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date: 05 July 2022

Environmental Justice, Ethics, and Public Health

Abstract and Keywords

Environmental problems raise important issues of justice when these problems affect people’s health prospects in systematically uneven ways, when people contribute to the problems in substantially unequal ways, and when the people who are affected by the problems have not been empowered to participate meaningfully and equally in the decisions that affect their lives. This chapter shows how these aspects of justice are relevant to waste disposal, air pollution, climate change, ecological footprints, and other environmental problems. After discussing how issues of justice arise, the chapter explores the work of environmental justice: ways to articulate, guide, and justify judgments of justice; ways to articulate and foster forms of responsibility; and ways to change social institutions and individual conduct to respond more adequately to environmental injustices.

Keywords: environmental justice, health prospects, waste disposal, air pollution, climate change, ecological footprints, judgments of justice, forms of responsibility, public health ethics

(p. 728) Introduction

Human beings build houses, roads, factories, cities, and much more. They also cut down trees, cultivate crops, use antibiotics, burn fossil fuels, and much more. These changes to the built and natural environments have profound effects on human health. Because the effects on people’s health prospects are unevenly distributed within societies, between nations, and between generations, environmental changes raise issues of justice. Issues of justice also arise because people’s contributions to environmental problems are quite different. Furthermore, issues of justice arise because many people who are affected by environmental problems have not been allowed or empowered to participate meaningfully and equally in decisions that profoundly affect their lives.

This view of environmental justice is broader than the view that the United States Environmental Protection Agency (EPA) uses:

Environmental justice is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. EPA has this goal for all communities and persons across this nation. It will be achieved when everyone enjoys: the same degree of protection from environmental and health hazards, and equal access to the decision-making process to have a healthy environment in which to live, learn, and work. 

(EPA, 2018)

The EPA view includes many valuable points, including the emphasis on meaningful involvement and equal access, the concern to protect people equally against health hazards, and the aim to achieve healthy environments for all. But this view is too narrow in (p. 729) several ways. Although it addresses the distribution of health risks, it ignores how these risks vary according to gender, nation of residence, and generation. Although it mentions laws, regulations, and policies, it does not focus attention on institutions, structures, and background conditions (Rawls, 1971; Young, 2011). Although it considers participation and distribution, it ignores altogether issues of justice that arise because of uneven contributions to environmental problems. The EPA’s view of environmental justice is too narrow because it reflects a legal model of nondiscrimination rather than a robust model of social justice. This chapter takes a broader view.

Issues of Environmental Justice

While issues of justice about a wide range of environmental problems could be raised, this chapter focuses on waste disposal, air pollution, climate change, and ecological footprints. It aims to show how these environmental problems raise issues of justice, not to settle these issues with a definitive analysis. Later it includes more about the analysis and work that needs to be done to address issues of environmental justice.

Waste Disposal

People produce waste. All of us eat food and excrete waste products. Many of us buy things and throw away plastic, glass, paper, and aluminum. Some of us drive cars and dispose of old tires, and we buy new computers and dispose of old ones. Some of us provide health care and generate medical waste. And many of us depend on industries that produce mining tailings, toxic chemicals, and other dangerous byproducts.

The value, kind, and amount of byproducts have changed over time. Products that were once valued are now considered waste products. Human waste and animal waste were used extensively as manure, but when concentrated animal feed operations produce tons of animal waste, tainted with antibiotics, this waste becomes a cost and a hazard. The kind of waste that some people produce has changed as well. For thousands of years, most waste was organic material that decomposed relatively quickly. Now some waste products remain intact and hazardous for generations. The amount of waste has also increased. By 1990 the average American was producing 4.5 pounds of waste per day, up from 2.7 pounds in 1960 (Rodenbeck, Orloff, and Falk, 2010).

