 Hello, everyone. Welcome back. This session is entitled A Dialogue on the Exposom and Population Health for Environmental Justice. I am Dr. Chandra Jackson, an environmental epidemiologist and investigator at the National Institute of Environmental Health Sciences. I'm delighted to serve as the moderator for this much needed and exciting conversation. We have a fantastic set of expert panelists and the purpose of this particular session is to identify frameworks and approaches across the entire spectrum of the research enterprise that can help us not only advance the science of environmental justice, but also actually address health inequities over the next 10 years. And so regarding the structure of this session, the panelists whose bios are on the workshop's web page, they've been asked to provide background on their research and their perspectives on this topic in just five minutes. And we will spend the remainder of the time in dialogue surrounding a particular scenario related to environmental justice that I'll describe after the brief introductions. I will incorporate questions from the audience during the conversation, so please at any time feel free to leave a question in the Q&A box, either directed to an individual or to the entire panel. And with that context, we will start with the five minute introductions with Dr. Aisha Dickerson, who is an assistant professor at the Johns Hopkins University. Dr. Dickerson. Thank you, Shandra. So, as was mentioned, I'm an assistant professor in the Department of Epidemiology at the Bloomberg School of Public Health, but my research focuses on environmental risk factors for neurological disorders, primarily neurodegenerative and neurodevelopmental disorders. All of this started with a passion to provide children with the opportunity at a successful future, regardless of the background that they were born into. The issue with all of that, however, though, is that we are exposed to a variety of environmental toxicants every day, not just at home but also in school and at work and this is across the life course. In my work, I started just looking at the general population but what I realized early on is that there are areas, especially areas with marginalized populations and low income communities that experience these exposures at a much greater rate. So I started to focus my research within these groups. It's important, though, when we're thinking about how to handle environmental justice, that we focus on solution-oriented procedures and that those solutions are research-based. So I don't even really need five minutes. I think there are plenty of people who have a lot more to say and I don't want to take any time away from them. Thank you, Dr. Dickerson. Dr. Warris has not been able to join us yet, so we'll move on to our next speaker. And so Dr. Robert Wright, he's a professor at the ICON School of Medicine at Mount Sinai and he will introduce his research background along with perspective. Thank you, Chandra, and thank you for the organizers for inviting me. Bob Wright, I'm a pediatrician, I'm a medical toxicologist, epidemiologist, and environmental scientist, and most recently I started writing a blog, so I guess a blog or two, so I wore a number of hats. I'm the PI of a Human Health Exposure Analysis Resource Targeted Lab. This is part of the NIH's really largest exposomics program. So I run the lab that does the targeted assays at Mount Sinai. I'm also a P30 core center director. And more recently, I joined the CTSA at Mount Sinai, we're the late of the exposomics and precision medicine function. This is a module that's designed to give educational workshops to both community members and to academics on learning about environmental health and how to incorporate it into clinical medicine. This is a new initiative that we started here, and I've been the PI of a longitudinal birth code in Mexico City for the last 15 years as well. My primary interest is how to introduce environmental health into clinical research, but also how to use exposomics to discover the underlying patterns of exposures that actually drive health inequities. I think that's all the time I need. Thank you very much, Dr. Wright. Our next speaker is Dr. Sikobi Wilson. He's an associate professor at the University of Maryland College Park. You'll now introduce his research background along with perspective. I'm sorry for joining a little bit late. So, I'm Sikobi. I'm a full professor now. Officially, I think it'll be soon at the University of Maryland College Park. Happy to be here today. So I am an environmental scientist. I've been doing environmental justice for a while, been doing environmental justice work for about 25 years. I direct the Center for Community Engagement, Environmental and Health. So at the heart of what we do is in, like to say empowerment science, doing science to put the scientific tools into the hands of the people, doing science to other people for the people and body people. And the idea is that there's a lot of extractive colonial science has been done as one of my commitments was to say guinea pig science and I don't support a guinea pig science, pay look up the science. We want to liberate folks from toxic trauma from the sacrifice zone. So I do a lot of work trying to address environmental racism because environmental racism is the driver behind a lot of environmental justice, environmental class. And so what we try to do is really get at the root causes, but do applied action oriented solution science. And so a lot of work is using the community base pieces or research framework. I'm editing, editing chief of the journal environmental justice. We actually have a special issue out now. I own liberation science. I'm also a member of the EPA scientific policy board, a former member of EPA's national program that's a positive channel so former member board member community campus partners for health. And also currently a board member citizens association so a lot of folks of our works are really around community science and making sure that that the science has real impact when it comes to the research topics that work on do a lot of work and helping to build and monitor networks, because the EPA monitor networks are not really monitoring where pollution is. And so we have monitors monitors from Chevrolet, Maryland with building out monitors that monitor networks in New Jersey and software, we're going to focus Savannah working and folks that are in Utah, Alabama, also in Charleston do a lot of work around plummet chains and stormwater issues. Do a lot of work building a mapping tools screen tools like Marilyn EJ screen, do a lot of stuff. So I'll stop talking but really about doing research for action and research for solutions so thanks for having me. Great. Our next and final speaker if Dr. Waris has not joined us as Dr. Amizota, and she is an associate professor at George Washington soon to be Columbia University, and she'll also provide her research background along with perspective. Thank you for the invitation and I also don't need five minutes I think a lot of the themes of my work have have been covered by the other panelists but broadly, as mentioned I'm an environmental health scientist, currently at George Washington University, open school public health and starting June 1 I'll be a Columbia University mailman school public health and environmental health sciences and I run the arise EJ lab, and our mission is to help secure environmental justice and improve health equity through advancements and science policy communication and training the next generation leaders. So hopefully I think one of the themes that we're going to be talking about is doing good science is not enough to actually move us towards justice and equity, we have to do something with the science. And that takes work that takes innovation that takes community engagement it cannot be an afterthought. Some of my research right now looks at social structural stress factors, I'm thinking a lot about intersectionality so how do we integrate systems of power and impression, especially their impacts on the lives of people and communities into environmental health sciences, both into identifying modifiable risk factors as well as solutions. And I'm also equally. And so I do that work. I look at how racism and sexism shaped beauty culture consumer product use chemical exposures, and the health of women and children across the life course. I'm equally committed to science communication research translation and training scientists from historically