Environmental justice conversations often focus on exposure: what is in the air, soil, or water, who is exposed, and what those exposures may mean for future health.

Those questions are critical. But there is another question that deserves more attention:

What does environmental injustice mean for people who are already living with chronic illness?

For someone managing asthma, autoimmune disease, cancer, cardiovascular disease, or multiple chronic conditions, environmental exposure is not only about future risk. It can intersect with symptoms, disease management, healthcare access, physical activity, economic stability, and quality of life right now.

That was the perspective I brought to Clear the Air, hosted by NOWINCLUDED in Houston on August 15, 2026. I represented The AIP BIPOC Network (ABN) on an environmental justice panel alongside Former Council Member Dr. Letitia Plummer and Rev. Crystal Bates, Vice Chair of the Environmental & Climate Justice Committee for the Texas State NAACP.

The program paired a screening of NOWINCLUDED’s Houston’s Fifth Ward Exposed with the panel discussion and opportunities for attendees to connect with health and community resources, including MD Anderson Cancer Center, Harris Health, Respire Institute, and the African American Male Wellness Agency through UpliftHER, among others. Attendees were also invited to complete pre- and post-event surveys.

The conversation raised a larger question that extends well beyond one event or one community:

How do we pursue structural environmental change while also supporting the health of people who cannot wait for that change?

The Fifth Ward Story Made the Stakes Visible

Houston’s Fifth Ward Exposed gave the environmental justice discussion a specific community context.

The documentary examines the experiences of residents of Houston’s Greater Fifth Ward alongside experts and public officials, connecting environmental contamination with longstanding health concerns in a community affected by a documented cancer cluster.

Historical operations at the Union Pacific Railroad wood-treatment site on Liberty Road resulted in soil and groundwater contamination in the Fifth Ward and Kashmere Gardens area. Public health investigations have subsequently examined cancer rates and environmental contaminants in the surrounding community.

Dr. Plummer’s presence in both the documentary and the panel created a natural connection between the community experiences presented on screen and the discussion that followed.

ABN was already familiar with the documentary through an earlier screening at ROCK the Block. At Clear the Air, the Fifth Ward story served as more than background. It grounded the conversation in the experiences of a community that has spent years navigating questions about environmental exposure, health, accountability, and response.

Environmental justice discussions can become highly technical, centered on exposure levels, monitoring, regulatory thresholds, remediation, risk, and epidemiology. Those tools are necessary, but they do not fully capture what it means to live with uncertainty about an exposure, question whether health problems may be connected, or wait for institutions to determine what happens next.

That gap between identifying environmental risk and living with its consequences is where the Fifth Ward story becomes especially relevant to chronic illness.

Fifth Ward Is a Case Study, Not the Boundary of the Issue

Fifth Ward provided the context for the event, but environmental injustice is not a Fifth Ward problem or a Houston problem.

Across the United States, environmental burdens intersect with decades of decisions about housing, transportation, industrial development, land use, infrastructure, and economic investment.

That history matters because exposure rarely occurs in isolation.

The U.S. Environmental Protection Agency describes cumulative impacts as the combined effects of chemical and nonchemical stressors on health, well-being, and quality of life.

That concept is particularly relevant when discussing historically under-resourced communities.

A person may be exposed to air pollution while also managing inadequate access to healthcare, transportation barriers, housing instability, occupational exposures, financial stress, limited green space, or an existing chronic condition.

Each factor matters independently.

Their intersection can matter even more.

That is why environmental justice cannot be reduced to asking whether a pollutant exceeds a particular threshold. We also have to examine the conditions surrounding the person who is being exposed.

What Changes When Someone Is Already Living With Chronic Illness?

For people already managing chronic conditions, environmental health becomes part of disease management, not simply a discussion about disease risk.

The relationship is especially clear with respiratory health.

Fine particulate matter, including PM2.5, can penetrate deeply into the respiratory system. The U.S. Environmental Protection Agency has associated particle pollution with aggravated asthma, decreased lung function, respiratory symptoms, cardiovascular effects, and other adverse health outcomes.

