As COVID-19 cases continue to soar across much of the country, we are beginning to learn about some of the factors that increase one’s susceptibility to the virus, as well as the morbidity and mortality associated with it. According to recent studies, air pollution, especially from fine particulate matter (PM2.5), has been linked with an increase in the COVID-19 death rate. One researcher stated that long term exposure to air pollution may be one of the most important contributors to deaths caused by the virus. It has also been shown that racial and ethnic minorities are exposed to 35% more air pollution than the average person in the US, and black people specifically are exposed to 54% more air pollution than the average person. Data compiled from hospitals in 14 states show that black people account for 33% of COVID-19 deaths when they make up only 18% of the total population in those same states. This pandemic highlights the connection between environmental stressors, like air pollution, disease, and the toll it takes on minority communities. This phenomenon is known as environmental racism, which is a form of social inequity which subjects minority communities to disproportionate impacts from environmental hazards. Recent examples include lead contamination in the municipal drinking water in Flint and Newark.
I trained in a hospital in the South Bronx where I spent countless nights clocking the respiratory rates of children, watching their chests move up and down and looking for any signs of respiratory distress, while the nebulizers buzzed and the coughs and audible wheezing filled the air. Pediatric asthma rates in the Bronx far exceed the national average rates and Bronx children are twice as likely to be hospitalized for asthma and more likely to die of asthma than other US children. Black and Latino people make up the majority of the population there. Although there are many factors that contribute to these statistics, air pollution is a major one. I never really took that into account. We focused on the inhalers and steroids, talked about environmental allergies, all important, and even life-saving, but we did not address one of the major root causes - air pollution.
The WHO places air pollution among the top global risks to health. Thought sitting was the new smoking? Nope, it’s air pollution. PM 2.5 stands for particulate matter that is 2.5 micrometers or smaller and is inhaled into the lungs and can also be absorbed into the bloodstream and causes not only respiratory diseases, but cardiovascular diseases as well. Both of these are factors that increase the morbidity and mortality from COVID-19. Long term exposure to PM 2.5 can play a role in high blood pressure, diabetes, heart failure, and increased infant mortality. It is also a known carcinogen and can cause reproductive and central nervous system dysfunction, as well as have implications in neurodegenerative diseases like Alzheimer’s and Parkinson’s. The majority of environmental pollutants come from industrial machinery, power-producing stations, refineries, chemical and fertilizer industries, combustion engines and cars. Other sources include dry cleaners, gas stations, and natural sources like forest fires.
Communities of color have been experiencing environmental racism for decades, increasing the risk of disease burden from environmental toxins like air pollution. Preliminary studies show that many of these diseases increase the risk of death in those with COVID-19. This is likely a major contributor to the disproportionate amounts of deaths from COVID-19 in communities of color. Racist and exclusionary policies have led to underinvestment in communities where many people of color live. This manifests as housing discrimination, lax legislation, corporate greed, and insufficient community representation. Lower property values lead to increased industrial acquisition, often the initial step in the cycle. Adding fuel to the fire is the weakened EPA which has reduced enforcement of environment regulations during this pandemic.
Environmental racism was not a concept I was aware of nor taught in my training. Knowledge and awareness of the issue is a start to change. Local, state, and federal laws need to be put in place to begin to reverse environmental racism. Residents need to be protected from industries that directly pollute neighborhoods. Environmental justice needs to be a priority.