How fixing air pollution closes lifespan disparity gap amongst Shelby County communities | Opinion

As a pediatrician, mother, native Memphian, Health Director, and Health Officer of the Shelby County Health Department, I knew that when I chose to dedicate my career to advancing public health in my hometown, it would not be easy finding equitable solutions to deeply ingrained issues where race and economics intersect.

It is well-documented and researched that enhanced resources, including education, money, healthcare, social support, housing, and neighborhood quality produce better health outcomes.These social determinants of health affect the quality and length of an individual’s life throughout the life span. In Shelby County, one of these determinants, neighborhood and built environment, will require a higher level of scrutiny and investment to achieve equitable health outcomes through a focus on environmental health.

The Shelby County Health Department’s 2022 Shelby County Commission District Health Profile report outlines the scope of health disparities in our county between 2015 and 2020.  These disparities are most starkly illustrated by life expectancy at birth in Shelby County.

While overall, a baby born in Shelby County in 2020 will live about 72.3 years, Non-Hispanic African American babies have a life expectancy of 69.2 years compared to 76.1 years for Non-Hispanic White babies born in the county the same year.  Much of this seven year difference by race can be explained by differences in the social determinants of health, or in simpler terms, by differences in the conditions in which people live, work, worship, and play.

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Shrinking the gap

One does not have to drive far to note the vast differences in the living conditions between Shelby County zip codes. Still, our community, through a health equity lens, must do more to account for and combat the lifespan disparities, acknowledging that many African Americans living in Shelby County, live in neighborhoods such as those found in South Memphis, with legacy chemical plants, transportation terminals, and other sources of environmental pollution and foul odors that lower the quality and length of life for thousands of Shelby County residents.

Located in South Memphis at 2396 Florida Street, Sterilization Services of Tennessee uses ethylene oxide (EtO) to sterilize medical equipment for the medical device manufacturing industry. Over half of all medical devices in the United States are sterilized with EtO. According to the Greater Memphis Medical Device Industry, 2022 Economic Impact Analysis Overview by Younger Associates, 18,762 jobs were generated and supported by the medical device industry, representing 3.4% of all jobs in Shelby County. Total wages for direct and indirect jobs are estimated at $1.5 billion annually, with the medical device industry sector generating approximately $50 million in local taxes. Sterilized materials help reduce the number of hospital-acquired infections, which is another significant public health risk.

The Centers for Disease Control and Prevention estimates that hospital-acquired infections cause more than 100,000 deaths in the U.S. annually. Preventing such infections is good for everyone in our community. But it should not come at the cost of the health of nearby residents.

EtO is a widely used chemical regulated by the U.S. Environmental Protection Agency (EPA). When inhaled, EtO is estimated to be 60 times more toxic to children and 30 times more toxic to adults than previously known by the EPA--linked to an increased risk of breast, stomach, and blood cell cancers. While the local sterilization facility is near densely populated residential areas like Mallory Heights and Longview Heights, it is important to note that the company complies with all current federal, state, and local regulations.

But, just as important is that the EPA's new findings suggest that the existing standards governing EtO emissions are not strong enough to protect communities like South Memphis from "fugitive emissions" where EtO leaks or escapes into the air during sterilization operations. EPA is now revising its EtO regulations to protect communities better.

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How to create better air quality

Shelby County Health Department has the legal authority to enforce existing EPA regulations under the Air Quality Act (1967)/Clean Air Act. As a result, SCHD regulates 129 industries that meet the definition of major sources of pollutants and 250 minor sources of pollutants. When businesses violate Clean Air Act standards, SCHD acts as an enforcement agency, as it did in 2021 when it shut down Planters Gin at 171 West Mallory Avenue for operating without an air quality permit, a clear violation of the Clean Air Act. Once new federal EtO regulations are in effect, SCHD will ensure they are enforced locally.

SCHD has also requested a Public Health Assessment and Health Consultation from the federal Agency for Toxic Substances and Disease Registry and is in the final stages of completing a contract for the first county-wide cancer study. SCHD is working closely with the EPA to ensure the concerns of Shelby County residents are considered in the pending revision of EtO regulations.

Additionally, SCHD had its first informational community meeting March 28 6 p.m. to 8 p.m. They presented residents with EtO facts, information, and an update on Health Department actions to address the issue.

The residents of the neighborhoods surrounding Sterilization Services of Tennessee already face more than their fair share of adverse health, social, and environmental conditions compared to many other parts of Shelby County.

They should not have to worry about an invisible threat in their air.

Michelle A. Taylor, MD DrPH, MPA is the Director and Health Officer of Shelby County Health Department

This article originally appeared on Memphis Commercial Appeal: How to fix life expectancy disparities amongst Shelby County communities