excluded backgrounds. And in 2019 I created the agents of change in environmental justice program, which seeks to empower environmental justice leaders from historically excluded backgrounds in science to reimagine solutions for just and healthy world. So our program agents of change seeks to increase diversity in environmental climate sciences spur innovation in environmental science and policy and increase accessibility of scientific information. And for those communities that have historically been and currently are left out of decision making. So I will, I will stop there and I'll turn it back to you. Thank you, Dr. Sota and the rest of the panelists for the brief introductions. Regarding the scenario that's up for discussion. It's important that the audience knows that we've asked the speakers to consider that in Eastern Carolina there are largely African American residential communities located near swine industrial livestock operations, and they've been producing air pollutants, including distressing odorant emissions for decades now. And these communities are experiencing poor health outcomes including clusters of cancer and neurodevelopmental disorders. And so we know that there are tools available like the cumulative impact assessments we've discussed earlier in the workshop. And so we can leverage them to assess the most common types of cancer and chronic diseases. We also have a central database with comprehensive information on biomarkers of dietary chemical and population pollution exposures, and this accessible to the public. So a task force has been formed, including policymakers and environmental scientists in hopes of working with the community to develop a plan for full remediation. And so keeping in mind that the purpose of this session is to identify the most useful frameworks stakeholders and approaches. And it's great to start the conversation by having speakers walk us through the most potentially impactful and currently available approaches across the entire spectrum of the research enterprise. And that's from bench science, such as toxicology but also population health, including implementation science. And so again the purpose is to advance efforts for full remediation. And note that the next question will actually be related to what will be available in the next 10 years. So would anyone like to start off the conversation and please use the raise hands function. I'm going to go ahead and share a copy Wilson. I couldn't find a raise hand function so I'm just raising my hand. So I'll start off and I'll try to. Let me be good here. So, I did my dissertation on industrial hog farming in North Carolina. So this is very much in my, why am I up here twice do you ask me twice. Okay, I see myself twice. Okay, sorry. So, so I did my, I did my dissertation on industrial hog farming. So there's been a lot of research done on the air quality impacts of these operations on human health. The other work that's been done by Dr. Steve wing, who's known with us has been going for about 6 years now, but he did that work looking at exposure to ammonia hydro sulfide and the impacts as least to immune function. And also irritation also is a throat using case case control studies, also work of his students looking at asthma differences between children who go to schools their whole case versus children that do not. And also looking at issues of impacts for occupational exposures and families when it comes to Mercer as well. So you've had, you've had some equity studies done, you've had exposes on this studies done microbiomic studies done that's the best way to say that. And also other types of innovative environmental assessment studies have been done even with the looking at what equality impacts to. So just to just to pass the mic and say, I'm saying there's a lot of work that's been already done on the assessment side. I think the need is on the solution side. Where's the science and places I said actually intervene when it comes to sustainable regenerative agriculture, when it comes to look at the impacts of animal husbandry and what's happened to the animals. And also when it comes to other issues now that you have emerging issues with bio biogas facilities not even want to capture the main thing from the Lagoon systems to use that for energy, which leads to more entrenchment of the industry and not actually addressing the long term problem of that particular industry in the communities and also they're starting to grow both chickens and hogs on the same farm. It's not smart that is, but there needs to be some research on that because of the whole issue of, you know, viruses and bacteria jumping from animals. So, I would say research on that is more research there needs to happen. And also more research on the policy intervention side because I would say, I'm not a community member, but they will say well we've had a lot of research. Where's the, where's the solutions where the solutions are so I'll pass the mic. So Dr. right across the entire research spectrum, are there opportunities to advance. I'd be happy to go next I think Dr. Dickerson is actually next. He had it up before me. Oh, well, you also lifted your hand. Before me though. So Dr. Dickerson, please. Thank you very much, Dr. right so just thinking about the approaches that are available now versus what we had a few years ago I was just explaining to a student during a meeting earlier today that now we can actually look at mixed exposures I think one of the biggest issues with looking at environmental exposures and adverse health outcomes is that people look at one thing at a time. The lead is it the noise is it the older. And so with these newer techniques, we can look at co occurring and joint exposures there are a lot of statistical methods like quanta G computation where we can actually look at a collection of exposures and try to pick out a priority for what we should go for first so when I think about how to make a policy change is hard to just go to a politician and say. We need to fix everything we know that everything is bad but when you're trying to explain to someone where money needs to be allocated to make a change is better to try to pick out a priority and with these new methods that we have we can actually pick out a priority not only can we do that we can pinpoint what particular exposure coming from those hog farms has the biggest impact so when you think about industry the first thing they'll say is it's not us doing it it's the McDonald's that you're eating and it's those pipes is not the hog farm but if you can use these methods to point out that yes it is the hog farm then that makes a stronger argument when you're trying to to clean up those areas. I'll get a little more into trying to prevent them from placing the hog farm there in the first place, but I'll wait till we get further in the discussion and I'll pass on the doctor right. Excellent. So, roughly 20 years ago I got involved in a Superfund site in Oklahoma. And, you know, it's actually closer 25 years ago and I was very young and very naive and I went out there for the first time to an EPA meeting, and I started out with the thought well of course they want the Superfund site cleaned up. And I was actually kind of astonished by the mixture of opinions, and it wasn't until afterwards I started to realize there are a lot of people who make their living off the activities that created the Superfund site. And some of this was tribal land so this was some of this was actually Bureau of Indian Affairs fault they lease the land to a mining company. But a lot of tribes were also using the mining waste, and there were financial issues and I think one of the things I've learned over the years is you have to factor in that nothing is ever unanimous and that there's going to be competing voices. And we do need to listen to them. I'm certainly not advocating for not cleaning it up, but we're going to have to factor in that there will be factions so to speak within the community that may actually not even be for the cleanup for whatever reason Superfund sites have a lot of financial and economic impacts on the community, including, you know, loss of income in terms of property values and there were actually a faction in this community that didn't want in order to have the clean up you have to be labeled a Superfund site. And it would be nice if there were ways around that, because once you're labeled a Superfund site property values plummet, and there's an economic impact across the community. And there's also a feeling of isolation