Routine Disasters,Routine Injustice

This issue of NEW SOLUTIONS is about routine disasters. This concept is epitomized by Persaud's Photo Essay Superfund Sites and the Bipartisan Infrastructure Law in New Jersey State. ¹ In that article, he states “The photos in this essay illustrate the degree to which hazardous waste sites have come to look like normal industrial sites. As a result, communities are often unaware of the dangerous exposures they face.” In addition, he states, “Although Brownfields vary demographically throughout the nation, many are located in urban areas. Neglected Brownfield sites may encourage investments and job development to move further away from city centers… Addressing Brownfields with funding from the BIL [Bipartisan Infrastructure Law] may help increase economic opportunities in those disproportionately affected communities and address environmental injustices.”

In making this statement, Persaud indicates that, in addition to appearing as if they were not hazardous, the location of these sites disproportionately harms those who are already socially disadvantaged. Regrettably, harming those who already lack social power, especially due to factors such as race, sex, gender, class, income, or education is, itself, routine. Almost every article that appears in this issue of NEW SOLUTIONS in some way discusses a disaster that is “routine” in that society tolerates it (or tolerates the fact that it happened) because it disproportionately harmed people with less social power.

Investigating the Medical Aspects of the World's Worst Industrial Disaster, ² by Dhara, is about the Bhopal, India, gas release, which, itself, was in no way routine. However, what is regrettably routine about the Bhopal disaster is the lack of care that was taken by a US-based multinational corporation to protect a disadvantaged population in a low-income country grappling with the legacy of colonization.

Similarly, three articles point out in different ways that the COVID-19 pandemic, while not routine in the degree of social disruption it caused worldwide, was nevertheless routine in that, like so many other disasters, it disproportionately harmed those already disadvantaged.

COVID-19: Self-reported Perceived Preparedness and Availability of New York City Home Health Aides: Six Month Survey Results, ³ by Oranato et al. examines the degree to which home health aides perceived that their employer protected them from the COVID-19 pandemic and the degree to which they made themselves available to work, as well as the relationship between the two. The authors report:

Black and Hispanic New Yorkers were hospitalized for COVID-19 twice as often as White New Yorkers. Yet controlling for variables including household size, health status and mental stress, Hispanic respondents to our survey were significantly less likely—and Black respondents somewhat more likely—to report work availability than White or other coworkers who responded to the study survey. Both Hispanic and Black populations in New York City face well documented structural racism including, among other things, residence in neighborhoods with high poverty, segregation and multigenerational housing. Yet among adults in the NYC metropolitan area, a June-July 2020 U.S. Census survey found that Hispanic respondents were four times more likely than Black respondents (12% vs 3%, respectively) to be concerned about getting COVID-19 and 1.45 times more likely (61% vs 42%, respectively) to report not working “in the past week” due to “any COVID-19-related reason.”

Here, the authors state that both Black and Hispanic New Yorkers face well-documented structural racism, and they faced hospitalization due to COVID-19 at twice the rate of White New Yorkers. Hence, COVID-19 in New York City was regrettably routine in the disproportionate harm it did to disadvantaged New Yorkers. At the same time, the authors found, but were unable to explain without further research, a large difference in availability to work between Black and Hispanic home health aides. Black home health aides were much more likely to make themselves available to work. The authors point out that this finding is consistent with other studies but say it will take further research to explain the result.

Measuring Indoor Air Quality Does Not Prevent COVID, ⁴ by Pechter and Lessin, calls out the Boston Public Schools (BPS) for their failure to take adequate steps to prevent the transmission of COVID-19. This commentary includes discussion of the demographics of the BPS student population: “43.8 percent are Hispanic, 28.4 percent are African American, 15.1 percent are white, and 8.7 percent Asian. The remaining four percent include Multi-Race, non-Hispanic, Native Americans, Native Hawaiians, and Pacific Islanders.” Again, the population harmed by BPS's failure to take adequate steps to prevent the transmission of COVID-19 is disproportionately one of color.

In Underreporting of Work-Related COVID-19 cases in Norway, ⁵ Samant et al. found that women in healthcare occupations aged 25 to 39 years yielded the highest incidence of work-related COVID-19 cases and that these results were consistent with the findings of studies conducted in Canada, Korea, and the UK. They explain this finding by the fact that “the healthcare sector harbors a higher risk of infection and…In Norway, 80 percent of the workers in the healthcare sector are women… Nonetheless, the absolute number of cases reported among women and across the age groups in this study is lower than the other COVID-19 studies, indicating underreporting.” Again, while the COVID-19 pandemic was in no way routine in its degree of social disruption, this article shows that COVID-19 not only disproportionately harmed people of color of both sexes but it also disproportionately harmed women.

