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Dr. Annie Belcourt joins the Agents of Change in Environmental Justice podcast to discuss using psychology to address the unique mental health challenges and issues in U.S. Indigenous communities.
Belcourt is an American Indian Professor in the College of Health at the University of Montana’s Pharmacy Practice and School of Public and Community Health Sciences Departments (enrolled tribal member of the Three Affiliated Tribes, Mandan, Hidatsa, Blackfeet, and Chippewa descent). She also discusses cultural contamination, and how to foster meaningful, respectful partnerships between Indigenous communities and researchers.
The Agents of Change in Environmental Justice podcast is a biweekly podcast featuring the stories and big ideas from past and present fellows, as well as others in the field. You can see all of the past episodes here.
Listen below to our discussion with Belcourt, and subscribe to the podcast at iTunes, Spotify, or Stitcher.
Transcript
Brian Bienkowski
Today's guest is Dr. Anie Belcourt, American Indian Assistant Professor in the College of Health Professions and Biomedical Sciences at the University of Montana's Pharmacy Practice and School of Public and Community Health Sciences Department –Man, what a mouthful some of these departments' names are! She is an enrolled tribal member of the three Affiliated Tribes Blackfeet, Chippewa, Mandan-Hidatsa. Belcourt talks about growing up on the Blackfeet reservation, cultural contamination and using psychology to address the unique mental health challenges and issues in US Indigenous communities. Enjoy. All right, I am very excited to be joined by Annie Belcourt. Annie, how are you doing today?
Annie Belcourt
I'm doing well. Excited to be here with you.
Brian Bienkowski
And where are you today?
Annie Belcourt
So I am in Montana, which is the traditional indigenous lands to the Salish and to many other tribal communities here in Montana. And I myself am Blackfeet, Chippewa, Mandan and Hidatsa. And so, and my Indian name I often share with people is Otter Woman in our Blackfeet language so.
Brian Bienkowski
So you, that's a good place to start. So you grew up on the Blackfeet reservation in Montana. Tell me about that place and how you think it may have shaped you.
Annie Belcourt
Oh, yeah. So I, excuse me, I grew up on the Blackfeet reservation just outside of Glacier National Park. And so our closest neighbor was a mile away. So you can imagine it was incredible as a child to grow up, you know, surrounded by, you know, in, you know, an environment that was so beautiful. And also, such a part of our family. I grew up in between home Glenridge and Red Blanket, we call it Hill, but it was very, very large buttes.
So we, you know, we had wild animals, we had grizzly bears, elk, moose, you know, you name it, all throughout our land. And so growing up in that, in that environment, was very special to me, it's a very spiritual place, and so allowing me and my family, to be a part of that community, which is really how the Blackfeet view other plants and other animals, as our relatives, and so we call them as such, so it was a real privilege to have that. And then I went to school at a small combined classroom school. And, you know, it, you know, I will say all the health disparities that, you know, we learn about and we unfortunately, teach about in our classes, are very much true for where I grew up, and how all the lives of the people who I know, were touched by, in some way or another, some of the struggles that American Indian people face as well. So it's within that reality that I sort of had, you know, wanted to develop an education and a pathway in academia ultimately. But that foundation is always with me of being, you know, a Blackfeet person.
Brian Bienkowski
And that educational path, you've definitely done that. So, you know, a lot of people I talked to on here, they shift majors, they shift areas of focus, you know, it's a time in your life when you're figuring things out. For myself, I didn't even start journalism until my late 20s. So, but you have a bachelor's, a masters and a PhD in psychology. So it seems like something grabbed you pretty early on, and I'm wondering what that was about the field?
Annie Belcourt
Yeah. So I also had an undergraduate minor before they had a major available in Native American studies. So you know, and there was no degree offered at the Masters or PhD level in Native American Studies at our university. So I... psychology really was an area that I felt very passionately about being able to help my communities and and to, you know, be curious about, you know, how people function how people make the decisions that they do, when problems happen, what does that look like? And how can we help people, you know, cope with many different barriers, including mental health aspects of their lives. So, for me, it was a really, incredibly hopeful field, because it looked at really difficult problems and things that people are afraid of – such as mental illness, people have a lot of fear around that – and really provides ways based on empirical science to help people improve. And for me, you know, there was a such a quiet, if not silenced voice for Native people within the academic field of psychology. And so for me, it was really a great opportunity to learn about all of the wonderful ways that we can help people through psychotherapy and other intervention formats, but also be able to understand how American Indians and their reality is different in some ways, and how some of that is shaped by, you know, numerous factors, but one of those factors being the environment and our relationship with the natural world as well. So, so there's many things that have led to that, but I've been very happy about that.
Brian Bienkowski
Yeah, and I want to get into some of those unique aspects in dealing with Indigenous communities. But but I've been asking everybody this question, and it's a big, unwieldy one. And that is, what is the defining moment or event that shaped your identity? This could be professional, personal.
Annie Belcourt
Yeah. I mean, I read this, and I had to really think about it, because there's been so many. I've been really blessed with, you know, incredible children, a family that was loving, and sober and kind, and all of the things that you want to see in a family, and, you know, all of those things of course shaped who I am in the most important ways, you know – build me as a compassionate human being who values intelligence than thought and all sorts of good things. But I do have to say, you know, my first encounter with like severe close loss was also very important in terms of my formation as a person and my academic career. And part of that was the loss of my sister, she died in 2001. And she was, she and a friend were out, and randomly ran into people who one of them killed her and ended her life. And so, when that happened, I was a, I think, a second-year graduate student in clinical psychology. And so as you can imagine, it was really, very difficult for me to over, you know, for me just to exist, actually, it was very, very painful. But I was able to do that because of my family, and because of my children and unable to complete a doctorate degree, and continue to do psychotherapy with people. And a lot of it is just, you know, of course, I would want my sister back, but I, it has made me, as an individual, challenge fears I have, and to lean into things like compassion and kindness in the work that I do. And that, to me, is her legacy. And that's really important to me that she has a legacy that is hopeful, and that is showing that you know, people can overcome loss because of the people that they love.