because you know who's going to buy my house I live in a Superfund site. And, and there's all these social aspects that come to it and actually one of the things we tried to study was the social impact of being a Superfund site or a site where there's toxic waste because the kids who live there, the other towns when they would go play them and say a basketball game, they were called chat raps because mining waste is chat. And so there was actually a stigma attached to actually being at living at this site, and there were assumptions that these kids were not going to be smart when they grew up and we're never going to college and it became almost this sort of conclusion that I think a lot of these kids had, and I don't have a great answer to this, but I do think it's something we have to consider, because sometimes we go in guns blazing saying we're going to clean up without really listening to all the components of the community and what their, what their concerns are. Now, I'll stop there. Hi, thank you so I'm just going to take us in a slightly different direction. As so Coby had mentioned, you know, we have a lot of data characterizing harm in these communities, and that this data actually goes back quite a long ways I mean I actually trained with Wayne, who took me to Eastern North Carolina as an undergraduate I won't tell you how long ago that is don't need to date myself but it was a while ago so that you know the evidence on on the conditions there and their impact on the health and wellness of, you know, minor ties for black and brown communities, you know, is well established so I think where we where we could, where we could use more scientific rigor is, how do we take that evidence and that information and translate it to effective action. I think we think we know how to do this but we actually don't have evidence based practices right and I think that that shows in the fact that even if you look at kind of the body of community based participatory research and this was the subject of a review done and published in HP by researchers at University of Arizona I think last year, you know, in terms of how many of them have moved the needle on systemic change. And it's very few right and there's a lot of barriers to that including funding, you know the kind of the cycle of our grants etc etc but. So I still don't think we have best practices evidence based practices on how to take the information we're generating and leverage it to create action and change. And because there's a myriad of strategies one is, you know, empowering those people that are living in the area to use the information to advocate for change. Another is, you know, doing an educational campaign focused on local policymakers or health professionals I mean there's, there's a wide range of things that one can do around, really around translating the science that we're doing to, you know, to kind of create change but I think we just kind of shoot from the hip, as opposed to kind of trying to take an evidence based approach to this and I do see an opportunity here for kind of implementation science. And, you know, I was part of that workshop that NIH has organized I think in February focused on implementation science, especially for health equity and EJ. You know, I think there are some tools there that that can help us and from what I gathered in the implementation science world, a lot of what they still study our interventions at the individual level, like changes in diet and behavior and exercise. And there's still some work to be done and kind of adapting those tools towards kind of studying the efficacy of policies and policy change. But I think there are some kind of promising and new opportunities there. Thank you. Considering promising and new opportunities. When we're considering leveraging emerging multi on the tools I wonder about your thoughts regarding using them to further advance the cumulative risk assessments that we discussed earlier in the workshop. I envision without being the expert in this area, being able to one day use omics to open up what was the black box and epidemiology to link exposures to the downstream health effects and in particular individuals or communities which could really serve as a powerful tool in terms of environmental justice because then it could make the case in terms of legislation litigation even and regulation. And so I wonder your thoughts about the opportunities or challenges related to multi omics advancing cumulative risk assessments that we've heard are already so powerful. I'll tell me real quick. I will make a couple, couple points. So I mentioned real briefly early that I'm on the EPA science advisory board and we did have a cumulative impacts discussion at our last science advisory board meeting. And just I wasn't able to participate in the workshop earlier so I apologize that I'm going to make a quick point. I think in general when it comes to our science. Our science is not keeping up with people's exposure. So when you think about environmental justice as your priority today, folks have been exposed to multiple stressors and multiple agents across multiple media cost multiple pathways. So they have omics to be succinct to provide to, as you said, address that that gap. I think it's very, very important whether it be as less accumulated exposure. We have the tendency to conflict the terms to risk or cumulative impact. They are different, but they're related. Right. So I think that's important. And they go back to the North Carolina example. There were several lawsuits in the past three to four years where folks who live near the hog farms, one their lawsuits. Now, previously they use tort law. As well as the trespass of the gas is right and nuisance right trespass of the waste been sprayed on their yards on their homes. You know, the way they won the lawsuits, they were able to show that through omics or through microbiome. They were able to show that DNA of bacteria in the gut of the hogs was found on the top of their table in the house was found in the kitchen was found on the floor was found in the bathroom. Right. So they were able to win based on that kind of data. Okay. So I think that's, there's power there. If you look at other issues, if you're able to bring in omics and as Dr. Zoda mentioned from evidence based approach, I think this is a powerful way to fill in that gap as relates to cumulative risk. And then what we'll say is to back to the EPA and some other agencies, you need to be included in this type of information into your cumulative risk assessment. Right now, the EPA does a poor job of cumulative risk assessment. And I think Dr. Dr. Dickinson said earlier, as a single compound my compound beyond like pesticides, when they've American population they've done a little bit more in cumulative, but the cumulative assessment work when EPA has it been great. So I like to say is if you can use risk assessment which has, you know, you have, you know, you have uncertainty factors. Why can't you do in cumulative we could have been using cumulative risk assessment. But I think the omics can help fill the gaps there, and then getting back again to North Carolina example and go to Dr. Zoda's point and I'll pass the mic. I think one of the things that I think about the systems of the the challenges and barriers. You have a right to farm act. That's a challenging barrier. You have industry relationships with politicians North Carolina, which is a challenging barrier. You have a hog from owners on the board and you see Chapel Hill challenges and barriers, right. And we actually have some real political challenges that can impact that ability that have impacted ability to actually address that problem in North Carolina. And I think with the new dollars from the infrastructure bill as relates to addressing some of the legacy pollution. To me, industrial hog farming is a legacy pollution issue. How can that money be activated in North Carolina to address the legacy pollution from industrial hog farming. I think that's a big question and also, and also is a big opportunity. I'll pass the mic back. Awesome. Dr. Right. I was going to make a different point first I wanted to echo something Dr Wilson said in our previous study in Oklahoma EPA reading six actually tried to shut us down, because they weren't happy that we were doing research there because they thought we were in cahoots with a community group that they didn't appreciate. But the actually to talk about omics, the omics that I think we sometimes forget about is phenomics. Earlier