People and corporations have disposed of waste by dumping it into bodies of water, discarding it on land, or burning it. Each method poses health risks and raises issues of justice. A terrible example of the risk of dumping waste into water comes from Minamata Bay, Japan. In 1951 the Chisso Corporation began using mercury sulfate and ferric sulfide as catalysts at its chemical factory in Minamata (Weiss, 1996). Because the factory discharged the wastewater into Minamata Bay, methylmercury accumulated in fish and shellfish (Harada, 1972). Perhaps as many as 10,000 people who ate this seafood (p. 730) developed forms of mercury poisoning. The harm went on for many years while the Chisso Corporation deceived people, obstructed investigations, and avoided responsibility (George, 2001).

The disposal of waste on land also involves health risks and raises issues of justice. The health risks include direct exposure to toxic substances; groundwater contaminated by leachates; gases released by decomposing waste; rats, mice, mosquitoes, and flies that flourish around dumps; and traffic and air pollution from trucks that haul waste. Issues of justice arise around the distribution of these risks, the participation of citizens in decisions, and the factors that contribute to the production of wastes. Indeed, in the United States, the disposal of solid waste led to the modern environmental justice movement (UCCCRJ, 1987).

In the United States, waste sites are disproportionately located in low-income and minority communities (EPA, 2015a). This pattern raises questions about whether it is fair for the larger community to impose the health risks of waste disposal on people who are already disadvantaged. This pattern also raises issues about political power and participation. Although minority communities have often opposed decisions to locate dumps in their communities, they have struggled to get the information they need, to be heard in the decision-making process, and to be treated as political equals. If disadvantaged people and communities had more political power, and if the health costs of waste were included in the cost of production, then producers and cities would have more incentives to reduce the waste stream.

Air Pollution

In December 1952 a disaster struck London. Because the weather was unusually cold, people burned more coal. Because the atmospheric conditions were stagnant, particulate matter and sulfur dioxide remained in the air. As a result of this air pollution, many people became ill and died. Retrospective analyses now estimate that 10,000–12,000 people died from the respiratory and cardiac effects of this air pollution (Bell, Davis, and Fletcher, 2004). When a hurricane or earthquake kills 10,000 people, it is recognized as a major disaster, but air pollution rarely receives the same attention, because the ill effects are often incremental and insidious.

People contribute to air pollution by burning coal, oil, gasoline, charcoal, wood, and other biomass. The combustion of these fuels adds particulate matter, sulfur dioxide, nitrogen oxides, ozone, mercury, and lead to the atmosphere (Bell and Samet, 2010). Particulate matter exacerbates respiratory and cardiac problems. Sulfur dioxide impairs lung function. Nitrogen oxides and ozone increase respiratory problems. Mercury can enter the food chain, bioaccumulate, and cause neurological problems. Lead, which was added to gasoline for many years, can cause cancer and neurological problems.

Although all people breathe air, they are not equally exposed to and affected by air pollution. Although most people burn fuels, they do not equally contribute to and profit from activities that produce air pollution. Although most people care about air quality, (p. 731) they are not equally empowered to participate in key decisions about air pollution. These differences in exposure, susceptibility, contribution, profit, participation, and power raise issues of justice.

Consider air pollution in the United States. Some groups are more exposed or susceptible to air pollution. People who work outdoors are more exposed than people who work indoors. People with asthma are more susceptible to the ill effects of sulfur dioxide and ozone, and children are more susceptible to the ill effects of nitrogen oxides, ozone, lead, and mercury. Race, ethnicity, and income also matter. The EPA’s mapping tool shows that five of its six measures of air pollution are disproportionately higher among low-income and minority groups (EPA, 2015a). It is hard to argue that this distribution is fair, especially for the children who are affected.

Consider air pollution in China. A recent study estimated that air pollution in China contributes to about 4,400 deaths per day (Rohde and Muller, 2015). As in the United States, some groups are more exposed to pollution or more susceptible to its ill effects. In addition, some groups profit more. Because air pollution is an externality (Samuelson and Nordhaus, 2009), Chinese corporations benefit from higher profits, some members of the middle-class benefit from economic growth, and consumers outside of China benefit from lower prices. These consumers buy goods at prices that do not reflect the true cost of production. One should recall Thoreau’s ([1854] 1995, 28) definition of cost: “the amount of what I will call life which is required to be exchanged for it, immediately or in the long run.” Of course, one could argue that Chinese citizens have made a political decision to trade clean air for economic growth, but this argument depends on widespread and meaningful participation in decisions about acceptable levels of pollution.

