Environmental Injustice and Public Health in India: Towards a “Decolonial Intersectional Environmental Justice” Framework

Public Health and Environmental Policies in India

The hardest hit of the global environmental crisis are the marginalised communities. Vulnerable populations in developed and developing countries first and foremost experience the catastrophic impacts of climate change (Nesmith et al 2021). In India, the environmental challenges are diverse, from a severe deficiency in environmental amenities like clean water and sanitation for bare human existence to pollution from the hazardous wastes generated by a modern consumer society (Sawhney 2018). Several environmental policies are intended to tackle environmental challenges, for example, the National Policy on Pollution Abatement, 1992; the National Conservation Strategy and Policy Statement on Environment and Development, 1992; the National Environment Policy of 2006; and the Clean India Mission of 2014. To implement these policies, the government has also set some legal frameworks such as the Air (Prevention and Control of Pollution) Act of 1981, amended in 1987; the Environment (Protection) Act of 1986; the Water (Prevention and Control of Pollution) Act of 1974, which was amended in 1988; the Water (Prevention and Control of Pollution) Cess Act of 1977, again amended in 1991; the Public Liability Insurance Act of 1991; the National Environmental Tribunal Act, 1995; the National Environmental Appellate Authority Act of 1997; and the National Action Plan on Climate Change, 2008.

However, these environmental policies often ignore the discourse on the body and health of marginalised populations and consistently fail to protect India's public health. These policies completely overlook and fail to evaluate the disaggregated disparities in health outcomes among the diverse social groups in India. Other toxic waste management rules, such as the Hazardous Wastes (Management, Handling and Transboundary Movement) Rules, 2008 and the Regulation of Persistent Organic Pollutants Rules of 2018, have also failed to reduce the rate of environmental violation in India. Sawhney (2018), therefore, remarks that

The number of polluted rivers in India more than doubled during 2008–15 due to the indiscriminate discharge of raw sewage and industrial waste into rivers. The deterioration of water quality has been so severe as to make these river waters unfit. There are signs of an acute water crisis, with contamination increasingly evident in surface water and groundwater. Considering that half of India's morbidity is water-related, water contamination imposes a high cost on the economy.

Over the decades, environmental health researchers across the globe firmly established a link between environmental inequities and inequalities in health outcomes, especially among the poor and marginalised sections, which are often socially categorised as ‘contaminated communities’ (Capek 1993; Barbosa et al. 2007; Bowen 2002; Brainard et al. 2002; Brulle and Pellow 2006). These communities, such as the black people in the United States (US) and Dalits and Schedule Tribes (STs) in India, have been facing a range of structural impediments to fuller participation in the decisions that affect their lives and have a greater likelihood of exposure to environmental risks in air, water, and soil (Capek 1993; Carrillo 2021).

Moreover, the expansive environmental health policies lack an understanding of a sustainability perspective and often ignore the non-material factors of health in policy formulations and implementations (Zhang and Liu 2018; Carrillo 2021). Besides, earlier environmental studies on health mostly considered only a single attribute in environmental health disparities, even though there are intersections of many social factors in health disparities. Furthermore, rather than focusing on the presence or absence of salutogenic aspects (that is, those that are beneficial), most environmental research has focused exclusively on the presence or absence of pathogenic components of the environment (Pearce et al. 2010: 523–24).

In the context of India, Gadgil and Guha (1995: 2) argue that “it is hardly surprising that the environmental movement in India has not given sufficient thought to the larger processes that are contributing both to ecological deterioration and to social strife.” Indeed, the environmental policies in India are still colonial in nature and have no interest in the sustainable development of the larger ecosystem (Gadgil and Guha 1995). Against these backdrops, this article examines the current inadequacy of environmental policies in protecting the health and ecology of the public, especially among the socially marginalised sections in India. It suggests adopting a “decolonial intersectional environmental justice” approach in framing environmental policies in India.

Environmental Injustice and Public Health: Who Are at Risk?

Environmental researchers often ignore the relations between the environment and cultures and view them separately. However, we cannot speak of environment and culture as different from the other. For instance, people living in hazardous environments always experience a higher prevalence of morbidity and mortality. The impact can be seen on their bodies due to lack of access to healthcare services, limited social and economic resources, and geographical inaccessibility to the health centres. For instance, more than 85 per cent of people and households in India currently reside in various districts where international air quality standards for PM_2.5 (particulate pollutant) are exceeded. Significantly, a substantial rise in PM_2.5 has been seen in districts with higher percentages of Scheduled Castes (SCs), young children, females, people with disabilities, poor housing conditions without toilets, and in less urbanised districts (Chakraborty and Basu 2021).

