Q&A WITH DR. DEJARNETT, Christina Lee Brown Envirome Institute, on her recent contributions to an upcoming 2022 book entitled, “Improving Women’s Health Across the Lifespan.”
Q: Dr. DeJarnett, your chapter in “Improving Women’s Health Across the Lifespan” is entitled, “Avoiding Risky Substances and Environmental Exposures.” Why is it important to consider environmental exposure when considering women’s overall health?
A: Toxins in air we breathe, the water we drink, and the soil that grows our food can harm health. Therefore, I believe environmental health should be important to everyone. From childhood, we have different developmental stages where exposures could impose short- and long-term health consequences. However, women have unique stages in our lifespan where exposures can have a greater burden, including childhood, adolescence, preconception, pregnancy/lactation, and menopause.
Q: What inspired you to take on environmental health challenges in your career? What inspires you today?
A: When I attended graduate school, I had the great opportunity to investigate a health conundrum that had plagued me for decades. I investigated why my well-controlled asthma would flare up when I visited my family in Birmingham, AL. Through this community health assessment, I discovered that the North Birmingham neighborhood where my grandparents lived, where my parents were raised, was historically home to numerous industrial polluters that contributed to poor air quality and soil contamination, and there are numerous environmental injustices that persist there today. These exposures were associated with higher chronic disease risk that this predominantly African American community currently faces. We all deserve clean air to breathe and safe water to drink, and this experience made clear just how important that is and how inequitably distributed dirty air can be across our communities. Further, it gave me my quest to give voice to those rendered voiceless, and that quest continues to inspire me today.
Q: How does the health of our air, water, and soil play into overall health for women? Are there other major factors that should be considered when assessing women’s health?
A: In toxicology, we have a saying that the dose makes the poison. This is absolutely true in a general sense; the amount, duration, and frequency of our exposures influence the toxicity of environmental hazards in our air, water, and soil. Nonetheless, there are additional factors that influence our susceptibility, including age, height, weight, nutritional status, pre-existing illness, as well as exposure route, but sex is also a key factor influencing our body’s response to toxins. We share in the chapter how exposures can affect women uniquely across different stages in our lifespan demonstrated through reproductive and gynecologic health outcomes, including age of menstruation onset, fertility, pregnancy, lactation, and onset of menopause.
Q: Why it is important to consider all forms of health when assessing women’s health? What considerations should we make for equity/justice in this evaluation of women’s overall health?
A: It is important to consider the biophychosocial differences experienced by women when evaluating potentially adverse health effects because these factors provide a more comprehensive view of sources of hazardous exposures, and they differ across the lifespan. During the different stages of women’s lifespan, adverse exposures can be more or less toxic. In addition, there are social and cultural characteristics that influence our exposures as well as our residential proximity to hazards. For example, consider that some personal care products used by women and girls contain phthalates, chemicals toxic to our endocrine system. A number of these hazardous personal care products have advertisements directed toward girls and women of color. Further, foods may differ by culture, leaving some women more or less exposed based on dietary factors. In addition, in some cultures, women may spend more time in the home and may have higher burden of exposure to indoor air quality factors like household cleaning products or cooking-related emissions. Environmental justice permeates all aspects of public health. Therefore, it is critical to keep equity and justice central in how we assess exposures across women’s lifespan.
Q: What is the single most important thing for women to know about ways to limit their environmental exposures at home?
A: I am pleased that we were able to offer several strong recommendations in the chapter regarding women’s exposure to air, water, soil, personal care products, plastics, and equity and justice. Among these, what I think is most important for women to know is that there is a wealth of information available online to help inform and guide personal decision-making. For example, using EPA’s Air Quality Index will empower women to make informed decisions based on local air quality levels, and The Environmental Working Group hosts a webpage and app includes a large database that describes potential toxins in our cosmetic products. Through resources like these, knowledge can be transformed into health protection, and thus, power.