An activist-research lab which combines scientific and data-driven investigation with social and racial justice principles to create tools for better understanding urban health inequality
Context
When you visit a doctor with a health problem, they ask you about your lifestyle: How much alcohol do you drink? Do you smoke? Do you eat enough fruit and vegetables? They are less likely to ask you about your built environment: Do you live near a construction site? What is the air quality like in your town? Are there trees on your street? The latter, argues Araceli Camargo, is far more important in determining health outcomes:
“Why we get sick isn’t a mystery, it’s tied to the environments that we’re in, and the experiences we have in those environments.”
Very recently, in the United Kingdom, awareness of the public health risks posed by people’s living environments has been increasing. In the context of the UK, with its appalling record of child poverty, the death of nine-year-old Ella Kissi-Debrah in 2013 was later attributed by a coroner to “asthma contributed to by exposure to excessive air pollution”. The death of two-year-old Awaab Ishak from a respiratory condition in 2020 was declared to have been caused by prolonged exposure to mould in his home. The relationship between environmental stress and health is a global problem—for instance, where “shade inequity” in India reduces the ability of both urban and rural communities to live with heat—but equally in western society that continually “refuses to see the suffering of its own people”. The racial dimension of the link between systemic marginalisation and the ill health of marginalised people was summarised in 1992 by Arline T. Geronimus as the “weathering” hypothesis: arguing that health is socially produced and that poor health outcomes mirror wider stresses.
Practice
The Biological Inequity Index is a project by Centric Lab—a science lab set up in 2017 by a group of neuroscience researchers from marginalised backgrounds who wanted to use data to highlight the links between social and health injustice in urban patterns, following Geronimus’ thesis. In partnership with geoscience technology company CGG, the project spatialises data on environmental factors that influence health. It is based on the principle that “people have a right to know” what their environment is doing to their health, and designed to enable organisations to make data-led campaigns and decisions relating to urban health and the built environment.
The index is based on an earlier piece of work—the Stress Risk Score—which mapped environmental stressors (air, noise, heat, light) alongside social indicators. It overwhelmingly found that where there are high levels of environmental stressors, “it is predominantly people of colour, specifically Black and Asian people, living in these habitats”. The concept of Biological Inequality takes this further, including the “deprivation and lived experience of being forced to live in these environments”. Deprivation is highly linked with chronic stress and creates both psychological and physical responses. People living in these areas are therefore already more susceptible to environmental health risks.
The index draws links between people’s lives, their stress and situations, and the environments they inhabit—describing through a data-based approach how people are unequally exposed to environmental risks, and that poor people are stuck with poorly designed and bad quality environments. In the face of climate breakdown, and the uneven distribution of climate risk and vulnerability, it becomes even more important to understand the relationship between deprivation, risk, and opportunities for building community health. Centric Lab’s Biological Inequity Index suggests that it is not possible to live a healthy life in unhealthy spaces, and offers the tools to understand the relationship between climate, social, and health justice.
“A person can only have agency over their health when they are part of a supportive ecosystem, which includes the places they inhabit.”