2015 NATIONAL

ENVIRONMENTAL JUSTICE
CONFERENCE
HEALTH DISPARITIES:
POVERTY, The Root of it All!

Congresswoman Donna M. Christensen

 Inequities in health and avoidable health

inequalities arise because of the

circumstances in which people grow, live,
work and age, and the systems put in place
to deal with them. The conditions in which
people live and die are, in turn, shaped by
political, social and economic forces.
WHO Commission on the Social Determinants of Health (2009)

The Roots of Health Disparities

Racism /discrimination
Lack of Access
POVERTY
Politics

RACISM: Discrimination in healthcare

2001 M Report, Unequal Treatment
2012 Study reported in AJPH
2/3 of primary care doctors demonstrated bias

towards their African American patients

African Americans still more likely to lack access to

early, surgery and emergency room care

Steady rise in people in medium, high-poverty

neighborhoods

Poverty and poor health worldwide are

inextricably linked. The causes of poor health
for millions globally are rooted in political,
social and economic injustices. Poverty is
both a cause and a consequence of poor
health. Poverty increases the chances of poor
health. Poor health in turn traps communities
in poverty. Infectious and neglected tropical
diseases kill and weaken millions of the
poorest and most vulnerable people each
year.
Health Poverty Action

POVERTY IS A WEAPON
OF MASS DESTRUCTION!
Rev. Jesse Jackson, Sr.
3/7/2015, NBC News

2000s: Population soars in extreme-poverty

neighborhoods

Blacks, Hispanics, Amer. Indians overconcentrated in high-poverty tracts

Poor blacks and Hispanics are more likely than

poor whites to live in medium- and high-poverty
tracts

Racial Residential Segregation Apartheid-era

South Africa (1991) and the US (2010)
Source: Frey 2011; Massey 2004; Iceland et al 2002

Negative Effects of Segregation on Health and

Human Development
Racial segregation concentrates poverty and

excludes and isolates communities of color from

the mainstream resources needed for success.
African Americans are more likely to reside in
poorer neighborhoods regardless of income level.

Segregation also restricts socio-economic

opportunity by channeling non-whites into

neighborhoods with poorer public schools, fewer
employment opportunities, and smaller returns on
real estate.

Negative Effects of Segregation on Health and

Human Development (contd)
African Americans are five times less likely than

whites to live in census tracts with supermarkets,

and are more likely to live in communities with a
high percentage of fast-food outlets, liquor stores
and convenience stores

Black and Latino neighborhoods also have fewer

parks and green spaces than white

neighborhoods, and fewer safe places to walk,
jog, bike or play, including fewer gyms,
recreational centers and swimming pools

Negative Effects of Segregation on Health and

Human Development (contd)
Low-income communities and communities of

color are more likely to be exposed to

environmental hazards. For example, in 2004
56% of residents in neighborhoods with
commercial hazardous waste facilities were
people of color even though they comprised less
than 30% of the U.S. population.

The Poverty Tax: Residents of poor

communities pay more for the exact same

consumer products than those in higher income
neighborhoods more for auto loans, furniture,
appliances, bank fees, and even groceries.

Some of the high health costs in minority

communities
Native American/Alaskan Native and African

Americans have lowest life expectancies

African American infant mortality 2X, Native American
1.5X white counterparts
Asian Americans have prevalence of Hepatitis B 1.6 X
African Americans and Latinos have highest diabetes
rates almost 2X that of Whites
African Americans almost 50% new HIV cases,
Hispanics 20%; African Americans 41% of those living
with HIV/AIDS, Hispanics 20%
African Americans highest death rates from heart
disease, cancer and stroke

Create Healthier Communities:

Improve food and nutritional options through

incentives for Farmers Markers and grocery

stores, and regulation of fast food and liquor
stores

Structure land use and zoning policy to reduce

the concentration of health risks

Institute Health Impact Assessments to determine

the public health consequences of any new

housing, transportation, labor, education policies

Strengthen education for disadvantaged

communities
Develop programs to promote/support early

childhood development
Expand preschool education access
Address academic barriers to higher education
Improved funding and teacher training in

disadvantaged communities

Improve the Physical Environment of Communities:

Improve air quality (e.g., by relocating bus depots

further from homes and schools)

Expand the availability of open space (e.g.,

encourage exercise- and pedestrian-friendly

communities)
Address disproportionate environmental impacts

(e.g., encourage Brownfields redevelopment)

