This map was developed by the City of Santa Ana to visualize the census tracts in the City that were considered environmental justice communities. The City made this map using CalEPA's data tool CalEnviroScreen 3.0, a census tract is considered an environmental justice community if its cumulative CalEnviroScreen score ranks above the 75th percentile. This map was created in May of 2020 and has since changed due to improvements in data.
This map was developed by the City of Santa Ana to visualize the census tracts in the City that were considered environmental justice communities. It also shows the changes in the map that occurred after the city received updated data from CalEPA. The City made this map using CalEPA’s data tool CalEnviroScreen 4.0. A census tract is considered an environmental justice community if its cumulative CalEnviroScreen score ranks above the 75th percentile amongst all census tracts in the State. This map was created in February of 2021 and has since changed due to improvements in data.
This map was developed by the City of Santa Ana to visualize the census tracts in the City that were considered environmental justice communities. The City made this map using CalEPA's data tool CalEnviroScreen 4.0. A census tract is considered an environmental justice community if its cumulative CalEnviroScreen score ranks above the 75th percentile amongst all census tracts in the State. This map was created in October 2021 and is the most up to date map of environmental justice communities in Santa Ana that has been produced by the City.
This map shows the flood risk in the City of Santa Ana, showing the highest risk along the Santa Ana River. The data visual comes from Flood Factor, a data tool that provides a comprehensive look at flood risk in the continental U.S. (First Street Foundation, 2020). Full article on the data tool here: Highlights From The First National Flood Risk Assessment (firststreet.org)
Map that shows the man focus areas where CUAL (Comunidad Unida, Aire Limpio)/MNPA monitor the area. The numbers represent stops that get recorded by an air monitor during air monitoring days.
This map shows the location of Madison Elementary, relative to BEHR Process Corporation's Standard facility and Gallade Chemical Inc., two nearby RMP facilities. Both are located in Santa Ana, a large city in Orange County. Madison Elementary is located 0.6 miles away from the BEHR Standard facility and serves just under 1,000 children in grades K-6.
According to Public Policy Institute of California, 34.1 -57.1% of the population of Orange County are African Americans, Latinos, and Natibe Americans. These groups of people are usually miscounted/misrepresented in the census.
This graph shows the percentage of Children and Teens with asthma in Santa Ana from 2011-2017. In 2017-2018 Santa Ana had 13.8% of children and teens that had been diagosed with asthma.
This website shows Urban Indicators and gives each indicator a score. These indicators for risk include sensitivity, adaptive capacity, and exposure. Indicatators for readiness include Governmental, Social, and Economic. They score Santa Ana has a high risk and low readiness.
Three of Santa Ana’s zip codes, including Madison Park’s 92707, are amongst the forty California zip codes with the highest reported number of children with Blood Lead Levels (BLL) that are 4.5 mcg/dL or greater.
The table at the right shows the percentage of children under the age of six in three of Santa Ana’s zip codes that have a BLL of 4.5 mcg/dL or greater.
According to the Center for Disease Control there is no safe level of lead in children's blood. Elevated BLL can result in neurodevelopmental impairment, with no blood lead level known to be without a damaging effect.
The CDC indicates that no level of lead is safe. As of 2021, they use a blood lead reference value (BLRV) of 3.5 micrograms per deciliter (µg/dL) to identify children with blood lead levels that are higher than most children’s levels. The California Department of Public Health plans to adopt this reference value but is currently “working to procure the required resources” to implement the new BLRV. CDPH encourages (but does not mandate or incentivize) healthcare providers to provide retesting and follow-up for blood lead levels ≥ 3.5 mcg/dL. BLRV
The actual number of children with lead blood levels is estimated to be higher than reported cases due to endemic undercounting and underreporting in California. A 2019 audit found that between 2009 and 2018, 1.4 million one- and two-year old children in California did not receive any of the required tests, and another 740,000 children missed one of the two tests. The Covid-19 pandemic has only exacerbated the problem, with 28% fewer children being tested.
The map on the left indicates 285 missed BLL tests for children in Medi-Cal Ages 1 and 2, and 17 children under the age of 6 with elevated BLLs in the Madison Park census tract.
The map on the left indicates 619 missed BLL tests for children in Medi-Cal Ages 1 and 2, and 16 children under the age of 6 with elevated BLLs in the Cornerstone Village census tract.
In collaboration with University of California of Irvine Department of Public Health, UCI Community Resilience, & Jovenes Cultivando Cambios (Youth Cultivating Changes), Orange County Environmental Justice conducted a study of soil lead contamination in Santa Ana showing lead concentrations that exceed both state and federal guidelines disporportionately affect socioeconomically disadvantaged Census tracts.
Airport lead-emissions are also concern, with John Wayne Airport’s annual lead emissions ranking 16 nationwide. Nearly 70& of airborne lead emissions come from leaded aviation fuel, which is no longer used by commercial airlines but still used by the majority of small planes.
The Orange County Childhood Lead Poisoning Prevention (CLPP) Program is implemented by the local Department of Public Health, the Orange County Health Care Agency. They are responsible for managing local blood lead testing data in partnership with healthcare providers and community organizations.
Complaints can be filed here to the OC Healthcare Agency in order to highlight the need for blood lead testing as mandated by California law.*
*Title 17 of the California Code Regulations require screening for lead poisoning for all children receiving public benefits at the ages of 12 and 24 months.
This image shows the thresholds set for both cancer and non-cancer risk posed by Toxic Release Facilities in the South Coast Air Quality Management District. The AQMD uses these thresholds to determine "Hot Spots," which require a thorough public health assessment and mitigation efforts on the part of the facility.