today, you know, when I saw Dr sheets speak Nikki sheets. He talked about community of impacts and and community of exposures, but you a lot of times we do these studies we get very focused on the risk assessment for cancer the risk assessment for some other disease, without considering that, you know, you can have an exposure cause actually multiple diseases. And also the disease itself can be part of the pathway for example, if exposure is an obesity and the obesity causes diabetes the diabetes calls heart disease. If there's lead that can cause hypertension hypertension causes heart disease that we tend to study the diseases as if they're independent of each other. What I really like to see is risk assessments that stop parsing out the disease, and instead of saying well there's only this much cancer well there's this much cancer there's this much heart disease is this much diabetes, and then, and the community number of cases actually can be more easily or more statistically powerfully related to the exposure than any individual disease so I would actually urge us to create methods to think about the links between these diseases and the exposures and not think of the diseases as being independent we think of the exposures as mixtures, but in fact, the outcomes are also mixtures but we rarely think of them that way. That's awesome Dr Zeldsum. Just a couple of points to, I think, to build off one I mean one from a regulatory perspective right so can kind of these earlier perturbations that, you know that pre maybe pre clinical perturbations that are, you know, we're more well equipped to pick up with with exposome measures, you know how can they make the like how can we integrate those into the regulatory process because right there has been a lot of resistance to that and just resistance to using human epidemiologic data in the regulatory process, especially through EPA so I think there there's an opportunity there. Also wondering, you know, is there ways to integrate exposome measurements into our intervention studies. You know, whether those are, you know, you know, looking at policy interventions, lifestyle intervention, you know, changes in industry practice that I think that could be another powerful set of data. I think one thing that I think we need to show caution about when it comes to exposome studies as they become right there's so molecular that it can it tends to kind of individualize the situation right it's a lot of focus on what's going on in the individual and so then I think there has been less kind of connecting factors let's just say like structural racism or residential racial segregation with exposome measures and so be, and it's very hard to do right to think about these kind of multi levels multi scalar approaches in in kind of one set of studies but I mean if we don't I think we can end up pathologizing black bodies, you know, putting more emphasis on these kind of lifestyle factors just because they're easier to measure and and to couple with kind of exposome measures, then kind of some of the social structural factors and. And so we published a piece last year called the intersectionality exposome, where we're kind of pushing the field to, to think about critical frameworks like intersectionality which is kind of more been used and you know the social sciences psychology in kind of use more and kind of qualitative data to find ways to kind of marry that with kind of our ideas of the exposome. Great, thank you, Dr. Dickerson. One of the things that I didn't mention when I introduced myself, unfortunately is that I used to work at the EPA. I used to work on those cumulative risk assessments it was only for a year. Before I realized that that wasn't the best use of my time but as somebody who has worked on those assessments, one of the biggest issues that I noticed with trying to do a cumulative risk assessment was publication bias. We were really only bringing in a bunch of papers that were published and if someone's paper wasn't published because it had a smaller sample size or because you know the results weren't necessarily sexy, then we didn't get to include it in our risk assessment. The other issue was that a lot of these papers focus on these point exposures. So if you were exposed last year, do you have the disease now? And we know, especially with the exposome, that a lot of toxicants can store in the body. Not only in the food, but they store up in the bone and in the fat. So when you think about lead for an example, lead can store up in the bone for decades. And so, you know, it's hard to look at outcomes 30 years later based on what a child was exposed to when they were two years of age. I think that's one of the greatest issues with environmental justice is that when people remove an exposure, they think, great, we fixed it, it's done. Now you can leave us alone, right? But just because you moved, removed lead pipes or because you got rid of a hog farm, the damage is already done. The fat is already stored in the bone and when a woman is pregnant during her third trimester, those toxicants will remobilize. When someone ages, as the bone begins to metabolize, it'll also remobilize and all of those things can cause more insults, not just when someone is exposed but much later in life. And I'm hoping that we will have the tools to better investigate those kinds of life course exposures for cumulative risk assessment. So Dr. Dickerson, you just mentioned a lot of the complexities that we're all concerned about familiar with and you've also mentioned at the start of your response that you didn't want to waste your time. And so I'm wondering if, if there are opportunities for the tools and approaches we've already discussed to address and inform primordial or primary prevention instead of continuing to investigate these sort of consequences of these clearly adverse exposures and illuminating biological mechanisms. I wonder if we can start to think about, well, what are the environmental and social conditions necessary to support optimal health? That is the definition of health equity. I find that definition to be sort of inspirational and instructive. And so instead of spending our limited energy on delineating all of these complexities that really stretch the human brain beyond its capacity, what can we be doing? Or how can we leverage these technologies and opportunities to inform primordial or primary prevention with primordial prevention being considered avoiding the risk factors from developing in the first place? And that question is open for anyone. I mean, I think that highlights the importance of team science, not necessarily team science, but teams in general. So we can't just pump out all of this research. You have to work with people to make sure that that evidence that you find is disseminated, not just the politicians, but also the community members that once that evidence is disseminated, we try to address how to fix it. I can see Dr. Wilson wants to say something. Is it all my face, Dr. Dickinson? I'm too obvious. I cannot play poker. Go ahead. I'm sorry. No, no, I want you to go ahead because you need to get it out. You say it. He's so bad. My face is so bad too. No, I was just when you asked that question. Thank you, Dr. Dickinson, that I'm so, I applaud you for giving passing the mic to me. So we asked the question, Dr. Jackson. I think that's the point. That's the question. I, as someone who admitted I do empowerment and liberation science, communities I deal with are kind of tired of some of the stuff that we've been talking about to be honest. Clean the air, clean the water, give people access to safe food, safe housing. Empowerment science, liberation science, anti-nationalism talks about salute genesis, hyperbolic health, well-being, and quality life across all dimensions of the environment. Systems approach, built environment, natural environment, economic environment, political environment, social environment, spiritual environment. So the folks I work with, they would say that's where the work should be. That's where our federal dollars should be invested in instead of trying to get, send what's wrong with our genes. Leave our genes, draw our genes. Leave genes, whatever genes you want to talk about. We're community folk. Like they're saying, we need to shift from where we're talking about here. We need to do more on human impact, just keep a little risk. But when it comes to real, they want to see solutions science, action science, change science. In my signature, it says the people's money should