Brian Bienkowski
Welch, thank you so much for sharing that. And I'm incredibly sorry for your loss. And I believe you're the first person on that question to talk about loss in that way. And I think it's a really beautiful way to look at a defining moment, we all deal with loss. I mean, it's a constant in our life, especially as we get older, so it's really powerful to turn that into something that's something beautiful and positive. So before we get into the nitty gritty of your work, I kind of wanted to set the foundation a little bit. Because we haven't had, you know, on this podcast, we haven't had a ton of Indigenous scientist on here. And I know Indigenous science and kind of traditional knowledge – I know at some point, it's called traditional ecological knowledge, I don't know if that's still a cool term or not – But these perspectives have historically been left out of western science or incorporated in ways that were haphazard, at best and disrespectful at worst. So I'm wondering, in your mind, in your research, you know, what does meaningful, respectful partnerships between indigenous communities and research look like to you and are you seeing progress on this front?
Annie Belcourt
Yeah. It's a great question. I mean, it's a complex question, because, you know, a lot of what we're seeing historically, is some of the things that you've talked about like that are more extractive science and people coming in, getting their information, writing their paper, getting their degree getting money, and it not really benefiting the community. So that is a process that has been gotten to be challenged by tribal communities. And I am happy to say that I've been a part of that journey. And I serve as a volunteer reviewer for a Blackfeet Nation IRB. And one of the first questions is how does this impact the community in positive ways? How does this benefit the community? And that doesn't seem like it should be a wild question. But, you know, a lot of applications that we see do struggle to answer that question in ways that are appropriate and adequate, frankly. A lot of times the old model has been this extractive –we come in, maybe tell you what's wrong, you know, and go away–, as opposed to having the community drive the research and have it be applied and having ways described that could help improve not only community health, but individuals health as well. So, you know, a lot of what we're seeing now is that, as we think about even the concept of human subjects research, that, you know, Native people have a more expansive definition of that that includes, you know, blood samples, it includes our relatives who have passed on, we have the National Graves Repatriation Act, you know, we, as reviewers of IRB proposals have to think about too, and this is also cultural knowledge that is protected. And it's protected for many reasons, including some of the past practices that have misapplied or misconstrued or misrepresented native culture and, and to have that be presented as something that we try to do. So, you know, as we think about traditional ecological knowledge, and how that applies to our behavior, it is also a nuanced discussion, because, you know, there's many wonderful examples of how native and Indigenous knowledge of knowledge has advanced science and, and continues to do so. And we have to think about how those advancements can be shared with Indigenous communities as well in effective ways. So, so those are some of the things I think that we're beginning to see be required. And it's taken a long time to have that happen. But people are more aware of the need to respect tribal sovereignty in these domains.
Brian Bienkowski
I think a lot of people when they think of psychology, they think of a person lying on the couch than another person writing on a pad and asking them about their mother or something. There's a trope that's in all the movies. So, you know, when I looked at your work, it looks like it's obviously much, much more than that. So just what does it look like to work in a clinical psychology setting with a with a community? I assume there's still probably some one on one interaction, but as a community, clinical psychologist, what does that look like?
Annie Belcourt
Yeah, thank you. I mean, I did actually just get a couch in fairness this week. Because I did actually just recently renew my office, but it's a small one, it's not... So I was trained as a scientist practitioner, and in clinical psychology. And so you know, always kind of doing clinical work or experience to help really inform the work that I do scientifically, and the research that I do. The work that I've done has been diverse in many ways. Because I had done a postdoc where we did a lot of psychiatric epidemiology, where we looked at things, we sliced up what problems are and how they're associated with things. And it was a wonderful opportunity. And I, you know, really cherish my time in Colorado. However, I also was like, had a growing impatience on how do we actually help communities and a lot of that was because I was a clinician, so I was trained to help people and communities. And so I shifted quickly into things that were not just dissemination, that were truly bringing the community in and hearing their voices and having that be documented and shared. So some of the things that we've done has been digital storytelling workshops, where we teach people the basics of video making, we've just started to do looking at creating podcasts and ways to increase our, as a native people, access to information and especially Indigenous kind of centered information as well. So those are some things that have kind of gone on over the time. There's a ton of things though. I mean, I've been involved with like RO1, which is like kind of like high, multi-level, year science projects, but I've incorporated video within that. I've incorporated traditional knowledge within that. We created an environmental exposure measure, specifically for Indigenous communities. And looking at traditional practices, and how that basically interacts with things like climate change, and for tribal communities, how people are coping with extreme weather events. And so that's a paper that's coming out and that we're very excited about, you know, being able to share information. And this was like, you know, gathered before the pandemic, right before. And so to be able to kind of have a snapshot of how things were there. And then, you know, future research, we can take a look at how things are going now. But a lot of my work is also mentorship, and I mentor, I have a doctoral student who's finishing and will be graduating next week. And he is looking at substance use and traditional cultural knowledge, attitudes and beliefs. And so D'Shane Barnett is you know, the next generation, you know, of people who are going to move this work forward, and he's also our county health director here in Missoula. So a lot of us are very proud of him as a native man, to be able to enter these spaces and to provide an Indigenous voice to, you know, spaces that often were not. So, you know, my research has really evolved over time, I am now I am a Hollywood producer, believe it or not
Brian Bienkowski
Wow!
Annie Belcourt
I know, it's wild! So my daughter is a filmmaker and a writer. And so we produced a short film, have a poster over here, called Dog with the summer. And it was completely shot on the Blackfeet reservation, with a Blackfeet crew, with Native cast. And it was looking at, you know, difficult topics around... We hear a lot about missing and murdered Indigenous women. And, in fact, tomorrow [May 5th] is the National Day of Remembrance for MMIW. And, you know, this film kind of looked at, what are some of the upstream variables? How was domestic violence, you know, within our homes and our communities impacting Native women? and how our Native women, you know, responded to, or more importantly, not responded to, by criminal justice systems? And so those are hard questions. And they're questions I didn't necessarily think I'd be doing when I was learning how to do psychotherapy or what have you. But all of those things have really converged into a place of inquiry, that I feel as a scholar is exciting. And as we move into, you know, hopefully beyond this past pandemic, that we can start to have post traumatic growth happen, and that there's ways that we can heal not only as individuals, but as communities. And psychology, and native scholars have real place within that.
