Achieving health justice through environmental justice

Editor's note: The opinions expressed by the authors do not necessarily reflect the opinions of the AAMC or its members.

On a rainy February day in 1968, two Black sanitation workers, Echol Cole and Robert Walker, were tragically crushed to death by a malfunctioning garbage truck compactor in Memphis, Tennessee. Seeking shelter from a downpour, they had been denied entry into a nearby building due to segregation laws, and so had climbed into the back of the garbage truck. Their deaths not only illuminated the perilous and discriminatory working conditions faced by Black workers but also underscored the broader issues of economic, racial, and environmental injustice.

The tragedy sparked the Memphis sanitation strike, a powerful community-led movement that garnered the attention of civil rights leader Dr. Martin Luther King Jr. and mobilized more than 1,300 Black men demanding "equality, dignity, and respect." This pivotal strike helped ignite the environmental justice movement, highlighting the inequities faced not just by Black sanitation workers, but by the many other communities impacted by environmental hazards and the health disparities that result from them.

Environmental justice (EJ) is defined by the U.S. Environmental Protection Agency as the just treatment and meaningful involvement of all people in environmental decision-making, to ensure full protection from disproportionate health and environmental impacts. These impacts include those related to climate change, as well as equitable access to a healthy, sustainable, and resilient environment.

Environmental injustice occurs when communities are unfairly and disproportionately exposed to environmental hazards such as air and water pollution, extreme heat, and hazardous waste, among others. Such exposures have been linked to health issues including cancer, asthma, cardiovascular diseases, and developmental disabilities. For instance, in 2014, the city of Flint, Michigan, switched its drinking water supply from Lake Huron to the Flint River, exposing thousands of residents to toxic levels of lead and other contaminants. (The residents sued, and the city eventually agreed to a remediation plan.)

Environmental injustice disproportionately impacts communities of color, low-income communities, and Indigenous communities. Similarly, climate injustice, a subsector of the broader environmental justice movement, highlights the disproportionate impacts of climate-related environmental hazards on marginalized communities. These communities often lack agency over decisions affecting their health and neighborhoods, leading to greater risks from climate-related health inequities.

Today the EJ movement strives to ensure that all communities have equal access to environmental benefits and protections, fostering a healthier and more equitable future for all.

At the AAMC Center for Health Justice we recognize the critical importance of EJ. In partnership with our Multisector Partner Group and Center partners, we are dedicated to amplifying community voices and codeveloping resources with grassroots organizations to ensure all communities can thrive in healthy environments.

To gauge public sentiment on these issues and on EJ and climate change more broadly, we conducted two nationally representative polls in collaboration with national polling researchers from Morning Consult and MyVoice. Our findings revealed that while seven in 10 adults support the goals of EJ, eight in 10 are unaware of any federal initiatives aimed at advancing it. And although many recognize that lower-income groups and communities of color are disproportionately exposed to environmental hazards, fewer understand the full scope of environmental injustice affecting these populations.

Our polls also indicated a strong belief among U.S. adults that climate change poses a significant threat, with 72% acknowledging its seriousness and 63% predicting it will impact their families within their lifetime. Despite this concern, many are reluctant to adopt lifestyle changes to mitigate its effects.

These results highlight a critical need for increased awareness of federal programs to combat environmental injustices. One such initiative is Justice40, which aims to ensure marginalized communities can access resources to combat climate and environmental injustice. Announced by the Biden Administration in April 2023, Justice40 decrees that "40 percent of the overall benefits of certain federal climate, clean energy, affordable and sustainable housing, and other investments flow to disadvantaged communities that are marginalized by underinvestment and overburdened by pollution."

At the AAMC Center for Health Justice, we are committed to amplifying the voices of communities that have long championed the fight against climate and environmental injustices. Through initiatives such as our Community Voices for Action storytelling campaign, where we are working in partnership with five communities to amplify their stories around environmental justice, and our partnership with the National Academy of Medicine's Climate Communities Network, to identify and develop solutions to climate-related health inequities, we aim to ensure that every community can benefit from a thriving natural environment.

Additionally, our Principles of Trustworthiness Toolkit provides organizations with a framework to build genuine, sustainable partnerships with communities. By prioritizing humility, authenticity, intentionality, and long-term commitment, we strive to foster lasting collaborations focused on climate and health justice.

As we reflect on the legacy of Cole and Walker, we must recognize that the fight for climate and environmental justice is not just a historical narrative but an urgent call to action for the academic medicine community and the general public. We need to unite in advocating for systemic change that ensures equitable access to healthy environments for all communities, particularly those that have been historically marginalized. This requires a commitment to amplifying the voices of those most affected by environmental injustices, fostering partnerships with grassroots organizations, and supporting federal initiatives, such as Justice40, that aim to direct resources where they are needed most.

We urge researchers, practitioners, and educators in the academic medicine community to integrate environmental justice into their work, emphasizing its critical link to health outcomes. By engaging in interdisciplinary collaborations and conducting research that amplifies tangible strategies for advancing environmental justice, we can drive meaningful change.