“Assembly Bill (AB) 2588 (Connelly), the Air Toxics 'Hot Spots' Information and Assessment Act, requires facilities that are ranked as a high priority (see Prioritization) to submit a health risk assessment (HRA) to the air pollution control and air quality management districts (district). A risk assessment, as defined under the Air Toxics 'Hot Spots' Act, includes a comprehensive analysis of the dispersion of hazardous substances into the environment, the potential for human exposure, and a quantitative assessment of both individual and population-wide health risks associated with those levels of exposure. The risk assessments submitted by the facilities are reviewed by the Office of Environmental Health Hazard Assessment (OEHHA) and approved by the district. In addition, the district may require facilities in the intermediate and low priority categories to also submit a health risk assessment."
According to this chart, South Coast AQMD sets the maximum incremental cancer risk threshold at 10 or more "chances" of cancer per 1 million residents, while a site is considered "cancer burdened" if exceeding 1 "chances" per 2 million residents (or .5 cases per 1 million). Further elaborated, this webpage specifies that an "actionable risk" is set at 25 "chances" per 1 million residents and a "significant risk" is set at 100 "chances" per 1 million residents. According to the website, "Facilities above these risk levels may be designated as a Potentially High Risk Level Facility under Rule 1402." However, it is unclear what AQMD means by "chances," or how this "facility-level" risk translates into community-level.
This list shows the registered and permited Toxic Release Facilities in Santa Ana, which are required to report their emissions to AQMD. Because these facilities have been determined not to meet the South Coast threshold for either cancer or non-cancer health risks, the public is not provided with any legible assessment of the level of risk these facilities may pose.
As shown here, CARB's facility search engine will provide emissions data on specific toxics, but this does not easily translate into an understanding of their health risks, especially any cumulative or combined risk.
AQMD's facility-level analysis is problematic when you consider the significant cumulative impact potential of tight clusters of these so-called "safe" or "low-emitting" facilities. Santa Ana has two prominent clusters which are shown here in the southwest and south east corners of the city.
Furthermore, the determination of "low risk" at the facility-level blatantly contradicts data at a more aggragated level. CalEnviroScreen's data on Toxic Release Inventories shows all of Santa Ana's census tracts as being above the 90th percentile for toxic emissions in the state. What is more, this data shows another dramatic increase in emissions for the census tracts containing these TRI clusters.
The census tract, too, may not be an adequate unit of analysis, given that these clusters often impact neighboring census tracts which do not contain TRIs themselves. For example, this census tract, which sits above a TRI cluster contains only one TRI facility, and yet it is still in the 96th percentile.
Provided by EIA (US Energy Information Administration) is a map of Texas Natural gas and Petroleum resources and plays. This image displays the current Texas Gulf Coast energy infrustructure. Shown as each point are Natural gas power plants, petroleum power plants, refineries and processing facilities, trading markets, and product terminals for import and export. Accourding to the EIA, "In 2020, Texas accounted for 43% of the nation's crude oil production and 26% of its marketed natural gas production." Texas is building out; oil and gas companies are attempting to stave off shut down as they increase capacity in ports and processing plants.
After the 2016 crude oil export ban was lifted, both production and export of oil grew. The increased export desire and open markets created opportunities to expand capacity in both ports, refineries, and extraction.
This is a map generated from Max Midstream Texas online profile. Max Midstream is working on the construction of the Nighthawk Lateral, Blackhawk pipeline and the 77 storage station that will hold 750,000 barrels of oil. The goal of the project is to expand the port's capacity and divert from oil and ship congestion in Huston and Corpus Christi, which are usually overcrowded. This diversion is slated to bring in jobs and business, as well as increase the speed of export from the Gulf Coast. Taking data from where Huston mainly exports, we can assume based on the goals of the project, that oil exported from Calhoun will also transport to the same regions that Huston transports oil. Based on the Houston Business Journal the main importers and partners with Houston are Mexico, Brazil, China, South Korea, and the Netherlands. A certain conclusion can be formulated that the expansion of the Port of Calhoun will also likely contribute to the export to these regions. The pipeline shown and the terminals were created to expand the export capacity of the Port of Calhoun. Projects like this one have occured along the Gulf Coast in light of expanding production and open global markets.
Darren Woods, chairman and Chief executive officer of Exxon Mobil Oil and Gas spoke, along with other oil executives on the future of oil in a CERAWeek conference in Huston during March of 2022. The theme, Pace of Change: Energy, Climate, and Innovation. Energy has exploded to the top of many news headlines due to the Russian invasion of Ukraine and the dramatic impact in the global supply chain and pricing of oil. New talks of energy independence, oil and gas market volitility, and US energy transitions have all risen to the top due to the geopolitical implications of the current world crisis. Accourding to a New York Times reporting on the conference, "Oil and gas producers who are not Russian are, as my colleague David Gelles put it, 'suddenly feeling very good about themselves.'" Many oil and gas companies have asked the United States government to increase permits and apporvals for oil drilling and expansion to compensate for the need, while others have argued that this is the perfect time to begin the US energy transition. Only time will tell where the United States and the world head next.
Immediately when visiting the site, the user is taken to the homepage of Cal Open Data Portal with a search bar that can filter open data sets using keywords that the user chooses.
This figure shows some of the categories that Cal Open Data Portal has on their website, all from existing federal agencies, that the user can click on to further filter their dataset searches.
This figure demonstrates that users can also search for state organizations through the organization tab at the top. Each organization has the number of open datasets listed below them, and is also available to click on to discover those datasets.
