摘要：The authors invoke a population health perspective to assess the distribution of environmental hazards according to race/ethnicity, social class, age, gender, and sexuality and the implications of these hazards for health. The unequal burden of environmental hazards borne by African American, Native American, Latino, and Asian American/Pacific Islander communities and their relationship to welldocumented racial/ethnic disparities in health have not been critically examined across all population groups, regions of the United States, and ages. The determinants of existing environmental inequities also require critical research attention. To ensure inclusiveness and fill important gaps, scientific evidence is needed on the health effects of the built environment as well as the natural environment, cities and suburbs as well as rural areas, and indoor as well as outdoor pollutants. CREDIT FOR DRAWING attention to the unequal burden of environmental exposures borne by communities of color and impoverished places goes to the grassroots activists—largely women—who first raised concerns about potential health effects. 1 In 1962, Rachel Carson helped mobilize mainstream environmentalism in the United States with the publicity surrounding the publication of her book Silent Spring, a salvo against the indiscriminate use of pesticides. 2 The environmental justice movement, however, developed from a civil rights tradition and is often dated to the 1982 protests staged by residents of Warren County, North Carolina, over a PCB (polychlorinated biphenyl) dump. 3 In 1994, as a result of the political activism of affected communities, President Bill Clinton signed Executive Order 12898, requiring federal agencies to identify and address disproportionately high and adverse human health or environmental effects of their programs, policies, and activities on people of color and impoverished communities in the United States and its territories and possessions. 4 Here we invoke a population health perspective in an attempt to provide a better understanding of the distribution of environmental hazards according to race/ethnicity, social class, age, gender, and sexuality, as well as their implications for health. While this framework has been applied more commonly in Canada and Europe than in the United States, it is particularly useful “for thinking about why some people are healthier than others as well as the policy development, research agenda, and resource allocation that flow from it.” 5 We focus here on recent scientific evidence that addresses the complexities surrounding environmental equity and health issues, methodological advances, and research implications for population health in the United States. We end by identifying critical gaps in the understanding of the distribution and determinants of environmental hazards among population groups and the need for scientific research to elucidate the resulting health effects.
