COVID-19 has dominated our lives for over a year, causing immense global suffering. High morbidity figures amongst BAME and deprived communities have placed a spotlight on the extent of inequity throughout society.
Inequity is a term describing something being unjust, unfair and avoidable. Sir Michael Marmot’s seminal work the Marmot Review: 10 years on provides relevant and pertinent insight into how inequity has a negative impact on the life chances of those groups most affected. The report highlights that people can expect to spend more of their lives in poor health and the health gap between wealthy and deprived has grown. Improvements to life expectancy have stalled, and declined for the poorest 10% of women. The report also shows how place matters – living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, to the extent that life expectancy is nearly five years less.
We don’t want to silo pollution and poverty; we want to see how it fits into the bigger picture.
So how does all this relate to pollution? Pollution has a significant and damaging lifelong effect on health, from conception to end of life. Some of the most dangerous pollutants, like PM2.5, PM10 and nanoparticles, are invisible to the eye and exposure increases the risk of developing respiratory conditions like asthma and COPD, life-limiting illnesses such as lung cancer, coronary heart disease and strokes, and degenerative conditions like Alzheimer’s and dementia. More recent research shows exposure can also increase the risk of serious mental health disorders and three years ago a London-based research team was the first to find carbon in placentas (Liu et al, 2018). No wonder it’s nicknamed the invisible killer.
Clean air campaigners and advocates have noticed that the same geographical communities being affected by COVID-19 and inequity are also the ones showing a greater propensity to being impacted by pollution and poor air quality. Those living in areas of high deprivation show a greater vulnerability, which is especially pronounced amongst the BAME residents within these deprived communities. Although the pattern of vulnerability related to pollution is higher in urban areas, non-urban areas can be affected too. This specific inequity is increasingly referred to as environmental, or climate, justice - a term that reflects the importance of giving people meaningful and equal protection with respect to the development, implementation and enforcement of environmental laws, regulations and policies.
Our recovery must bend towards the science and justice.
Imperial College London takes environmental justice seriously and is working across disciplines to tackle pollution and its consequences, engaging with the local community and inspiring change through its new Transition to Zero Pollution initiative. The research the College is currently undertaking to work towards a zero pollution society includes zero waste, sustainable systems and zero pollution transport, including the electrification of transport and electric aircraft.
A recent study from Harvard and two UK universities published in The Environmental Journal attributes more than 8 million deaths in 2018 from fossil fuel pollution (Vohra et al, 2021), which is much higher than previously thought. That equates to a staggering one in five of all global deaths annually, far exceeding the previously documented figure of 6.7 million deaths, referenced by the Global Burden of Disease Study (GBD, 2019) and even COVID-19’s grim worldwide tally. Given that a large proportion of these deaths will be from deprived, vulnerable and BAME communities it’s clear that inequity in relation to pollution is a growing social and health concern.
Research shows that lived environments are a key contributory factor to this vulnerability. Many of the people most impacted live in close knit or crowded communities and intergenerational homes, with a significant number on or close to the poverty line. Noise and heat pollution are less well-known but can cause significant distress and represent an environmental inequality that is disproportionately experienced by marginalised communities. Such difficult living environments may mean a struggle to make healthy lifestyle choices.
When you look at societal choices, people make poor choices for good reason. Poverty drives pollution and pollution drives poverty.
The disproportionate health impact of air pollution causes an economic burden, too. When people get sick, they cannot go to work or school and there is the additional strain on families and individuals of repeat trips to A&E, or hospitalisation.
Four years ago, the Ostravia Declaration (WHO, 2017) tried to address this societal vulnerability by getting an international ministerial commitment to consider equity, social inclusion and gender equality in policy making decisions. However, this doesn’t appear to be widely taken up as the majority of people living in extremely polluted areas still bear a disproportionate health burden from pollution’s adverse effects, even though they typically contribute the least - and the numbers of people this affects seems to be increasing.
