The Mental Distress of Environmental Injustice
Feb 2023
by
Lead Author: Marie Müller, PhD
Editor: Araceli Camargo, MSc Neuroscience,
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DESCRIPTION
In the UK and the US, communities that are marginalised and racialised are disproportionately exposed to environmental hazards (source). Naturally, people have different exposures to health hazards; there always is variation. However, when these differences are not random but systematic, when people are disproportionately exposed to pollution because of racialisation, how they are gendered, disability or their income class, they face environmental injustice.
There is now a very clear understanding that environmental hazards, such as air pollution have a direct effect on our health (source). However, what is often missing from the conversation is how environmental hazards, due to being an experience of stress and trauma can lead to mental distress. In addition to the disproportionate exposure to health hazards, being aware of the injustice underlying this disproportionate exposure may be a psychosocial stressor that affects health negatively.
What is Environmental Injustice?
Injustice can be defined as a situation or condition that is unfair and is lacking justice (source). Social injustice can be defined as ‘the denial or violation of economic, sociocultural, political, civil, or human rights of specific populations or groups in the society based on the perception of their inferiority by those with more power or influence’ (source). Environmental injustice, a form of social injustice, can be defined as the disproportionate exposure of certain populations, including ethnic minority populations and people living in poverty, to environmental hazards (source/source/source).
‘Environmental injustice is about [the state] creating sacrifice zones where we place everything which no one else wants. The justification is always an economic one, that it makes sense to build chemical plants on so-called cheap lands where poor people and people of colour live, but which are only cheap because all the wealth and economic opportunities have been stripped out. The people who live in these areas are unseen, unheard and undervalued.’
-- Mustafa Ali in The Guardian, 2019 (source)
Environmental Injustice and Health
We have identified three key pathways in which environmental injustice affects health.
The first pathway is the exposure to an environmental hazard: more exposure (time and quantity) is associated with poorer health outcomes. This is the most obvious pathway because it describes the most direct effect an environmental hazard has on health. Namely that when a hazard like air pollution enters the human body through our respiratory system it causes harm to every organ in our body due to its particles circulating through our bloodstream (source). The longer a person is exposed to air pollution and the higher quantity, the more it burdens the body. With time, the body can become so overwhelmed that even low amounts of air pollution can have deeply damaging effects (source).
The second pathway is the perception of the hazard. This is different to the first pathway because it is not about the direct, physical effect of the environmental hazard on the body but about people’s perceptions of the hazard. Being aware of an environmental hazard and how it could harm your health can lead to people feeling anxious, worried, and distressed (source).
The third pathway is the most understudied and the focus of this report, the experience of injustice due to an environmental hazard. If high exposure to an environmental hazard is due to environmental injustice, it may not only be the effect of the hazard on the body or the perception of the hazard, but the experience of injustice that affects health negatively. For this pathway to be relevant, people, of course, must be aware of the injustice. They must be aware that the disproportionate exposure to a given hazard is not random but systematic, and the reason for the disproportionate exposure is that they belong to a certain group that governing systems perceive as inferior. They must be aware that this is not fair and not just. If they are, and in most cases, they will be, especially when they are part of an ‘environmental justice community’, this experience of injustice is likely to also affect their health. The experience of injustice may be similar to the experience of discrimination which has already been linked to health (source/source).
Why is this important?
In this report, we are going to be focusing on environmental pollutants as psychosocial stressors and we will using air pollution as the leading example. We will addressing the two aforementioned pathways, which is the awareness of air pollution and the experience of air pollution as an environmental injustice.
It is important that we, as scientists, begin to explore this pathway in depth for three reasons;
Air pollution as a psychosocial stressor is a significant pathway to poor health outcomes, yet it is understudied. This lack of scientific knowledge is important to understand the full ecological scope of air pollution and how it contributes to the onset of mental health illnesses such as PTSD, depression and anxiety.
There is a need to understand how psychosocial factors of air pollution interact and amplify physiological symptomology.
This research can be a significant tool for changing air pollution laws as well as seeking legal compensation for communities. When a community is faced with an air pollution incident, i.e. a site polluting their neighbourhood, they have to fight their case based only on the physiological experience. This ignores the mental burden that many communities face, which is often the first and most long-lasting consequence of air pollution exposure.
After an air pollution or environmental hazard is removed, the mental toll of facing the injustice and often the death of loved ones can leave many in the community with long lasting effects such as anxiety, depression, PTSD, digestive issues, insomnia, or even chronic fatigue. This is not discussed in depth in the scientific literature or when addressing air pollution policies.