Brian Bienkowski
So you mentioned earlier, some of the unique aspects of working with tribes. And part of this I remember as a reporter, when I wrote about environmental pollution on tribal land and how it not only contaminates bodies, but contaminates culture, you know. So, for example, I remember being in upstate New York with the Mohawk. And if you can't eat fish out of the St. Lawrence River, not only are you losing a fish, you're losing the opportunity for language to be passed on for the teaching how to get that fish, a whole, a whole cascade of effects. I recall visiting out your way visiting the Crow Reservation and chief Plenty Coups spring which was a sacred spring use for Sundance's and for drinking after fast and they couldn't do that because it was contaminated. So it put these traditions on hold. So I'm wondering, can you talk about some of these cultural impacts of pollution and environmental insults that you've seen in your work and why that's such a kind of a unique aspect and working with tribal communities?
Annie Belcourt
Yeah, you know, it is, in fact, a very significant topic for all Indigenous communities in one way or another. Here in Montana, we see, like you said, water pollution being an issue; climate change is increasing temperatures quite rapidly and we're seeing things like, you know, more zooonotical you know, like Giardia in the water. And so, in fact, even though we're I grew up is seen as a very pristine, it's actually not safe to drink water from the river, you have to boil it or treat it in some way. And also, the droughts have really impacted our traditional foods. And we've had, you know, times where we haven't been able to gather the foods that we need for ceremony, let alone sustenance on a sustained basis. And, as we know, many Native people live in poverty. And some of the foods that are, you know, best for us to eat our traditional foods, yet are very expensive. And not only if you're able to gather, then you have to pay for transportation to get there and get, you know, permits and things at some places. And so those are just examples of here in Montana. I have a friend who is, her name is Stephanie Moore. She's a researcher for NOAA on the Pacific Coast near Seattle. And she's done a number of different really important pieces of science, but some of them have been with our tribal communities partners. And one of the stories that really stood out to me was, you know, the – well, there's many – but they have a high level of domoic acid and some of the shellfish. And so it'll cause widespread closures of beaches, because it's toxic to humans, it's a neuro-toxin. And it can cause acute amnesia. And so there's studies looking at the low-level exposures within our Native communities and how it may or may not impact people. So, but a story was shared by an elder from the community – and his name is Larry Campbell – And he, he shared with us that you know, the importance of spiritual foods and how, you know, he saw a woman, you know, taking a Benadryl, which is like an allergy medication, right. And they were in a communal fishing kind of feast and, and he asked her, "Well, why are you taking this Benadryl? Are you okay?" And she said, "Well, I'm allergic to shellfish." And, you know, and we don't know if, again, if that's because of how shellfish are treated, once they're out of the water, or what have you. But the point is, is he was like, "Well, why would you eat it, you can't eat," she said, "My Spirit needs to eat the food, it's not that I need to eat the food. And, and so I'll take this, because I need this to kind of have spiritual nourishment, and to continue on." And not everybody understands that about Native people. You know, where I grew up, we've literally, you know, the landscape was named for our ancestors, because that's where we have always been, and that's our belief system. And, you know, and so the relationships we have with our environment is so critical. So those are some of the things that we have to think about, as we we, you know, think about the environmental impact of climate change, of pollution, of inequality, of planned eco-toxic areas that are exposed to all of these different challenges and having it not be always, you know, more likely that people of color experience the after-effects of that. And unfortunately, that's too often true across the country, with tribal communities I have worked with, you know, throughout the nation that there has been consistently discussions of how the environmental changes that we're seeing are impacting them very directly. You know, that not as some thought, it's like, you know, every day
Brian Bienkowski
so one of your papers that stuck out to me when I was doing some research is, you pointed out the very health health disparities in Indigenous communities that you just mentioned, and how I believe you said, it was a moral imperative that the U.S. makes up for this lack of research and find strategies to address this. And this is, of course, against the backdrop of historical backdrop of genocide, forced removal, environmental contamination, a lot of the really ugly history of that relationship. So what do you see as a path forward, to do better in researching and reaching out to these communities and improving and eliminating these health disparities?
Annie Belcourt
Well, it's a wonderful question, because I don't know that I have the entirety of the answers. But I do know, a lot of it really relies upon, you know, including communities at the center of any work and having and that sounds so simple, and, like obvious. But frequently, it's not the case. Usually, what happens is, a researcher comes in, has a particular expertise, and then wants to do research to confirm that expertise, essentially – I mean, that's a little crass, I apologize – but still, like, you know, basically, like it's a very sort of linear process, right, or a plus b, and then let's find out if a plus b works again, in this community, or what have you. And, you know, and there's a growing impatience for that sort of slow incremental science. There's a place for that, of course, right? But there's also a place for dynamic ways of engaging communities in discussions. And those are some things that are really hopeful. How do we find people who are within the community to be agents of change, to really look at advocating within many different spheres, including policy, legislation, funding, research, healthcare? all those different kinds of ways that we can help to improve health of a given community. And unfortunately, we've had too few leaders We have stepped up to that. And that's, you know, it's challenging. You know, here, in Montana, we've had a really challenging few years, of course, like everybody, but also politically, we've had laws passed here to actually decrease gun restrictions on our campus, and to increase, open carry on our, our campuses, which is really, you know, just profound to me that that would, and, you know, when we know, suicide is the biggest killer of our Native people in our state, and we have the highest rates of suicide. And you know, you know, why on earth would we not want to invest in ways to help people live hopeful lives, and longer lives, right? Why, you know, what are the things that we can do to unpack that inequality in ways that is empowering to communities, and that's what's really needed, we need to have people, you know, at the helm, deciding what is helpful, and telling their stories, and that's why I've kind of really gotten into storytelling and film and applied public health. It's, it's not, I was just told the other day, it was just dissemination way too. And I really bristled at that, because, you know, I have done the classic like churn-and-burn paper market, you know, like writing and writing, and getting grants and different things like that. But some of the most meaningful things I've ever done in my life has been to listen to tribal people, and, and to learn about ways that they try to bring healing and peace to others in a very selfless way. And it's a beautiful thing to know that we have communities who have ways of healing, you know, not only each other, but communities and a lot of our ceremonies are about healing our relationship with the planet and other other worlds that we have. And I think that that's a really powerful thing, I think that we can, we can learn from that. And those are ways that we can teach others about some of these things, so that there's less fear, that there's less hatred that is directed towards American Indian people. Showing that when, when our people go missing, it matters, and that we find them, and we hold those who hurt them accountable. Those are all examples of ways that we can kind of show that Native American lives do in fact, matter. And that we, as a people, and as communities are important in this world. And, and that, you know, it's a really, it could be a win-win, right? To learn about the richness of our cultures is not, you know, an onerous thing. And we've from day one had to learn about other cultures, right? And, and, you know, yet we're trying to, you know, play catch up when we think about, you know, Native communities. And so, that time is here, you know, I don't think we need to wait anymore. I think the time is right for us to invest in ways to promote even arts, our language, our culture, our stories, our scholars in in ways that will be, you know, ultimately helpful to everyone, including science.