Systematic differences in health can be seen between cities of different median household income, and between individuals of different race/ethnicity. This report highlights the cities and racial/ethnic populations of highest need, and underscores the importance of further efforts to understand and address health disparities to achieve health equity among all residents of Orange County
Opportunity Zones are census tracts that are economically-distressed communities where new investments may, under certain conditions, be eligible for preferential federal tax treatment or preferential consideration for federal grants and programs
Conduent Healthy Community Institute's Food Insecurity Index is calculated using social and economic factors ranging from household expenditures to perceived health status that may impact a household's ability to access and purchase food. Based on these factors, an index value (from 0 - 100) is generated for each zip code, census tract, and county in the nation. Communities with the highest values are estimated to have the highest food insecurity, which is correlated with household and community measures of financial stress, such as Medicaid enrollment, SNAP enrollment, and mental health burden.
The SocioNeeds Index takes social and economic factors that are well known to be strong determinants of health outcomes (which range from poverty to education), and generates an index value (from 0 - 100) for each zip code, census tract, and county in the nation. Those with the highest values are estimated to have the highest socioeconomic need which is correlated with preventable hospitalizations and premature death
“The California Healthy Places Index (HPI) is a powerful new tool, developed by the Public Health Alliance of Southern California, to assist you in exploring local factors that predict life expectancy and comparing community conditions across the state.”
It showcases community conditions that predict life expectancy and influence health. People’s health is shaped dramatically by “non-health” policies and community characteristics, such as housing, education, economic, environmental, and social factors. These community conditions are called the “social determinants of health”, which inform the indicators used on the HPI platform.
The Orange County Community Indicators report of 2015, reported an “opportunity gap” seen in “abundant support and resources for the children of higher-income families and stalled or declining social mobility for the children of lower-income and less educated families” (American Family Housing 2015). Although an improving economy generates high-paying jobs for the educated, a housing shortage for the middle class and the poor caused, in part, by a 6 percent drop in the county’s median income between 2006 and 2013, where “lower-paid occupations such as administrative assistants and retail sales clerks declined, and salaries for such higher-paid jobs as computer programmers rose,” along with a growing proportion of Latinos in Orange County where “the academic gap between Latino students and their classmates “remains substantial and persistent, showing little lasting improvement,” (American Family Housing 2015) shows the significance of educational disparity in determining financial security and consequently, health outcomes
Research indicates that economic opportunity is one the most powerful predictors of good health, and that impacts on health are especially pronounced for people in or near poverty.
A college education is essential for higher-paying careers; helps people develop the cognitive skills and knowledge necessary to make healthy choices; builds important social and physiological skills.
Early childhood is a crucial period for brain development;
Voting is an indicator of social power and social cohesion, which have been linked to a wide variety of health outcomes at the individual and community levels
Cars are tools of transportation to new opportunities, while people may use a bike, bus, etc, communities with no bike lanes, sidewalks, and other open/green areas are at a disadvantage and will have a hard time being active/ moving around without a car.
People in the bottom half of poverty percentile are also located in areas that have the lowest percentage of tree canopy, park access, low-Income homeowner severe housing cost burden, and also the lowest percentage of healthcare insured adults.
Trees are beneficial for mental and physical health in many ways. They can provide shade and cool surrounding areas, reduce stress, and promote health, wellness and physical activity. Trees are essential to mitigate the effects of climate change, especially extreme heat events.
Where there is less tress coverage, there are more paved surfaces, like roads and parking lots, that absorb and radiate heat. That adds to up to higher summer temperatures compared to the city average.
Neighborhoods that have been neglected politically and left with no access to green spaces, overcrowded housing, insufficient wages and no access to health care are often composed of underrepresented communities
Everyone should have the opportunity to build wealth over time by purchasing a home, which can protect against rising rents and promote social ties and neighborhood stability. High housing costs and housing instability are associated with increased stress and depression, communicable diseases like tuberculosis, and decreased children’s wellbeing and educational outcomes
When parents don't have financial support, and aren't able to take time off because of inaccessible insurance and no days off with increasingly higher bills, then their children are more likely to suffer neglect and poverty. This usually means they will grow old in a neighborhood with no environmental regulation and at higher risk of being “high risk.”
According to 2018 data from kidsdata.org, 1% of children from the ages of 0-5 in Orange County have blood lead levels that are 9.5 µg/dL or higher. Lead exposure in Orange County can be attributed to lead paint exposure in homes and schools, or even in contaminated soil, water, or air.
Risk Assessment of Soil Heavy Metal Contamination at the Census Tract Level in the City of Santa Ana, CA:
Shown in Fig. 3 is a map depicting Santa Ana Census tracts according to HI scores that were derived using both lower and upper RfD values (see Table 2) where applicable (Mn only). As shown, depending on whether upper or lower RfDs were applied for Mn, between 35 and 61 (57–100%) Census tracts in Santa Ana showed HI ≥ 1, implying the potential for non-carcinogenic health effects across the majority of Census tracts. The pattern of risk was similar across both lower and upper risk scenarios, with the cluster of Census tracts in the central region of the city, just south of the I-5 and SR-22 freeways, showing the highest HI values. When assessing the average concentration of each heavy metal across all sampling points, the cumulative HI for Santa Ana was calculated to be 1.3 under lower risk assumptions.
This is the average heavy metal concentrations and 95% CIs (shown as error bars) of heavy metal soil samples based on the median household income across Census tracts.
In terms of social patterning, relative to soil samples collected from the lowest tertiles, soil samples collected in tertiles with: the highest proportion of non-English speaking residents had 66.1% and 24.7% higher Pb and Zn concentrations, respectively; the highest proportion of immigrant residents had 96.4%, 18.8%, 20.9%, and 32.4% higher Pb, Cu, Cd, and Zn concentrations, respectively; the highest proportion of Latina/o/x or Hispanic residents had 105.1%, 17.0%, 20.6% and 32.6% higher Pb, As, Cd, and Zn concentrations, respectively. In contrast, the opposite pattern was observed for Mn where the tertile with the lowest proportion of Latina/o/x or Hispanic residents had 11.5% higher Mn concentrations relative to those from the lowest tertile.
