Environmental Justice: The Disproportionate Burden of Risk and Disease

The INDIAbetes documentary discusses the role of environmental factors in the growing prevalence of Type 2 diabetes and obesity in India and in the US. On Sunday, the INDIAbetes team attended Atlanta Streets Alive, an event that opened up the streets of downtown Atlanta for people to play, walk, bike, breathe, and be free of the danger of downtown traffic for a day.

We were able to talk to a few of the organizers and attendees of Atlanta Streets Alive. Here's what they said (4min, 30sec):

Environmental burdens are disproportionately borne by indigenous populations, low-income communities, and people of color¹. These burdens include immediate health hazards^{2, 3, 4, 5, 6, 7, 8}, but also the more subtle inequities like lack of access to healthy foods⁹, safe locations for physical activity¹⁰, as well as the aggressive advertising of “junk food”^{11, 12} and alcohol¹³. There is strong evidence showing that increased access to healthy foods tends to correlate with healthier eating behaviors¹⁴, provided the food is affordable and culturally appropriate¹⁵.

Local parks and walkable neighborhoods are elements of the urban environment that promote physical activity and reduce obesity risk¹⁶. You may say: What about Piedmont Park?^{17, 18} Woodruff Park? Freedom Park? Atlanta is the city of trees! Surely, Atlantans have access to parks. However, in the United States and abroad, the populations most vulnerable to obesity-related diseases, such as Type 2 diabetes, tend to live in areas where outdoor physical activities are themselves a health and safety risk.

"In Atlanta, one of the greatest barriers to more people biking is that they don't feel safe on our streets." - Rebecca Serna, Atlanta Streets Alive Director & Atlanta Bicycle Coalition Executive Director

A review of built environment correlates of obesity and related health behaviors (ex: physical inactivity) identified locations for physical activity and safety of these locations, including crime and traffic, as two of the three strongest correlates (the third being access to healthy food). This is relevant to what Rebecca and Ashley said about Atlanta's roads, in the short video posted above.

I ride a bicycle as my main mode of transportation in Atlanta and I could spend the rest of the evening listing just a small subset of the safety and infrastructure issues that remain to be addressed, but I'll restrain myself in the interest of my mental health. This is what I looked like 6 months ago, after getting hit by a car (hit & run) while commuting on my bicycle in Atlanta:

An individual's personal perception of risk is key in behavior change. If you want people to start biking to work instead of driving, you've got to show them that they can do it safely and it is worth doing. Events like Atlanta Streets Alive highlight this, so thank you!

Another safety challenge is crime. A recent survey of the city of Phoenix found that although the city's populations most vulnerable to obesity and related chronic diseases (Phoenix's Latino and African American populations) are more likely to live in walkable neighborhoods and have access to parks than other populations, the crime rate is highest in these "walkable" neighborhoods. In this case, a simple GIS analysis of the relationship between distribution of vulnerable populations and proximity to parks/walkable streets fails to elucidate the true scenario: the potential health benefits of a "walkable" built environment with relatively few physical barriers are offset by social barriers, and the rates of obesity remain high.

By highlighting the role of environmental factors in an individual and their community’s risk of obesity and Type 2 diabetes, INDIAbetes will act as a platform for discussion, empowering communities to respond to these challenges.

Catherine R. Armbruster, MPH
Director, The INDIAbetes documentary

This work by BZD Films is licensed under a Creative Commons Attribution-Noncommercial 3.0 United States License.