Brian Bienkowski
And that's there's such a breadth and richness to this nation's tribes. I mean, there's all there's not a monolith when it comes to Native people here. And it seems as if you've gotten to work with a lot of different communities, both your own and outside outside of that. So I kind of two questions, one, if you could talk about some of the rewarding and positive aspects of your work, and also, how much goes into understanding of community maybe you're not familiar with, because I know tribes, even if they are near in geography can have very different history and culture.
Annie Belcourt
Oh, yeah, completely. I mean, I myself am in four different tribal nations, right. So I grew up on the Blackfeet. So I know more about Blackfeet culture and history. But I'm also Chippewa on my dad's side, my grandfather was, that's where the Belcourt name comes from – he was Chippewa and but he lost his parents in the Spanish flu, and so ended up in an orphanage. And so you know, and then on my mom's side, there Mandan Hidatsa. And so just for me as an individual, learning our personal history or family tree, looking at even things like the Garrison dam was built, you know, when it was built, it flooded the best agricultural area for an agrarian or farming tribe, multiple, and the place where my mother was born is underwater, because she was born in that valley in a place called elbow woods that's now underwater. And these these systematic decisions to marginalize us and to commit that genocide, really, upon native people has really required that we really be strong and not just in some sort of stoic trope – like a really dynamic way of thinking About our communities and how we share our culture in ways that are responsible, as well as hopeful, because that's at the heart of it is hope, you know, we want our children to have a better place than what we were born into. And so that's the reason why so many of us are passionate about, you know, telling our stories as well as like the hard parts as well as the joyful parts. And I have such admiration for storytellers, who are out there, creating in a time of chaos in some ways, and that there is reasons to have difficulties hoping and, and that that's, you know, I'm reminded in our work with Blackfeet, this, they were doing culture classes, and one of the elders is from Canada – because we have tribes that are in Canada that are part of our Blackfeet Confederacy –, and he was talking about this story about a ceremony and some of the songs and he described the different animals. So the different animals have different songs, and one of them was the dog. And, and it was a story of this dog that was by the lodge, and he was, this dog was a mom dog, Mother dog, and was singing the song. And she was encouraging her baby puppies to like live hopeful lives, so that they could continue to live with the Blackfeet, their relatives. And it was just like, the beauty of that connection, and the power and how amazing is that to be from a community that has always loved each other. And, and that's, that's the thing that I've learned, the, you know, come, you know, time again, is that, you know, for for my own tribal communities, the strength of our love, and our compassion for each other, is stronger than the things that tear us apart. And that is a lesson that I've also seen in other tribal communities that I have worked with facing very similar challenges, having very different ways –you know, culture, language, everything, you know, very, very different. But some of the commonalities are what bring us together as people, and allow us to think about how do we solve some of these problems in ways that are more effective, that provide true solutions? And how is that something that we can share with other tribal communities? and that generosity, like you mentioned, is so apparent, with Native people, we want truly everyone to win. And there's times where people get kind of jealous or whatever, things like that, but at the end of the day, I just want people to do better and to feel better, and to do a life that feels good and whole and livable to them. And to share that with her children in hopeful and happy ways. You know, so not radical thing is in many ways, but, but yeah, working with with different tribes is just I've been struck by how incredibly rich our communities and cultures are, and how much more we can share.
Brian Bienkowski
So you spend a lot of time thinking about other people's mental health. How do you perform your work and still maintain your own?
Annie Belcourt
Yeah, yeah, that's a great question. Um, so I do, you know, I am a psychologist, so thank God for that, right, because I know what to do. But doesn't mean I always do it completely. But you know, with me, I love spending time with my family, I love,I've done many of the pandemic, things of like learning how to make sourdough bread, I just grew mushrooms. But getting into like, my culture has been really a joyful part of the last few years, and, you know, learning our language a little more, I'm really bad at it. But it doesn't keep me from trying, you know, because it just like I mentioned, with a story with the shellfish, like, you know, it feeds my spirit to learn more about, you know, the language of my ancestors, the practices that keep us whole, and how, how beautiful, you know, our culture and communities are truly and that that is really, those are things that really feed, you know, and nourish my spirit and, and help me wanting to keep writing and doing things that will help others and, and it's hard. There are days I will say that, you know, it becomes really discouraging, you know, especially here in Montana, we see, you know, you're in I live in Missoula and native people can't afford to live here. They can't afford to move here. We don't have housing, we have people who are moving and forcing up all the prices and we're not paying people enough to live here. And, and we're followed in stores and we have all of these realities on a daily basis. So you have to find ways to take care of yourself and your family. For some that ceremony and culture for others. It's just a daily you know, I'm smudging, like many ceremonies and things of that nature, but, but the big picture is, is that you're building towards something better. And that always gives me a lot of hope. But yeah, there's smaller things to, you know, but, you know, we're learning more about radical acceptance, you know, in our family and how some of the suffering that we experience, part of our culture is that you offer it to creator when you have experienced suffering, and you do so on behalf of others, so that you can heal for them, and you can be strong for them. And that's a lot of what we, as a family tried to do is we try to help each other, and we try to help other people live more hopeful lives. And, and that's, that's something for me, that's really, you know, an honor to be a part of, as part of my family and my friends and things. And, and then, you know, like you said, I just laugh, sometimes inappropriately.
