How and why are the poorest people most likely to have exposure to toxins?

Research suggests that people with lower incomes have more exposure to toxic pollution, particularly in areas where they live and work. Structural racism exacerbates these issues.

Share on PinterestThis Special Feature investigates the link between financial precarity and the risk of exposure to toxic chemicals. iznashih/Getty Images

The degradation of the environment through toxic pollution has a direct effect on human health. This burden falls disproportionately on the world’s poor and is disproportionately due to specific polluters.

Researchers note that environmental pollution is a leading factor contributing to premature mortality for people living in low and middle income countries.

In the past, environmental pollution was primarily an issue for higher income countries. However, researchers writing in the journal Environmental Health Perspectives note that this has changed.

According to Dr. William A. Suk — from the National Institute of Environmental Health Sciences — and his co-authors, 94% of deaths due to environmental pollution now occur in low and middle income countries.

Dr. Suk and his co-authors write that in previous studies, contaminated drinking water and indoor air pollution have been the key causes of mortality in low and middle income countries. These factors still contribute to the burden of disease.

However, as chemical manufacturing has expanded beyond higher income countries, exposure to toxic chemicals is damaging the health of poorer people around the world — regardless of whether they live in a low, middle, or high income country.

Chemical pollution

Dr. Suk and his co-authors point out that thousands of toxic chemicals and pesticides have been released into the environment during the past hundred years.

Many of these chemicals have not undergone proper safety testing. Their short- and long-term health effects are unknown, and it is not clear what exposure to multiple chemicals that can interact with one another may do to a person’s health.

For Dr. Suk and his co-authors, the chemicals of most concern are organic chemicals that stay in the environment for a long time and organic chemicals that a person may have exposure to on a regular basis.

There is an association between exposure to these chemicals and cardiovascular disease, diabetes, cancer, hypertension, and obesity. These are chronic health conditions that previously primarily affected higher income countries but that now affect communities wherever businesses are allowed to pollute the environment.

In particular, endocrine-disrupting chemicals (EDCs) are a key concern for many scientists. In a 2020 report, the Endocrine Society found that EDCs were present in almost all people due, in large part, to the ubiquity of EDCs in everyday plastics.

According to the Endocrine Society, EDCs “disturb the body’s hormone systems and can cause cancer, diabetes, reproductive disorders, and neurological impairments of developing fetuses and children.”

The Endocrine Society notes that there is “a wealth of evidence supporting direct cause-and-effect links between the toxic chemical additives in plastics and specific health impacts to the endocrine system.”

Disproportionate exposure

Although EDCs are a risk for anyone who comes into contact with everyday plastics, some groups are at higher risk of exposure to EDCs than others.

A study in the journal Diabetes Care found that Latino and African American people, as well as people with low incomes, have disproportionate exposure to EDCs — particularly those caused by industry. According to Dr. Robert Sargis and his co-authors, this exposure is one of the factors that accounts for higher rates of diabetes in these demographics.

In addition, researchers suggest that marginalized communities are disproportionately affected by toxin exposure and that a minority of firms account for the vast majority of pollution.

According to Dr. Mary B. Collins — of the SUNY College of Environmental Science and Forestry in Syracuse, NY — and her co-authors, “[A]lthough polluters are likely to disproportionately impact poor and nonwhite communities, these disproportionalities become even more pronounced when considering the smaller group of facilities who generate the majority of exposure risk.”

A key driver of this disproportionate exposure is structural racism and the histories of colonialism that continue to affect the world today.

As Dr. Sargis and his co-authors note, “Accounts of the industrial division of labor by race in major [United States] cities document how people of color were restricted to low wage, hazardous occupations while simultaneously being confined to low income housing near these industries.”

For example, in the U.S., a stretch of land that follows the Mississippi River between Baton Rouge and New Orleans, LA, is known as “Cancer Alley.” This area is densely populated by industrial chemical facilities.

The effects of toxic exposure are readily apparent to the residents of communities in the area. However, despite the Environmental Protection Agency (EPA) highlighting the scale of the increased risk of cancer, little has been done to address the issue.

Speaking with Medical News Today, Dr. Kay Jowers — a senior policy associate at the Nicholas Institute of Duke University in Durham, NC — said, “We know that poverty and racial and ethnic identity are correlated. For example, in the U.S., [Black people] make up a higher share of the poor population than their share of the general population.”

“So, to the extent that power is structured by and rooted in the same racist ideologies that made colonization of a particular society possible, then we can link the ongoing histories of colonialism with toxic exposure for groups that have been historically marginalized in a society.”

– Dr. Kay Jowers

“Colonization was fueled by racist ideologies around the supposed inferiority of Indigenous people and the superiority of the colonizers. Those ideologies shaped the institutions and policies [that] colonizers adopted regarding who could own property and who was property, who had access to resources and who did not,” she explained.

“Environmental injustices, such as frontline communities being disproportionately burdened by toxic exposures, are inextricably linked with the social, economic, and structural disparities that exist within and between societies. We also know that land and resources were appropriated by colonizers forcing Indigenous populations onto less desirable land,” Dr. Jowers added.

Residence and work

Speaking with MNT, Dr. Sarah Dickin — a research fellow at the Stockholm Environment Institute (SEI) — agreed that a key issue is where a person is forced to live.