Climate Change

Human beings are producing, in aggregate, more greenhouse gases than the natural world can absorb and recycle. In 2013, for the first time, the measurement of carbon dioxide at the Mauna Loa Observatory in Hawaii exceeded 400 ppm (NOAA ESRL, 2015). In 1959 the average measurement at the same observatory was 316 ppm, and the preindustrial level was probably about 280 ppm. The net increase in greenhouse gases is changing the earth’s climate.

This change poses serious risks to people’s health (IPCC, 2007). Heat waves will lead to deaths by thermal stress. Storms will combine with rising sea levels to produce surges that will kill or displace people, damage infrastructure, and compromise farmland. Climate change will also exacerbate a number of infectious diseases, such as diarrhea, malaria, dengue fever, and others (Patz, 2010). The largest health risks may result from the impact of climate change on water resources and food production. Melting glaciers, declining snowpacks, and persistent droughts will impact water resources that are already overdrawn in many areas (WWF, 2014).

Climate change has already affected human health in a serious way. Careful estimates have attributed between 160,000 and 300,000 deaths per year to climate change (p. 732) (McMichael et al., 2004; Global Humanitarian Forum, 2015). These estimates were based on an increase in average temperature of 0.5°C. It now seems likely that the increase will exceed 2.0°C. Of course, much of the impact on human health still depends on what people and societies do now to reduce emissions and to adapt to changes that are coming.

We are all vulnerable to the health risks posed by climate change, but we are not equally vulnerable. Because greenhouse gases are increasing and portions of those gases remain in the atmosphere for long periods, future generations will be at greater risk. People’s vulnerability also depends on their geographical location. People who live at low elevations near coasts, in drought-prone areas, and in cities where the climate is already hot will be at greater risk. People’s vulnerability depends, furthermore, on the qualities of the society in which they live. People who live in high-income and well-governed societies will be, in general, less vulnerable to the health risks of climate change, because these societies will have the resources and commitment to protect their citizens. People will also be less vulnerable in communities with high levels of solidarity, civic engagement, and neighborliness (McKibben, 2010). People’s vulnerability also depends on their relative position within society. Social determinants, such as power, wealth, income, employment, education, housing, race, and gender, are likely to affect people’s vulnerability to the health risks posed by climate change.

The distribution of risk leads to issues of justice, but so do the differing contributions to the problem. Future generations have not contributed any emissions, but they will enter a world filled with all the health risks associated with climate change. Even if we focus on the present generation, we see large differences in emissions between and within countries. Per capita emissions in the United States are twice as high as in Japan, five times as high as in Chile, and fifty times as high as in Ghana (Boden, Marland, and Andres, 2015). But in every country, some people’s emissions are unsustainable. About 11 percent of the world’s population is responsible for 50 percent of its carbon emissions (Chakravarty et al., 2009).

Ecological Footprints

An ecological footprint is a mode of measuring the amount of land and water that people require to provide the resources they use and to absorb the wastes they produce (Wackernagel and Rees, 1996). Since some land can produce more goods or absorb more wastes than other land, an ecological footprint needs to be expressed in a common unit. It is often expressed in global hectares (ghas) of land with average biological productivity. It can also be expressed in the number of “earths” that would be required if everyone used resources and produced wastes at a given level. Since the earth currently has about 1.8 ghas per person, the footprint in earths is the footprint in ghas divided by 1.8.

The global ecological footprint depends on the total population, patterns of consumption and production, the amount of biologically productive land available, and the productivity of that land. For example, consuming vegetables and grains has less impact than consuming beef, since raising cattle often uses large amounts of grain, water, and (p. 733) oil, and also produces large amounts of greenhouse gases (Steinfeld et al., 2006). Because of increases in population, production, and consumption, the global footprint is now about 1.5 earths.

Although the overall global footprint raises important issues of justice between generations, it conceals large differences between and within countries. As a first step toward disaggregating the overall footprint, Table 62.1 lists average footprints in selected countries (Global Footprint Network, 2016).