Brian Bienkowski
Awesome. Well, Amy, this has been so much fun learning about you, learning about your work. Thank you so much for doing this.
Annie Belcourt
Thank you. Thank you very much. Appreciate it.
Brian Bienkowski
All right. That's all for this week, folks. I hope you enjoyed my conversation with Annie.
People who live in areas that come with long-term exposure to high levels of air pollution face a 51% higher chance of dying from Covid-19, and thousands of lives could have been saved during the pandemic if air quality standards were met, a new public health research study has found.
The study, which focused on California residents, is the latest of several exploring the impacts of air pollution on the incidence and severity of Covid-19 infections. And the research adds to a growing body of global research highlighting the importance of reducing air pollution for overall health.
The researchers determined that 9%, or at least 4,250 Covid-19 deaths, could have been prevented if California met national air quality standards.
The most vulnerable people in terms of air pollution exposure were likely to be Latinos and those living in low-income areas, the researchers found.
The study, published in Environmental Advances, was authored by Paul English, director of the Public Health Institute and its “Tracking California” program, along with ten other researchers, including some affiliated with the University of California San Francisco (UCSF) department of medicine and the UCSF department of epidemiology and biostatistics.
“People of color live in communities that have some of the worst air pollution, and also have greater chances of getting sick and even greater chances of dying from COVID,” English said in a release announcing the study.
“This is really concerning, especially in regions like the San Joaquin Valley where wildfires are occurring right now and contributing to greater air pollution. We can save lives by making sure families and schools have access to free and low-cost air cleaners, and that outdoor workers receive paid time off and adequate personal protection during high-pollution events like wildfires,” English stated in the release.
Vehicle emissions, including from commuters and from farm machinery in agricultural areas, were big contributors to the harmful air pollution, according to English. Dust from agricultural areas is also a factor, he said in an interview.
Farmworkers and other outdoor workers are particularly vulnerable to the dangers of the pollution, he said.
Wide range of air quality
The worst areas for air pollution were the San Joaquin Valley and the South Coast air basin. Credit: The New Lede.
The authors examined data for 3.1 million SARS-CoV-2 infections and 49,691 COVID-19 deaths in California from February 2020 to February 2021, looking at where the people infected with the respiratory disease lived.
The study found that people living in the highest quintile of long-term exposure to air pollution – defined as particulate matter less than 2.5 pm in diameter (PM2.5) – had a 20% higher risk of contracting Covid-19 compared to people living in the lowest quintile.
The researchers said that for those people living in those highest exposure areas, the risk of death from COVID-19 was 51% higher when compared to people living in the lowest exposure areas.
PM2.5 describes fine inhalable particles that can lodge in the lungs and pass into the bloodstream, potentially also impacting an individual’s heart.
English said that while conducting the research, the study team saw a striking difference in the wide range of air quality in the state.
“When you compare the areas that have the cleanest air, the air quality is up to nine times [900 percent] better than in dirty air areas,” he said. The worst areas for air pollution were the San Joaquin Valley and the South Coast air basin, he said.
Looking across the US, the ramifications literally translate to life and death.
“There’s probably 140,000 total deaths due to outdoor air pollution in the US,” said English. “If you say California is about 10% of that, that’s 14,000 deaths due to air pollution each year.”
“Already compromised”
Jose Luis Velez, founder of the southern California-based environmental justice group Comité Cívico Del Valle, said the statistics resonated with his experience of the pandemic.
“It’s a bad combination when you have a virus that attacks your respiratory system and your respiratory system is already compromised,” said Velez. “People aren’t understanding how deadly air pollution is. It’s out of control. We can’t just continue to ignore these issues. Our families, our kids, are getting sick. We have more respiratory problems than ever before.”
In Imperial County, where 85% of residents are Hispanic, there were 5,255 deaths from Covid-19 per million compared to 2,390 deaths per million statewide, according to the Centers for Disease Control and Prevention.
English said Imperial County was a “really highly polluted area with particulate matter.”
About 15.1% of Imperial County residents are affected by asthma and the county has twice as many pediatric, asthma-related emergency room visits and hospitalizations compared to the state’s average, according to a 2021 study by the University of California, Riverside, California.
In 2009, Comité Cívico Del Valle sued the EPA for its failure to hold the county accountable for federal air standards compliance. “They let the county go on and drag their feet and never put together a plan of how they’re going to get to compliance,” he said. The suit was settled in 2010.
The California Air Resources Board (CARB) commissioned the new study to get a detailed picture of the specific risks for people living in California, which ranks worst in air pollution in the nation.
The data should help inform new policies, said Bonnie Holmes, chief of the CARB health and exposure assessment branch.
“These studies underscore the critical importance of our air pollution control work, and that is the big policy implication,” she said.
California’s recent move to prohibit the sale of new gasoline-powered cars by 2035 should help reduce air pollution, but will not solve the problem.
The new study concludes with a warning: “With the growing evidence from studies worldwide that suggest there is additional risk of COVID-19 morbidity and mortality associated with air pollution, reducing concentrations of air contaminants is now even more critical to protecting public health,” the study concludes.
(This story was originally published in The New Lede)
Brenda Trejo Rosas joins the Agents of Change in Environmental Justice podcast to discuss how public health can move beyond treating race as a mere data point.
Trejo Rosas is a PhD Candidate in the Environmental and Occupational Health Department at The George Washington University Milken Institute School of Public Health, and a senior Agents of Change fellow. She also talks about different forms of environmentalism, the power of mentors, and her research on healthcare workers during COVID-19.
The Agents of Change in Environmental Justice podcast is a biweekly podcast featuring the stories and big ideas from past and present fellows, as well as others in the field. You can see all of the past episodes here.
Listen below to our discussion with Trejo Rosas, and subscribe to the podcast at iTunes, Spotify, or Stitcher.
Transcript
Brian Bienkowski
All right, I am super happy to be joined by Brenda Trejo Rosas. Brenda, how are you?
Brenda Trejo Rosas
I'm doing well. It's so good to be here and see you, Brian.