Expanding Housing Mobility Options:

Moving To Opportunity (MTO)
U.S. Department of Housing and Urban Development (HUD) launched MTO

demonstration in 1994 in five cities: Baltimore, Boston, Chicago, Los Angeles, and
New York.
MTO targeted families living in some of the nations poorest, highest-crime

communities and used housing subsidies to offer them a chance to move to lowerpoverty neighborhoods.
Findings from the follow up Three-City Study of MTO, in 2004 and 2005, answer

some questions but also highlight the complexity of the MTO experience and the
limitations of a relocation-only strategy.
Away from concentrated poverty, it has been shown that families fare better in terms

of physical and mental health, risky sexual behavior and delinquency?

Adolescent girls benefited from moving out of high poverty more than boys.

Implementing the CBC 10/20/30 Initiative

I believe that of all of the resources coming out of these
programs, at least 10% of it ought to be directed into these
communities where 20% or more of the population has
been stuck below the poverty level for the last 30 years.
there are currently 488 persistent poverty counties in
America so defined because 20% of the population has
lived below the poverty line for the past 30 years or
more.
Assistant Democratic Leader
James E Clyburn,
author of the Initiative

POVERTY IS A WEAPON
OF MASS DESTRUCTION!
Rev. Jesse Jackson, Sr.
3/7/2015, NBC News

CLOSING THE GAP

REPORT (2005)
Inequities within the health care
system and within larger social,
environmental and economic
structures persist not because of a
dearth of solutions, but because of a
failure of political will
24

It is up to We the People to
ensure that there is equal
opportunity for all!
General Colin Powell
3/8/2015 on This Week

THANK YOU
Donna M. Christensen, M.D.
Former Member of Congress, US Virgin Islands

A Study of Environmental Health

of the Industrial Area of St. Croix
HOVENSA REFINERY

University of the Virgin Islands

Eastern Caribbean Center

EPA Toxic Emissions Reports in the USVI

ONE OF THE HIGHEST TOXIC EMISSIONS INVENTORIES IN
THENATION AND CARIBBEAN REGION UNTIL 2012
2010 760,000 pounds
2011 1.8million pounds
All but 25,480 pounds from HOVENSA
2012 0.3milliion pounds
An 83% reduction
*NOTE: HOVENSA closed in January 2012

A Study of Environmental Health

of the Industrial Area of St. Croix
The disparity by race and ethnicity is evident in that

proportionately more Blacks (74%) live closer to the

industrial area than in the reference area (66%), and
similarly, a smaller percentage of Whites (2%) live
near to the target area than in the reference area (9%).
41% with less than high school diploma tend to live

near the SSIZ, compared to 28% in the reference area

A Study of Environmental Health

of the Industrial Area of St. Croix
Residents in the target area expressed the frequent

presence of or reported higher frequencies of the

occurrence of (1)strong and irritating odors, (2) mold,
(3) transportation emissions and exhaust and (4)
factory smoke.
The residents of the reference area do not consider

themselves to be impacted to the same intensity as

residents in the target zone

A Study of Environmental Health

of the Industrial Area of St. Croix
About 1 in every 5 persons (21.3%) in the target area

reported that had experienced asthmatic conditions

within the last 5 years and this compares with 1 in 8
(12.5%) in the reference area.
There were more than twice as many residents near

the industrial zone who indicate having chronic

bronchitis 10.4% - compared to residents who live in
the reference area 4.1%

Next steps for the Industrial Area and its residents

Careful planning for re-use of the HOVENSA site in

consultation and collaboration with the communities

Requests a complete Public Health Assessment from

CDC
Target Health Department efforts to address the

health findings in the report

SPECIAL THANK YOU TO THE DEPARTMENT OF

INTERIOR, OFFICE OF INSULAR AFFAIRS AND ASST.
SECRETARY ANTHONY BABAUTA; UVI EASTERN
CARIBBEAN CENTER DIRECTOR DR. FRANK MILLS
AND HIS COLLABORATORS AND MOST OF ALL TO THE
PEOPLE LIVING IN THE TARGETED AREA FOR THEIR
PERSEVERANCE, TRUST AND COOPERATION.
IT TOOK 16 YEARS TO GET HERE!
Donna M. Christensen, M.D.
Former Member of Congress, US Virgin Islands