On the left: The vulnerability index is composed of U.S. Census estimates, which may underestimate the population in sub-locales of Santa Ana. For instance, in Santa Ana a sizable proportion of youth and adults of color have engaged with the criminal legal system and thus may not be represented in Census estimates of the population. Any systematic undercounts of the population may contribute to conservative estimates of the cumulative burden of exposure to metals. Further, Santa Ana is experiencing a gentrification process that has augmented housing instability, homelessness, and housing quality concerns that may also contribute to population undercounts.
The following pictures belong to Santa Ana’s city profile in the Notre Dame’s Urban Adaptation Assessment (UAA) interactive database. It has data for five different environmental hazards: flood, heat, cold, sea-level rise, and drought. Each Hazard has a “Potential Future Cost” window that provides information on the historical and projected cost, or casualties, and probability of the hazard occurring in 2040. The data comes from the National Oceanic and Atmospheric Administration and the MACA data portal to estimate the probability of the hazard occurring in 2040.
The overall risk at the top provides an indication of how well cities performed in all indicators. It shows how well cities performed on all indicators relative to how other cities performed in the assessment. Santa Ana was measured to have an overall “high risk” score of 79.64 and an overall “low readiness” score of 29.15.
The overall risk score is comprised of sensitivity, exposure, and adaptive capacity. Each categories has its own set of indicators. The colored bar shows where the score fall on a scale of 0 to 100, relative to other cities in the assessment. A lower sensitivity score is better, while a higher adaptive capacity score is better. The green shows the more desirable side.
This image shows Santa Ana has an overall flooding risk score of 54.9. This is based on the following indicators:
The sensitivity score is 70.5. Data points used to measure the indicator include percent of area that is impervious surface, percent of buildings built before 1999, percent of households without access to a vehicle, percent of population spending over 50 percent of income on rent, percent of population that is 65 years or older living alone, percent of population that is under 5 years old, and percent of total housing units that are mobile homes.
The exposure score is 35.5. Data points used to measure the indicator include percent of buildings in high risk flood zone, percent of cars in high risk flood zone, and percent of population living in high risk flood zone.
The adaptive capacity score is 21.9. Data points used to measure the indicator include number of acute care hospital beds available per 1000 residents, percent of population with health insurance, and water quality enforcement.
This image shows Santa Ana has an overall heating risk score of 89.1. This is based on the following indicators:
The sensitivity score is 63.5. Data points used to measure the indicator include percent of buildings built before 1979, percent of employed population that works outdoors, percent of households receiving public assistance, percent of population spending over 50 percent of income on rent, percent of population that is 65 years or older living alone, percent of population that is under 5 years old, and percent of population with a disability
The exposure score is 99.0. Data points used to measure the indicator include population density.
The adaptive capacity score is 5.0. Data points used to measure the indicator include number of acute care hospital beds available per 1000 residents, percent of land covered by tree canopy, and percent of population with health insurance.
This image shows Santa Ana has an overall cold risk score of 88.4. This is based on the following indicators:
The sensitivity score is 63.5. Data points used to measure the indicator include percent of buildings built before 1979, percent of employed population that works outdoors, percent of households receiving public assistance, percent of population spending over 50 percent of income on rent, percent of population that have a disability, percent of population that is 65 years or older living alone, and percent of population that is under 5 years old.
The exposure score is 99.0. Data points used to measure the indicator include population density.
The adaptive capacity score is 8.0. Data points used to measure the indicator include number of acute care hospital beds available per 1000 residents, percent of households with heating fuel, and percent of population with health insurance.
This image shows Santa Ana has an overall sea-level rise risk score of 0. This is based on the following indicators:
The sensitivity score is 70.5. Data points used to measure the indicator include percent of area that is impervious surface, percent of buildings built before 1999, percent of households without access to a vehicle, percent of population spending over 50 percent of income on rent, percent of population that is 65 years old or older living alone, percent of population that is under 5 years old, and percent of total housing units that are mobile homes.
The exposure score is 0.0. Data points used to measure the indicator include percent of population in 1ft sea level rise zone and percent of population in 3ft sea level rise zone.
The adaptive capacity score is 21.9. Data points used to measure the indicator include number of acute care hospital beds available per 1000 residents, percent of population with health insurance, and water quality enforcement.
This image shows Santa Ana has an overall drought risk score of 86.2. This is based on the following indicators:
The sensitivity score is 46.8. Data points used to measure the indicator include baseline water stress, percent of GDP based on water intensive industries, percent of workforce in farming, fishing and forestry
The exposure score is 99.0. Data points used to measure the indicator include population density.
The adaptive capacity score is 0.0. Data points used to measure the indicator include existence of drought management plan and existence of water management plan.
The readiness indicator is the same for all the hazards. It is based on governmental, economic, and social factors.
Santa Ana has an overall readiness score of 29.1. This is based on the following indicators:
The governmental readiness score is 32.6. Data points used to measure the indicator include estimated percent of adults who think global warming is already harming people in the US now or will within 10 years, percent of population with a 12th grade education or higher, and total number of federal public convictions by district.
The economic readiness score is 27.2. Data points used to measure the indicator include bond worthiness, city debt per resident, and tax incentives for renewable energy.
The social readiness score is 27.5. Data points used to measure the indicator include civic engagement and general innovation capabilities.
This essay offers a visual example of maps that can be created using the California Healthy Places Index. These maps specifically focus on various health-related indicators in Santa Ana, California.
The California Healthy Places Index is made available by the Public Health Alliance of Southern California to make health equity and racial justice a reality through data collection that informs policy.
