Environmental Justice

I am a daughter of the South, with Mississippi roots, but my personal and professional trajectories were shaped by a five-year stint in Louisiana’s Cancer Alley corridor. Cancer Alley is an 85-mile stretch along the Mississippi River between Baton Rouge and New Orleans that has more than 135 petrochemical companies and other pollution-generating facilities. I remember those years in Baton Rouge vividly. The pollution index was always high, and the air and the water smelled like rotten eggs, even in my middle-class neighborhood. Eventually, I started suffering from a condition called hypopigmentation—light-colored splotches on my skin. I visited several doctors who performed a battery of tests, but they never came up with a cause. Still, I didn’t have hypopigmentation before I lived in Cancer Alley, and it went away when I moved.

Cancer Alley became more than just a name and a medical mystery for me when my mother was diagnosed with breast cancer after living in the area. While we could not make a direct connection between my mother’s diagnosis and the facilities nearby, the possibility compelled me to begin studying these issues.

Fortunately, my mother is still with me—and so is my passion for creating a clean, healthy environment. In this article, I’ll share an overview of the intertwined problems of pollution and climate change and their disproportionate impacts on the health of marginalized communities. Then, I’ll attempt to inspire you to join in the fight for environmental justice by describing my community-based work in west Atlanta and sharing ideas for how we all can get involved.

Place Matters

A growing body of evidence points to the zip code as the single best predictor of one’s future health, wealth, and well-being.¹ All places were not created equal: data from across the United States have revealed huge differences in life expectancy in neighborhoods within the same geographic locales, particularly in urban settings. A 2018 study produced estimates of life expectancy at birth for the majority of the census tracts in the United States from 2010 to 2015.² In cities like Atlanta, Chicago, New Orleans, and New York—cities with significantly higher than average racial and ethnic segregation—life expectancy varied along geographic and racial lines, offering a powerful demonstration of both the influence of place on health and its association with residential segregation by race.³

What’s behind these findings? Studies in disciplines as diverse as environmental health, geography, sociology, and urban planning offer evidence that residents of chronically under-resourced communities and communities of color suffer disproportionately from a host of negative and often overlapping environmental factors that harm health.⁴ These factors include

• poor air quality from nearby diesel bus depots, highways, or industrial sites;
• substandard housing that exposes residents to mold, lead, and/or asbestos;
• an abundance of convenience stores with unhealthy, shelf-stable snacks but a dearth of grocery stores with healthy, fresh, affordable foods;
• an overrepresentation of fast-food establishments with high salt, high sugar, and calorie-dense dollar menu items;
• inadequate access to sanitation or to clean, affordable drinking water; and
• increasing exposure to climate change impacts, such as extreme heat in low-income communities where there are few trees and many residents cannot afford air conditioning, and/or frequent flooding in neighborhoods where sewer systems (and other mitigation infrastructure) have not been updated in decades.

Such communities also often lack access to health-promoting resources and amenities, such as quality open spaces, green spaces and playgrounds, sidewalks, well-paying jobs, healthcare, and representation at decision-making tables.

In Atlanta, where I’ve lived for more than 20 years, such disparities are stark and abundant. But to see them, you have to be willing to look across communities. A study of the five core counties that make up the Atlanta metro area found the highest life expectancy—nearly 88 years—in Vinings and the lowest—fewer than 64 years—in Bankhead.⁵ Vinings is in suburban Cobb County, on the northwest edge of Atlanta. It’s predominantly white and wealthy, with easy access to well-maintained parks, green space and recreational sites along the Chattahoochee River, quality foods, and high-paying jobs. Bankhead is in the city of Atlanta in a pollution hot spot. Named for the former highway (now renamed Donald Lee Hollowell Parkway) that runs through it, Bankhead is crisscrossed by railroad tracks, home to city solid waste and combined sewer overflow facilities (the hazards of which are discussed below), and bounded by a Superfund site to the east. Although its demographics are starting to change as gentrification reaches the area, it has long been predominantly Black and very low income. Bankhead is less than 10 miles from Vinings, but it is a marginalized community cut off from key resources for health and well-being.