Brian Bienkowski
So I wanted to start. As I said, I had the good fortune to work with you with our first cohort. And your essay ended up being one of my favorites from that cohort. And that's like picking a child, I guess. But it really, it was just a really nice piece. And I wanted to start there because it talked, you spoke briefly about some of your upbringing, and I wanted to quote it. So in the essay you wrote: "an abundance of family practices connected me to others and the environment, as a young child, my great uncle would solicit my help to shell corncobs for tortilla nixtamal," – I'm probably pronouncing that wrong– "passing on the cultural, ecological knowledge of Mesoamerica. My parents built a well to collect rainwater for home use, connecting me to vital elements." So I really liked this painting a picture of kind of early connections to the environment, to people, to family. So from that starting point, can you talk about this upbringing and how it shaped your decisions to pursue a career examining health and the environment?
Brenda Trejo Rosas
We are farmworkers. And we come from this small town, and I think I've mentioned it in the blog, it's called Zimapán Hidalgo, in Mexico, and that city is historically a mining town. And if you want to understand the history of the town too, it was colonized by Spain. And so there's still a lot of indigenous people there. And so we have a lot of those indigenous practices. Moving from that, there's a lot of like things, recognizing that, you know, my grandparents and my parents and my great grandparents spoke their indigenous language, I had a nickname in their indigenous language, and they just did things differently. And we had land, or the family had land and farms and animals. But that changed drastically too because of drought, you know? there was less water as the decades went by. And so that influenced my family to come to the States.
Brian Bienkowski
And another thing you mentioned in the essay was how environmentalism was framed as you got older, you know, getting past some of your childhood and some of these experiences with questionable folks like John Muir, who has kind of a racist past or, you know, just seeing it all be expensive outdoor gear and white people out hiking as the kind of model of environmentalism. So, can you talk about how this was at odds with your experience and maybe some of the environmentalists that you do look up to and drive your work?
Brenda Trejo Rosas
Yeah, I think that was super at odds with my experience because just with my family, we spend a lot of time outside, you know? it doesn't have to be outdoors, we just call it outside. Like going to college undergrad, a lot of people taking these hikes but you had to have all this fancy gear and shoes. And I didn't really understand that. And I was like, "Oh, is this the barrier to go to this hike out here?" And then I learned it doesn't have to be like that, you know? you can have very simple things to go out there. Yeah, some of the equipment is helpful, but it's not necessary. And I think in my... I appreciate my department and I learned so much from it. But I think there wasn't an emphasis of other environmentalists outside of American environmentalism, except they would call it southern environmentalism. Yeah, they included I think, like even the Chipko movement in India. I think the environmentalists that I look up to are, first and foremost, my family.
Brian Bienkowski
So I've been asking all of the fellows what is the defining moment or event that shaped your identity. So this could be personal, professional, just something that stands out in your mind that was a lightbulb moment of helping to kind of shape who you are.
Brenda Trejo Rosas
There's many, of course. One that comes to mind right now is more of a relationship. And that relationship was my English teacher / literature teacher in high school –I'm used to calling everybody a professor, she wasn't a professor– my high school teacher, Miss Courtney Morgan, she's amazing. This was in Idaho Falls, Idaho, Skyline High School, shout out to them, shout out to. She was also the advisor of our newspaper, the West Side Story. And she was amazing. Actually, I met her through my older sister. When she was in high school and I was in junior high, she would stay late for late nights. And so I'd have to walk over there and be like, "Come on, let's go home." And that's how I met [her], this way. She was like, "Oh, who's this young person?" And maybe that's when she started recruiting me into the newspaper. But she was amazing. She, and she agreed with this. Unfortunately, Miss Morgan passed away in early 2020. Now that I reflect on it, she had a great impact in my life that I didn't even realize she was having at the time. And she did this to so many of us. I think she, one of the things is like she saw us, she heard us, she saw us and she gave us opportunities. And she let us develop our voices by giving us the newspaper. So what I did in the newspaper was [that] I was the Spanish page editor. And at that time, we were the only high school newspaper with a Spanish page. And so we would do it bilingual. So that was really cool. Because I didn't have any other space to be myself, you know?
Brian Bienkowski
Yeah, what a touching relationship. It's amazing how much of an influence a good teacher can have. And they're just such under-appreciated pillars of society. So thanks so much for sharing that. And so now speaking of where you're at today, so you're focusing on... you're a PhD candidate looking at disparities in environmental and occupational health. So tell me a little bit about [that]. We're going to dig into some of the research that you've been involved in lately, but just kind of give us what your focus is on and why this field?
Brenda Trejo Rosas
Okay, yeah, I think, definitely folks should read my paper that I wrote for Agents of Change, because I think that'll delve into it in terms of why did I decided to go into this field and it has to do with learning about a toxic waste dump being builtin Zimapán Hidalgo, Mexico, where my family is from. And it was built without the consent of the community, they faced repression for it, and we didn't want that in the community. And so I wanted to learn, you know, like, how can people hear our voices? And then I reached out to the folks engaged in the movement, and I was like, “Hey, I'm out in Idaho. How can I help you all from here?,” they're like, "well, Brenda, you can start by figuring out how the US deals with their toxic waste. Because I don't think what's being done here is the way that they would do it there, you know? can you find out what regulations they have?" And at that point, I was, like, 18 years old in undergrad. I had no idea, you know? I didn't know where to look or anything. And so that's why I started exploring environmental studies trying to learn as much as I could. And I was reflecting on that. And actually, today, I could! I could probably figure out where to look, who to ask, I have mentors, and I could also be like, "you know what? actually, in the US they do violate people's [rights] – we actually don't, we don't have a right to a clean, safe environment." So I would say they would violate that, but we don't have that right legally, you know? um, so yeah, that's why I went into it. And so yeah, I am proud of myself and the relationships that have gotten me to here.
Brian Bienkowski
That leads me nicely into the next question. So you were recently a senior author on a paper called "Pervasive structural racism and environmental epidemiology," which kind of speaks to this body of literature that you were just mentioning. So you're now part of that, of course. And you wrote, one of the lines was, "health research reduces race to a mere data point, and avoids the social dimensions of health, and thus fails to improve population health for all." So I think that one line summed up a lot of the paper for my small brain, the non-scientists brain, and I really liked it. So can you talk about this issue, and maybe some of the solutions that you and your co-authors put forward to not have this be ignored? And not have this be the case in health research?