This indicator measures percentage of adults aged 18 to 64 years with health insurance. This is also one of the indicators that go into the California Healthy Places Index Score. The California Healthy Places Index mapping tool provides policy recommendations meant to address this indicator.
This indicator measures the percentage of land with tree canopy (weighted by number of people per acre).
This is also one of the indicators that go into the California Healthy Places Index Score. The California Healthy Places Index mapping tool provides policy recommendations meant to address this indicator.
This indicator measures the percentage of the population living within walkable distance (half-mile) of a park, beach, or open space greater than 1 acre.
This is also one of the indicators that go into the California Healthy Places Index Score. The California Healthy Places Index mapping tool provides policy recommendations meant to address this indicator.
This indicator measures the percentage of people aged 25-64 who are employed.
This is also one of the indicators that go into the California Healthy Places Index Score. The California Healthy Places Index mapping tools provide policy recommendations meant to address this indicator.
This indicator measures median annual household income. This is also one of the indicators that go into the California Healthy Places Index Score. The California Healthy Places Index mapping tools provide policy recommendations meant to address this indicator.
Wednesday, November 3rd 2021, John J. Hainkel, Jr. Briefing Room
A little bit after 9:00 AM
Politicians, physicians and public health advocates debate the accuracy and meaning of data on health care outcomes.
Luneau: “I agree with that—but there was at least some level—just to put it real plainly, the PAs and NPs came in and said: everything’s been great, we’ve had no problems, we’re not working under these doctor’s agreements, we’ve been exempt from that, and everything was great. And a lot of doctors disagreed with that. … This task force is going to flesh out what that information was and how accurate that is. It might be 10 percent of the people it might be 20 percent – I don’t know.” … but that was the purpose of this—not to suggest that we go one way or the other. Just to get the information … “so when it gets back to the legislature we can realistically respond to it”
Giglia (relenting somewhat): but when we have asked to the data, people have said they don’t have it
Luneau: “With all due respect, I’m trying to avoid what’s happening here right now” [voice very stern, clearly losing patience] “This is what happens in the legislature when we have this, and this is what I’m trying to avoid”
Representative from Med Board of Examiners is laughing with hand over is face (middle aged man with a bowtie and suit, glasses, cane)
The logics producing inequities are central to legal and scientific structures of power where a focus on progress, objectivity, and efficiency reproduces health disparities, environmental injustice and racial capitalism.
What are some ways of thinking creatively about health equity?
Van Gogh painted “Garden of the Hospital in Arles” while staying there as a patient. The hospital was a charitable institution located in Arles (Provence-Alpes-Côte d'Azur). Van Gogh was hospitalized there twice and diagnosed by the hospital with “acute mania with generalised delirium”. The former hospital is now a center for van Gogh’s works.
This piece was created by Véronique Vanblaere from Birmingham, Alabama for the Visualize Healthy Equity community art project managed by the National Academy of Medicine.
Vanblaere’s descriptive caption is as follows:
“We need more green spaces in our community. Spaces where people feel safe to walk, run, breathe the outside air during their lunch hour, before or after work, or to replace the cigarette pause. When we put our body in motion, it expands our mind.”
The stated mission of the Visualize Health Equity project is to get more people thinking and talking about health equity and the social determinants of health. The secondary aim of the project is also to take a creative approach to better understand how people across the United States conceptualize the health challenges and opportunities in their communities. The project was managed by the National Academy of Medicine and funded by the Robert Wood Johnson Foundation.
This is a graphic the Robert Wood Johnson Foundation developed to promote health equity. The image emphasizes that equity entails providing the resources that match individual needs, rather than allocating the same quantity or type of resources for everyone. In this framing, understanding difference (on an individual or group level) is integral to equity.
Part of the reason this image caught my attention is because much of the language defining health equity has developed through the disability rights movements, and an emphasis on individual rights.. This framing has provoked critique from anthropological disability studies which argue that “disability is not a category of difference unto itself … rather disability is profoundly relational and radically contingent, (inter)dependent on specific social and material conditions that too often exclude full participation in society” (5).
Ginsburg, Faye, and Rayna Rapp. 2020. “Disability/Anthropology: Rethinking the Parameters of the Human: An Introduction to Supplement 21.” Current Anthropology 61 (S21): S4–15.https://doi.org/10.1086/705503.
This visual represents the model on which the Louisiana Department of Health’s health assessment initiative developed out of. This framework was developed by the Robert Wood Johnson Foundation for its Sentinel Communities Surveillance project, which began in 2016 and monitors the development of a “Culture of Health” at 30 different sites across the United States. In this framework, health equity is the foundation of a “Culture of Health”. Specifically, the image is taken from a report RWJF produced that: “provides insight into how 11 communities conceptualize health equity” and how those conceptualizes influence their strategies and approaches for promoting health equity. I wonder here if their overuse of the word equity starts to make it redundant? Overly abstract? RWJF defines health equity as follows: ”Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.” (Braveman et. al, 2017).
Copyright 2015. Robert Wood Johnson Foundation/From Vision to Action: A Framework and Measures to Mobilize a Culture of Health.
The National Academies of Sciences, Engineering and Medicine - “Strategic Plan”. This image is on the “About Us” section of the National Academies website. The header for the image is “Our Strategic Plan,” which the text field below the image describes as a plan “to build a more proactive, innovative, and efficient approach” to their work. On the same page, the institution is described as providing “independent, objective advice to inform policy with evidence, spark progress and innovation, and confront challenging issues for the benefit of society”.
These paintings were created by Noshaba Bakht from Kansas City, Missouri for the Visualize Healthy Equity community art project managed by the National Academy of Medicine.