These phenomena, in the Atlanta region and in other locales, did not happen by chance, and attempts to “fix” these injustices and societal ills have been insufficient because they don’t address the larger structural issues. Cries from the streets and ivory towers alike are beginning to coalesce around a consistent refrain: the system is not broken—it was built this way.

The Enduring Effects of Redlining

Among the many factors that have made zip code such a strong determinant of health, redlining stands out as the most far reaching, detrimental, and long lasting. Redlining refers to lenders’ practice of denying borrowers access to mortgages based on neighborhood demographics. In the wake of the Great Depression, as a part of President Franklin Delano Roosevelt’s New Deal, the US government created the Home Owners’ Loan Corporation (HOLC) as an emergency agency tasked with limiting foreclosures and stabilizing the housing market. The HOLC did this, in part, through loaning billions of dollars to American homeowners and transforming and standardizing the way property was appraised. Most notably, the HOLC established a system to assess neighborhood creditworthiness. Neighborhoods were systematically ranked based on housing-related factors such as age and quality of housing stock, occupancy, and prices, along with community-related factors such as access to transportation and proximity to amenities like parks or to undesirable land uses such as polluting industries. But these rankings were also based on nonhousing-related demographic factors, such as neighborhood racial and ethnic composition, immigration status, and socioeconomic status, as well as the employment status of residents and the percentage of renters in the community.⁶

When the HOLC put this new appraisal system in place, it used real estate agents throughout the country to determine property values. At the time, agents were professionally responsible for upholding segregation. In 1924, the National Association of Real Estate Boards adopted a code of ethics that stated, “A realtor should never be instrumental in introducing into a neighborhood … members of any race or nationality … whose presence will clearly be detrimental to property values in that neighborhood.”⁷ In essence, the HOLC’s system for assessing neighborhood creditworthiness and home values was largely influenced by the documentation of specific social factors such as race, ethnicity, and economic class. Neighborhoods were graded from A to D, with the lowest ranking areas in each city identified as “hazardous.” These undesirable areas were colored in red on the maps, and they were largely correlated with the areas with the highest percentages of Black residents. They were also correlated with pollution, as many municipalities intentionally put industrial zones—for landfills, incinerators, chemical plants, and other facilities that make air and water toxic—near Black residential zones.⁸

One year after the HOLC was established, Congress and President Roosevelt created the Federal Housing Administration (FHA) to help renters become homeowners. But it operated much like the HOLC, strongly favoring white neighborhoods, creating policies to maintain segregation, and making it very difficult for Black people to get mortgages (regardless of their income). Then, after World War II, the Veterans Administration (VA) compounded the problem; when it began backing mortgages, it adopted the FHA’s racist policies.⁹

Ultimately, the HOLC, the FHA, and the VA helped build the white middle class by making it easier for white people (including those with lower-paying jobs) to refinance or buy homes—but they prevented Black people from doing the same (including professionals who could have easily afforded the types of mortgages routinely offered to white people). Because redlining made homeownership for Black Americans nearly impossible, it also created highly segregated, under-resourced communities, with Black families crowded into rental units and landlords largely unable to secure credit to make repairs to their buildings. The relatively few Black people who were fortunate enough to purchase homes had their investments severely devalued. As a result, both those forced to rent and those able to buy had their wealth-building capacity stifled for generations.¹⁰

Although the HOLC was rendered defunct by 1954, and the Fair Housing Act was passed in 1968 (largely reforming FHA and VA policies), the effects of redlining persist.* Seventy-four percent of the neighborhoods that the HOLC graded as “hazardous” are low-to-moderate income communities today, and 64 percent of these areas are predominantly populated by people of color.¹² Compared with white people, on average, Black people still have lower rates of homeownership¹³ and are more likely to rent in unhealthy buildings¹⁴ (with mold, lead, and/or asbestos) and live near pollution-generating businesses, with less access to quality foods and jobs.¹⁵ As a result, they have far less wealth and suffer from far more stress, asthma, diabetes, and other health problems.¹⁶

Although the history of government-backed segregation, disinvestment in Black communities, and minimal support for low-income people of all races is far more extensive than can be addressed here, even this brief introduction to redlining makes clear the relationship between where we live and how we live. The need for structural solutions to dismantle this legacy becomes even more evident when we consider the climate crisis.

