Commentary on community-engaged epidemiology and abolitional possibility with a case study on aluminum worker health

Abstract

This collaborative project addresses the possibilities and limits of occupational epidemiology in supporting struggles for environmental justice through a case study of aluminum smelting. We focus on illness and toxic exposure among Black workers and their families in Badin, North Carolina, a primary aluminum smelting plant site for Alcoa, in operation from 1915 to 2007. We conducted two quantitative analyses—one documenting disparities in work exposure trajectories, and one comparing mortality rates among workers to those in the general population. Supplementing these conventional epidemiological methods, we developed a third approach in collaboration with community members: an open-ended household survey designed to gather qualitative data regarding former workers’ job histories, medical histories, and concerns related to toxic exposures and discrimination at the smelting plant. This approach was conceived in response to residents’ questions about disparate health outcomes of toxic exposure in the workplace. The current occupational epidemiology literature published about aluminum smelting does not reflect concerns voiced by community collaborators regarding the extent of harm caused by occupational exposure to toxins, nor does it include analyses of race or gender disparities due to discriminate labor divisions. We argue that despite the discipline’s history of efforts to address health inequities, contemporary occupational epidemiology is limited in its methodological capacity eliminate health disparities rooted in structural racism. We illustrate how such a method may both broaden the scientific knowledge base and support organizing towards developing an abolitional approach to epidemiology.