1. Chemical Exposure, Obesity and Diabetes in Communities of Color and Low Income Communities Presentation to the Chemicals, Obesity and Diabetes Conference By Mark A. Mitchell M.D., MPH Mitchell Environmental Health Associates October 14, 2011

2. Chemicas Obesity and Diabetes Conference October 14, 2011 2 Thanks to the sponsors Environmental Health Strategy Center Colby College Environmental Studies Program and Goldfarb Center for including this important topic

3. Chemicas Obesity and Diabetes Conference October 14, 2011 3 Conflict Declaration I Have No Commercial Interests in Products or Services Presented

4. Chemicas Obesity and Diabetes Conference October 14, 2011 4 Overview I will present: Definition of environmental justice Definition of environmental justice Link between EJ and obesogens Link between EJ and obesogens Prevalence of obesity in Blacks and Latinos Prevalence of obesity in Blacks and Latinos Chemical exposures in Blacks and Latinos Chemical exposures in Blacks and Latinos Increased vulnerability factors Increased vulnerability factors How low income people can decrease risks How low income people can decrease risks

5. Chemicas Obesity and Diabetes Conference October 14, 2011 5 What is Environmental Justice? The U.S. Environmental Protection Agency defines Environmental Justices as: The U.S. Environmental Protection Agency defines Environmental Justices as: ”The fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.” ”The fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.”

6. Chemicas Obesity and Diabetes Conference October 14, 2011 6 What is Environmental Justice? Continued Fair treatment means that no group of people, including racial, ethnic, or socioeconomic group should bear a disproportionate share of the negative environmental consequences resulting from industrial, municipal, and commercial operations or the execution of federal, state, local, and tribal programs and policies.” Fair treatment means that no group of people, including racial, ethnic, or socioeconomic group should bear a disproportionate share of the negative environmental consequences resulting from industrial, municipal, and commercial operations or the execution of federal, state, local, and tribal programs and policies.”

7. Chemicas Obesity and Diabetes Conference October 14, 2011 7 Environmental Justice is About Health Environmental Hazards Disproportionately Located in Low-income and Black and Latino Neighborhoods Environmental Hazards Disproportionately Located in Low-income and Black and Latino Neighborhoods Contributes to Health Disparities Contributes to Health Disparities Environmental Injustice is Institutional Racism Environmental Injustice is Institutional Racism EJ is about Stopping Environmental Injustice and Changing Environmental Policy to reduce Health Effects EJ is about Stopping Environmental Injustice and Changing Environmental Policy to reduce Health Effects

8. Chemicas Obesity and Diabetes Conference October 14, 2011 8 Point Source Air Pollution Emissions in Connecticut 2000

9. Chemicas Obesity and Diabetes Conference October 14, 2011 9 What Does Environmental Justice Have to do With Obesogens? High and disproportionate exposure High and disproportionate exposure Increased vulnerability Increased vulnerability Probable increased effects Probable increased effects

10. Chemicas Obesity and Diabetes Conference October 14, 2011 10 (*BMI 30) White non-Hispanic State-specific Prevalence of Obesity* Among U.S. Adults, by Race/Ethnicity, NHANES 2006-2008

11. Chemicas Obesity and Diabetes Conference October 14, 2011 11 (*BMI 30) Hispanic State-specific Prevalence of Obesity* Among U.S. Adults, by Race/Ethnicity, NHANES 2006-2008

12. Chemicas Obesity and Diabetes Conference October 14, 2011 12 (*BMI 30) State-specific Prevalence of Obesity* Among U.S. Adults, by Race/Ethnicity, NHANES 2006-2008 Black non-Hispanic

13. Chemicas Obesity and Diabetes Conference October 14, 2011 13 (*BMI 30) Hispanic State-specific Prevalence of Obesity* Among U.S. Adults, by Race/Ethnicity, 2006-2008 White non-Hispanic Black non-Hispanic

14. Chemicas Obesity and Diabetes Conference October 14, 2011 14 Prevalence of obesity, by region and race/ethnicity, 2006-2008 Blacks had the highest prevalence, followed by Hispanics, and Whites Blacks had the highest prevalence, followed by Hispanics, and Whites For Blacks For Blacks − Overall prevalence of obesity—35.7% − Prevalence ranged from 23.0% (New Hampshire) to 45.1% (Maine)

15. Chemicas Obesity and Diabetes Conference October 14, 2011 15 Summary (Cont’d) For Hispanics For Hispanics − Overall prevalence of obesity—28.7% − Lower prevalence was observed in the Northeast For Whites For Whites − Overall prevalence of obesity—23.7% − Higher prevalences were found in the Midwest and South