“Where you live affects your health, and poorer residents are more likely to live in areas with greater exposure to toxins. For instance, informal settlements or slums may be established near large roads, waste dump sites, or polluting industry, as the land is less desirable. This can result in higher levels of air and water pollution for those residents.”

– Dr. Sarah Dickin

“Furthermore, informal settlements may not be recognized by local government, so there is less political will to act, and marginalized residents have [fewer] options to realize their human rights to health, such as limited say in decision making,” she added.

As well as where people are forced to live, the jobs that are open to poorer people are also a key source of exposure to toxins.

Dr. Dickin noted that “[p]oor people are also more likely to do jobs where they are directly exposed to toxins, such as informal waste picking, often without having access to safety equipment or personal protection.”

Charrlotte Adelina, a research associate at the SEI, highlighted the experience of waste pickers in Bangkok.

Speaking with MNT, Adelina noted that “[s]upplementing the municipal waste collection system, informal waste pickers independently rummage for wastes in streets, landfills, or other public places or collect wastes from communities and shops as per demand in Bangkok, like in many other Asian cities.”

“Waste picking is a precarious occupation but has low barriers to entry — therefore, marginalized groups such as single women with children, the widowed, elderly, […] ex-prisoners, or other chronic urban poor [people] choose this line of work,” she went on to explain.

“Waste workers operate in [hazardous] work conditions, some also living next to landfills and other polluting environments. They are at risk of exposure to toxic substances due to weak regulation and implementation of waste segregation at [the] source. They have little protection equipment to safeguard from exposure [to] toxic and infectious wastes, and they also lack social safeguards, such as the presence of strong labor-based organizations and social protections.”

– Charrlotte Adelina

“Most of the waste pickers we surveyed reported lack of spaces or covered areas for storing wastes. In this case, they may store wastes in or near their households before sale, which poses further health hazards to these disadvantaged groups and their families,” said Adelina.

Profit motive

Several factors account for the link between the risk of toxic exposure and poverty, and these vary depending on location.

An underlying factor, however, is the profit motive that incentivizes chemical businesses to pollute local environments if such a course of action will maximize profit — whether this is in the short, mid, or long term.

This was a key finding of a paper that appeared in the journal European Economic Review. The researchers found that potentially polluting firms were more likely to establish factories in poorer areas, where the risk of litigation following the release of pollutants would be lower than in richer areas.

This meant that it was more profitable to pollute poorer areas than richer areas.

The researchers also found that firms established in lower income areas were more likely to release toxic pollutants and spend less on waste management processes than firms established in richer areas.

Speaking with MNT, corresponding study author Dr. Aurélie Slechten — a lecturer in economics at Lancaster University in the United Kingdom — said that “firms tend to respond to incentives in terms of pollution decisions. They will choose their location and pollution levels based on demographic characteristics that might affect their production costs.”

“In our conclusion, we explain that disparities in toxic chemicals exposure may persist even with programs like the Toxic Release Inventory because poorer communities may not be able to exert pressure on firms or local government to give them an incentive to reduce pollution. That’s why we conclude by saying that serious thought should then be given to the regulations on compensation schemes, to ensure that all communities have the opportunity to act against local polluters.”

– Dr. Aurélie Slechten

For Prof. Chris Timmins — a professor of economics at Duke University — the profit motive may be an issue, but while it is a central part of global economies, it can also be mobilized to dissuade firms from polluting — particularly if combined with effective regulations.

Speaking with MNT, Prof. Timmins said, “There are certainly problems with profit maximization in general, but there are also problems with the alternatives. Profit maximization is what makes economic incentives work.”

“If we are to keep profit maximization in our economic system, then the best solution may be profit maximization with a good set of regulations to curb market failures,” he added.

Local action

Dr. Slechten said that local communities can have an important role to play in resisting the pollution of their neighborhoods.

“The objective of the Toxic Release Inventory Program was to provide information to local communities about the firms releasing toxic chemicals in their neighborhood. This information was supposed to help local communities to act against big polluters [— for example,] by negotiating directly with the polluting firms or lobbying the local government.”

– Dr. Aurélie Slechten

“Our paper suggests that the extent to which this local activism works depends on demographic characteristics [—] in particular income,” she added.

“We believe that local activism could play an important role in reducing local pollution, but some form of public intervention is needed to ensure that all communities can afford to take part in these environmental actions.”

Speaking with MNT, Dr. Sarah West — center director of SEI York — highlighted the role that citizen science can play in pushing back against polluting firms.

“Citizen science, where the public [takes] part in scientific research, can be used to monitor air and water pollution for toxins. There are many community-level monitoring projects across the world, for example FreshWater Watch,” she noted.

“Such activities can then be used to demonstrate to local officials and polluting industries that there is an issue. A famous case of local people campaigning about toxins in water was in Flint, MI, in the U.S.,” she explained.

For Dr. Jowers, “Activism and protest are important forms of political engagement for those with little or no access to and/or have been historically excluded from full participation [in] governments and institutions.”

“Local activism can be important for holding the government decision makers who oversee environmental regulation and permitting accountable, and [it] can also directly target firms and industries to press for changes that [have not] been possible through other channels,” she said.