Policy Approaches to Protect Communities from the Local

Effects of Air Pollution

John R. Balmes, MDUCSF and UC Berkeley

Outline

• Define the problem• Locate the most impacted communities• Develop policies to improve the air quality

and environmental health of those communities

Health Disparities

• Racial and socioeconomic health disparities persist in the United States.

• In birth outcomes, for example, blacks have greater rates than whites for – infant mortality– very low-birth-weight– pre-term births

Racial-ethnic Differences in Asthma Mortality

NCHS

Racial-ethnic and Income Differences in Cancer Risk from Exposure to Hazardous Air Pollutants

Morello-Frosch R, et al. Environ HealthPerspect 2002;110 suppl 2:149

Health Disparities

• Individual-level factors– health behaviors– access to health care

• Non-environmental place-based factors– neighborhood poverty– poor housing– segregation

• Environmental hazards

Health Disparities• Little research to integrate these different

factors into a unified approach to the problem

• Place-based factors can– affect health outcomes directly – increase exposures to environmental hazards,

such as air pollutants – enhance susceptibility to the toxic effects of

pollutant exposures

Framework for Integrating Community and Individual-level Stressors

DeFur P, et al. Environ Health Perspect 2007;115:817

Disparities in both Exposures to Environmental Hazards and Health

• Low-income communities and communities of color face a higher impact from environmental hazards as well as psychosocial stressors.

• These disparities are likely determinants of health inequalities.

• The potential interaction of elevated environmental hazards and socioeconomic stressors can be described as a form of “double jeopardy.”

Environmental Justice

…means that no population, due to policy or economic disempowerment, is forced to bear a disproportionate burden of the negative human health or environmental impacts of pollution.... (Environmental Protection Agency, 1998)

High capacity hazardous waste sites and ethnic churning, 1970–1990, southern Los Angeles County

TSDF = treatment, storage, anddisposal facilities Morello-Frosch R, et al.

Environ Health Perspect 2002;110 Suppl 2:149.

Exposure to Hazardous Air Pollutants

In the U.S. EPA’sNational-Scale Air Toxics Assessment (NATA) data for LA,most of the cancer risk is from diesel exhaust particles.(Morello-Frosch R, Jesdale BM. Environ Health Perspect 2006;114:386.)

Surface Goods Movement

• Exposures to oxidant gas and particle pollution from surface goods movement (primarily powered by diesel engines) can be high for people who live near ports, railroads, highways and distribution centers.

• People of color and low SES are the most likely to be exposed.

Container Ships

Inter-modal Shipping Facilities

Real People Live Near Train Yards

Container Trucks and Trains

Distribution Centers

Real People Live Near Distribution Centers

Distribution Center ↓

Distribution Trucking

Pollutant Exposures Near Freeways

Zhu et al, 2002

…more black

carbon (diesel marker) near 710

freeway…

Zhu et al 2002

Real People Live Near Freeways

↓Truck on 710 Freeway

Demographics of Children Living Near Freeways

– Children of color 3x more likely to live near high traffic density in California

Gunier et al., California Dept of Health Services, 2003

– Schools near busy roads have a disproportionate number of children who are economically disadvantaged and non-white

RS Green et al, Environ Health Perspect 2004;112:61.

School↓

Cumulative Impacts• Methodological challenge:

– need indicators of cumulative impacts to address environmental health inequities.

• The traditional EPA risk assessment model is inadequate.

• A NAS committee on risk assessment recently recommended that the EPA draw on other approaches, including those from ecology and social epidemiology, to– incorporate interactions between chemical and non-

chemical stressors in assessments – develop simpler analytical tools to support cumulative

risk assessment and to provide for greater involvement of stakeholders.

Cumulative Impacts• Pastor, Sadd, and Morello-

Frosch have developed an environmental justice screening tool.

• Su and colleagues at UC Berkeley have developed an index capable of summarizing inequalities of impact from cumulative environmental hazards.

Environmental Justice Screening Tool (Pastor et al.)

Environmental Justice Screening Tool (Pastor et al.)

Environmental Justice Screening Tool (Pastor et al.)

