change mitigation strategies-some of which have been specified in the Scoping Plan for the implementation of the California Global Warming Solutions Act of 2006 (AB 32). We discuss: (1) the environmental equity concerns regarding certain forms of climate change mitigation; (2) the health co-benefits of AB 32 GHG mitigation policies; (3) the economic implications of different climate change policies on households of low socioeconomic status; and (4) future steps and research needs to leverage GHG mitigation as a health and economic opportunity for vulnerable communities that face disproportionate exposures to social stressors and environmental hazards.

Journal of Urban Affairs, 2005

Environmental justice advocates have recently focused attention on cumulative exposure in minorit... more Environmental justice advocates have recently focused attention on cumulative exposure in minority neighborhoods due to multiple sources of pollution. This article uses U.S. EPA's National Air Toxics Assessment (NATA) for 1996 to examine environmental inequality in California, a state that has been a recent innovator in environmental justice policy. We first estimate potential lifetime cancer risks from mobile and stationary sources. We then consider the distribution of these risks using both simple comparisons and a multivariate model in which we control for income, land use, and other explanatory factors, as well as spatial correlation. We find large racial disparities in California's ''riskscape'' as well as inequalities by other factors and suggest several implications for environmental and land use policy.