A Social Vulnerability Framework to Identify and Assist With Environmental Injustice

ABSTRACT

t is well established that socioeconomic and demographic factors, such as race and ethnicity, income, and education, are independently linked to health disparities.1 Tools that combine multiple socioeconomic and demographic variables into an overall rank, such as the Centers for Disease Control and Prevention (CDC)/Agency for Toxic Substances and Disease Registry (ATSDR) Social Vulnerability Index (SVI), provide a quantitative framework that can be used by policymakers to identify communities that have higher overall social vulnerability with regard to disparate health outcomes and living conditions across multiple factors, and to develop targeted interventions.2 Historically, the SVI and similar frameworks have been crafted for emergency preparedness and response and used for study and practice in more extreme natural and human-caused disaster scenarios. Over the years, the SVI has been used for public health research and practice, communications, and accessibility planning, and to target geographically specific interventions related to natural disasters such as flooding and hurricanes,3, human-caused events such as chemical spills,2 and disease outbreaks like the recent COVID-19 pandemic.4 However, addressing issues of health inequity attributable to environmental injustice is imperative, and should not be restricted to alleviating the impact of event-specific hazards. Environmental injustice in the built environment is often associated with the disproportionate placement of hazardous and industrial sites and polluting transportation infrastructure in socially vulnerable neighborhoods,5 where residents often lack the social or economic capital to influence policy decisions.6 Although existing research links housing and health equity,7 the impact of poor housing conditions and household exposures to lead, pests, and indoor air pollutants on the health and well-being of socially vulnerable populations is an important and often overlooked aspect of environmental injustice.7,8 The Environmental Protection Agency's definition of environmental justice is all-encompassing and espouses the idea that environmental justice is only achieved when "everyone enjoys The SVI has already been used outside the realm of disaster management to better characterize obesity10 and physical fitness.11 Hollar et al. set a new precedent for the value it may bring to the environmental justice sector, and additional research should be done to understand its utility in identifying communities that may be more likely to experience other socially linked conditions associated with environmental injustice, such as routine exposure to indoor and outdoor environmental pollutants, chronic disease burden, poor working conditions, lack of greenspace, and other issues with the built environment, in addition to housing conditions.