The Growing Effects of Climate Change

Climate change affects all of us, but not equally. Once again, zip code is a powerful predictor of health impacts, which are far more severe in communities that have been made vulnerable by redlining and other discriminatory planning and investment practices. In effect, climate change acts as a great multiplier. Its impacts layer on top of other inequities, interacting with and exacerbating the effects of the social determinants of health. A 2021 Environmental Protection Agency (EPA) study revealed that Black and African Americans are projected to face higher climate change–related impacts for each of the areas analyzed in the report, including changes to air quality, extreme temperature (and related work disruption), and coastal and inland flooding.¹⁷

We can get a better picture of what this means by focusing on two of the major climate-related challenges: extreme heat and urban flooding.

Extreme Heat

The leading cause of weather-related deaths in the United States is exposure to extreme heat.¹⁸ In 2021, record-breaking summer temperatures across the country amplified nationwide concern about this phenomenon and its potential to cause harm.¹⁹ Extreme heat even prompted the establishment of a new federal initiative to reduce heat-related illness, protect public health, and bolster the economy, part of the Biden administration’s broader commitment to addressing workplace safety, climate resilience, and environmental justice by focusing on children, seniors, workers, and other vulnerable groups.²⁰

Urban heat islands are one cause of extreme heat. Heat islands occur when natural land cover is replaced with dense development, which often brings with it massive amounts of asphalt, concrete, buildings, and other surfaces that absorb and trap heat.²¹ Research published in 2020 demonstrated that in 94 percent of US cities studied, there was a positive association between the intensity of urban heat islands and the location of historically redlined neighborhoods—the lower the HOLC rating of a given neighborhood, the hotter it was.²² The legacy of racist policies and planning has created widespread inequities across urban landscapes, with a lack of investment in natural land cover and trees, green and open spaces, or built environment infrastructure like parks, all of which help mitigate the effects of urban heat islands.²³

Exposure to urban heat islands can impair the health of children, older adults, people with respiratory illnesses or other underlying health conditions, unhoused people, and those who work outdoors or engage in outside recreation for long periods of time. With increasing temperatures comes increased risk of heat-related illnesses, such as heat cramps, heat stress, heat stroke, heat exhaustion, and death. People with underlying chronic health conditions, people with disabilities or mobility constraints, and people taking certain medications can also be vulnerable to extreme heat exposure. In addition to direct health effects, higher temperatures can worsen air pollution through the formation of photochemical smog, a pollutant associated with asthma and other respiratory illnesses.²⁴ And for those fortunate enough to have air conditioning, urban heat islands also increase energy costs, making it more difficult for those who are most vulnerable to the effects of extreme heat to protect themselves.

We can counter the effects of urban heat islands in part by helping to unmake them—by increasing the proportion of urban green space and tree canopy cover in affected neighborhoods. In Atlanta, a place with a strong legacy of redlining,²⁵ I am co-leading efforts to map urban heat islands across neighborhoods by engaging student and community scientists and equipping them with low-cost, high-tech mobile temperature sensors. While we are only one year into our data collection efforts, we have been intentional about bringing a diverse set of stakeholders to the table, including city officials, a key audience for setting environmental justice priorities and proposing practical policies and remedies. We have been able to provide officials and local communities with valuable data about urban heat island impacts and begin discussing the role of urban green space, city planning, and energy burdens, especially as they relate to people with low incomes and communities of color living in historically redlined neighborhoods—with all of this coming directly from local students and other people who live and work in those communities and are most affected.²⁶