According to Bakht’s descriptive caption for the paintings, she sought to contrast two environments: the trees outside the Art Institute of Houston (US) and the food market at night in downtown Lahore (Pakistan). Bakht notes that the land surrounding the Art Institute has no housing. The night market is “rich in fast food” but there are no “trees to clean the air”.
The stated mission of the Visualize Health Equity project is to get more people thinking and talking about health equity and the social determinants of health. The secondary aim of the project is also to take a creative approach to better understand how people across the United States conceptualize the health challenges and opportunities in their communities. The project was managed by the National Academy of Medicine and funded by the Robert Wood Johnson Foundation.
Image reproduced here with permission of the artist.
This map was used in a powerpoint presentation given by the Louisiana Department of Health to the Task Force on Health Care Outcomes in the John J. Hainkel, Jr. Briefing Room in Baton Rouge, LA on Wednesday, November 3rd 2021 (the 3-hour meeting was recorded and archived in the Louisiana State Legislative website: https://legis.la.gov/legis/Broadcast.aspx). The primary focus of the meeting was to review data related to how physician assistants (PAs) had performed under the emergency conditions of Covid-19, for which normal regulations on the scope of their practice had been loosened (e.g. they were permitted to do more without physician oversight). The meeting began with this overview of healthcare shortages in the state, as a way to establish the potential positive impact of expanding scope of practice for PAs.
This is a newspaper article published by the Louisiana Illuminator that highlights activists’ calls for the creation of an office dedicated to improving women’s health outcomes within the Louisiana Health Department. A bill meant to establish this office stalled last summer (2021), prompting Alma Stewart (founder and president of the Louisiana Center for Health Equity) to demand answers for why the bill (House Bill 193) wasn’t passed. It had pass unanimously in the House of Representatives but was held up in the Senate Finance Committee because it was never taken up by the committee chair, Senator Mack “Bodi” White (R-Baton Rouge). White could not be reached for comment by either the Illuminator or Stewart. The specific image heading the article is a photograph of a press conference in front of the Louisiana State Capitol Building held by the Select Committee for Women and Children. Senator Regina Barrow, who is standing at the podium, is the chairwoman of the committee.
Controlled Infertility and Childbirth (Guilbeau Center for Public History). This image is part of a digital exhibit, “Resistance through Persistence: Enslaved Women and Culture in Louisiana.” The exhibit was curated by UL Lafayette History students studying the public history of slavery. The exhibit emphasizes the many ways enslaved women engaged in everyday acts of resistance.
The exhibit is housed in the Guilbeau Center for Public History in the Department of History, Geography and Philosophy at the University of Louisiana, Lafayette. The center is aimed at “helping public historians incorporate diversity, inclusion, equity and accessibility in their work and we focus on projects that decolonize public history … as historians, we rely on rigorous historical research to demonstrate the distinctions between public memory, falsified historical narratives, and evidence based historical facts” (https://www.guilbeaucenter.com/about).
The Guilbeau Center also houses the Recent Louisiana Disasters Oral History Project, as well as other materials from other projects—historians for the center are currently working on building a collection of stories from the UL Lafayette community on the covid-19 pandemic and Movement for Black Lives, which they have named Shared Histories. They are building an archive of photos, typed entries, audio recordings, and videos. They also already have an exhibit at the Arsenal-Cabildo at Louisiana State Museum in New Orleans called “Do No Harm: The Healing Touch of Louisiana Women in Medicine”.
Lastly, the center also has a student-driven Public History project called “Museum on the Move”. This exhibit is designed and curated by students within the interior of the van, which can take exhibits around the state. Travelling exhibits have included: “Cross the Line: Louisiana Women in a Century of Change,”, “Drill Baby Drill” on the oil industry in Louisiana, and “Unmasking Traditions: Mardi Gras in Louisiana,” as well as an exhibit on Hurricane Harvey oral histories.
Abshire, Cody, et al. 2019. “Resistance through Persistence: Enslaved Women and Culture in Louisiana.” UL Department of History, Geography and Philosophy and the Guilbeau Center for Public History. https://www.guilbeaucenter.com/new-page-42.
Nombre de médecins (généralistes et spécialistes) pour 100 000 habitants par région. [Physicians (general and speciality) for every 100,000 residents by region].
This chart was published in a Senate report written for the Committee on Regional Planning and Sustainable Development [la commission de l'aménagement du territoire et du développement durable], for a working group on medical deserts [le groupe de travail sur les déserts médicaux] in January 2020.
The chart illustrates the variation in practicing physicians by region in France, with fewer physicians practicing in rural areas like Centre-Val de Loire, Normandie, and Hauts-de-France, particularly relative to more urban areas like Ile-de-France (Paris) and Provence-Alpes-Côte d'Azur. Other regions with notably disparate access to physicians are the DROM (overseas departments, regions and collectivities).
The report begins with a quote from Georges Clémenceau (French physician, journalist and politician): “Il faut savoir ce que l’on veut. Quand on le sait, il faut avoir le courage de le dire ; quand on le dit, il faut avoir le courage de le faire” [One must know what one wants. Once one knows, one must have the courage to say it; once one says it, one must have the courage to do it].
This image comes from the website of newly graduated physician Martial Jardel, who embarked on a project in 2020 to travel through France and briefly “replace” overburdened physicians working in medical deserts. The stated mission of his project is to soigner (heal), recontrer (meet), and apprende (learn). More specifically, the project’s aims are to understand the motivations of doctors who persist in working in areas that are steadily “abandoned” by healthcare professionals, as well as the diverse ways in which medicine is practiced in France--and ultimately to encourage young physicians to consider settling in rural areas. His project received significant media coverage, not just in France but the US.