be used for the people's research to get to the people's solutions. They want solutions, y'all. And so, and part of the future casting, we need to be casting about solutions, about systems, about creating healthy community ecosystems. And so I could go on and on, but that to me, that's the, that's the place where we send more time on. And in the volumetric model, I appreciate a lot of this, but that's not what folks want. Reductions is not what folks want to hear about. They want to hear about how you, you address the problem. Dr. Zoda alluded to it. She mentioned that. She said it. So when we're going to get to these solutions, folks, talk to any EJ folks, talk to any folks dealing with these cumulative exposures. And if this is not about investing in solutions, real change, then they're saying we're not doing enough. And we're not doing enough. And we're still having the same old conversation. I'll stop. Thank you. Thank you, Dr. Dixon. You saw my excitement. Dr. Wright. I like what so Kobe just said, I think in the end, it's about clean water, healthy food, clean air, and good schools. And if you give people that quite frankly, maybe you don't even need to clean up the hog farm because if people had that, they'd be resistant to whatever the hog farm was doing. And it's, and those are the issues that never seem to change, but those are the most important issues. Great. Any other comments? Okay, so we're now getting into the one more thing. Yeah, I would just say, I mean, I think. I think, you know, she Kobe said it very well. And, and so I don't think there's that much more to add, but I just wanted to say, you know, I think there are some inspiring researchers that are really trying to do solutions oriented research that we can learn from and thinking about like Dr. Dr. Eugenia South and Philly, who's doing all this great work in cleaning up lots and vacant lot lots and actually connecting it to reductions and gun violence. And so I think also thinking more expansively around, you know, when we do these solutions oriented projects or efforts on like, you know, the positive ripple effects right so thinking aspirationally about, you know, kind of what, you know, what kind of health equity could really look like what that vision of health equity could look like. So, so I, you know, I found that work really aspirational because probably if she had told people that cleaning up vacant lots would have an impact on gun violence, I'm sure so many people probably told her that, you know, that is irrational. But, you know, she's done the work she showed with quantitative data, you know, these impressive outcomes so and I think kind of having those visionary models takes, you know, having strong conceptual models systems based approaches that that have to be informed by the communities that we work with they have to lead that work. And I even think in when we in our kind of conceptualization of the exposome, right which is really in its broadest sense the totality of exposures across the life course. I mean that also should be informed by, you know, community engagement the communities that we're working with I mean, I just think about the hog farms and, you know, odor is such a huge issue right a huge health effect quality of life issue. And probably for a lot of researchers that wasn't something that came came to mind as something to study but you know was born you know came from from from talking to to impacted community so even I think our notion of the exposome. You know there need there's room for a lot more bi-directional communication there. Just to just to add in going with Dr. Zotis was saying just a positive exposures to me think about exposure science. The solution is this is about positive exposures. So when it comes to solutions how we're talking about, we talk about cumulative impacts, but usually we talk about the cumulative impacts in terms of negative impacts. I think that's an important part of the of the work that we need to, we need to kind of, it's part of the future casters part of the shift. And Dr. words is not here but I think the public of expose on paper that I'm also co-op on that paper is something that they can provide some insight into some of that too so as well as your thank you Dr. Jackson. Dr. Dickerson. Just gonna make one last comment on this so I submitted a grant proposal a while ago. Also, we're trying to look at like reduction and violence reduction and as Dr. Zota mentioned, the reviewers are like no that's nonsense. So it's important that if we're trying to find these solutions based projects that we kind of need some buy in from the funding agencies. And from the reviewers who are looking at the grants for these funding agency so we just kind of need a bit of a paradigm shift on where the funding is going because as an academic. I have to find my own salary now yes we can we can hope that health departments can try to mitigate some of these things but when you're thinking about just rigorous research, a lot of times that does come from academic institutions and we need the funding to back. These solutions based projects. Awesome response thank you. And so we're going down the line of considering all the challenges, and I can't help but think about how acquiring data is insufficient to affect change and certainly political will on a number of levels is often needed. And so I'm wondering the thoughts of the panelists regarding how we can garner political will to take on these environmental justice issues with a greater sense of urgency. So considering how data is often enough we can think about Coronavirus pandemic and there's some recent data that was published suggesting that once folks realize that COVID was disproportionately affecting a minoritized groups, then concerns were less. They call restrictions but really protections were lessened and people have reduced empathy. And so this is a part of the social conditions that influence what is prioritized and what is not. So I'm wondering if anyone has thoughts, centering around how we can garner greater political will in order to advance environmental injustices research in efforts. So, I think coalition building is really, really key to this right because when, when, when you can kind of, you know, mentally when people say that's not my problem right then, then they're less likely to be invested in solutions. And so I think kind of building coalitions and kind of helping kind of make the case of why, you know, lead, you know, in water in drinking water is a problem for everybody over multiple kind of powerful stakeholders is really important and kind of, I can give one example from my work when I was a postdoc at UCSF working on chemical flame retardants, they were particularly elevated in California and homes and people, and a lot of it had been linked back to these, you know, old furniture flammability managers, which weren't evidence base, which you know was really because the chemical industry and the tobacco industry were in cahoots. They didn't have fires were because people were smoking indoors but they're like let's try to make the furniture less flammable and they started putting weapons in that migrated out of the furniture and into the dust and into people's bodies and then, and you know there were many attempts to change legislation and, you know, I provided informational testimonies so many times that went nowhere and it wasn't until, you know, a coalition was developed and included firefighters so they were really, really key powerful advocates, right they were kind of like an unlikely ally health professionals children's health advocates. We also kind of did a lot of work to get at you know, EJ organizations on board because you know these flame retardants were were higher in black and brown children, and we knew that the flame retardants really had adverse impacts on children's health and also making the case for like, here is a way to protect the health and development of all kids. And it was, you know that that that coalition was was really powerful and, and also engaging with the media so that is also why I constantly come back to this communication translation thing because there was all this great work done but then when the Chicago Tribune did their five part series that was actually really what got the governor to change his mind. So, so I think media and influencers need to be part of this coalition, these coalitions as well. I'll try to be succinct but Dr Zoda said a lot of great stuff I want to piggyback off a few things. For example, on the coalition