Similarly, in 2005, child malnutrition claimed as many as 718 lives of tribal children in one single district, namely Palghar, Maharashtra. Even after a decade of double-digit economic growth, in 2016, more than 600 children died due to undernutrition in the same district (Ghosh and Varerkar 2019). Other research shows that malnutrition is not only a single factor of death among children in India. Instead, other environmental factors, such as the general cleanliness of the mother’s hands and clothes and the quality of drinking water, are significant predictors of undernutrition and death among children in India (Matariya et al 2016). This is what we can refer to as an environmental injustice. Specifically, environmental injustice, according to Maantay (2002: 161), can be defined as “the disproportionate exposure of communities of colour and the poor to pollution, and its concomitant effects on health and environment, as well as the unequal environmental protection and environmental quality provided through laws, regulations, governmental programs, enforcement, and policies.”

In India, most of its poor and socially marginalised people are still dependent on the natural environment of their locality to meet their basic material needs, which Dasmann (1989), Gadgil and Guha (1995: 3) referred to as ecosystem people (EP).[1] These ecosystem people have been largely exploited by biosphere people (BP – better-off urban dwellers) in a colonial manner (Dasmann 1989; Gadgil and Guha 1995; Gadgil 2023). Biosphere people enjoy almost all the productions of the biosphere, while the ecosystem people only have limited resource catchment (Dasmann 1989; Gadgil and Guha 1995). Gadgil (2023) further asserts that the biosphere people are insensitive to the negative impacts of environmental deterioration in rural regions and have the political and economic authority to utilise the riches of the entire global biosphere. For instance, the wealthier biosphere people of Mumbai consume power from hydel installations in the Western Ghats and are utterly unsympathetic to the numerous struggles the ecosystem people confront. Moreover, increasing environmental inequities and inequalities have significantly destroyed the traditional livelihood patterns of ecosystem people, who are forced to migrate from their place of origin and join construction work or other unskilled work. Gadgil and Guha (1995) call these people ecological refugees (ER). These ecosystem people and ecological refugees are mostly indigenous, Adivasi and tribal people who are now more prone to various forms of environmental injustices. For instance, the Anakkayam Small Hydro Electric Project has a negative effect on the Kadar community’s way of life and the local ecology in Kerala. The Idu Mishmi and other tribes are anticipated to be displaced by the Etalin project, the Dibang dam, and the 169 other dams in Arunachal Pradesh of northeast India. Private miners can mine coal in 41 blocks in Chhattisgarh (Gupta 2020).

Other empirical studies (Nix et al. 2020; Singh et al. 2018; Bhagat 2013: 64) show how a poor and hazardous ecological environment negatively affects the health of marginalised communities in India. Women and girls suffer the most due to hazardous living environments as they are overburdened with many household chores. For instance, in India, most households have no adequate access to liquefied petroleum gas (LPG). They are hence dependent on wood, which seriously impacts the health status of women and girls. It was reported that people living in households that cook with wood and dung are 2.6 times more likely to suffer from active tuberculosis in India, and this mostly affects women as they are likely to engage in cooking activities (Bhagat 2013). Similarly, the aged population has higher chances of morbidity due to their low immune system and poor living conditions. Studies also reported increasing neonatal and child mortality due to pneumonia, diarrhoea, malaria, and various infectious diseases among children in India, which is again closely linked to hazardous living environments. Again, child mortality was five times higher among girls than boys. And it has been significantly higher among the lower socio-economic groups living in rural and inaccessible areas (Yadav et al. 2016; Bassani et al. 2010; Dhingra et al. 2010).