[Welcome to this virtual tour of the Formosa Plastics Group Museum! We, your tour guides, are a collection of academics and researchers studying Formosa Plastics Group (FPG), an international petrochemical corporation headquartered in Taiwan. As we share images and interpretations of museum exhibits with you, we encourage the audience to consider: How does FPG as a company view itself? How does FPG hope others view the company?]
The Formosa Plastics Group Museum is located on the grounds of Chang Gung Formosa Plastics University, near Taipei. Chang Gung University grew out of a hospital set up by [FPG] in 1976 “to make a meaningful contribution to Taiwan’s society.” Today, the university uses “the successful management model of Formosa Plastics Corporation and its resources” to build students’ management knowledge (https://www.cgu.edu.tw/p/404-1000-17343.php?Lang=en).
[edit the image to be both the front & back of the flyer]
The Formosa Plastics Museum has [seven total] floors of exhibits celebrating the founder and spirit of the Formosa Plastics Group--complete with dioramas, wax figures, and a miniature replica of Formosa’s Sixth Naphtha Cracking Plant. Other highlights include the Earth Conservation Theatre on the fifth floor [and a simulated forest experience in the basement level, alongside a souvenir shop. Exploring the entirety of the museum takes 4 to 5 hours!] The sixth floor conveys how Formosa has given back to society through investment in education, hospitals, and cultural heritage projects. [I'm thinking save this last sentence for later in the essay]
[When entering the museum, guests are greeted by this large FPG logo engraving, complete with the company's Chinese name, "台塑企業."
Formosa Plastics Group is a massive conglomerate of over 100 subsidiary companies, which produce a vast array of industrial and chemical products. FPG highlights some of its most prominent subsidiary companies in eleven small icons included in the logo, including Formosa Plastics Corporation, Nan Ya Plastics, Formosa Petrochemical Corporation, and Formosa Ha Tinh Steel Corporation.]
The Formosa Plastics Museum's second floor features the details of Founder Wang Yang-ching's (王永慶) upbringing and rise to prominence. This Western-style portrait, mounted in a grandiose gold frame, depicts Founder Wang sitting in front of a crowd of employees dressed in white. The mass is running forward, presumably a reference to the exercise events that FPG hosted, but also suggesting Founder Wang as an inspiration moving thousands forward towards progress. The golden letters above his head, 勤勞樸實, are a corporate slogan utilized consistently throughout the museum. The four characters mean diligence, hard work, frugality, and sincerity--values that Founder Wang claims FPG strives to accomplish.
This replica depicts the original ox-drawn cart that Formosa Plastics (originally known as Fumao Plastics 福懋塑膠) used in the 1950s to transport PVC resin. Emphasizing their humble beginnings, Formosa Plastics began as a small company producing 4 tons of PVC resin daily, surviving Taiwan's depression and growing over the decades into a massive corporation.
Besides the display is the phrase "篳路藍縷開展石化王國," meaning "enduring hard beginnings to develop a petrochemical kingdom." The Chinese idiom utilized to describe hard beginnings invokes an image of a pioneer driving a cart in ragged clothes. This language suggests that Formosa Plastics is an innovating, resourceful company that deserves its current success. Using its scrappy origins, the company justifies its current behavior as rooted in humility.
[I think we should replace this image with one of young Founder Wang's wax figure--would look a little more interesting and emphasize the narcissism of it all. I have a photo we can use!]
[A significant portion of the museum--virtually all of the second floor--describes the upbringing and philosophical approach of the company's founder. Growing up in a poor rural community, Founder Wang is said to have created this vastly wealthy company through wit and resourcefulness.
An exhibit of his early life describes the "Theory of the Starving Goose," which references Wang's time raising geese in his village. He could not afford enough feed to keep his geese well-nourished, so to prevent their starvation, Wang supplemented the goose feed with leftover vegetable leaves from neighbors. His spendthrift approach allowed the geese to survive and his livelihood to continue.]
[Despite its humble origins, Formosa Plastics Group is the fourth largest petrochemical company in the world today, worth over $100 billion in annual market capitalization. FPG began expanding facility operations across the globe in the 1990s, especially in China, the United States, and Southeast Asia. In this wall-sized map of world operations, FPG depicts facilities in over 16 U.S. states.
It is noteworthy that this map depicts Taiwan, the company's home country, as significantly larger than on its actual geographic size. By making the island the same size as Taiwan and the United States, could FPG be suggesting that it is growing the geopolitical power of Taiwan through economic expansion?]
Upon entering the Formosa Plastics Group Museum in Taoyuan, Taiwan, the first thing that visitors see is a large piece of wood, kept under a dome of glass. The label at the bottom reads:
This magnificent piece of New Zealand Kauri burl had been buried in the ground for more than fifty thousand years before being unearthed. The timber is a rare hard resin-filled solid wood. This beautifully-shaped burl weighs 8.5 tons, well over the the 6 ton piece held by the British Museum in London, making it unique in the world. In 2002, Chairman Wang Yung-ching came across the Kauri burl in Kaohsiung and was drawn to its strength so much that he decided to make this Kauri burl the centerpiece of his collection. This remarkable piece of wood on display here at the entrance to the museum symbolizes the vitality of the Formosa Plastics Group capable of immeasurable possibilities. and longevity.
I later learned that a burl is considered a tree's natural response to "some form of stress such as an injury or a viral or fungal infection" (Wikipedia). I also looked up the Mandarin translation for burl, which is 瘤 (liú). This term can mean hump, knurl, lump, nubble, or tumor. The latter invokes environmental and health impacts, such as high cancer rates in petrochemical fenceline communities. However, these issues are not addressed in the museum. Instead, the piece of wood is paired with an all-plastic recreation of a New Zealand rainforest in the museum's B1 gift shop. This recreation includes chirping bird sound effects, leaving visitors with a greenwashed first and last impression.