Urban Flooding

As climate change brings more heavy rain events, many communities’ stormwater and wastewater systems are being overwhelmed. Aging water and sewer infrastructure, as well as inadequate stormwater management, subject some communities to contaminated drinking water and flows of raw, untreated sewage mixed with stormwater runoff contaminants like pathogens, metals, sediment, and chemical pollutants.²⁷ Approximately 860 communities—about 40 million residents—are especially vulnerable because their communities have combined sewer systems, which are remnants of 19th-century sewage and sanitation technology.²⁸ Here’s how the EPA describes the problem:

A combined sewer system (CSS) collects rainwater runoff, domestic sewage, and industrial wastewater into one pipe. Under normal conditions, it transports all of the wastewater it collects to a sewage treatment plant for treatment, then discharges to a water body. The volume of wastewater can sometimes exceed the capacity of the CSS or treatment plant (e.g., during heavy rainfall events or snowmelt). When this occurs, untreated stormwater and wastewater, discharges directly to nearby streams, rivers, and other water bodies.

Combined sewer overflows (CSOs) contain untreated or partially treated human and industrial waste, toxic materials, and debris as well as stormwater. They are a priority water pollution concern for the nearly 860 municipalities across the US that have CSSs.²⁹

While most communities affected by combined sewer systems are located in the Northeast and Great Lakes regions of the country (in states such as Pennsylvania, New York, Maine, Michigan, Illinois, Indiana, and Ohio), they are also found in the Appalachian and Southeastern regions (in states such as West Virginia and Georgia). Most areas served by these systems have populations of fewer than 10,000 people, but large and midsized cities, including Philadelphia, New York, and Atlanta, also face combined sewer overflow challenges.³⁰

The EPA views combined sewer overflows as “a major water pollution concern for cities” because of their potent combination of untreated waste, harmful contaminants, and debris.³¹ Raw sewage carries a variety of human bacteria and viruses. Depending on the amount and concentration of the sewage and the route of people’s exposure to it, the accompanying bacteria and viruses can cause illnesses including hepatitis and gastroenteritis, cholera, skin rashes, and infections like giardiasis. In cities like Atlanta that are affected by combined sewer systems, this means that potential hazards are all around us. Creeks and streams that run through front and back yards, alongside apartment buildings, in public parks, and on school grounds where children and adults fish, swim, and play are not fit for such activities because of the potential for exposure to disease-causing pathogens.³²

In neighborhoods like those in west Atlanta that were redlined and remain predominantly low income and Black, the risk of exposure is significant. In these older parts of the city, the legacies of turn of the 20th century wastewater infrastructure and older, often substandard housing stock are akin to preexisting conditions for the community. Families have been displaced by historic floods laced with sewage, losing both their homes and their property. Some people fish in overflow-contaminated streams to supplement their diets. Some children play in the creeks because they have few other options. To solve challenges like these, the United States will have to rebuild its wastewater and stormwater infrastructures and act to slow climate change. Doing one without the other will not be enough.

Communities of color and under-resourced communities are the proverbial canaries in the coal mine when it comes to climate change. The impact of our climate crisis is currently more severe for these communities, but eventually it will be severe for all of us. The time to act is now—and as a health professional, there’s so much you can do in your community to restore our collective health and well-being. To inspire you to think creatively about ways to get involved, I’ll share some of the work I’m doing.

Fighting for Environmental Justice in West Atlanta

As important as it is to acknowledge how unevenly the perils of place are distributed, it is even more urgent that we elevate and leverage the promise of place in the pursuit of health equity. I have devoted my career to doing both. In addition to being an assistant professor at Spelman College, I lead the West Atlanta Watershed Alliance (WAWA), a community-based environmental justice organization that works to grow a cleaner, greener, healthier, more sustainable west Atlanta. WAWA represents communities of color in west Atlanta’s Proctor, Utoy, and Sandy Creek watersheds—the communities most inundated with environmental challenges but often least represented at environmental decision-making tables. Living in these watersheds, with their long legacy of inequity, gives us expert knowledge of how place can be dangerous—and our community knowledge is essential to finding the solutions that will make our neighborhoods healthy and safe for everyone.