Similarly, working-class people in various industrial cities live in exclusive, exploitative, and hazardous environments. Empirical research indicates that, in India, people working in every sector ranging from the manufacturing industry and municipal solid waste workers to agricultural workers, have been suffering from various environmental and occupational health hazards, which include hypertension, liver disease, tuberculosis, high-stress and burden, diabetes, eye and hearing problem, circulatory, digestive system, musculoskeletal complaints, behavioural health problem, skin-related disease nervous system, urinary problem, and cancer (Suri and Das 2016; Nag et al. 2016; Yasmin et al. 2020; Kaup et al. 2017; Regmi et al. 2019; Chaudhuri 2000). Reasons such as lack of proper protective measures, basic amenities, proper training as well as awareness, along with the ignorant attitude and reluctance of employers to organise treatment for work-related accidents and occupational and environmental health issues have been identified as major causes of such health-related issues among the workers (Thakur et al. 2018; Agarwalla et al. 2017; Annamalai 2015; Nag et al. 2016). Annamalai (2015) reported that in India, over 95 per cent of the e-waste is treated and processed in the majority of urban slums of the country, where untrained workers carry out dangerous procedures without personal protective equipment, which are detrimental not only to their health but also to the environment. Significantly, these health hazards were mostly found among the lower level of workers like casual labourers and other casual industrial workers who mostly belong to a lower caste and marginalised sections of Indian society (Regmi et al. 2019). Thus, the marginalised sections, including the SCs, STs, rural poor, urban slum dwellers and working-class people, face environmental issues and are at a higher risk, which is hardly addressed by the environmental policies in India.

A Decolonial Intersectional Environmental Justice: Towards a New Framework for an Inclusive Environmental Policy

In the late 20th century, countries in the Global North were trying to bring the idea of justice in their environmental policies. The idea of environmental justice germinated from “environmental racism” in the US, a term coined by Benjamin Chavis in 1982. Later on, environmental researchers moved beyond race to include others (regardless of race or ethnicity) who are deprived of their environmental rights, such as women, children, and the poor (Cutter 1995). The basic principles of environmental justice incorporate the protection from environmental deprivation, including adverse health impacts, irrespective of the individual- or area-level socio-economic status and have been used to investigate disparities in exposure to key aspects of the physical environment that are either beneficial or harmful to health (Pearce et al 2010: 523). This environmental justice, however, is a colonial construct. Current environmental research strongly shows the continuation of coloniality in environmental injustices (Whyte 2018; Sloan and Schmitz 2019). The tribal people of Jharkhand, for instance, have been displaced from both their land and land rights. They have also been denied access to diverse biological resources and values and are now forced to migrate to other places for livelihoods. As a result, they are the most striking examples of ecological refugees in the country (Gadgil 2023: 14). Similarly, approximately 245 Baiga households from Chhattisgarh were forced to leave the Achanakmar Tiger Reserve in 2009. The families were relocated to a location where their customary source of income, gathering sal (Shorea robusta) leaves, tendu, and bamboo, was no longer feasible. In addition, the families did not get the entire amount of compensation due to them being under the Project Tiger Relocation Scheme nor did they receive pattas (articles proving ownership of land) for farming. Furthermore, it has been reported that the relocation of these groups has forced them to leave their original habitats and move to hostile environments. Their vulnerability to exploitation has grown due to the forced relocation process, which has led to poverty, chronic undernourishment, famine, ill health, and severe psychological trauma (Nadimpally et al. 2019). Additionally, Sharma (2023) demonstrates how the sense of freedom, belonging, and values of marginalized people in the Jhajjar district of Haryana is impacted by the profound ecological, social, and cultural processes involved in the making and unmaking of environment and labour in a caste-capitalist economy. Gupta (2020) thus argues that “the struggle of indigenous populations against environmental injustice is not purely a civil or environmental concern, but instead a complex interplay of self-determination, colonialism, racism, sovereignty and environmental destruction.”

Realising such complex nature of environmental injustices, Thomas (2021) questioned, “how is it possible that environmentalists and conservationists could advocate for the protection of even the smallest of species, but not Black lives or endangered people?” He strongly advocates the urgent need for diversity and inclusion of intersectional approaches within the environmental sector. There have been growing scholarships on the “intersectional approach” as a theoretical or methodological lens across the disciplines that highlights the diverse nature and locations of individual identities (such as class, caste, gender, race, sexuality, and citizenship) and shows how these multiple factors intersect with one another in the social world (Collins and Bilge 2016). These factors or entities are “not mutually exclusive entities, but as reciprocally constructing phenomena that in turn shape complex social inequalities” (Collins 2015). Research using an intersectionality framework has shown how inequities never result from individual, isolated, and distinct factors (only class or gender) but are due to the ways that multiple factors intersect with one another (Mishra 2017: 27). We, therefore, suggest the “intersectional justice approach” in framing inclusive environmental policies to provide environmental justice to the people living at the margins who are always prone to many forms of environmental risks. This framework can question the status quo and raise questions about the meaning and relationship between different social categories and intersecting systems of privilege and oppression. Further, it serves as an anchor to advance equity and provide social justice for marginalised communities that have experienced and continue to experience structural inequalities primarily by focusing on power relations at the individual, institutional and global levels and the convergence of experiences in a given socio-historical context and situational landscape (López and Gadsden 2016: 2). As Sen and colleagues (2009: 412) have argued,

