Structural Racism as an Environmental Justice Issue: A Multilevel Analysis of the State Racism Index and Environmental Health Risk from Air Toxics

Communities of color and poor neighborhoods are disproportionately exposed to more air pollution—a pattern known as environmental injustices. Environmental injustices increase susceptibility to negative health outcomes among residents in affected communities. The structural mechanisms distributing environmental injustices in the USA are understudied. Bridging the literatures on the social determinants of health and environmental justice highlights the importance of the environmental conditions for health inequalities and sheds light on the institutional mechanisms driving environmental health inequalities. Employing a critical quantitative methods approach, we use data from an innovative state racism index to argue that systematic racialized inequalities in areas from housing to employment increase outdoor airborne environmental health risks in neighborhoods. Results of a multilevel analysis in over 65,000 census tracts demonstrate that tracts in states with higher levels of state-level Black–white gaps report greater environmental health risk exposure to outdoor air pollution. The state racism index explains four-to-ten percent of county- and state-level variation in carcinogenic risk and noncarcinogenic respiratory system risks from outdoor air toxics. The findings suggest that the disproportional exposure across communities is tied to systematic inequalities in environmental regulation and other structural elements such as housing and incarceration. Structural racism is an environmental justice issue.

Perceived Health and Earnings: Evidence from the European Working Conditions Survey 2015

This paper aims to analyse the relationship between perceived health and earnings across Europe. Empirical analysis is based on the last published round from the European Working Conditions Survey (N = 43,850) and offers updated evidence on the effect of earnings on perceived health in 35 countries. The main findings show a positive and significant relationship between earnings and health, which is consistent with the existing literature. Moreover, health seems to be U-shaped relative to earnings. On the other hand, age is negatively related to health, which is consistent with previous research. This paper shows the health differences between countries, where cultural, geographic, and economic differences imply health inequalities across countries. From a practical perspective, understanding the dynamics of perceived health and earnings’ processes can contribute to health policy.

Salutogenesis in Prison

This chapter concludes Part VII, with a focus on salutogenesis in prisons. In this chapter, the authors present and debate how prison health rhetoric, policy and practice are influenced by a pathogenic view of prisoner “health.” The authors comment that there is a growing recognition of a salutogenic approach to prison health policy and practice, to help tackle the root causes of health, criminality and inequality. This chapter emphasises that while the health of prisoners is influenced by material and social factors beyond their control, a salutogenic approach offers an alternative way of delivering public health and health promotion in prisons. The chapter concludes noting that the application of salutogenesis in prisons is in its infancy. They call for research, policy and practice framed by a salutogenic orientation, leading to sustained and effective measures to improve the health of people in criminal justice settings, and reducing health inequalities in prisons.

Obesity Levels of Individuals With Intellectual Disabilities

Individuals with intellectual disabilities (ID) have considerable health inequalities including higher levels of unmet health needs and a shorter life expectancy compared to the general population. The prevalence of obesity, a commonly accepted measure of health inequalities, is higher in people with ID than in the general population, and the factors leading to the increased prevalence among people with ID have not been well understood yet. This has become worse during the COVID-19 pandemic due to nationwide full and partial curfews. In this study, based on a dataset that comprises a set of parameters related to eating habits and physical conditions of a number individuals, the use of classification algorithms for predicting obesity levels of individuals with ID is proposed, and a performance analysis is made using well-known performance metrics. The results could be used by researchers and practitioners in this field to choose the best classifier for their mobile application solutions. Opportunities, research challenges, and future research directions in this topic are also presented.

“Known to be unhealthy” - How social epidemiology produces health differences

Inspired and informed by contemporary research within Science and Technology Studies (STS), this essay discusses how social epidemiological research serves to create and produce health inequalities in society. Focusing in particular on how social epidemiology establishes the relationship between socio-economic status and health, it examines how the accumulation of different studies relying on different indicators and measures results in the construction of new facts and generalizations concerning the health of people with a lower socio-economic status. By identifying groups “known to be unhealthy”, the essay presents social epidemiology as participating in the co-production of the social and political infrastructures underlying policy decisions. To increase awareness within social epidemiology of the politics of its own knowledge practices, it concludes by recommending new interdisciplinary collaborations.

SOCIAL EXCLUSION AND HEALTH INEQUALITIES IN THE TIME OF COVID-19

Social exclusion as a process leads to a state of multiple relative deprivations in diverse areas of social life, like employment, education, healthcare, social ties, respect. Individuals or groups may have a worse position in several areas, particularly with other individuals or groups in society. Coronavirus pandemics disproportionately affect poorer communities and socially excluded people. Socially excluded are double victims; due to their position, they are more prone to infection by a coronavirus, further increasing their exclusion. The purpose of this contribution is to provide a conceptual framework for analyzing the relationship between social exclusion and health disparities during the COVID-19 pandemic. The goal is to comprehend the causes and consequences of unequal power relationships and offer critical assessments of current policies and measures to reduce health inequalities. Health and social inequalities are a significant constraint to economic revival and a successful fight against pandemics. The extent of the economic and health crisis caused by pandemic shock largely depends on past health and social inequality.