building that Dr Zoda mentioned, I'm a co founder of the Mid-Atlantic Justice Coalition. It's Mid-Atlantic environmental justice coalition so we have EJ groups, advocacy groups, green groups, Delaware, Maryland, DC, and Virginia. And so we've been working together as a region to try to advance environmental economic justice and put the economy back into the hands of people. And so that's part of what we've been doing. We've been, we've had a legislative work group. In 2020, the legislative work group, we worked with legislators on bills. That work group led to the refounding of the DMV EJ coalition, which we found in 2012, which is not as new coalition. Dr Zoda's point about media, I think it's very, very important. I think as y'all many of you heard me say, I'll say it for y'all, my Yota statement, PVE publications is not science communication make. No, no public, politician, no community members cares about your peer review publication. That's important for you. That's not really important for them. You're going to present your report back to community folks. It needs to be a white paper. It needs to be a data story map. It could be a fact sheet. It needs to be a blog, maybe blog, some folks like blogs. You'd be using the old media, you know, radio and TV. You can use a new media, you can use Facebook and Instagram and Twittering and tick talking, right? We got to get science communications in the hands of the way people get it, right? And knowing your audience. So I think Dr Zoda's point is very, very, you know, that's a very powerful point. And I also think, you know, you know, when you think about this moving the political groups, no politician goes to politician school. So who's talking to them? If the community members are not talking to them, they're having business and industry and other folks talking to them. So we have to have a seat at the table when we engage with policymakers. So one last point, one of the things that we're trying to do is we just released a legislative scorecard, environmentalist scorecard, the only the second one in the country. Seja has one in California to score our legislators on how they're working on environmental justice issues in the state of Maryland, how they're voting on bills. And it also we, because I built Maryland EJ screen, we also have for the legislative district with their EJ score. So then now community members can say, hey, what you're doing on EJ, you got a terrible score, but we're in a 99% on the state of Maryland, right? So that's something that folks can use to advocate around to push their legislators to do more. And also we have an agency scorecard. So we're judging not eight agencies in the state of Maryland on what they're doing is based on integrating environmental justice into their policies and programs that's going to come out next month. So that's another opportunity for community members to push their agencies on how they're addressing environmental justice. And so I just want to share those two tools as ways we can move forward about pushing the political folks and also agencies to do more. Thank you. Dr. Dickerson. Thank you. So one of the things that I always point out is that justice movements are often formed by the youth. Anybody who works on a college campus has seen how students can mobilize quickly when they want to advocate for something right. I try to convince the youth of the community that environmental justice is something that they should pick up. I've been working with a student, a Zeta Amiri, who's with one of the Bloomberg American Health Initiative fellows and she's been working in North Alabama to try to one train high school students on how to do environmental tests and then to have them work with politicians to advocate for their communities. That's one thing, but the other thing that I always point out is that you have to vote in your local elections. It's the city council officials that are the ones that are approving these licenses to build and things like that. And oftentimes when I talk to communities, they say, you know, I sent a message to the EPA. You went a little too high up. You have to stay in your community because it's better to try to work with your community politicians to keep those facilities from being built in the first place, rather than trying to go to the EPA later on to try to get them to clean up some environmental disaster even when they clean it up. You have to make sure that they don't just throw everything into a barrel and bury it in your backyard so it's better to try to attack it from the beginning. It's better to have advocates and it's, it's a little easier to get advocates who are youthful and vigorous. I agree. Dr. Wright. I just had a question really for the group. I'm too old for social media I never did Facebook I never did anything. I don't understand tick tock. And I understand that the that there's an energy in youth, and there's also the ability to connect through social media, but there's a lot of people like me. People who are older who are not very savvy at it and quite honestly are not interested in so how do we reach them. I mean I think part of this is really kind of understanding like well I'm having an idea of who are you trying to reach. And then what are the best ways to reach them. Right. And so, I think it's it, you know, there are people that kind of have this knowledge base I think traditional media is still a really powerful tool and it's like social media is almost complimentary to traditional media. And I mean like we published a paper on fast food and phthalates that, you know, was covered in Washington Post in USA today and so forth and we had to. We had a senator, I mean, Senator Feinstein's office reached out to us, and somebody in the House oversight committee reached out to us, because they read about it in the Washington Post, right. And so, I think there is still a role for traditional media for people, you know, who don't may not be on social media but I think even if you think about these policymakers, even if they're not active on social media they have staffers and research assistants and other people, you know, who you know whose job it is is to be kind of seeing kind of, you know, what things may may be trending so I think I think it's kind of helpful to really take like, be strategic about it, and really think about like what are the goals you're trying to accomplish, who are you trying to reach, and kind of what are the different ways to kind of to, you know, accomplish these goals or reach or reach your your key stakeholders. So I'll just stop there. Excellent. Yeah, just add to that. Sorry, I have to jump right back. But yeah, you got to know your audience. So one, I just had a conversation today with one of the NPR stations about doing stuff from the NPR, because some folks listen to radio. You know, they, some, some people, you know, they don't do social media. So, I think knowing your audience is very important, but my point my earlier point was, there's different communication modalities. If you're going to get to your specific audience, you didn't know your audience will enough to know which modalities that they use and what and which ways they can receive the information. So it's not just the modalities, but what are the forms of information and who are the who are the messengers to this multiple points of science communication that we have to be aware of. And I would say that that's probably as part of this future cast, as Dr. Zoda mentioned, that's probably that's one of the biggest, in my opinion, area, areas of need. And so, many of us are not trained to do good science communication when we want to get Dr. Zoda has a great program, but when did you get great science communication train do we have a science communication class. I mean, maybe we will, maybe my point is maybe we should have classes. And maybe it's not good enough to say, well, I, you know, I'll say to myself, you know, project, I'm a scientist. I published that's all I do. Well, you should be required to do more. We should be trained to do better. Right. So we can't fall back on that anymore reporting back to communities and our policy makers is a big part of I think of the responsible accountability scientists. So I'll stop there. Sorry, can I just add to that. I think, especially because this is a panel about environmental justice. We have to also do better in increasing the accessibility of our information. I mean, so one thing is just right getting it into, you know, kind of open source open access information, you