An environmental justice framework for understanding neighbourhood inequalities in health and well-being

A theme in neighbourhood effects research that has gained a lot of attention has been how neighbourhood contexts can play a role in individual health outcomes. This chapter charts the long history of investigations into the links between health and place and highlights the deficiencies in many of the previous studies. Crucially, much of the previous work has focused on a deficit model of health, suggesting that the majority of problems can be solved if the individuals knew more about the consequences of their actions, the so-called informational deficit approach. This approach suggest that with greater knowledge, individuals would modify their 'suboptimal' behaviour and thus reduce the health related problems, such as obesity, that they faced, ignoring the wider social, economic and political context. As a counter point, a key development in this chapter is the promotion of an environmental justice framework. Building on the concepts of spatial justice this approach makes direct links between health inequalities and the socio-economic distribution of harmful pathogens and salutogens across neighbourhoods. One aspect that has received a lot of attention has been the link between poor health outcomes and air pollution and the levels of pollutants tend to be higher in socially deprived neighbourhoods than elsewhere. However, the idea of environmental justice extends beyond that of air pollution and can also encompass the provision (or otherwise) of green space, water quality, noise environments as well as environmental events such as Hurricane Katrina. Literature from the social sciences consistently demonstrates that low income, vulnerable individuals are at the greatest risk of excessive exposure and lower resources to cope with and respond to the problems posed by these factors.