Inspired by an article published in 2020 by Joy Lloyd-Montgomery MPH, who is a member of the My Green Doctor Foundation Board of Directors and a medical student at the Howard University College of Medicine
Clinicians frequently encounter troubling patterns: a child with persistent asthma, a teenager struggling academically, or a young adult with unexplained neurological symptoms. Increasingly, research shows that these conditions may be rooted not only in individual behavior or genetics, but in environmental exposures shaped by inequitable land use, housing, and infrastructure decisions.
Environmental injustice occurs when low-income communities and communities of color disproportionately bear the burden of harmful environmental hazards. A 2023 national analysis found that race remains the strongest predictor of proximity to toxic industrial sites in the United States. Children in these communities experience higher exposure to air pollution, heavy metals, and chemical residues—risks that directly influence long-term health outcomes and development.
Air pollution provides one of the clearest examples. Black children in the U.S. experience nearly double the asthma emergency department visit rate of white children. Long-term exposure to microscopic particulate matter (PM2.5) has also been linked to significantly increased cardiovascular disease risk, even at pollution levels below current regulatory standards.
Environmental risks extend beyond air quality. Millions of American homes still contain lead hazards, particularly older housing stock. Climate-driven flooding further compounds risk, especially in low-income and coastal communities, increasing exposure to mold, contaminated water, and respiratory irritants.
Environmental injustice is not an abstract policy issue—it is a clinical reality.
Clinicians are uniquely positioned to identify when illness may be influenced by environmental factors. Integrating exposure-related questions into routine care—such as housing age, proximity to highways or industrial sites, and workplace conditions—can reveal critical risks that might otherwise be overlooked.
Healthcare professionals can also play an important role beyond the exam room. Participation in local planning and zoning discussions allows clinicians to bring a health-centered perspective to community decisions. Patient education is equally powerful. Simple guidance on indoor air quality, water filtration, or safe renovation practices can reduce exposure risks immediately.
Environmental injustice reminds us that health is inseparable from place. By recognizing the environmental realities their patients face, outpatient clinics can provide more informed care and help protect vulnerable communities.
Sources & References
- Centers for Disease Control and Prevention (CDC). Asthma Surveillance Data, 2024. https://www.cdc.gov/asthma
- Banzhaf, H. et al. Environmental inequality and exposure disparities. PNAS, 2023.
- Harvard T.H. Chan School of Public Health. Particulate air pollution and cardiovascular risk, 2022.
- U.S. Environmental Protection Agency. Brownfields Inventory, 2024.
- U.S. Department of Housing and Urban Development. Lead Hazard Control Report, 2024.
- The Lancet Planetary Health. Environmental exposure and health outcomes, 2024.