Collaborating on Community-Centered Solutions

WAWA was established in the aftermath of two successful community struggles to advance environmental justice in southwest Atlanta’s Utoy Creek watershed. The community came together to fight the construction of (1) a combined sewer overflow facility in a community park and (2) an eight-mile sewage tunnel that would burden Black neighborhoods with carrying and treating waste from predominantly white and affluent communities on Atlanta’s north side and from two neighboring municipalities, DeKalb and Gwinnett counties.³³ In both situations, southwest Atlanta residents conducted their own research, educated and mobilized themselves, built important coalitions with environmental activists from other communities, and developed their own “citizens’ plans” to address the technical wastewater challenges that the city of Atlanta had proposed to remedy by effectively adding to the community’s pollution burden. Community elders who led these campaigns by establishing an ad hoc group, the Environmental Trust, laid the foundation for the formation of WAWA.

As an organization, we fight projects and policies deemed to have a negative effect on the environment, health, and well-being of west Atlanta communities, but we do more than that. Together, we also elevate a positive vision for what west Atlanta can be and is becoming: a community that protects our watersheds and recognizes and appreciates our important connections to these vital resources; a population of informed and engaged residents who fully participate in decision making on issues that impact environmental quality, our health, and community well-being; and a place with strong and equitable environmental protections.

WAWA believes that a healthy environment is a key ingredient of a healthy community, and the guiding principle of our work is that the process, in which we work together and learn from one another, is just as important as the results. That process must center the needs of the community and leverage the community’s unique local knowledge and expertise in the development and implementation of solutions. We don’t believe that our actions empower the rest of the community—we help to set conditions that enable residents to empower themselves and elevate their voices as we work together to advocate for our neighborhoods and press for environmental, community, and systems change. We get results for and with west Atlanta communities through

• grassroots organizing;
• creating and delivering place-based, culturally relevant, and responsive environmental education to “K through Gray” community audiences;
• engaging in community science and other participatory research approaches; and
• facilitating community-led environmental protection strategies and hands-on land and watershed stewardship.

As a key approach to our community research, WAWA engages west Atlanta residents in environmentally overburdened neighborhoods to bring their local community knowledge and lived experiences to bear on the problems; we also work together to monitor local environmental conditions so we can generate actionable data for community change. This helps us to develop effective interventions that revitalize toxic, degraded spaces and transform them into healthy places. In addition, we collaborate with community members to engage in advocacy and cultivate relationships with government agencies, schools and universities, local businesses, and community organizations. Building these public-private-community partnerships enables us to influence how public and private dollars are spent on projects that impact environmental quality, health, and quality of life in our watersheds.

Revitalizing the Proctor Creek Watershed

The power and promise of community-engaged research and action approaches is evident in WAWA’s work to restore Atlanta’s Proctor Creek watershed. Proctor Creek is an urban tributary to the Chattahoochee River, the drinking water source for over 70 percent of metro Atlanta and the most heavily used water resource in Georgia; Proctor Creek is also the only major watershed located wholly in the city of Atlanta.

The creek originates in downtown Atlanta and travels for nine miles northwest to the Chattahoochee River, meandering through historic Black neighborhoods on Atlanta’s Westside. The Proctor Creek watershed—the land that drains to this imperiled yet resilient body of water—represents rich history, culture, and strength. The creek travels through more than 38 neighborhoods, the same soil where Rev. Dr. Martin Luther King Jr. lived with his wife and children and where other civil rights leaders, internationally known entertainers, and Black scholars such as Dr. W. E. B. Du Bois and Dr. Benjamin Elijah Mays lived and worked. It is also home to the Atlanta University Center Consortium, the largest consortium of historically Black colleges in the United States. Historically, Proctor Creek has been a source of pride for northwest Atlanta communities, a place where children played and where people fished, swam, and were baptized. Today, however, Proctor Creek is highly impacted by pollution and other stressors and is not safe for fishing or any other use.³⁴ What once was a community amenity has become a toxic nuisance and eyesore.