know, changing the language but, you know, like, making things available in Spanish. Especially for a lot of the communities and the issues we're working with this is a big barrier. Another thing that the agents of change fellows have made me realize is thinking about disability. Right. So, like with our podcast, we now, you know, provide text for all the, you know, for all the audio translations, just with an eye towards inclusivity. And so I think when we're talking particularly around issues of EJ, we always have to think about, you know, who are we ignoring or and who are we leaving out or who else could benefit from this information. I think that's where I was getting at. I worry that social media is sort of analogous to multi omics. We, you know, these really fancy high, you know, I run a here lab. These really fancy high throughput, you know, high dimensional assays are the bright shiny object everybody wants to do. And then I worry that in, you know, science communication, social media is the bright shiny object and it leaves certain people behind. I think about my mother who passed away recently, I could never reach her by social media I tried desperately to teach her how to use Skype so I could have a video call with her and it never worked. And I don't know what the right answer is, but there is a generation of people for whom technology is very, very difficult my mother was an immigrant as well so language was also a barrier for her. So there are just, you know, there are so many issues that I worry that we leave people behind because they're not part of social media. Okay, so, you know, I'm going to take us back to considering all the opportunities across the entire research spectrum and I'm curious to know in the next 10 years. What are the most pressing research opportunities and actions that would help the expose on advanced environmental justice efforts. And so what can scientists do now or within the next 10 years that would be of maximum benefit. Just in general, as I said earlier in my introduction, I'm a fan proponent community science. So training more community scientists, I think it's going to be really important, particularly from an environmental justice perspective. Principles five and seven, you don't know, you don't know the 70% of environmental justice. I'm just going to talk about principles five and seven self determination communities engaged in all stages, you know, decision making. And so to me, we may need to make sure that folks are they have their own scientific tools they can do their own research right exposure research so training more community members who come from frontline fence communities who have these issues, whether it be traditional or non traditional training, whether it be two year college for your college getting degrees, or just community training programs. I think that's what we need to have more folks who actually had lived experience contextual experience being trained and and value that to experience those community cultural models systems and network driving the work we do, because that don't be focused will be really interested in solutions. I come from community that with a landfill was so what you're going to plant right with a hallway. There's other folks I know who come from these communities. These folks will be really into doing the rigorous the best science and getting to the best solution so I think that's what we need to be going. Great. I think the future has a lot of opportunities as well for community based research I think sensors are going to be a big part going forward I think community sensors I think we're both devices letting people crowdsource orders and and noise pollution in their neighborhoods. I think mapping is getting a lot easier. You don't have to be a programmer to create maps and you can probably go to a library and actually start to create maps using EPA I think we can train folks on how what the resources are and what the software is they need to make maps so they can see where the pollution is in their community we can see the air quality and the water quality data in their communities I think I think that's what the future is going to be. I think you know it's actually going to be much easier, I would argue, for communities in the next five to 10 years, as long as we do our role in helping them, pointing them in the right direction to how to use these tools and how to acquire these tools because the tools are getting more and more sophisticated at some level but they're also getting easier to employ at other levels so it is it is becoming, I think a more just world in that way so hopefully that's what I hope is going to happen next five to 10 years. Excellent point I actually have spent a lot of time wondering why we haven't leveraged apps like that the neighborhood apps that many people have already connected to to communicate with policymakers or other decision makers regarding what issues there might be in local communities because they could be fixed quite readily if they're identified by community members who are constituents of the individuals who want to remain in a leadership position. I'm like low hanging crude and currently a missed opportunity to take action, and perhaps researchers could evaluate the effectiveness of that sort of approach. And so Dr Wilson were you going to. Yes, I was going to respond to your question thank you you set me up well so I'm going to connect two things. This is great discussion I got three I'm triple book right now so I suppose being like two other meetings right now right like 230 I'm supposed to be doing this. I just out called my blog counts what you just said Dr Jackson, we get very granular data and going back to Dr writes comment to connect a couple points very granular data at the block level. So the idea is you can you can be used as part of the decision support tools to say almost like a 411 this is what's going on my community when we have eight to 10 different categories around infrastructure housing, you know, food, you know, schools also social disorders, etc. And so we're building this app out and then the app will be connected to Dr's rights point, it'll be connected to Maryland each screen so we better geolocate this data and having maps at the block level. And this is a quick for our Maryland agent screen tool when it gets updated and released in a couple months, it will be the you better map in great human impact, you just scores at the track level block group level block level let's live this level in school district level. Plus we have this block data. Plus going back to Dr right point we also build a hyper local air quality monster numbers Dr right so we have a real time air quality interface in our mapping tool too so you have the block data and air quality data in the tool. And so this is one app that we're developing. We're also developing other apps around Park Access, Park Equity Mapping, a tool that we have, we're building an app for that and we're building apps related to other types of apps as well. So I think this tool is something that we're getting funding from Environmental Defense Fund and some other sources. It should be, it should roll out in a couple of months, but I'm really excited about the tool. And I think it's something that can be really useful to communities collect, and it's very easy to use y'all. So I'll talk more about that, but thank you Dr. Jackson for that question and I'll stop talking because I'm excited about that too, but I'm passing my mic back, thank you. Awesome, Dr. Dickerson. Well, my thought is you only know what you need. So I tell students that all the time, a lot of times you think you know a lot until somebody tells you something else. It's like, oh, I didn't even know I could do that. And what I found is when I do community panels and things like that, a lot of people have no idea what publicly available resources there are just to figure out what's going on in their communities. A lot of people don't know about the EPA's EJ screening tool. There's a tool that one of my colleagues at Johns Hopkins, Jamie Magigrano has developed and I think is really just the importance of spreading information in a helpful way. If we learned, well, we learned a lot from COVID. Let me not say if we didn't learn anything, but one of the things that we learned from COVID is that you have to be able to disseminate information and able for people to educate themselves. In addition to just publicly available resources, a lot of people are unaware that you can test your own water. You can usually