Robert Shorten, Professor of Cyber-physical Systems at Imperial’s Dyson School of Design Engineering, is concerned that communities who are affected by this societal disadvantage shouldn’t be blamed. He believes there’s a clear need to take a broader and more compassionate approach when creating solutions, so they don’t feel unhelpfully targeted and judged.
“When you look at societal choices, people make poor choices for good reason. Poverty drives pollution and pollution drives poverty,” says Professor Shorten. “Take electric vehicles and electric bikes – we expect people to make these choices, but they can’t afford them. They don’t have access to these choices – that’s access poverty.”
Professor Shorten was one of three Imperial academics who contributed to the think tank IPPR's recent report on A plan for fairly decarbonising how people travel. The report outlines a vision for a transport system that is fair to all, works to improve people’s health and wellbeing and provides a better environment for nature. Find out more about the report and Imperial's involvement.
"Imagine if you could see the pollution – you’d operate completely differently. It’s not visible and yet it takes the lives of people every day."
Dr Mark Richards
Studies carried out by Imperial’s Geospatial Health Lecturer Dr Daniela Fecht highlight this inequity. Her Netherlands/UK study in 2015 found that exposure to pollution is higher if you are from an ethnic minority group, even adjusting for the health indices of social deprivation. Intriguingly her most recent study – a travel demand and noise pollution survey - found Liverpool to be more equal than some places in London. This UK specific study looked at where people worked and how they got there, and her findings showed that “even if you have a high income and you live in a more deprived area where the air pollution is higher, your individual level of exposure is lower.” She concludes that it may be down to the mode of travel: using a car versus public transport. Effectively, a higher income may protect you from the worst effects of pollution.
This research also exposes how deeply imbedded this inequity is and how equitable mobility needs to be a key consideration in future transport conversations. Those who are most affected may have limited means to escape their exposure to pollution if they live, travel or work close to a busy road. Perhaps their children walk to school along heavily polluted routes, or their school and nursery are situated by one. We only have to reference the recent inquest hearing into Ella Kissi-Debrah, a 9-year-old London school girl, to see the real-life tragedy of this exposure. The close geographical proximation of her home to the South Circular road in south London was a key factor in the coroner’s landmark decision to associate Ella’s death from asthma to her exposure to traffic emissions.
Dr Mark Richards, an atmospheric scientist and Senior Teaching Fellow at Imperial’s Department of Physics has developed personal mobile technology solutions to map the pollution and believes that Imperial has a vital role in making science more accessible to the public.
“Imagine if you could see the pollution – you’d operate completely differently. We have developed the technology to allow you to detect it, so you can use the data to help you visualise it.
“If all households turned on the tap and it was brown everyone would be complaining. If it’s not in front of your face it’s not visible and yet it takes the lives of people every day. With Ella’s case there is a human face to air pollution.”
Even if you have a high income and you live in a more deprived area where the air pollution is higher, your individual level of exposure is lower.
Connecting the community and campus
In White City, close to where Imperial’s new campus is being built, the Westway – a main arterial route running from west London into the city - dominates the landscape. You can see the Grenfell Tower from the campus, as it is situated between two boroughs: Hammersmith & Fulham and the Royal Borough of Kensington & Chelsea (RBKC). There are several schools situated close to the Westway, a community centre and there’s even a sports pitch directly underneath. The skies carry nanoparticle pollution from the aircraft flying above. The inequity is clearly demonstrated in one stark statistic: in Golborne Ward, adjacent to the Grenfell Tower, life expectancy for men was 22 years shorter than that in the richest part of RBKC, near the luxury department store, Harrods.
The latter is an area that Dr Gary Fuller, a Senior Lecturer in Air Quality Measurement who leads Imperial’s air pollution measurement team, is looking into. Residents living in social housing don’t always have a say in heating or ventilating their home, which may lead to a cold and damp living environment. Even everyday activities like cooking with gas can heighten their exposure to particulates. The indoor environment is an area of research that Imperial hopes to explore further once the whole team is back together at the new campus.