The Proctor Creek watershed has a population of more than 127,000.³⁵ Many of the watershed’s residents, who are primarily Black, face multiple environmental challenges that pose health risks, including illegal dumping, impaired water quality, aging sewer infrastructure, potentially contaminated and abandoned industrial sites (known as brownfields), and pervasive flooding.³⁶ The Bankhead community, which I noted in the introduction for its low life expectancy, is in this watershed and is the location of one of metropolitan Atlanta’s top five environmental justice hotspots.³⁷

WAWA works with residents in Proctor Creek communities to improve the health of our water and land while also addressing other critical community priorities. Among these problems are aged wastewater infrastructure, lax code enforcement, environmental degradation, long-term divestment of public resources in Proctor Creek neighborhoods, blighted and substandard housing, and little regard for our natural resources, along with inadequate stormwater management and sewage, trash, and debris in our surface waters.

For several years, WAWA was part of the Urban Waters Federal Partnership for Atlanta’s Proctor Creek watershed. This partnership seeks to reconnect urban communities, particularly those that are overburdened or economically distressed, with their waterways to help community members become stewards for clean urban waters. From 2013 to 2020, the urban waters designation brought new attention and resources from a diverse array of federal agencies to focus on restoration of the watershed. New and previously unlikely partnerships emerged as federal agencies and national nonprofit organizations collaborated with watershed residents and community-based organizations, leveraging the financial and staff resources of these organizations and agencies to prioritize community-led initiatives that address the watershed’s varied environmental, economic, health, and social challenges.

Embracing Our Community Power

WAWA collaborated with Environmental Community Action and the Community Improvement Association to launch the Proctor Creek Stewardship Council. The council is a grassroots organization whose mission is to restore, revitalize, and protect the ecological health of the Proctor Creek watershed basin and the quality of life of all its people. It helps residents of the watershed harness collective power to advance community-centered and community-chosen solutions to the challenges we face.

As a resident, community leader, and researcher, I’ve been at tables with multiple stakeholders where the community’s vision for a playable, fishable, swimmable Proctor Creek has been a source of consensus, but the process by which we make the Proctor Creek watershed cleaner, greener, healthier, and more sustainable has not. I’ve seen and heard the voices of community residents dismissed when we’ve complained about pollution in our creek, illegal dumping on our land, and flooding in our neighborhoods. We’ve been told numerous times by city officials that many of these occurrences were nonexistent or that we were exaggerating. For example, when Proctor Creek watershed residents first began reporting thousands of tires in the watershed, officials did not trust us and did not believe there was a major dumping problem. By carefully documenting the tires with photographs and exact locations, our community scientists pressed officials to take note. An early achievement of the council’s Compliance and Enforcement Committee was the city of Atlanta investing tens of thousands of dollars in cleaning up the creek, including the removal of at least 20,000 illegally dumped tires in the watershed.³⁸ This win was hard fought, but still, it showed that we could accomplish our goals.

For years, WAWA has worked with Proctor Creek watershed residents—sometimes as the lone voice crying out in the wilderness. Government agencies have not always been responsive to community concerns. Nongovernmental organizations (NGOs) have come and gone. Some NGOs brought a program here or there to the community when there was available funding, but they followed the trail of financial resources to other efforts and activities when the Proctor Creek well of funding ran dry. As a result, community-based groups have been left to themselves to figure out most of the solutions. But one thing we’ve learned in the process is that we have the knowledge and power to make meaningful change within our community, together.

The Stewardship Council is one of several community-based organizations in Atlanta whose members have engaged in participatory research initiatives using community science³⁹ and community-driven citizen-science approaches. These projects have fostered community participation in water quality monitoring,⁴⁰ identifying community assets and environmental health concerns utilizing photovoice (a specific participatory research methodology),⁴¹ and documenting neighborhood conditions and the spatial distribution of “hidden” environmental hazards through participatory mapping.⁴² Little by little, drop by drop, local community knowledge is being amplified by the practice of community science.