Study into air pollution as a psychosocial stressor should also be of top priority to health professionals and organisations. Understanding that air pollution can affect a person’s mental health is part of a robust care plan for those experiencing an environmental hazard.
Throughout this text, we will explore how air pollution affects community health. The aim is to provide a more complete picture of the air pollution-health relationship. We argue that there is more to this relationship than a mere ‘physical’ effect of a pollutant entering the human body and causing harm. We argue that there is a whole range of psychosocial effects that negatively affect individual and community health. It is crucial for health services to be aware of these ‘secondary’ effects of air pollution on health.
Thirdly, this report will explore focus on communities with an identifiable air pollution problem (or an identifiable environmental justice concern). However, it is important to note that every single person that is breathing polluted air is facing environmental injustice as any amount of air pollution has an adverse effect on our health and personhood.
The Mental Burden & Trauma of Environmental Injustice
We identified three psychosocial pathways to (poor) health: 1) experiencing trauma; 2) experiencing uncertainty and powerlessness; and 3) experiencing injustice.
Trauma
Living in environments with high levels of air pollution can be traumatic. Knowing that you and your family, friends, and neighbours are exposed to air pollution is stressful and frightening. Being aware that you live in an area that is unhealthy, being aware that you cannot escape the threat because you need to breathe to stay alive, and being aware that everyone else around you is affected too is a highly distressing experience. It gets even worse because typically air pollution is not a one-off event but an ongoing problem. You may be worried about your own health and the health of others; you may feel that the pollution starts affecting your health; you may see other people suffering or passing away; you may feel unheard and unsupported (source) by the organisations that should be supporting you such as local authorities and health practioners. All these feelings are common to experiencing trauma (source). Trauma is associated with poor mental well-being ‘in the moment’ but also with the development of more severe, long-term mental ill-health. It is now known that pollutants can affect the human brain (source) and that exposure to air pollution is linked to an increased risk of mental health problems (source). However, how much of this link is due to a direct ‘physical’ effect of the pollutant on the body, and how much may be due to the psychosocial experience of pollution remains unclear. From our work with communities affected by air pollution (e.g., Southall), it is clear that one must not underestimate the trauma that air pollution can cause and the negative effect that this can have on community (mental) health and well-being.
Uncertainty and powerlessness
There are two factors that likely add to or exacerbate the trauma: uncertainty and powerlessness. These two factors have been identified to be key drivers for chronic stress in the context of unconventional oil and gas (UOG) production in the US (source). Although this is a relatively specific case of pollution, the two causes of distress, uncertainty and powerlessness, are likely to also play an important role for communities affected by other types of pollution.
The first factor, uncertainty, refers to insufficient and non-transparent information about environmental health risks, amplifying people’s experience of chronic stress. Typically, communities do not have free access to scientific publications, and it costs them a lot of time and money to get the information they need. It must be the role of public health and regulatory agencies to inform the public about potential environmental health risks, honestly and transparently. Unfortunately, all too often, this is not the case, leading to uncertainty and increasing chronic stress. Recently, Centric Lab has published an open letter in support of the ‘Stop the Stink’ campaign, in which we highlight the incomplete communication by Public Health England and the Environment Agency about the pollution coming from a landfill in Staffordshire and how it affects community health (source). This is an example of poor communication of health risks and the uncertainty that this poor communication causes.
The second factor, powerlessness, refers to people being excluded from decision-making processes. Not having a say in the decisions that affect your health and the health of your family and friends is a stressful experience. People know that there is an environmental health hazard, they want to do something about it, but they have no power to change the situation. This powerlessness makes them feel helpless, hopeless, and exhausted (source). Not being in control of your own health aggravates stress and exacerbates poor health. All too often we see communities campaigning and fighting but achieving little to no change.
Injustice
Another psychosocial pathway linking air pollution to health is the experience of injustice. Injustice can be defined as a situation or condition that is unfair and lacking justice (source). Social injustice is ‘the denial or violation of economic, sociocultural, political, civil, or human rights of specific populations or groups in the society based on the perception of their inferiority by those with more power or influence’ (source). Environmental injustice is a form of social injustice and can be defined as the disproportionate exposure of certain populations, including ethnic minority populations and people living in poverty, to environmental hazards (source/source/source).