(p. 734) Table 62.1 Ecological Footprints


Footprint in ghas

Footprint in earths

United Arab Emirates



United States












Costa Rica



Sierra Leone






Source: Global Footprint Network, 2016.

These averages show large differences between countries, but they conceal large differences between people within the same country. In every country, some people are using resources, producing wastes, and damaging ecosystems at a high and unsustainable rate. In an essay on sustainable development, Kate Raworth (2012, 19) writes, “the biggest source of planetary-boundary stress today is excessive resource consumption by roughly the wealthiest ten percent of the world’s population.”

Some people will view biocapacity as a commodity to be owned, used, and traded by private individuals, for-profit corporations, and sovereign countries. Other people will argue that many forms of biocapacity—especially the capacity of the oceans and atmosphere to act as carbon sinks—should be treated as a global commons, to which people have an equal right (Singer, 2004). Although the use of ecological footprints as environmental accounting tools will not settle disputed issues of justice, it will help to focus attention on these important issues.

The use of ecological footprints also focuses attention on a crucial ethical task: the need to promote health in ways that recognize the claims of justice and sustainability (Dwyer, 2009). Some societies have done a better job at this ethical task. In the United States, the average life expectancy is about seventy-eight years, but the average ecological footprint is about 4.4 earths. In other words, the United States only attains about eighteen years of life from one earth. In Costa Rica, the average life expectancy is also about seventy-eight years, but the ecological footprint is much less, about 1.5 earths. That is about fifty-two years from one earth. Fortunately, there are many ways that countries could promote health that also reduce environmental impacts.

The Work of Environmental Justice

A sense of justice needs to include a sense of environmental justice: a disposition to treat people fairly with respect to environmental changes and problems. This disposition should lead people to work to address environmental injustices. Depending on the context, this work might take somewhat different forms and have somewhat different aims.

The first, and perhaps most important, form of work aims to show how certain environmental problems or conditions raise issues of justice. At an abstract level, this work tries to show that environmental problems and conditions affect people’s life prospects in an uneven, and seemingly unfair, way; that people contribute to environmental problems in an uneven, and seemingly unfair, way; or that people are not empowered to participate in environmental decisions in a meaningful and fair way. For example, the EPA mapping tool shows that eleven of the twelve environmental risks that it measures are higher in minority and low-income communities (EPA, 2015b, 24).

Uneven distributions tend to raise issues of justice, but they do not always settle those issues, because some uneven distributions may turn out to be justified when all things are considered. So the second form of work seeks to articulate, guide, and justify judgments of justice. This work encompasses different approaches. One approach is to articulate features or concerns that are morally salient in making judgments of environmental justice. This chapter has already noted three features: the distribution of risks, the contributions to the problem, and opportunities for participation. Depending on the context and the problem, it may be important to explain more specific features, such as the effects on disadvantaged groups, the benefits that natural environments provide, knowledge of the risks, past contributions, basic rights and liberties, the nature of community-based participatory research, and other features. This work helps people to take morally relevant features into account when making judgments.

Philosophers and other thinkers have often sought to do more than articulate morally salient features or concerns. They have developed a range of approaches to deal with multiple concerns and to address conflicts. Some approaches formulate decision methods (Resnik, 2012; Beauchamp and Childress, 2001). These methods often include strategies, processes, and unranked principles. Other approaches rely on principles that rank values or establish priorities. For example, in A Theory of Justice, John Rawls (1971) tries to show why a principle of equal liberty, and a principle of equality of opportunity, should take priority over a principle that governs economic goods. Some philosophers have not been satisfied with ordered principles. They have sought to develop comprehensive theories by which conflicting concerns can be evaluated in commensurate terms. Utilitarianism is a classic example.

It is not my purpose here to evaluate these various approaches, since there is no simple way to overcome disagreements about principles and theories. For example, libertarian thinkers continue to insist that the formal opportunity provided by contracts and (p. 735) markets is sufficient, whereas Rawlsian thinkers continue to emphasize the importance of fair equality of opportunity and the need to correct market failures that result in pollution. Notably, even when people disagree about principles, they sometimes agree about particular judgments and actions (Jonsen and Toulmin, 1990). When there is enough agreement on judgments of justice, it is vitally important to consider ethical issues about responsibility. So the third aspect of work on environmental justice tries to articulate and foster forms of responsibility.