The inequalities that exist have been exacerbated by COVID-19 and there is no future prospect of the Westway being removed. However, Professor Mary Ryan, Vice-Dean (Research) at the Faculty of Engineering who also leads the College’s Transition to Zero Pollution initiative, believes that the most vulnerable and pollution-impacted communities can experience a brighter future if a holistic consideration of people’s needs is the central driver of any systems level change.
“Last year, Mary Robinson talked about climate justice [at the launch of Transition to Zero Pollution],” she says. “We don’t want to silo pollution and poverty; we want to see how it fits into the bigger picture. There’s a prosperity angle – it’s about building a better future. We want to frame the narrative, to improve things in an equitable manner.”
"Air quality is getting better. When ULEZ is extended, air quality will improve substantially.”
Professor Frank Kelly
Building a better future
Building a better future was certainly a primary motivation behind Imperial’s decision to locate its new campus in White City and can be viewed as a positive step to levelling the inequality and its health impacts in the local area. Professor Neil Alford, Associate Provost (Academic Planning) at Imperial, has been keen to liaise with partners to ensure the buildings are “future proof in the reduction of emissions”.
“Our students and staff all have a huge appetite for sustainability issues,” he adds.
As well as being a beacon of sustainability, the new campus buildings provide facilities that support the collaboration, innovation and sharing of ideas between Imperial’s academic and student community to benefit local businesses, the council and the local community.
Our students and staff all have a huge appetite for sustainability issues.
Public health will be central to this work and in 2023, the new buildings for the School of Public Health will open on the campus, with Professor Frank Kelly, who leads the Environmental Research Group, and his team looking at deprivation and inequalities. Professor Kelly himself admits the “enormous regeneration” of White City was a primary motivator in moving across to Imperial, saying: “it’s a great opportunity to move into this community to address the air quality problems, as well as other inequality problems”.
Professor Kelly’s team were behind the traffic monitoring that led to London Mayor Sadiq Khan introducing the Ultra Low Emissions Zone (ULEZ) in 2019. This resulted in a reduction in NOx emissions and later this year will be extended to reach the north and south circulars: “Air quality is getting better,” says Professor Kelly. “When ULEZ is extended, air quality will improve substantially, although it will take a number of years for the public health benefits to occur. In terms of those individuals who are most sensitive, they should see an immediate benefit. They will require less medication and less hospitalisation – and fewer people will develop these respiratory conditions.”
This is an impressive health win for the future, but so keen are Imperial academics to breach the equalities gap now, that they’ve been working with the council and local White City community to explore - rather than assume - how the community really feels about the health inequalities and challenges they experience. This community engagement has already been taking place for five years and although COVID-19 has meant their work has been online rather than face to face, the discussions and learnings have been valuable.
In engagement work, the challenge can be that certain voices are heard more than others – and that the groups most impacted are often not represented. Priya Pallan, Community Engagement Manager at Imperial’s White City Campus, explains that this can happen for a number of reasons such as “people not feeling safe or seen as equal contributors in these discussions. It can also be challenging to find the time to engage with these discussions when people are focused on keeping a roof over their families heads and food on the table. Part of our role as an engagement team is to educate colleagues to recognise these barriers and then support them to design barriers out of their engagements and interactions.”
We're helping people find out more about pollution, understand it better and reduce their personal exposure.
Dr Audrey de Nazelle, Senior Lecturer and Co-Deputy Director of the Centre of Environmental Policy, has been involved in some of the recent workshops Imperial has set up with community groups as well as the local council, NGOs and businesses. Dr de Nazelle, who leads NExAir, Imperial's air quality network of excellence, has found engagement with the White City residents to be a very positive experience: “We did a workshop that identified issues residents were concerned about. We had an open discussion of what future cities would look like: more green space, reducing cars and promoting active travel. People were quick to identify with this vision of urban transformation.”
