Box 4-4 Living Is for Everyone, Nogales, Mexico
Nogales, Arizona, a community located on the U.S.-Mexico border, has fewer than 30,000 inhabitants. Population statistics are uncertain for Nogales, Mexico, immediately across the border, with estimates ranging from 200,000 to 350,000. A significant portion of the city on the Mexican side lacks electricity or running water. On the Mexican side, there is considerable industry, known as the maquiladoras.
A curtain of smoke or haze surrounds the city. The committee learned that this stems from discharges from manufacturing plants and from large-scale burning at dumps. Aside from these airborne transmissions of pollution, the people of Nogales live near an arroyo.* Emissions from a specialty resin plant nearby the arroyo send fumes to the areas where some of the largest clusters of systemic lupus erythematosus have been found.
Living Is for Everyone (LIFE) is a community-based clinic that began in 1991 when natives of the area shared their suspicions that an unusual number of residents were being diagnosed with serious diseases: systemic lupus erythematosus, multiple myeloma, leukemia, and other types of cancer. This led to a grassroots or lay epidemiologic study conducted chiefly by reviewing the death records of inhabitants of the city, noting the cause of death, and mapping areas where the deceased had resided. Death certificates were obtained from local funeral homes, and a map delineating the locations of diseased people was constructed.
The information obtained by these residents gained national attention. Some hoped that it would result in better health care; others worried about the bad image that it conveyed and the potential for damage to tourism. The committee was told that Arizona officials initially denied that there were any cancer cases in the area during the period because none appeared in the state registry. It was soon discovered, however, that the state's reporting system did not include Nogales. A later study by the University of Arizona confirmed the basic findings of the LIFE study, finding that the incidence of multiple myeloma from 1989 to 1993 was 2.4 times the expected rate; the systemic lupus erythematosus rate was 94.5 per 100,000 residents, compared with the highest published rate of 50.8 per 100,000. As a result, state and local governments and the local universities have provided support to LIFE and have become involved in monitoring the population.
A good example of participatory research that is applied to environmental justice issues is COEP, which was discussed earlier in this chapter. COEP is based in the Mount Sinai Environmental Health Sciences Center in New York City. The aims of this program are geared toward education: (1) increasing the numbers of students from underrepresented minority groups at the high school