Intersectionality has the potential to provide critical guidance for policies and programmes. By giving precise insights into who is affected and how in different settings, it provides a scalpel for policies rather than the current hatchet. It enables policies and programmes to identify whom to focus on, whom to protect, what exactly to promote and why. It also provides a simple way to monitor and evaluate the impact of policies and programmes on different sub-groups from the most disadvantaged through the middle layers to those with particular advantages.

According to the intersectional justice approach, public health injustice primarily arises from economic maldistribution, cultural misrecognition, and political misrepresentation. Here, health justice will require an integrated, intersectional approach that brings together the three spheres of health justice: economic redistribution, cultural recognition, and political representation (Barras 2020: 208). However, the reviews in this study suggest expanding the intersectional justice framework in health by expanding the “ecological sphere of justice,” which we termed as “ecological reinforcements” in bringing environmental health justice to be more inclusive. Because contemporary risk patterns and health consequences do not fit within the simple models of causality and intervention, there is a need to consider the interdependence between humans, health, and their physical and social environments (McLaren and Hawe 2005: 9). Moreover, the ecological sphere of justice is equally important for the welfare of the whole ecosystem. People from marginal social and geographical locations (such as the STs, SCs, slum dwellers and char chapori [2] dwellers of Assam) often reside in ecologically vulnerable areas, inviting more harm to themselves and others. Be it natural vulnerabilities of flood, landslides or earthquakes or human-made vulnerabilities of living downstream of industrial effluents or at the receiving ends of flash floods in urban concrete jungles, the victims are often drawn from the lowest quintiles of the socio-economic spectrum. Their openness to ecological hazards is equally responsible for their susceptibilities to accessing quality healthcare or healthy lifestyles. Therefore, reinforcing the ecological resources is equally important as economic redistribution, cultural recognition, or political representation for formulating an inclusive environmental policy across nations.

However, we argue that this intersectional framework in environmental policies also needs a decolonial approach that is “a form of struggle and survival, an epistemic and existence-based response and practice against the colonial matrix of power in all of its dimensions” (Mignolo and Walsh 2018: 17). The intersectional environmental justice framework could be strengthened by a decolonial perspective because it aims to challenge rather than legitimise authority and to abolish systems that support exploitation and dispossession. However, when decolonial practice is applied to global health, equity must be a guideline. Such a strategy should seek to eliminate structural vulnerability in individuals and countries (Fofana 2021: 1163).

A decolonial approach to environmental policies can transform power imbalances between government and indigenous communities. By transforming power imbalances, a decolonial environmental policy will restore land rights and sovereignty among the indigenous tribes and other marginalised populations in India. It would help us understand indigenous voices, stories and ideas in framing and implementing an inclusive environmental policy. Finally, it would help us to bring “indigenous-led” (Indigenous Climate Action 2023) practices in protecting the lives, livelihoods, and the larger ecosystem of marginalised communities in India. For instance, indigenous communities always incorporate practical ways to ensure the balance of the environment in which they live, so they may continue to provide services such as water, fertile soil, food, shelter, and traditional plant-based medicines (Drissi 2020). Thus, it is high time to decolonise the existing environmental policies as it is an empowering process. It is a “process for changing human structures, systems, and ethics as a first step in reclaiming the natural ecology and our relationship with it” (Nesmith et al. 2021: 113).

Conclusions

This article reflects on how current environmental policies have failed to protect the health of the marginalised communities in India and provides insights into the formulations and implementations of inclusive environmental policies that can protect the health, livelihoods, and the larger ecosystem of the marginalised sections. Based on our analysis, we thus argue that the current climate crisis and global environmental health inequities and inequalities strongly urge governments across nationalities to revise their environmental policies. We urge policymakers to look into the environment-related health issues the marginalised groups face by framing intersectional policy research supplemented by decolonial ethics and approach. In doing so, the government should provide research grants to the environmental and natural scientists and involve social scientists in framing innovative research and policy paradigms that can lead to a better ecosystem and provide environmental justice to the people living at the margins.