Dr Gia Pendred, who is working with Dr de Nazelle, says people are receptive to the messaging about reducing their exposure. “We’re not saying we can magically reduce air pollution for local communities, because sadly we can’t, but we're helping people find out more about pollution, understand it better and reduce their personal exposure and contributions to it. We’re spending a lot of time indoors at the moment and unfortunately there’s generally a low awareness of indoor pollutants. People merrily cook, griddle and burn toast, use cleaning chemicals and personal hygiene products and think that’s fine, but you need to ventilate and be aware of what products you’re using.”
Behavioural change and citizen science
Dr Pendred reflects that hearing directly from these communities and providing non-judgemental advice can be empowering: “Our aim is to inform people so they’re able to make those decisions for themselves or their children – do they walk to school or cycle, rather than drive? Do they want to do something further as a community or as a group? It’s about having an influence on a wider scale.”
Dr Ben Barratt, Reader in Environmental Exposures & Public Health and Deputy Director of the Environmental Research Group, concurs that individual responsibility can help bring about positive change. He also sees low-cost measures like active travel and community engagement as being examples of relatively small changes that can drive a bigger public health change. Active travel is a triple win, addressing the major public health challenges of obesity, climate change and air quality in one simple behavioural shift.
His rationale is partially based on the success of his Breathe London Wearables air quality monitoring project. This citizen science project entailed hundreds of children wearing backpacks to monitor air quality when travelling between home and school. This led to children and families being able to make decisions to reduce their personal exposure to pollution, such as walking to school a street away from the main road. “Children are key educators. They can influence their parents very effectively,” he says. Such is the success of the project that it will soon launch in Birmingham and Liverpool.
Dr Barratt also believes in the power of personal testimony to engage with communities - by sharing stories, listening and being non-judgemental, we can all learn from one another and help influence positive behavioural change.
Cutting-edge technology and innovation
Imperial’s reputation for innovation is also bearing fruit with projects that tackle pollution at source that will benefit the White City community, as well as many others living along busy roads.
Imperial has now partnered with Arborea, a company founded by former Imperial student Julian Melchiorri. He used cutting edge technology to devise a ‘solar leaf’ that purifies the air by removing carbon more efficiently than trees. The leaves are high-tech panels filled with bio-organisms that remove carbon dioxide and produce breathable oxygen at a rate equivalent to 100 trees. This amazing technology has been adopted by the London Borough of Hammersmith & Fulham and Arborea is now utilising this technology and sunlight to facilitate the growth of microscopic plants to produce healthy food ingredients that will be sold to the food industry.
Another inspiring group of Imperial and Royal College of Art students co-founded The Tyre Collective in 2018, as part of their Master's project. The idea came about through their collective shock on discovering that tyre wear was the second largest microplastic pollutant in the environment, after single-use plastic, and a major source of air pollution. Siobhan Anderson explains how the idea was further germinated by “seeing that people living along the busy main roads are getting the majority of the pollution from cars, delivery vans and HGVs and we wanted a fast, systemic way to balance this inequity.”
Seeing that people living on main roads are getting the majority of the pollution from cars, we wanted a fast, systemic way to balance this inequity.
They have devised a bike trial prototype which has successfully captured 60% of particulates from tyre emissions. Their aim, according to co-founder Hanson Cheng, is to create their first vehicle prototype by the end of the year and launch the project in 2023. Like Arborea, the team is not content on gaining accolades from just their main project; they also want to upcycle the materials captured to produce recycled tyres or new products.
Imperial students and alumni are involved in innovation projects that have the potential to improve millions of people’s lives in the future - and this is only likely to increase as the benefits of Imperial's new campus inspire the student body to do more great work that benefits the local and wider communities.
Dr Gary Fuller believes that measures to improve air quality need to be done equitably. “Air pollution in London has improved this decade but this has been uneven – some areas, and therefore communities, have benefited more than others. We also need to ensure that we tackle all sources of air pollution.
Should we look to change our regulatory approaches and include the right to a healthy environment as a key environmental principle? Should we have the right not to be harmed by the air that we breathe?