Cumulative Environmental Hazard Inequality Index

Su J, et al. Environ Sci Technol 2009;43:7626

Cumulative Environmental Hazard Inequality Index (Su et al.)

Cumulative Environmental Hazard

Inequality Index (Su et al.)

Policy Approaches to Reducing Health Disparities

• First, “do no harm”– Revitalization of urban areas to arrest the suburban

sprawl can lead to the dispersion and fragmentation of poor inner city neighborhoods.

• Distinguish between “ameliorative” and “fundamental” approaches– The former (e.g., approving access to health care) will

not lead to the elimination of disparities– The latter (e.g., elimination of poverty) requires

working at multiple levels (individual, community, regional or state, national).

Policy Approaches to Protecting Communities from Local Pollution

• Use screening tools to identify communities of concern re: either exposures or vulnerabilities using publicly available data in a transparent process

• Once impacted communities are defined– No new sources of pollution should be allowed– Community must be involved in land-use decisions– Need improved communication about exposure to

hazards and health risks to communities (e.g., public meetings, decreased language barrier)

Policy Approaches to Protecting Communities from Local Pollution

• Cincinnati has an ordinance to do no further harm once a community has been identified as “impacted.”

• The Bay Area Air Quality Management District has adopted a proposal from the Bay Area Environmental Health Collaborative for a cumulative impacts policy.– Priority communities with disproportionate impacts

should have no new pollution sources.

Policy Approaches to Protecting Communities from Local Pollution

• In San Francisco, the Dept. of Public Health has been using Health Impact Assessment as a tool to address local community concerns about new development.– Healthy Development Management Tool

(screening, scoping, assessment, reporting, monitoring)

– Need multiple methods; not all impacts can be combined quantitatively, but they can be qualitatively combined

Policy Approaches to Protecting Communities from Local Pollution

• AB 32 provides opportunities for co-benefits to communities both in terms of air quality improvement and resource allocation– “ensure no disproportionate impact on low-income communities” – “direct public and private investment to the most disadvantaged

communities and provide opportunities for community institutions”– CARB will use a modified Pastor screening tool to identify impacted

communities • SB 375 provides opportunities for communities to affect

land-use decisions that can improve the built environment of communities– Regional planning agencies are required to adopt a sustainable

communities strategy– CARB sets regional targets for the purpose of reducing greenhouse gas

emissions from passenger vehicles – Increased access to green space has been shown to mitigate some of

the negative cardiovascular effects of poverty

EAAC Recommendations for Cap-and-Trade Allowance Value

• Allowances should be auctioned• A “significant share” of the value should be used to finance

– low-cost emissions reductions (both directly and through investments in cleantech R&D)

– adaptation to climate impacts, – environmental remediation, – improvements to disadvantaged communities– job training

• Some of the value should go to assist economically disadvantaged households

• A “fraction” of the value should be allocated to a contingency fund to be devoted to any communities experiencing increased exposure to co-pollutants as a result of any possible fossil-fuel burning stemming from AB 32 implementation. – The funds would be for the purpose of environmental

remediation.

Policy Approaches to Protecting Communities from Local Pollution

• Schools and parks should not be sited next to freeways or major industrial facilities.

• Community exposures to diesel exhaust can be reduced through cleaner trucks and locomotives, electrification of cranes, electric power for ships– Off-road and On-road diesel rule from CARB; Prop.

1B; Carl Moyer Program.• Policies are needed to increase green space,

neighborhood safety, and access to healthy foods (e.g., grocery stores) in impacted communities.

Fundamental Change• Regulatory challenge:

– Need to change the current Clean Air Act paradigm of regulating single pollutants

• Land-use challenge:– High-density residential housing in urban centers

reduces suburban sprawl, but– People should not live close to major roadways

• Transportation challenge– Need to move away from a fossil fuel combustion,

single-occupancy vehicle-based transportation system.

Acknowledgements

• UC Berkeley School of Public Health– Rachel Morello-Frosch– Michael Jerrett– Amy Kyle– Jason Su– Bill Jesdale

• UCSF– Gina Solomon

• UCLA– Andrea Hricko

• Coalition for Clean Air– Shankar Prasad

• California Environmental Rights Alliance and the SCAQMD– Joe Lyou