For someone living with asthma, that can turn air quality into a disease-management issue.

The relationship with autoimmune disease requires more caution.

Autoimmune diseases result from complex interactions among genetics, immune function, environmental influences, hormonal factors, and other mechanisms. Current research is examining how exposures including particulate matter and other pollutants may contribute to oxidative stress, systemic inflammation, and immune dysregulation.

Associations have been investigated across conditions including rheumatoid arthritis, lupus, Sjögren’s syndrome, and systemic sclerosis.

That evidence does not support saying that air pollution simply causes autoimmune disease.

It does support asking better questions about how environmental conditions may interact with immune-mediated disease and why people living with autoimmune conditions should be included in environmental health research and policy conversations.

For me, that distinction matters.

I understand chronic illness not only through advocacy, but through lived experience. Environmental health discussions look different when the question is not simply whether exposure might make someone sick someday, but what it means when someone is already managing their health every day.

Environmental Injustice Is Also a Quality-of-Life Issue

Disease incidence and mortality are essential measures of environmental health, but they are not the only measures that matter.

Chronic illness already requires people to make constant calculations about symptoms, medications, appointments, physical activity, work, family responsibilities, and finances. Environmental conditions can add another layer.

• Can I safely exercise outside today?
• Does my work environment increase my exposure?
• Can I afford tools, such as air filtration, that could reduce my exposure?
• If I learn that my community has experienced a particular environmental hazard, can I access appropriate healthcare or screening?

These questions point to a larger inequity:

The ability to avoid or respond to environmental risk is itself unequally distributed.

Two people may receive the same air-quality warning and have very different abilities to act on it.

One may work remotely, own an air purifier, have comprehensive health insurance, and easily reschedule outdoor activity.

Another may work outside, depend on public transportation, live in poorly maintained housing, or have limited access to healthcare.

Exposure matters.

So does the capacity to respond to exposure.

Supporting Health in the Midst of Structural Change

One of the questions directed to me during the panel addressed a challenge at the center of environmental justice:

How can community networks support individuals who are currently suffering from chronic illness or environmental exposure while the larger structural fight for justice takes place?

Environmental justice requires structural solutions. Communities cannot education-program their way out of industrial pollution. Individuals cannot lifestyle-change their way out of contaminated soil. An AQI app cannot replace environmental regulation, enforcement, remediation, or sound public policy.

But structural change takes time, and people still need support while it is happening.

That creates an important role for community organizations, healthcare systems, advocates, researchers, and public health institutions.

We can help people understand credible environmental health information. We can connect residents with healthcare, screening, benefits, and community resources. We can help people recognize questions worth bringing to their healthcare providers. We can also create mechanisms for communities to document and communicate what they are experiencing.

Just as importantly, that information needs to travel in the other direction.

Community knowledge should inform research questions, program design, public health interventions, advocacy priorities, and policy. People experiencing environmental burdens should not simply receive information after decisions have already been made. Their experiences should help shape the decisions themselves.

The goal is not to substitute community support for structural change.

The goal is to make sure people are not abandoned while structural change is being pursued.

Access, Inclusion, and Prevention in Practice

The conversation also reinforced how ABN’s AIP framework, Access, Inclusion, and Prevention, applies to environmental justice.

Not as three definitions, but as three questions:

Access: What Can People Actually Reach?

It is not enough for environmental data, healthcare services, screening programs, or community resources to exist.

Can the people who need them find them, understand them, afford them, trust them, and use them?

Environmental justice requires us to consider access not only to a healthy environment, but also to the resources people need when that environment has already affected their health.

Inclusion: Who Helps Define the Problem?

Communities affected by environmental hazards should not enter the process only after researchers, institutions, or policymakers have already decided what questions matter.

Residents hold knowledge that cannot be captured entirely through environmental monitoring or medical records.

Meaningful inclusion means involving communities in defining problems, identifying priorities, shaping research, evaluating interventions, and determining what successful change looks like.

Prevention: How Far Upstream Are We Willing to Go?

Prevention is often framed around individual behavior.