Community science brings together community residents, academics, nonprofits, and others, tapping into the wisdom of some of our most knowledgeable community experts, who collectively represent hundreds of years of lived experience in the watershed. We’ve joined together to leverage this community knowledge of environmental hazards to elevate community concerns in a way that cannot be ignored. The old saying “the squeaky wheel gets the grease” has not been the experience of Proctor Creek watershed residents with respect to demand for equity in services to address code enforcement, watershed management, and infrastructure problems. But now we are changing that paradigm. Our efforts have not only helped to democratize scientific research but also have led to stronger community-based watershed protection and restoration outcomes. For example, ongoing water quality data collected by WAWA personnel, Proctor Creek residents, and Stewardship Council members were instrumental in helping the city of Atlanta to discover leaking sewer pipes that were delivering untreated waste to Proctor Creek. After the city confirmed the validity of the community-generated data with its own data, it was compelled to invest nearly $100,000 in fixing the problem.⁴³

We have found that the photovoice research methodology has been especially effective in our community science work.⁴⁴ Photovoice has three goals: (1) to help people use photographs to document strengths in and concerns about their communities, (2) to raise awareness and encourage critical dialogue about personal and community challenges through discussions of those photographs, and (3) to influence decision makers.⁴⁵ It involves giving cameras to people whose perspectives may not always be valued by those in positions of power—such as workers, people with low incomes or little formal education, people with disabilities, unhoused people, immigrants, and children—recognizing that they have unique knowledge and access to their communities that outsiders do not. Photovoice helps community researchers empower themselves to define the challenges they face and help shape the proposed solutions.

The photovoice process in the Proctor Creek watershed has been useful in amplifying community concerns about little to no enforcement of illegal dumping ordinances, the need for new community green spaces in park deserts, gentrification and community displacement in the wake of new developments, and authentic community engagement in infrastructure improvement projects. We can’t claim that the photovoice project is the sole reason that illegal dumping areas have received more attention from the city, new parks and green spaces have come online, and some city officials have taken unprecedented steps to co-design, with community leaders, community engagement processes for new watershed restoration projects. However, since the community has been engaged in collecting and presenting its own data to city officials, we have seen numerous positive changes. We have more open and direct lines of communication between Proctor Creek residents and community-based organizations such as WAWA and the Proctor Creek Stewardship Council, the city has become more responsive to community concerns, and city agencies are more willing to collaborate with the community on the design and implementation of initiatives that impact environmental quality, health, and quality of life in the Proctor Creek watershed.

What’s more, in the context of documenting Proctor Creek environmental challenges, maps produced by watershed (community) researchers and their associated databases lend credibility to community concerns. In a community-university collaboration, watershed researchers worked with local college students to co-design a mobile app that aids community members in collecting GPS-enabled data. The app helps to precisely identify the locations of illegal dumping sites on land and in Proctor Creek itself, flooding or water pooling in the Proctor Creek watershed, and failing stormwater infrastructure. Through co-creating and using this app, residents have leveraged their knowledge of environmental stressors in the watershed to elevate community concerns in a way that cannot be ignored by the city, as some residents feel has happened in the past.

Demonstrating the existence of these “hidden hazards” helps to fill in gaps, providing data about environmental conditions in the Proctor Creek watershed that don’t show up in public data repositories and therefore have not previously been used in environmental decision making. In generating our own maps, we bear witness to our toxic realities. Where we once used our literal voices, now the data tell our stories. Our truths are no longer hidden, and we are getting some traction: sites have been cleaned up, and enforcement actions have been taken against polluters. In addition, resident engagement in these projects and in other watershed-based training, capacity-building, and community-science efforts has begun to improve the city’s responsiveness to problems that are identified by community members.