16. Chemicas Obesity and Diabetes Conference October 14, 2011 16 Common Environmental Justice Issues Linked to Chemical Policy Land and Solid Waste Pollution Landfills and Dumps Landfills and Dumps Brownfields Brownfields Hazardous Waste Hazardous Waste Abandoned Storage Drums of Chemicals Abandoned Storage Drums of Chemicals PCB’s in Soil PCB’s in Soil TCE Contaminated Soil TCE Contaminated Soil Air Toxics Trash, Sewage Sludge and Other Incinerators Trash, Sewage Sludge and Other Incinerators Indoor air contaminants Indoor air contaminants Water Contamination Chemical and Pharmaceutical Sewage Contamination Chemical and Pharmaceutical Sewage Contamination Fish Contamination with PCB’s Fish Contamination with PCB’s Sewage Sludge Compost/Pellets Sewage Sludge Compost/Pellets

17. Chemicas Obesity and Diabetes Conference October 14, 2011 17 Common Environmental Justice Issues Linked to Chemical Policy Industrial Pollution Refineries Refineries Chemical Plants Chemical Plants Plastics/Rubber Factories Plastics/Rubber Factories Pharmaceutical Plants Pharmaceutical Plants Industrial or Chemical Fires/Explosions/Spills Industrial or Chemical Fires/Explosions/Spills Local Business Toxins Cement Kilns Cement Kilns Agricultural Pesticides Agricultural Pesticides Toxic Release Inventory (TRI) Listed Facilities Toxic Release Inventory (TRI) Listed Facilities

18. Chemicas Obesity and Diabetes Conference October 14, 2011 18 Common Environmental Justice Issues Linked to Chemical Policy Consumer Product Exposures Discount Store Selling Toxic Toys Discount Store Selling Toxic Toys Home Pesticides Home Pesticides Cosmetics/Personal Care Products Cosmetics/Personal Care Products BPA in canned food and drink containers BPA in canned food and drink containers Lead in tire weights Lead in tire weights Legacy lead in paint Legacy lead in paint

19. Chemicas Obesity and Diabetes Conference October 14, 2011 19 Ethnic Cosmetic Toxicants Hair relaxers: sometimes contain placenta (linked with early puberty in children, toddlers) Hair relaxers: sometimes contain placenta (linked with early puberty in children, toddlers)

20. Chemicas Obesity and Diabetes Conference October 14, 2011 20 Exposure Over the Chemical Lifecycle Production Production fenceline exposure, maintenance fenceline exposure, maintenance Transportation and storage Transportation and storage accidents, fires, spills accidents, fires, spills Use Use canned goods, lead tire weights canned goods, lead tire weights Disposal Disposal incinerators, landfills (LBW) incinerators, landfills (LBW) Legacy Legacy PCB’s, DDT, lead based paint PCB’s, DDT, lead based paint

21. Chemicas Obesity and Diabetes Conference October 14, 2011 21 Vulnerability Malnutrition Malnutrition Lead absorbtion Lead absorbtion PBT’s PBT’s Psychosocial stress Psychosocial stress Income disparity Income disparity

22. Chemicas Obesity and Diabetes Conference October 14, 2011 22 What Can Low Income People Do? Wash fruits and vegetables to reduce pesticides Wash fruits and vegetables to reduce pesticides If they can’t eat organic, then low-fat foods, especially milk, meats and eggs If they can’t eat organic, then low-fat foods, especially milk, meats and eggs Look for hormone and antibiotic free meat and eggs Look for hormone and antibiotic free meat and eggs Don’t microwave in plastic containers or allow plastic wrap to touch hot food Don’t microwave in plastic containers or allow plastic wrap to touch hot food Look for BPA-free plastic water bottles and baby bottles Look for BPA-free plastic water bottles and baby bottles Don’t buy PVC plastic containers Don’t buy PVC plastic containers Eat fresh, frozen, or glass bottled rather than canned foods and drinks Eat fresh, frozen, or glass bottled rather than canned foods and drinks Join organizations that work on chemical policy Join organizations that work on chemical policy

23. Chemicas Obesity and Diabetes Conference October 14, 2011 23 Summary Defined environmental justice Defined environmental justice Link between EJ and obesogens Link between EJ and obesogens Higher obesity rates in Blacks and Latinos Higher obesity rates in Blacks and Latinos Higher chemical exposures in Blacks and Latinos Higher chemical exposures in Blacks and Latinos Increased vulnerability factors Increased vulnerability factors How low income people can decrease risks How low income people can decrease risks

24. Chemicas Obesity and Diabetes Conference October 14, 2011 24 Contact information Mark A. Mitchell M.D., MPH Mitchell Environmental Health Associates mmitchell@enviro-md.com (860) 794-9497

25. Chemicas Obesity and Diabetes Conference October 14, 2011 25 Table. Prevalence of obesity, by region and race/ethnicity, 2006-2008 Non-Hispanic white Non-Hispanic black Hispanic Total Both sexes Both sexes23.735.728.7 Men Men25.431.627.8 Women Women21.839.229.4 Northeast Both sexes Both sexes22.631.726.6 Men Men25.026.526.9 Women Women20.036.126.0 Midwest Both sexes Both sexes25.436.329.6 Men Men27.032.129.7 Women Women23.840.129.2 South Both sexes Both sexes24.436.929.2 Men Men26.332.628.3 Women Women22.540.629.7 West Both sexes Both sexes21.033.129.0 Men Men22.134.127.3 Women Women19.832.030.4