By Hunter Carter
Nurses have a responsibility to understand and address multiple facets of health and health care, including the impact of environmental factors on community health. When considering environmental health, it is also imperative to address environmental and institutional racism.
University of Alabama at Birmingham School of Nursing Associate Dean of Diversity, Equity and Inclusion Felesia Bowen, PhD, DNP, APRN, PPCNP-BC, FAAN, recently addressed this topic in “Failing to address racism: A commentary on 'From Florence to Fossil Fuels: Nursing Has Always Been About Environmental Health'.”
“There is clear evidence that racism is a primary antecedent for poor health outcomes among Black, Indigenous and people of color (BIPOC) yet health care providers, policymakers and nurse scientists continue to address this fact in a cursory way,” Bowen wrote in the article, which was co-authored by Professor and Chair of the Child, Family and Population Health Nursing at the University of Washington, Teresa Ward, RN, PhD, FAAN.
In addition to addressing the ways physical, chemical, biological and cultural hazards affect environmental health, Bowen says the role of institutional and environmental racism cannot be overlooked.
“Institutional racism, also referred to as structural racism, isn't something that one person or group of people choose to do to someone. It is the result of policies and procedures that were deliberately established to perpetuate racial inequalities,” Bowen said. “These inequalities result in health disparities, therefore nurses need to understand this if they are going to be instruments of change.”
The effects of institutional racism also include unequal access to medical care, under-resourced schools, a justice system that results in higher numbers of incarcerated BIPOC and discriminatory housing practices. Many times, individuals in these communities also lack resources to leave areas with environmental hazards, lower-performing school systems and more.
“One of the most egregious features of environmental racism is that we know the impact of toxin exposures on humans. We know that exposure to chemicals such as lead and oil causes harm to humans and animals, however decisions are made to deposit them or delay mitigation in BIPOC communities,” Bowen said. “Privilege and advantage allow people to have options such as moving or using their own resources to mitigate harm. People with little or no resources are stuck. They cannot move because they lack the resources; they have no other choice but to stay and endure the consequences of the harmful environment. Those consequences often result in poor health and premature death.”
These issues were also exacerbated in the COVID-19 pandemic, as communities of color were hit harder by initial infection rates while also lacking access to health care.
Bowen said the most important thing scholars can do when addressing the environment and health is acknowledging environmental racism, which often skipped over by most scholars, and ensuring its impact is included by scholars to improve education and research in this area.