Through this research and other on-the-ground efforts, the Proctor Creek Stewardship Council has established itself as a critical forum for resident engagement on topics related to the environment and quality of life within the Proctor Creek watershed. At its monthly meetings, the council convenes residents along with government, nonprofit, and other Proctor Creek stakeholders to ensure that residents’ voices are heard as restoration and revitalization efforts for the watershed are planned. While it is a work in progress, the dialogue on meaningful citizen engagement in the restoration and revitalization of the Proctor Creek watershed has dramatically changed, with greater respect for community leadership and community-identified needs. The roles that the Proctor Creek Stewardship Council, Proctor Creek watershed residents, and organizations such as WAWA have played in advancing environmental health protections through participatory approaches to research are also works in progress. But we can see the tangible results of our efforts. They have helped to improve municipal services, address community health concerns, advance environmental justice, and positively impact the implementation of urban policies and practices that influence health, livability, and quality of life. This knowledge of our collective power pushes us to continue the fight.

Join the Fight

No one person can tackle all of these interrelated pollution, climate, and health problems, but we can each choose something to work on where we live. As health professionals, you are among the most trusted people in your communities. You can use that power to make your neighborhoods safer and healthier for everyone and to ensure that all of your neighbors have the opportunity to be heard. You can

• learn more about the history of redlining and the related environmental and health issues in your region;^†
• join, volunteer with, or provide financial support to a grassroots or community-based organization that addresses environmental justice issues in your local community or another community nearby;
• join or start an organization to plant and maintain trees, particularly in city neighborhoods with minimal tree cover that are suffering from extreme heat;
• become an advocate for replacing diesel buses with electric buses—especially school buses that pollute the air and make children more likely to develop asthma or cancer;
• get engaged with local policymaking to add your voice and expertise to important decisions that have the potential to impact intersecting environmental, climate change, and health issues in your community;
• advocate statewide or regionally to advance policies that promote emissions reduction to improve air quality and public health;
• lend your expertise to local community-based efforts to advance environmental justice and health equity;
• learn about specific climate-related threats to your patient population and join with others in your practice to develop education strategies that will help patients better adapt to a changing climate and eliminate impacts where feasible;
• join or start an organization of health professionals to engage in systematic, interdisciplinary, and applied research or to create and advance a policy and action agenda to address health-related climate change impacts in vulnerable communities (see, for example, Georgia Clinicians for Climate Action); and
• work with others in your health system by joining or starting a task force to reduce the system’s carbon footprint, minimize waste, and green your operations.

The wrongs of segregation, chronic disinvestment in low-income neighborhoods, and inaction on climate issues will not be righted overnight. The challenges we face are persistent and stubborn, and we need to be equally persistent and determined in confronting them. It will take a village of community residents and other stakeholders—all of us, working together—to secure healthy and sustainable futures for us all.

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Na’Taki Osborne Jelks is a nationally recognized environmental justice leader and innovator in engaging urban communities and youth of color in environmental stewardship through hands-on watershed and land restoration initiatives, environmental education, and training. She is an assistant professor of environmental and health sciences at Spelman College and cofounder of the West Atlanta Watershed Alliance.

*It’s important to note that our government is still harming some of our most vulnerable people. Here’s one example: of the more than five million families across the United States who live in federal public housing, the majority are Black, Latinx, children, people with disabilities, and members of other groups who are most susceptible to exposure to environmental hazards. And yet, even though the federal government released data in 2017 showing that more than 70 percent of this country’s Superfund sites are located within one mile of federal public housing,¹¹ little has been done to protect residents. (return to article)
^†For a searchable, nationwide map of redlining, see 
“Mapping Inequality.” (return to article)

Endnotes

1. G. Graham, “Why Your ZIP Code Matters More Than Your Genetic Code: Promoting Healthy Outcomes from Mother to Child,” Breastfeeding Medicine 11, no. 8 (October 2016): 396–97.
2. National Center for Health Statistics, “U.S. Small-Area Life Expectancy Estimates Project - USALEEP,” Centers for Disease Control and Prevention, cdc.gov/nchs/nvss/usaleep/usaleep.html.
3. NYU Langone Health, “Large Life Expectancy Gaps in U.S. Cities Linked to Racial and Ethnic Segregation by Neighborhood,” press release, June 5, 2019.
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[Illustrations by Jessie Lin]