Should Environmental Justice be Part of Family Therapy?

Posted on January 10, 2010. Filed under: Environmental, Family Therapy, Health, Pollution, Public Health | Tags: , , , , |

This post is an addendum to my “Is it ADHD or Expose to Toxins?”  I was reminded by a friend at the Adler Institute of Social Exclusion that exposure to pollution or toxins do not occur evenly throughout the population.  Poor people and ethnic minorities are more likely to be exposed to pollution and toxins.  Within the public health sphere, there is a term called Environmental Justice.  The EPA has a page devoted to Environmental Justice and the EPA defines it as:

Environmental Justice is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. EPA has this goal for all communities and persons across this Nation. It will be achieved when everyone enjoys the same degree of protection from environmental and health hazards and equal access to the decision-making process to have a healthy environment in which to live, learn, and work.

Environmental justice is an important piece of addressing health disparities.  I will discuss some of the key issues of environmental justice and then highlight what family therapists can do to address issues of environmental injustice.

Environmental justice is rooted in the civil rights movement of the 1960’s as black leaders become concerned about the connection between their communities and environmental risks (Click HERE for a timeline).  Community leaders were concerned about what they termed environmental racism.  Environmental racism occurs when policies, regulations, and/or practices that put people of color or low income communities at risk for being exposed to toxins.  There are many historical examples but all we need to do is to look at Hurricane Katrina and Dickson, TN to see that issues of environmental injustice are still around.  Some other startling facts from a United Church of Christ 2007 report (they have done some remarkable work in this area):

  • More than 870,000 of the 1.9 million (46 percent) housing units for the poor, mostly minorities, sit within about a mile of factories that reported toxic emissions to the Environmental Protection Agency (p. 4).
  • More than 600,000 students in Massachusetts, New York, New Jersey, Michigan and California were attending nearly 1,200 public schools, with largely African Americans and other children of color, that are located within a half mile of federal Superfund or state­identified contaminated sites (p. 4).
  • Neighborhoods with a hazardous waste facility in Arizona, California and Nevada are majority Hispanic or Latino. Other states with very large disparities in Hispanic or Latino percentages include Colorado, Connecticut, Florida, Illinois, Kansas and Utah (p. 58-59).
  • While Race and SocioEconomic Status are important variables in predicting the location of a hazardous waste site, Race appears to be more important (p. 62).  Indicating that hazardous waste sites are located in middle class and affluent Black neighborhoods.

While these issues are usually addressed by community organizations, family therapists should inquire about exposure to toxins to understand possible causes or contributors to psychological, behavior, or emotional problems.  These issues should be part of every intake form.  We might be “treating” ADHD when in fact someone has lead poisoning.  And while family therapists cannot change the SES circumstances of our clients, we can provide information on how their housing or community is connected to their health (read physical and mental).

In a previous post I highlighted some questions that family therapists can ask about toxins in the environment.  Here are some other things that family therapists can do:

  • Use the EPA’s website as a source of information about the communities that your clients live in.  Go to the EPA’s Where You Live website and click on the region where your clients reside.  This will give you information about the EPA’s work in your region.
  • Go the Environmental Justice Geographic Tool to see what issues are in the neighborhoods of your clients.  Once you get the region you will need to choose which features you would like to explore.  Here is a link to what Utica, NY looks like.  I chose all the regulated sites (Click on the +) and Schools under Places.
  • If you learn about a possible exposure (e.g., lead, mercury) have them contact their health care provider immediately OR their local Public Health Office. You can locate federally funded health care sites from here by clicking HERE.

I have just touched the surface of this issue.  There are some great resources out there for people wanting to learn more about Environmental Justice.  I will list some resources below and let me know if you have more.  Please leave a comment, concern, or story.  I will respond to all of them.  As always, take care.



Democracy Now: Interview with Dr. Robert Bullard

Environmental Justice Resource Center at Clark Atlanta University (EXCELLENT SITE.  This is really all you need to see what the current key issues are).