For chronic illness communities, we hear a great deal about nutrition, exercise, medication adherence, stress, sleep, and preventive care.

Those things matter.

But prevention also requires looking upstream:

• What conditions are producing risk before someone enters a clinic?
• What exposures could be reduced?
• What policies determine where environmental hazards are concentrated?
• What happens when the healthier choice is not realistically available?

Environmental justice expands prevention from what individuals should do to what systems should stop doing to them.

Responsibility Cannot Stop With the Individual

There are practical things individuals can do.

People can monitor the Air Quality Index, learn about environmental concerns where they live, pay attention to patterns between environmental conditions and symptoms, discuss those concerns with healthcare providers, participate in public meetings, and support community advocacy.

Those actions have value.

But an environmental justice framework should resist turning systemic problems into another list of responsibilities for people already carrying the burden.

Healthcare organizations can ask more consistently about environmental conditions affecting patients.

Researchers can involve communities earlier and more meaningfully.

Community organizations can connect education with navigation and resources.

Industry has responsibilities related to environmental stewardship, transparency, and the communities affected by its operations.

Policymakers and regulators have responsibilities for standards, monitoring, enforcement, remediation, investment, and accountability.

And advocates can continue pushing environmental health into broader conversations about chronic disease and health equity.

Everyone has a role, but those roles are not equal.

The person breathing polluted air should not carry the same responsibility for solving the problem as the institutions with the power to prevent or reduce the exposure.

Where the Chronic Illness Community Fits

Clear the Air reinforced for me that environmental justice is not outside the scope of chronic illness advocacy. If our work addresses quality of life, prevention, healthcare access, disparities, and the conditions that influence health, environmental health is already part of that work.

We do not need to become environmental scientists to participate responsibly. We do need to understand the evidence, avoid overstating what the science can prove, partner with people who hold expertise we do not, and ensure that people living with chronic illness are represented in conversations that affect their health.

Environmental justice adds another dimension to how we think about Access, Inclusion, and Prevention, while chronic illness adds another dimension to how environmental justice is understood.

Moving the Conversation Forward

At the end of our panel, we were asked what immediate action people could take to support environmental justice and advocate for lung health.

My answer was about knowing what is happening in our own environments and using that knowledge beyond ourselves.

After reflecting on the entire conversation, I would take that one step further.

We need to stop treating environmental exposure, chronic illness, healthcare access, social conditions, and community voice as separate conversations.

For many communities, they are happening at the same time.

Our response should reflect that reality.

Protecting health means addressing not only how people manage illness, but also the conditions in which they are being asked to manage it.

Frequently Asked Questions

What is the connection between environmental justice and chronic illness?
Environmental justice examines how environmental burdens and protections are distributed across communities. For people living with chronic illness, environmental exposures may intersect with existing disease, healthcare access, socioeconomic conditions, and the ability to avoid or respond to environmental risks.

What are cumulative impacts?
The EPA uses cumulative impacts to describe the combined effects of chemical and nonchemical stressors on health, well-being, and quality of life. This approach recognizes that communities may experience multiple environmental and social stressors simultaneously.

Can air pollution worsen asthma?
Yes. Particle pollution and other air pollutants can aggravate asthma, contribute to respiratory symptoms, and affect lung function.

Is air pollution linked to autoimmune disease?
Researchers are investigating associations between environmental exposures and autoimmune disease, including potential pathways involving oxidative stress, inflammation, and immune dysregulation. The evidence varies by exposure and condition and does not establish that air pollution causes every autoimmune disease.

Why are some communities more vulnerable to environmental health risks?
Exposure is only one factor. Existing health conditions, housing, occupation, income, healthcare access, transportation, historical patterns of development and investment, and the resources available to respond to environmental hazards can all influence vulnerability.

What can someone living with chronic illness do about environmental health concerns?
Monitor local environmental conditions when relevant, learn about known environmental concerns in your community, document patterns you notice between exposures and symptoms, discuss concerns with your healthcare provider, and use credible public health and environmental resources. Individual action can reduce some risks, but systemic environmental problems also require institutional and policy solutions.