Brenda Trejo Rosas
This article also came out of the COVID, 19 pandemic, and she given me space in her lab to voice what I was feeling. They're like, "No, we can't keep this going and stuff." And so this paper comes out of that. And the lab and everybody, they're amazing. So, yeah, I like that sentence, it talks about, you know, it's something I remember actually asking one of my professors in a data analysis class, you know, like, "I don't understand, we're using race as a categorical variable. But race is a social construct. So what does this tell us? like, is there something biological? I don't understand why are we using it like this?" And she… I don't remember like what they answered, but I wasn't content with the answer. And I think it continues on. Also, you can look at a lot of literature in environmental health where white is the norm, the default. Even if you look at race as a categorical variable, you have all these different races/ethnicities also, and there can be a mix of them. But one that you're definitely sure to find in that mix is white. And other ones can actually be "non white," you know? so like, Okay, what is the default here? but rarely, actually, yeah, very rarely, you'll have people explain... Actually, I can't think of a public health journal, but that doesn't matter, because I don't know everything, right? But most of them don't tell you how they're using race, you know? It's like, "oh, we measured race." Okay. And so I'm like, "Okay, so, alright, you're measuring it. But what's it a proxy for? What is it a proxy for? What are you? What does it tell you?" And that was never answered in my classes. So if we're going to use it, and we do see disparities, you know, differences when you're looking at things through different races. But that's not the whole story, you know, and it's like super simplified, and unfortunately, because of the history of the US, and a lot of medical history too, people don't understand it either, [people] that are using it. But most of the times they think there's biological reasons, you know, that, “Oh, because you're this race, you're going to have worst health outcomes” and stuff like that, but it doesn't work like that. RaceCISM is very real, it's a system, it doesn't have to be individual. There's a structural system that shapes the reality of many people in this country specifically, and I'm pretty sure around the world, and that impacts your health. To me, it's very, it's kinda like, it's just walking, right? Because it's part of my life and my experience and my community's experience, you know? And now I'm in the position where I'm trying to get other folks to explain it, to understand it. I think it can make people uncomfortable. What I see is people, many people, not all people, of course, are not comfortable with being wrong, you know? like, wrong is like the worst thing you could be, you know? and wrong means that you're learning, and wrong doesn't define your character. And you can change after that. We should always be learning and changing. Our culture is always doing that, you know? the planet is always doing that. So I think there needs to be like more humility, and accountability, and more acceptance of the learning process, you know? we're not always going to be right. And so okay, we're doing it this way, let's be accountable, know that that has had an impact, and let's move forward. But genuinely move forward to change how we address racism in the field and other systems of oppression.
Brian Bienkowski
That's true for research, it's true for journalism. You get people that have... part of what you said is true on the individual level, just people not wanting to be wrong, not wanting to change. But it's also true on a systems level. Where, you know, the way I think of media a lot, the way media has operated for decades, which is how they operated, and [they're like] "we know how to do this," [they'd say] "well you worked at a newspaper, you know the structure." But you know, now people are saying, "Well, hey, maybe that's not enough," you know, now we're in this age where facts don't matter, and post truth and all that, so journalism needs to change, we need to adapt. And research [is] the same thing, you did the same, not you, but the broader you, the field, did the same thing for so many decades of "this is how we research, these are the data points we look at, we spit out a study, we get a grant, we get tenure, we go on with our lives." And so to change that is difficult. But you know, I know folks like you are pushing the change and changing a system obviously, is a challenge.
Brenda Trejo Rosas
It happens though. I think it reminds me of... one of my majors in undergrad was cultural anthropology. And so in the courses that I took, we had to learn the history about the field. And they had what they called "armchair anthropologists," where they literally sat on what they describe as the veranda, like anthropologists, and watched the other people. So there was a differentiation between people and other, you know? and I know people use, like, "armchair epidemiologist" or something, but I don't know if they're aware that that was used, well I don't know, but it was used in anthropology to describe those anthropologists. And so the anthropologists had to sit down, you know, they came up as a field, you know? they came up with new methods that they use, and I think some of those methods could be very useful in epidemiology. For example, understanding your positionality and self-reflexivity, you know? like, you're not just a researcher that is researching. Who you are, how systems of power and oppression influence you and how people engage with you, is going to inform your research, you know? and so anthropologists have the practice of right at the beginning, you know, like, it's kind of like, what do they call it? Disclaimer? I don't know. [It's similar to] what they do in public health with conflict of interest, you know, it's kind of their version of conflict of interest – our version is weak, I think – where they talk about, like, This is who I am, these are my identities, and that's how that could have influenced my relationships with participants, or studying this, you know? but it's like a strength and a weakness, you know? and so you just put it forward. So, I think, knowing about that history, about how a whole field could change, you know? gives me hope that public health and environmental health, environmental epi can change as well.
Brian Bienkowski
Excellent. Yeah, I totally agree. And I'm glad to hear a little bit of optimism because it does seem like there are some cracks in the foundation. And maybe it's just the people I'm speaking to and around, but it seems like there's people trying to shake the system for the better. And this study was not the only thing that I saw you've worked on recently. You were part of, speaking of COVID, you were part of the COVID-19 healthcare worker survey. I mean, we've all seen what's going on with healthcare workers the last few years. I know, I have multiple health care workers in my family and my partner's family, and what they've gone through the last few years is nothing short of traumatic in just about every case. So tell me about the survey. What did you ask, what did you find out?