‘Environmental injustice is about [the state] creating sacrifice zones where we place everything which no one else wants. The justification is always an economic one, that it makes sense to build chemical plants on so-called cheap lands where poor people and people of color live, but which are only cheap because all the wealth and economic opportunities have been stripped out. The people who live in these areas are unseen, unheard and undervalued.’ -- Mustafa Ali in The Guardian, 2019 (source)
Living in an area with high levels of pollution, being worried about its effects on your health and on the health of others, already feeling and seeing its effects, having insufficient access to information, and being powerless impacts negatively on community health and well-being (source).
What could exacerbate this experience of trauma is the experience of injustice. If a community is disproportionately exposed to pollution not randomly but because of systemic injustice deeply rooted in society, this experience of injustice will likely worsen the negative effect of air pollution on health. Usually, it is not ‘bad luck’ that some people live in more polluted areas than others; racism and classism force certain communities to live in unhealthy areas.
One of the major lines of environmental injustice is environmental racism. Black and minority ethnic populations are more likely to live in areas with high levels of pollution, and this is due to structural racism (source). The experience of injustice in general and racism in particular is associated with mental ill-health (source). It is therefore plausible that the experience of environmental injustice -- being aware that one is exposed to high levels of pollution not randomly but systematically -- is another psychosocial pathway linking air pollution to health. We should note that there is not much research into this pathway, at least not specifically for the link between air pollution and health. We argue that future research should look into this pathway to get a more complete understanding of the relationship between air pollution and health.
Environmental injustice is a form of social injustice and can be defined as the disproportionate exposure of certain populations, including ethnic minority populations and people living in poverty, to environmental hazards
The Mind-Body Connection
At Centric Lab we understand health as a spectrum of good to poor well-being and functioning. The individual is constantly moving on this spectrum depending on personal and environmental factors. Air pollution tends to push the individual towards poor health.
Health does not only refer to physical health but also includes mental health (source). Above we outlined psychosocial pathways that primarily affect mental health. Further, we know that air pollution has physical effects on the human body, affecting both physical and mental health. What we now need to add to get an even more complete picture of the relationship between air pollution and health is the mind-body connection. Physical health and mental health are not separate but connected: physical health affects mental health, and mental health affects physical health (source). In other words, poor physical and mental health are reinforcing each other. One example of this is the bidirectional relationship between obesity and depression, where obesity is a physical health problem and depression is a mental health problem. Not only do obesity and depression cause each other (source), but air pollution has been shown to cause both. Note, however, that the evidence is not consistent (source/source).
Air pollution causes both obesity and depression, likely not only through a ‘physical’ pathway but also through a psychosocial pathway; obesity and depression are reinforcing each other; chronic exposure to air pollution fuels both (source) (source). In brief, we face complex, interconnected, and reinforcing relationships. The link between air pollution, obesity, and depression is only one example that illustrates the detrimental effect that air pollution has on health, not only on respiratory and cardiovascular systems, but on the whole system, on physical and mental health.
The Right to Breathe Clean Air
Air pollution affects each and everyone of us. Some people are more affected than other people, and, crucially, some communities are affected more than other communities, often due to structural racism and classism. Importantly, these communities are not only exposed to higher levels of pollution, but often they are also more susceptible to pollution, due to other factors, such as limited resources for healthy nutrition, shift working, and working in unhealthy environments. It is crucial that these communities are listened to, heard, and empowered. It is unjust that whole communities are forced to live in neighbourhoods that make them sick and lower their quality of life.
The relationship between air pollution and health is not linear, and the effects of air pollution on health largely depend on other factors. As we have explored in this report, the experience of psychosocial stress makes the individual more susceptible to the effects of air pollution. Similarly, other factors, such as age or existing health conditions, also moderate the effect of air pollution on health. Ultimately, every individual comes with their own health profile and it is impossible to identify healthy levels of air pollution, although the WHO continues to do so (source). There are no safe levels of air pollution. Any level of pollution has a negative effect on health -- on some people more than on others. It is time that we move towards a zero tolerance for air pollution (source).
Earlier we have highlighted that certain communities are disproportionately exposed to and affected by air pollution, facing environmental injustice. Without meaning to curtail this injustice, we would like to go one step further and argue that, ultimately, each and everyone of us experiences some level of injustice. All of us have the right to breathe clean air, but all of us breathe polluted air every single day of our lives. Some communities experience greater injustice, and we do not mean to belittle this injustice, but it is important to understand that all of us are affected. It is not just ‘the others’. We are all affected. We all must demand change.