“Lack of holistic thinking is perhaps one of the reasons why, nearly 70 years after the great smog, we are still struggling to clean our air. The solution to the air pollution problems of the 1950s was to reduce smoke without tackling sulphur from coal and oil. This led to the acid rain problems of the 1970s. We therefore turned our attention to industry but largely ignored the growing problem of air pollution from traffic. Today most people think of air pollution as being synonymous with diesel cars and while we have focused on them a return to solid fuel burning, mostly wood fires, has become a major urban problem.
“There is lots of evidence. We should talk about what we do know now rather than the scientific uncertainty of the future. Should we look to change our regulatory approaches and include the right to a healthy environment as a key environmental principle? Should we have the right not to be harmed by the air that we breathe?”
Dr Fuller is right to express concern as the latest government statistics show that domestic wood burning in both closed stoves and open fires was responsible for 38% of PM2.5 emissions in 2019. This emissions source has more than doubled since 2003, to 41,000 tonnes a year, and increased by 1% between 2018 and 2019. In real terms, although it’s only a relatively small number of people who burn fuel indoors (8%), the majority (two-thirds) live in urban areas where levels of dirty air are worst and use their fires for aesthetic reasons rather than as a necessity. This is clearly a growing concern and will increasingly have a negative impact on all our health, but especially the deprived communities, even though they don’t typically cause this pollution.
Lack of holistic thinking is perhaps one of the reasons why we are still struggling to clean our air.
The same data source says road traffic caused 12% of PM2.5 emissions in 2019. There are high hopes that Ella Kissi-Debrah’s case will have a positive impact on deprived communities so that future planning measures will avoid building schools, nurseries, new housing, community centres and care homes next to busy roads. Road pricing is a move that will be welcomed by many, as long as it’s done in an equitable way – the larger and most polluting vehicles taxed at a higher level. There appears to be a new trend towards building communities on brownfield sites (including old gasworks sites) and the health impact of pollution from remediation and building works on local established and deprived communities looks set to be a key area of future research.
Valuable research into the effects of other pollution sources on health and communities also looks set to gather pace. Andrew Grieve, Senior Air Quality Analyst at Imperial, has developed the Canairy app to help people working on the frontline of the construction industry to monitor their own personal exposure to pollutants - the pilot project results are due imminently and it’s hoped success will result in a national rollout. The insight provided will have a positive scope for making improvements to the environmental health of construction work, which typically attracts people from deprived communities.
Professor Frank Kelly’s Environmental Research Group will undertake analysis and new methodologies to establish the different types of microplastics and see what health impacts they have. This is a rapidly developing area of research, of which Imperial will be at the forefront.
The end of this year also brings the UN COP26 Climate Change Conference to Glasgow, a landmark event where it is hoped that governments, industry and the public will commit to reducing carbon emissions and preventing irreversible damage to the planet.
This is the first time Britain has hosted the event and Imperial has the privilege of leading the COP26 Universities Network, a growing group of UK-based universities and research centres working together to raise ambition for tangible outcomes from the event. The expectation is that the event will not only create lasting partnerships and legacies, but will further strengthen Imperial’s advisory influence on politicians and legislators who make the decisions that impact our lives here in the UK, as well as globally. Find out more about Imperial's involvement in COP26.
Imperial’s community engagement team will once again be having face to face meetings with the local community to address the effects of pollution in the here and now - and support more residents to get involved in air quality discussions and take action (writing letters to their local MPs, for example).
There are hopes this collective action will place pressure on the politicians to implement change. The Forum team continues to engage with peers on the Environment Bill that is currently being scrutinised by the House of Lords. At a roundtable with parliamentarians organised by The Forum, Imperial academics maintained that a key first step will be adopting the WHO limits and giving councils funds that enable them to address health inequalities caused by pollution in their local area, targeting the most vulnerable and deprived communities.
The Forum is Imperial’s policy engagement programme. It connects Imperial researchers with policy makers to discover new thinking on global challenges. Our features provide a shop window into the world leading research taking place at Imperial and provide insight into how it can inform and contribute to public policy debates.