How do Air Pollution and Environmental Racism affect Black Maternal and Infant Health?

Setting the Stage

Here is a glossary of terms I will be using throughout the article. You can click each term to learn more about the topic.

  • Disability-Adjusted Life Years (DALYs): A metric used to estimate and discuss health effects on a population level. For example, 10 DALYs could occur when one person is sick for 10 years; or, when 10 people are sick from the same thing for one year each.
  • Environmental racism: “Racial discrimination in environmental policy-making, enforcement of regulations and laws, and targeting of communities of color for toxic waste disposal and siting of polluting industries.” – Reverend Benjamin E. Chavis, former NAACP chairman and inventor of the term environmental racism.
  • Maternal and child health (MCH): An umbrella term used in public health to describe a host of health concerns, challenges, and successes experienced by mothers, birthing people, fetuses, and children.
  • PM2.5: Particulate matter that is 2.5 microns or less in width. These very small amounts of liquids and solids are light enough to stay suspended in the air we breathe and small enough to enter our lungs and bloodstreams. PM2.5 is too small to see with the naked eye, but when there is a lot of it, it can cause visible smog.

Air pollution and environmental racism

St. Louis and the Metro East area rank #7 on the list of the worst places to live in the U.S. for exposure to air pollution.  You can view your neighborhood’s PM2.5 levels here.

However, not all areas of St. Louis are impacted equally. Specifically, areas with a larger proportion of Black people are more likely to have high PM2.5 pollution.

We already know that in St. Louis, zip code is a reliable predictor of life expectancy. Research has shown that people in mostly Black-populated zip codes die up to 18 years younger on average than people in mostly white zip codes, despite being in very close proximity. St. Louis is extremely segregated by race because of racist redlining practices. As a result, policymakers and industrialists have prioritized protecting white neighborhoods by building factories and dumping waste in predominantly Black neighborhoods. Existing environmental regulations are inadequate to protect Black families. The rules that do exist are often ignored to cut costs. The PM2.5 levels uncovered by The Guardian might be the most recently discovered consequence of environmental racism in St. Louis, but they are far from its only manifestation.

Like all environmental racism, elevated PM2.5 levels are imminently harmful. They have been linked to a host of health problems including but not limited to dementia, migraines, heart disease, miscarriage, and premature death. Because PM2.5 is small enough to enter the bloodstream through the lungs, exposure can cause disease anywhere in the body.

L: Screenshot from The Guardian’s pollution mapping tool. The darker the color, the higher the concentration of PM2.5 particles. (The Guardian)  R: Screen shot from the Generate Health FLOURISH Data Hub. (GH)

PM2.5 effects on MCH

The World Health Organization recognizes ambient air pollution—which includes PM2.5—as one of the leading causes of DALYs and premature death worldwide. In the US, it is estimated that exposure to air

pollution resulted in approximately 1.74 million DALYs and 93,874 deaths in 2019 alone. While the field of MCH typically focuses on more visible social determinants of health such as housing, education, income, and the built environment, air pollution and PM2.5 are emerging as critical contributors to health issues faced by women, birthing people, and their children.

Indeed, children and fetuses are at a particularly high risk for adverse health outcomes due to exposure to PM2.5. Children are small and rapidly developing, so they are more vulnerable to toxins than adults. And because PM2.5 travels through the blood, prenatal exposure can occur easily. Despite their best efforts, Black pregnant and parenting families can experience adverse outcomes because of high levels of air pollution in their neighborhood.

Research suggests that PM2.5 exposure during pregnancy can increase the risk of many adverse outcomes for the mother or birthing parent and child. These outcomes include preterm birth, low birth weight, miscarriage, childhood asthma and respiratory disease, behavioral issues and neurological disorders in childhood, and immune and metabolic dysfunction. In addition, PM2.5 exposure throughout the life span is correlated with reproductive health issues and infertility because the particles can accumulate in the reproductive organs after passing through the bloodstream.

Air pollution alone is not responsible for the rate of infant mortality that we see in St. Louis, but it is a critical piece of the larger puzzle, and one that has often been overlooked in the MCH field.

What can we do?

The findings published by The Guardian are one chapter of a larger story. It is a story of racism. It is a story of corporations that put profits over people. This is a systemic problem that demands systemic solutions. Some people might try to shift the blame to individuals and say that individuals must change their behavior to fix these environmental issues. And while it is important to consider the impact of our everyday decisions, the people most affected by environmental racism are not the main decision makers who created this problem.   But all hope is not lost—there are ways for everyone to get involved and make positive change, moving the needle from environmental racism to environmental justice and shifting power to Black communities.

Reverend Rodrick Burton, a St. Louis local, has been a leader in combining traditional religious activism with environmental justice through Green the Church, a national organization. Action St. Louis, ArchCityDefenders, Dutchtown South, and the Sierra Club published their groundbreaking report, Environmental Racism in St. Louis, in 2020 and they continue to work towards environmental justice. Metropolitan Congregations United hosts the AirWatchSTL tool, a “community-based air quality monitoring program,” which was developed in response to Environmental Racism in St. Louis. The Black Hive is a collective that brings together advocacy and climate experts and is part of the Movement for Black Lives. Rustic Roots Sanctuary in Spanish Lake  provide education and fresh, local food to their neighborhood and encourage community stewardship of the soil. Connect with one or more of these groups to get involved with their environmental justice efforts!

Prioritize Self Care

Consequences of urban industrialization and environmental racism stretch beyond air pollution. Black communities in St. Louis are also less likely to be located near high quality green spaces, which offer fresh air and respite from everyday stressors.  Consider connecting with a local outdoor activity group.  There are several that are led by and specifically tailored for Black folks, like Outdoor Afro, Black Women Hike Sundays, and GirlTrek.

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