However, one way to capture the ambivalent meaning of the object at the center of the museum is through Kim Fortun's (2019) reflection on "toxic vitalism," a term that describes "the way systems can take on a life of their own, often beyond what experts planned or expected.
The museum has an array of FPG-made products in a souvenir shop on the basement level. Items on display ranged from beauty products and toiletries to dried snacks, tea, bleach, and commemorative jewelry. This Lego-like plastic building set, which creates a FPG Museum replica, was purchased in the museum.
Their souvenir shop leaves critical visitors with a few takeaways. First, it displays the uncanny diversity of goods that FPG and its subsidiaries create--the company's influence ranges far beyond what the public imagines petrochemical production to be. Secondly, for visitors familiar with FPG's extensive legal and human rights violations, the shop feels tone-deaf to the point of absurdity.
This visual is from a Harvard-led (Wu et al. 2020), investigating the relationship between exposure to PM. 2.5 and COVID-19 mortality in the US. After the onset of the pandemic in spring, St. John Parish, Louisiana saw one of the COVID-19 highest death rates in the country (Kasakove 2020); in August, the Louisiana Department of Health reported 1,1442 cases and 92 deaths.
Kimberly Terrell, Outreach Director at the Tulane Environmental Law Clinic, further analyzed the data on request of the environmental justice group Concerned Citizens of St. John. Terrell particularly looked into the significance of underlying conditions. In her final report, Terrell notes low diabetes and high obesity rates. However, she emphasizes that the number of COVID-19 deaths in St. John is much higher than in parishes with similar obesity rates (Terrell 2020).
The visual was altered by Terell, adding geographic information (location of the Parish) and adjusted transparency to identify air pollution "hotspots" for fenceline communities along the river.
Witnesses were Mustafa Santiago Ali (Environmental Justice, Climate, and Community Revitalization, National Advocacy Center at the National Wildlife Federation), Jacqueline Patterson (Environmental and Climate Justice Program, NAACP), and Shay Hawkins (Opportunity Funds Association).
Nurdle Patrol is a citizen science project run by the Mission-Aransas National Estuarine Research Reserve (Reserve) to collect, report, and archive nurdles that wash up on beaches and rivers across the world. Nurdles are plastic pellets, the raw material for manufacturing plastic products. They degrade riverine and oceanic ecosystems and livelihoods, entering our food chains and water supplies.
Undergraduates at Emory University examine unsolved and unpunished racially motivated murders in Jim Crow American South, relying on primary evidence and secondary readings. In their words: "Emory students have focused their attention less on figuring out who-done-it (because in most cases, the assailants were known) and more on exploring why"
The Paradise or Panama Papers are 13.4 million leaked documents--emails, financial spreadsheets, passports, and corporate records-- from Panama Law Firm Mossack Fonesca that show how businesses, politicians, and public figures hide their assets in offshore shell companies to avoid paying taxes. In 2017, the European Parliament debated about how some member countries made it easier for corporations to avoid paying taxes, arguing for a more transparent EU-wide tax policy.
Tax avoidance and aversion in the United States is tied to slavery in the American South. Present-day colorblind federal tax policies that undermine working-class communities of color have deep historical roots in debates about whether enslaved people were property or persons.
Jerusalem, We Are Here is a digital storytelling project about the Kotamon neighborhood in Jerusalem from which Palestinians were expelled in 1948. An instance of participatory mapping, the project raises ethical questions about collecting sensitive and painful data, and how that data lives on in a digital public space.
Anthropologist Deborah Thomas writes about the decade-long project Witnessing 2.0, using archival material for reparative accountability in Jamaica. This book (2019) scaffolds the project's stakes by tracing how rebellious Black bodies were expelled and disciplined from life and the archive since the 18th century.
The Opportunity Index was developed in 2011 by non-profit Child Trends the Forum for Youth Investment to index communities on basis of their educational, economic, health, and other community-related indicators. The grade of C- hides layers of historical disadvantage in the region.
This visual originates from a Harvard-led (Wu et al. 2020), investigating the relationship between exposure to PM. 2.5 and COVID-19 mortality in the US. After the onset of the pandemic in spring, St. John Parish, Louisiana saw one of the COVID-19 highest death rates in the country (Kasakove 2020); in August, the Louisiana Department of Health reported 1,1442 cases and 92 deaths.
Kimberly Terrell, Outreach Director at the Tulane Environmental Law Clinic, further analyzed the data on request of the environmental justice group Concerned Citizens of St. John. Terrell particularly looked into the significance of underlying conditions. In her final report, Terrell notes low diabetes and high obesity rates. However, she emphasizes that the number of COVID-19 deaths in St. John is much higher than in parishes with similar obesity rates (Terrell 2020).
From a distance, you see a white mound rising over green fields. 960 acres and 960m tonnes of radioactive phosphogypsum, moving 0.7 inches per day. Owned by the fertilizer-producing Mosaic Company, the stack is located in St James Parish. Residents through their activist organization Rise St James have been alerting Louisiana's Department of Environmental Quality (LDEQ) for years about Mosaic. The Guardian reports that if the stack falls, those tonnes of waste would seep into nearby communities and remain there for millennia.
Meanwhile, company spokespersons deny claims that the stack is moving. Mosaic even proposed vaporizing gypsum and releasing it into the air.
Wilma Subra, an environmental scientist, has been helping and organizing vulnerable communities in the Mississippi Delta by documenting and archiving the health effects of toxics for decades.
This map was developed by the City of Santa Ana to visualize the census tracts in the City that were considered environmental justice communities. The City made this map using CalEPA's data tool CalEnviroScreen 3.0, a census tract is considered an environmental justice community if its cumulative CalEnviroScreen score ranks above the 75th percentile. This map was created in May of 2020 and has since changed due to improvements in data.