get those kits for free from your local health department. And I'm always advocating for letting people know where they can get access to air pollution data. So there are a few community based air pollution monitors that have been placed around Baltimore City, specifically by Kirsten Kohler. And she's providing access to this air pollution data is just a matter of who knows it. And so I just want to harp on the importance of spreading awareness of resources. There are a lot that people are just not aware of and maybe social media is the way to do that or media, the regular media as well. So Dr. Souther. Yeah, I'm just, I think building on what Dr. Wright and Dr. Wilson were talking about, it seems like, I mean, I completely agree with Dr. Wilson that community led science is, it's, I think it's the way that it has to be done and there's a lot of work to be done and there's a lot of kind of promising tools that are emerging to one that still seems to be lacking, right? We're having this, the whole point of this panel is the expo zone is there's not really easy ways for communities to actually do biomonitoring or measure biological markers that we're talking about. And so a lot of the sensors and a lot of the kind of tools right now available, are useful for air monitoring or knowing kind of what industries are near in your neighborhood or even noise monitoring, but when it still comes to kind of what becomes biologically embodied, those assays are really expensive and out of reach. And so I think that is kind of a barrier that somehow needs to be addressed to kind of fully realize the community science model. And because that data can be so powerful and gets you closer to disease which kind of has impact for a lot of people in decision-making. The other thing I just wanna say about kind of why community science is so important and community-led science is so important is because I think one thing we haven't really talked about that COVID has showed us is that there is a lot of distrust in scientific and medical institutions. And actually this seems like it's almost going in the wrong direction, right? It seems like almost that kind of the distrust and skepticism of these institutions is increasing as we've seen with the vaccine rollout. And I think part of this is, you think about black and brown communities, there is historical and contemporary, I mean, exploitation at times by scientific and medical establishments. And I think also a lot of people just don't see themselves reflected in these institutions and they feel very removed from these institutions. And so I think if we also invest in community training, scientific programs and engage them in the kind of data generation and interpretation process that it can also potentially kind of connect people back to the value of these institutions because if the general public does not believe in the credibility and value of these institutions then we can do great work, but it won't be as useful as it could be. And so I mean, I think as, I think we as scientists have to contend with that, with that more just as we have to contend with the epidemic of misinformation which nobody seems to really be talking about or trying to teach our students on how to navigate or think about this. These are kind of emerging issues that we have to kind of get in front of. Excellent, so we actually have just five more minutes left and I know Dr. Wilson and Dr. Wright wanted to provide a response. And so I'll ask you to add any commentary to your closing remarks after I asked this last question. So you might wanna integrate what you were going to say in your response to this question. So I'm wondering how we can support toxicologists, epidemiologists and so forth and moving towards a more ethical engagement with communities and have the teams that ethically advance use the emerging tools in order to advance the science. So I'm unsure if you want to respond, Dr. Wilson or Dr. Wright. Okay. I'll go ahead and jump in. Thank you for that question. I think Dr. Zoda hit on a few of the points of in regards to this question, when we're talking about partnerships and doing work with communities, I think in general, the ethics of it, you have to build relationships. What are the great agreements of relationship, trust, respect, Dr. Zoda mentioned some baggage. We all bring baggage into a partnership when you come from an academic institution, just in general, not just your individual baggage, but the university baggage. So those are things that you have to be aware of when you're trying to build relationships with communities and what you did well in one community, doesn't necessarily mean it's gonna work well in another community. So I think Dr. Zoda's point about the community science part, I think I said earlier, anybody could be a scientist. So the idea is how can we make sure we're increasing scientific literacy and trust in science by connecting to communities. I think that's part of what we have to do with the epidemiologists and toxicologists. And then in addition to that, when you think about the ethics of doing this work, you got to make it every day, you got to make it pocketbook, you got to make it proximal. You got to connect the issues you're working on, the food, faith, family, health and jobs. You got to connect to the stuff that's important to folks, okay? And so how are you connecting the omics, the technology and its use? What's the impact and utility of that work to the actual communities that are impacted by the issues? So you got to have a solutions, as part of your continuum work, you got to have a solutions piece of that work. It just can't be the discovery science that has to be a component where you have good investment engagement and good investment in solutions. So just, I know I'm talking too much, but just to kind of conclude, hopefully I can conclude the next 30 seconds or 25 seconds, I think it's gonna be important to build those relationships and put the community first, right? Your questions are important, but when it comes to environmental justice issues, meaningful engagement, principles five and seven, that has to be at the top of your kind of list of things to do to make sure those community voices are heard. If you do that and understand the baggage and build the trust and respect and have solutions, talking about solutions and application, I think that's something that will be beneficial to you, individually and also to those communities that you're trying to serve. So make sure we're doing science that serves. That's one of the other problems we're gonna make when Dr. Thilistar talked to you, reminded me. Science that serves. Okay, I'll start there, thank you. Absolutely, Dr. Wright. Hopefully my dog will be settled. Oh, sorry about that. I just will add about what do taxicologists and epidemiologists need? When I think about genomics and why it's been such a powerful force, whether or not it's been a force for change, I think it's very debatable, but it's certainly been a powerful force in science. And there was an enormous investment in giving researchers a tool to understand genomics. So there's websites like online Mendelian, oh man, online Mendelian, Heritage and Man. There's database repositories like DVGaP and Geo, and there's all kinds of resources to help you understand the data. That doesn't exist in expezomics. What I would really like to see is NIH make even one-tenth the investment in trying to understand the expezomics. And when I say the expezomics, I don't mean just the chemical, but also the physical, the social and the nutritional. And it's geospatial distribution across the United States, which will almost certainly correlate with health inequities and also life stage differences. And until we make that investment so that we actually have the tools to actually interpret expezomic data, it's gonna be really hard when you measure 10,000 things to know what's important and what's not. We have to make that foundational investment in those sorts of databases that will help us understand what it is we're measuring. That is the perfect charge to conclude this session with. I'd like to thank all of the panelists for such an excellent and informative discussion. We hope that it's translated into action in the short term. And I'd also like to thank the audience for the engagement. And so this actually concludes our wonderful session on the Exposome and Population Health for Environmental Justice. We'll actually take a break and return at 3 p.m. So we can have a dialogue on climate change and health.