Interagency Working Group (11 federal agencies and several White House offices working to integrate environmental justice into its individual programs)

National Black Environmental Justice Network

Pollution Issues: Environmental Racism

Social Science Research Council: Toxic Soup Redux

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Is it ADHD or Exposure to Toxins?

Posted on January 4, 2010. Filed under: Environmental, Family Therapy, Housing Quality, Pollution, Public Health | Tags: , , , |

In my December 20, 2010 blog I asked if mental health therapists are asking about Housing Quality. The CDC has linked housing quality to health. There are ranges of issues that therapists could be asking but today I will focus on Indoor Pollution. But first, lets explore the issue.

The Environmental Protection Agency (EPA) has reported that people from Industrialized Nations spend up to 90% of their time indoors. This number makes sense when we think about the time we spend at work, socializing, buying (i.e., groceries, mall), and hanging out in our homes. When we think about small children and the elderly, this number may be even higher. Because of this time spent indoors, people are more likely to be exposed to pollution and toxins in their homes rather than from the outside. The EPA, CDC, and Physicians for Social Responsibility (PSR) list a number of indoor pollutants that are of concern. They include; second-hand smoke, lead, radon, biological contaminants (e.g., bacteria, molds, mildew, animal dander, house dust mites, cockroaches, pollen), carbon monoxide, nitrogen dioxide, organic chemicals (e.g., paints, aerosol sprays, pesticides, disinfectants, air fresheners, hobby supplies, dry-cleaned clothing), and asbestos. This list is overwhelming!!

And while we might be concerned with these issues, we might think that someone else should explore these issues. There are a number of reasons why a therapist should ask about Indoor Pollution. First, children and the elderly are highly susceptible to toxins. Children like to crawl around, put things in their mouth, and have increased metabolisms. The Elderly are more likely to stay inside thus increasing their expose to molds, mildew, radon, and pesticides. Reactions to indoor pollution can mimic psychological issues. For example, children exposed to lead attention deficits, increased impulsiveness, reduced school performance, aggression, and delinquent behavior. These exposures may also mimic cognitive deficits like memory loss. As therapists we might be missing a key contextual factor that plays a significant role in the issue that brought a client to us. Next, exposure to a range of indoor pollutants is harmful to expectant mothers. Exposure to lead, mercury, alcohol, second-hand smoke, and pesticides can adversely affect fetus development. Lastly, parents are concerned about these issues but their primary care providers are not addressing environmental health issues. Physicians for Social Responsibility highlighted a report in the journal Environment Health Perspective in which pediatricians stated that doing an environmental assessment was important but due to lack of training did not feel confident to do one.

Hopefully you agree that therapists could play a pivotal role and one that does not take too much time. So here is what you can do:

  • Ask about the occupation of all people in the household that work? What do they do? Do they think they might be exposed to chemicals on the job? Employers are required by federal law to keep a list of all chemicals that are harmful to employees. This is important because workers can bring chemicals back into their homes. This information could be collected during the intake.
  • Ask about if they have any hobbies that include solvents (e.g., glue, paints, paint thinners, art materials)? Where are they stored? Do kids have access to them?
  • Ask about their diet. Do they eat a lot of fish? Where do they get their fish? Fish can contain high levels of mercury.
  • Is there lead paint in the home? Homes built prior to 1978 used lead paint. Older apartments can have lead paint.
  • Any hazardous sites near their homes? Click HERE for an EPA website.
  • Where do they get their drinking water? This is especially important for your rural clients.
  • When was the last time they had their heating system serviced? Does not matter the type of heating? This is also related to my previous post on Home Fires.
  • Have they talked to your Primary Care Provider about environmental health issues?

I know there is a lot of information above but the conversation you have with a client might only take a few minutes. If you or your clients are curious or have more questions, you can check out the website below. Leave a comment, questions, or concern below and thanks for following.


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