Many discussions of responsibility tend to be rather legalistic. They try to set out the conditions under which it would be right to punish people for acts or to hold them liable for harms. A particular harm is identified in the past; then an individual person is held liable if a clear causal chain connects the harm to the person’s actions and if that person was at fault (acted intentionally, recklessly, or negligently). Although this model of responsibility can be applied or extended to some environmental injustices, it doesn’t quite fit or illuminate problems with the following features: the harm is a future risk; the victims are not specifiable; the causal chains are not clear; the people and corporations contributing to the problems are acting according to accepted norms and practices.

We need an account of responsibility that illuminates people’s responsibility to change accepted practices, background conditions, and structural processes. In her discussion of responsibility for structural injustices, Iris Marion Young (2011, 110) writes:

The ground of my responsibility lies in the fact that I participate in the structural processes that have unjust outcomes. These processes are ongoing and ought to be transformed so that they are less unjust. Thus I share with others the responsibility to transform these processes to reduce and eliminate the injustice that they cause. My responsibility is essentially shared with others because the harms are produced by many of us acting together within accepted institutions and practices, and because it is not possible for any of us to identify just what in our own actions results in which aspects of the injustice that particular individuals suffer.

Since many structures, institutions, and practices do not adequately account for environmental risks, people need to take responsibility to bring about change. Thus, responsibility, as its etymology suggests, shades into responsiveness (Dwyer, 2013).

To respond more adequately to environmental injustices, many people and institutions will need to change. To further this change is the fourth aspect of the work of environmental justice. It involves both practical and philosophical work. Indeed, John Dewey (1916, 336) writes, “Philosophy is thinking what the known demands of us—what responsive attitude it exacts.” And in much of his philosophical work, Dewey tries to show how attitudes, habits, and institutions need to change to respond to current problems and situations.

What does the current environmental situation demand? To respond more adequately, many societies will need to change practices, institutions, structures, and background conditions. For example, market economies that externalize environmental costs and harms will have to change. Maybe it will be possible to tax pollution and decouple economic development from carbon emissions and environmental degradation (p. 736) (Nordhaus, 2015). But maybe it will be necessary to change deep ideas about what economic development means (Jackson, 2011). I am not sure. But given the analysis presented here, it seems that a just and sustainable future demands much greater equity in terms of carbon emissions, environmental footprints, environmental health risks, and political power.

To respond to environmental injustices, many people will need to change the way they live. Many of us contribute too much to solid waste and air pollution; many of us have environmental footprints that are unsustainable; and 10 percent of us produce about 50 percent of carbon emissions. To address the most serious and urgent environmental injustices will probably require changes in habits of actions, attitudes toward people and nature, and ideas about what is good and just. In other words, the changes will need to include virtues.

The virtue of justice needs to include a sense of environmental justice that is combined with solidarity, respect, responsibility, and a duty to care. People may also need to develop dispositions that are more specifically focused on the environment: concern for sustainability, modesty of consumption, humility with respect to nature, and gratitude for the home that the earth provides. None of these individual and social changes is likely to occur without the active engagement of many citizens and civic groups. And so the work of environmental justice needs to emphasize active citizenship: a courage to confront injustice, a habit of engaging with others, a disposition for advocacy, a sense of the common good, and an understanding that important goods will sometimes conflict. The people who engage in this work need political freedom and ways to overcome the influence of money.


Because many environmental problems are so serious and urgent, public health ethics needs to raise issues of environmental justice, explore what justice demands, address questions of responsibility, and work to change things for the better. But some ethical issues extend beyond human health and environmental justice; they concern how human beings should relate to nonhuman animals, plants, ecosystems, and the whole of nature. The attitudes that we adopt toward nature, the respect we show the earth, the awe we feel for the diversity of life, and the scope of our sense of community—all these are matters of deep ethical concern.


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