The Devil they Knew: Chemical Documents Analysis of Industry Influence on PFAS Science.

Background: Per-and polyfluoroalkyl substances (PFAS) are a class of widely-used chemicals that persist in the environment and bioaccumulate in humans and animals, becoming an increasing cause for global concern. While PFAS have been commercially produced since the 1940s, their toxicity was not publicly established until the late 1990s. The objective of this paper is to evaluate industry documents on PFAS and compare them to the public health literature in order to understand this consequential delay. Methods: We reviewed a collection of previously secret industry documents archived at the UCSF Chemical Industry Documents Library, examining whether and how strategies of corporate manipulation of science were used by manufacturers of PFAS. Using well-established methods of document analysis, we developed deductive codes to assess industry influence on the conduct and publication of research. We also conducted a literature review using standard search strategies to establish when scientific information on the health effects of PFAS became public. Results: Our review of industry documents shows that companies knew PFAS was "highly toxic when inhaled and moderately toxic when ingested" by 1970, forty years before the public health community. Further, the industry used several strategies that have been shown common to tobacco, pharmaceutical and other industries to influence science and regulation - most notably, suppressing unfavorable research and distorting public discourse. We did not find evidence in this archive of funding favorable research or targeted dissemination of those results. Conclusions: The lack of transparency in industry-driven research on industrial chemicals has significant legal, political and public health consequences. Industry strategies to suppress scientific research findings or early warnings about the hazards of industrial chemicals can be analyzed and exposed, in order to guide prevention.

COVID-19 and the political geography of racialisation: Ethnographic cases in San Francisco, Los Angeles and Detroit.

The COVID-19 pandemic has overwhelmed health systems around the globe, and intensified the lethality of social and political inequality. In the United States, where public health departments have been severely defunded, Black, Native, Latinx communities and those experiencing poverty in the country's largest cities are disproportionately infected and disproportionately dying. Based on our collective ethnographic work in three global cities in the U.S. (San Francisco, Los Angeles, and Detroit), we identify how the political geography of racialisation potentiated the COVID-19 crisis, exacerbating the social and economic toll of the pandemic for non-white communities, and undercut the public health response. Our analysis is specific to the current COVID19 crisis in the U.S, however the lessons from these cases are important for understanding and responding to the corrosive political processes that have entrenched inequality in pandemics around the world.

Water insecurity and psychosocial distress: case study of the Detroit water shutoffs.

BACKGROUND: Water insecurity poses a significant global challenge to health and development. While the biophysical and economic impacts of inadequate water and sanitation are well documented, the complex emotional and social tolls of water insecurity are less understood- particularly in the global North. In this article, we advance understandings of the psychosocial dimensions of water insecurity in Detroit, MI, where an estimated 100 000 households have been disconnected from water and sanitation services since the city declared bankruptcy in 2013. METHODS: A community-based participatory research study was conducted among residents of a local food pantry. A culturally relevant measure of water insecurity was developed through ethnographic engagement, then administered alongside the Kessler Psychological Distress scale. RESULTS: Our models reveal a substantial, statistically significant effect of water insecurity on psychological distress. Additionally, financial stress in paying for water and sanitation produces significant distress, even independent of water supply status. CONCLUSIONS: Curtailing water and sanitation access has complex, intersecting effects, including implications for community mental health. Rapidly rising utility rates across the USA, in the context of growing poverty, underscore the urgency of addressing this issue. The present study is the first we know of in the USA to examine the relationship between water insecurity and psychosocial distress.

Mobilizing Health Metrics for the Human Right to Water in Flint and Detroit, Michigan.

The ongoing water crises in Detroit and Flint, Michigan, offer dramatic cases of retrogression in realizing the human right to water-particularly striking in a region that enjoys access to one-fifth of the world's freshwater and a country that has historically enjoyed near-universal access to water and sanitation. Efforts to secure safe, sufficient, affordable, acceptable, and accessible water in these cities reveal a troubling inability to protect the human right to water through legal measures. Compounding the challenge is the lack of reliable government data on the scope and impacts of the water crises-a void that residents have organized to fill. Activists have engaged a number of citizen-led research projects to demonstrate the health impacts of unsafe and unaffordable water. This paper discusses the process and potential of such projects to advance the substance of the human right to water in the United States, considering their effects within and outside the law. These research efforts have significant methodological and legal constraints with respect to widespread water insecurity, exposing a serious vulnerability in communities' ability to protect drinking water and public health in the United States through legal means. However, drawing on Amartya Sen's theory of human rights, I elaborate the extra-juridical powers of human rights, emphasizing their power to galvanize action and articulate ethical demands. Citizen science is a powerful mode of engaging residents in the articulation-and quantification-of those human rights demands, as I demonstrate with local cases.

Protecting Urban Health and Safety: Balancing Care and Harm in the Era of Mass Incarceration.

This paper explores theoretical, spatial, and mediatized pathways through which policing poses harms to the health of marginalized communities in the urban USA, including analysis of two recent and widely publicized incidents of officer-involved killings in Ferguson, Missouri and Staten Island, New York. We examine the influence of the "broken windows" model in both policing and public health, revealing alternate institutional strategies for responding to urban disorder in the interests of the health and safety of the city. Drawing on ecosocial theory and medical anthropology, we consider the roles of the segregated built environment and historical experience in the embodiment of structural vulnerability with respect to police violence. We examine the recent shootings of Eric Garner and Michael Brown as the most visible, most circulated symbols of this complex and contradictory terrain, focusing on the pathways through which theories of causality authorize violent and/or caring intervention by the state. We show how police killings reveal an underlying and racialized association between disorder and deviance that becomes institutionalized and embodied through spatial and symbolic pathways. If public health workers and advocates are to play a role in responding to the call of the Black Lives Matter movement, it is important to understand the interpretations and translations of urban social life that circulate on the streets, in the media, in public policy, and in institutional practice.