As Canada begins work on its recently passed Environmental Justice Bill mandating a national strategy to examine the link between race/socio-economic status and environmental risk, researchers to the South have been busily purging any mention of the terms “climate justice” as a result of orders from the Trump administration that such research will no longer be supported.
Landing in the middle of this bizarrely changing research policy context, we re-examined a previously published scoping review on the health effects of unconventional oil and gas development (UOGD – commonly known as “fracking”). The original review was done by some of the current authors, included 52 published papers from 2000 to 2022, and reported that most studies demonstrated evidence of adverse health outcomes, related to living proximal to UOGD. Because we had not done so in our original review, we decided to have another look at the same 52 studies to ask, “How are we doing with integrating environmental justice principles into this line of research?” The project was part of a second-year “scholar project” led by two family medicine residents.
Inequitable land-use policies are often implemented around oil and gas development, resulting in Indigenous and racialized communities being disproportionately exposed to these sites. Oil and gas development impacts community health both through increased exposure to environmental contamination and harmful social impacts such as decreased social cohesion and economic boom busts (particularly in rural settings). Populations near oil and gas sites may also have been less healthy prior to the land developments due to historic systemic and structural inequities. As such, even in cases where exposure levels are similar to non-marginalized populations, the impacts of environmental contaminant exposure may disproportionally affect these communities.
Our goal was to interrogate the original review as a case study of whether and how environmental justice principles were being integrated into health research on UOGD exposure/outcomes.
In doing so, we observed four themes.
First, few studies specifically framed their work around environmental justice principles.
Second, while most of the 52 studies in the original review included covariates that accounted for race, socioeconomic status and/or rurality in their modelling, authors for the most part provided no rationale for inclusion of these variables. This lack of rationale has been criticized by environmental justice scholars as potentially inferring attribution of disease risk to personal characteristics (for example, race) rather than the systemic and structural policy inequities driving those characteristics. Future efforts should be made to inform readers about the context represented by these data. Examples of this might be the measurement and inclusion of policy-level markers of structural disadvantage, such as real estate red-lining in the U.S., unequal access to clean drinking water among First Nations and Inuit communities in Canada, and safe waste disposal facilities in rural and remote communities to elucidate causal pathways for observed differences by disadvantaged subpopulations.
Third, we observed the absence of Indigenous populations in most articles. Only two studies included Native Alaskan and American Indian as population descriptors and neither of the only two Canadian studies measured Indigeneity. No studies analyzed disproportionality of health harms related to UOGD on Indigenous populations. This absence was rarely addressed but when a rationale was provided, small numbers represented by Indigenous people and/or the absence of available data were noted.
The exclusion of Indigenous populations based on statistical “underpowering” and small sample size inadvertently perpetuates historical erasure. In settler-colonial countries such as Canada, the systematic expropriation of Indigenous people from their land, untreated smallpox epidemics, cultural erasure through residential schools and the banning of Indigenous ceremonies and language resulted in a massive reduction of Indigenous populations. Measuring Indigenous identity is especially relevant given the markedly lower life expectancy of Indigenous people in both Canada and the U.S. when compared to all other racialized populations.
While small sample size and absence of data are real issues in quantitative measurement, researchers have a duty to acknowledge the history represented by these small sample sizes and actively advocate for data collection of Indigenous identity data controlled by Indigenous communities.
Fourth, we found an ongoing paucity of studies that meaningfully included the communities they were studying. One important exception is a study by Johnston et al that employed many facets of environmental justice and included the community (>90 per cent non-white) in the research process. The study highlighted the possibility of a more fulsome approach in which local health workers were trained in recruitment and research methods and surveys were administered in multiple languages, adapted to the community with the help of these health workers.
Although we acknowledge that not all studies can be structured to include communities through the research process, building these relationships increases the likelihood of policy change and contributes to the capacity-building of research users. Community-based approaches can provide context to the results, bring control back to communities and strengthen the evidence required for efforts to resist harmful environmental exposures. Time is a necessary component to build shared understanding with communities on data collection, data sovereignty and stewardship. This extends to understanding the types of data required for decolonial data measurement, upholding Indigenous Ecologic Knowledge, and supporting communities to lead research.
Our conclusion, based on one case look at 52 published articles on UOGD and health outcomes, is that embedding environmental justice principles in health research is a journey we have only just begun. However, with the encouragement of Canada’s newly passed Environmental Justice Bill and despite the challenging times presented by the Trump administration’s research policy direction, this journey is more important than ever for researchers to undertake.