In Public Health Experts Ask Centers for Disease Control and Prevention (CDC) Director to Broaden Input on Revisions to Key Infection Control Guidelines, ⁶ Brosseau et al. call out the Health Care Infection Control Practices Advisory Committee (HICPAC) to the CDC for its failure to take input from experts, and from the disproportionately disadvantaged and their representatives as to how best to present transmission of COVID-19 in healthcare settings:

As a result of knowledge gained during the COVID-19 pandemic, it is now more widely recognized that many pathogens, including SARS-CoV-2 are transmitted by infectious aerosols, and that ventilation, isolation practices, and respiratory protection are necessary control measures to limit exposure and transmission. Aerosol scientists, industrial hygienists, ventilation engineers, and respiratory protection experts… with valuable expertise on transmission and control of infectious aerosols… should be fully included in the revision of the guidelines.

But there is currently no mechanism… to garner input from these experts or health care personnel, their unions, patients, and community members regarding the updates to guidance… Input from these groups is essential to creating effective guidance because they have insights regarding content, implementation, and language that will be key to the guidance being effectively adopted after publication. The Liaisons to CDC/HICPAC, some of whom are members of the work group, primarily represent health care associations and health care employers.

Here, we learn that, adding insult to injury, not only are women and people of color harmed to a greater degree by COVID-19 than others, especially in their capacity as employees, but neither they, their representatives, nor experts who advocate on their behalf to have proper input in decisions regarding revisions of guidelines that could spell the difference between life and death.

The case of workers, disproportionately Latino, who cut engineered stone for countertops is regrettably similar. In Active Surveillance of Engineered Stone Workers Facilitates Early Identification of Silicosis: A Discussion of Surveillance of Occupational Lung Diseases, ⁷ Gandhi et al. argue for active surveillance of lung diseases such as silicosis, especially found in workers who cut engineered stone for countertops. The authors report that 89% of the cases identified were Latino workers. Regardless of intent, the burden of this disaster falls disproportionately on people of color.

Methylene Chloride Comment ⁸ is a submission to an EPA docket authored by Goodwin and Holm of the Center for Progressive Reform (CPR). It addresses a proposed rule, to restrict the production and use of methylene chloride. In support of the proposal, EPA prepared a cost–benefit analysis (CBA), which calculates its net benefits, defined as the rule's likely benefits over and above its likely costs. The CPR authors criticized the agency for an overly formalistic CBA, which both systematically undervalues benefits and ignores worker justice. In addition, they criticized the Agency's failure to follow the proposed reforms now being developed by the Biden Administration.

Importantly, the authors note the following:

[A]ccording to the demographic data discussed in the CBA, the primary beneficiaries of the proposal would seem to be people of color… One of the important benefits… would be to begin redressing one contributor to… environmental injustice. Accordingly, the revised CBA should account for how the proposal would promote greater racial justice as part of a broader discussion of its distributional consequences…

[W]e urge the EPA to follow the guidance provided [by the White House]… and provide a detailed, qualitative discussion of distributional impacts of the proposal, including the manner in which it promotes greater economic, social, and racial justice.

Hence, the health consequences of methylene chloride represent another “routine disaster” disproportionately affecting people of color. Unfortunately, EPA's CBA does not address it adequately.

Two articles, Workers speak out at OSHA's first Workers’ Voice Summit ⁹ by Kerson and Vazquez and Responding to Disasters: Training Can Overcome Issues in Disaster Response, ¹⁰ by Rosen et al. offer some actions that have been taken or could be taken to address the routine injustice of routine disasters.

Although Workers Speak Out is not about a routine disaster, it does describe an action taken by OSHA that can reduce the disproportionate impact of occupational hazards on undocumented immigrants:

Too often employers… take advantage of workers’ precarious immigration status and their fear of retaliation or deportation. When any worker is unable to speak up about dangerous conditions, it puts all workers at risk of injury, illness, and death. National COSH and its labor partners have been advocating for OSHA to support workers with temporary legal status, so they can speak up and participate fully in labor investigations… This demand was presented at the Workers’ Voice Summit. Less than three months later, [the Department of Labor] responded by providing OSHA with the authority to provide non-immigrant visas that allow victims of specific crimes (in this case violations of the Occupational Safety and Health Act of 1970) to help law enforcement (in this case OSHA) to detect, investigate and prosecute crimes without fear of retaliation based on their immigration status.

Responding to Disasters briefly addresses the protection of communities disproportionately affected by disasters. Recommendations include:

- Identify accurate, appropriate, and trusted sources of information.

- Bring together different agencies and organizations for training on disaster response. These might include community-based organizations, unions, worker centers, local health departments, and others.

- Communicate with (and presumably train) workers in their native languages.

Every article in this issue, in one way or another, points to the disproportionate impact of disasters on those who are already socially disadvantaged. In the international arena, when courts rule in favor of companies like those responsible for the Bhopal disaster and, in the national arena, when courts impede the ability of agencies to regulate in the midst of a disaster, such as a pandemic, these actions by the so-called “justice system,” serve to reinforce the routine injustices that disasters inflict on the socially disadvantaged.