Brenda Trejo Rosas
I do have a connection with healthcare workers, you know? my sisters are in health care, they live in different states. And I just, I think at the beginning of the pandemic, my mentors in Environmental and Occupational Health have trained me well, to understand what PPE is – personal protective equipment – , and the hierarchy of controls, you know? of what interventions can be used in a certain context. And seeing that healthcare workers didn't have this PPE to protect them just frightened me, you know? and I wanted my sisters and other health care workers and other family members to be safe and they weren't. I was hearing all these stories about how some employers didn't believe in COVID-19 or retaliated, because they wanted to advocate for themselves and use PPE. And it was different all over the map, actually, because there wasn't a federal response. So I know, like, one of my sisters is in a state where they, from the get-go, were protecting their health care workers the best that they could, including providing PPE, and using telemedicine, if that was feasible. And then another sister, that was not the case, you know? and she didn't learn about some opportunities until later. So yeah, and then I was like, "Okay, well, we need to find out..." I talked to Dr. David Michaels, and I'm like, "Hey, I'm very concerned about health care workers, and how can we find out you know, how many of them are getting COVID-19?" and all these things. And so he suggested places that I should look and that were reporting like COVID-19 cases, and none of them... There were actually some state departments, early on into the pandemic, health departments that were reporting by occupation and reporting health care workers. Of course, these were under reported, but some of them had [this data] others didn't. And so I think, from the beginning, and from, like, my training that I have in public health, I'm like, "Oh, it would be important and useful to do this." But it wasn't being done. And the stories of healthcare workers weren't being told. And there wasn't a place I could go to that was reporting on, you know, are they getting PPE? Are they being trained on how to use PPE? What are they being told? Or in terms of like, COVID-19? What do they think, you know, what is their experience? And so, with Dr. David Michaels, we and other folks at GW and and other folks that Dr. Michaels knows, that works with workers, healthcare workers; I think some unions also, so they represent the voice of these workers. We came up with this survey, and it's completely anonymous. And what we found, I don't have the report in front of me, but we could share the report later. But in general, there were, there was... I think, for me, one of the most powerful results from the study was the voices of the health care workers because there was a space where we asked them, you know, to share about their experience. And they did, you know? and even going through the responses can be traumatic in terms of them being made fun of, being retaliated against for advocating for themselves, not having a space to share what's going on. I know there were some healthcare workers of color who mentioned that health care workers of color were less likely to have PPE. And then also there was a hierarchy in terms of like, maybe doctors would have more access to PPE than other folks who work in the healthcare setting, like, folks that – I'm not a person that works in the healthcare setting so I don't remember the name– but I think they're transporters, they transport the patients, they would be less likely to have PPE. Or some folks with medical degrees wouldn't see the patients and would have nurses see the patients instead. So yeah, there were a lot of things that don't seem right and seem influenced by power, you know, who has power in this context? And how are they using that power? Now, there were employers and other people who do have power, who may have higher power through higher educational attainment, who did advocate for their workers, you know? and so some of the health care workers share that as well. So we did come out with a report. I encourage people to look at it. And it's on Excuse me. It's so unfortunate, that is still the case, we're still not listening to health care workers.
Brian Bienkowski
Before I get to my last question. My second to last one is, you talked about this a little bit before about some of the ways you're optimistic about the field, you know, some directions we can go. I just wonder if you could just expand about that. What are you optimistic about when you think about the field of environmental health and justice? What are some things you're seeing, people you're watching? What are some of the things that give you hope?
Brenda Trejo Rosas
Brian, I think the Agents of Change in Environmental Justice program for sure. I think that is a rock for my hope right now in the field, in terms of learning about the work that other scientists are doing to address environmental injustice in our world. So yeah, I think that's super important and it gives me hope, it makes me feel less alone. And it helps me see that there's a lot of relationships that might not be highlighted elsewhere, and research of folks that are doing numerous of things to make the field and address environmental injustice, make the field better and address environmental injustice. So yeah, I think that's definitely one. The other is through social media and following some of these folks, I learned about other people too, you know? and their research and so that gives me a lot of hope. Like I think about Dr… I think, I may pronounce it wrong. So bad. But Dr. Chandra Jackson, and she studies health inequities in the environment. And she came to GW where I'm a candidate and talked about sleep disparities and how their environment impacts sleep, then she did like a whole history and she used terms that... she used racism, you know? she used systems of power and privilege to explain what's going on, to contextualize how that's impacting sleep disparities. And so she, to me, she is a powerhouse, you know? it's super competent and knows what she's talking about and explains it. And I envision moving forward that folks will be using the terminology that she's using and doing research the way that she's doing research to address environmental injustice. Yeah.
Brian Bienkowski
Great. Well, thanks so much for that answer. I promise listeners that we do not ask, I do not ask that question so people say Agents of Change, but it is really an honor that you do mention it. And you know, for me, too, it is a source of optimism for me too. I've covered science as a journalist for more than a decade, and just seeing the breadth of people out there, who are doing science outside of the same people you see in the media being quoted all the time, is a source of optimism. And I totally agree. So Brenda, we've reached the end, and I've been asking everybody this question, what is the last book that you read for fun?
Brenda Trejo Rosas
There's two.
Brian Bienkowski
There's two. All right.
Brenda Trejo Rosas
One is called "Trejo." So it's by Danny Trejo. I don't know if you're familiar with Danny Trejo?
Brian Bienkowski
Everybody's familiar with him even if they know it or not!
Brenda Trejo Rosas
Yeah, he's amazing! And so his book is really awesome too, you know? it talks about trials and tribulations in his life, and how he has used that to make change and to help other people, you know? and he focuses a lot on relationships and nourishing those relationships. And yeah, it's just an amazing book. I actually listened to the audiobook, and it's read by him. So it's really cool to have to be listening to Danny Trejo narrate his book. And then the other one that I just finished also an audiobook, I'm very into audiobooks, because I like to listen and move around. Is... what's it called? It's... I think it's "White tears and brown scars, how white feminism betrays women of color." And so, yeah, that one is a really good book, too. It can be heavy, but for me, I found it very validating about my experiences as a woman of color. And hearing about, you know, why some of the things that we experience happen historically. And so it just really opened up my eyes about these things. And I think for anything to improve, we have to bring to light some things that aren't working. And so I think that book helps bring that to light, you know? And, yeah, so I hope that's a hopeful note, Brian.
Brian Bienkowski
yes, yes, definitely. You know, I was listening to a podcast, I want to say it was over last summer. Last summer I was listening to and Danny Trejo was on talking about his book. And for those who don't know, if you just do a quick search of Danny Trejo, you will know who he is because you've seen him in a zillion movies often playing a bad guy. But I really want to check that out! both of those books sound really great, and I appreciate you sharing those.