LISTEN: Brenda Trejo Rosas on the social dimensions of health

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Brenda Trejo Rosas joins the Agents of Change in Environmental Justice podcast to discuss how public health can move beyond treating race as a mere data point.


Trejo Rosas is a PhD Candidate in the Environmental and Occupational Health Department at The George Washington University Milken Institute School of Public Health, and a senior Agents of Change fellow. She also talks about different forms of environmentalism, the power of mentors, and her research on healthcare workers during COVID-19.

The Agents of Change in Environmental Justice podcast is a biweekly podcast featuring the stories and big ideas from past and present fellows, as well as others in the field. You can see all of the past episodes here.

Listen below to our discussion with Trejo Rosas, and subscribe to the podcast at iTunes, Spotify, or Stitcher.

Transcript

Brian Bienkowski

All right, I am super happy to be joined by Brenda Trejo Rosas. Brenda, how are you?

Brenda Trejo Rosas

I’m doing well. It’s so good to be here and see you, Brian.

Brian Bienkowski

So I wanted to start. As I said, I had the good fortune to work with you with our first cohort. And your essay ended up being one of my favorites from that cohort. And that’s like picking a child, I guess. But it really, it was just a really nice piece. And I wanted to start there because it talked, you spoke briefly about some of your upbringing, and I wanted to quote it. So in the essay you wrote: “an abundance of family practices connected me to others and the environment, as a young child, my great uncle would solicit my help to shell corncobs for tortilla nixtamal,” – I’m probably pronouncing that wrong– “passing on the cultural, ecological knowledge of Mesoamerica. My parents built a well to collect rainwater for home use, connecting me to vital elements.” So I really liked this painting a picture of kind of early connections to the environment, to people, to family. So from that starting point, can you talk about this upbringing and how it shaped your decisions to pursue a career examining health and the environment?

Brenda Trejo Rosas

We are farmworkers. And we come from this small town, and I think I’ve mentioned it in the blog, it’s called Zimapán Hidalgo, in Mexico, and that city is historically a mining town. And if you want to understand the history of the town too, it was colonized by Spain. And so there’s still a lot of indigenous people there. And so we have a lot of those indigenous practices. Moving from that, there’s a lot of like things, recognizing that, you know, my grandparents and my parents and my great grandparents spoke their indigenous language, I had a nickname in their indigenous language, and they just did things differently. And we had land, or the family had land and farms and animals. But that changed drastically too because of drought, you know? there was less water as the decades went by. And so that influenced my family to come to the States.

Brian Bienkowski

And another thing you mentioned in the essay was how environmentalism was framed as you got older, you know, getting past some of your childhood and some of these experiences with questionable folks like John Muir, who has kind of a racist past or, you know, just seeing it all be expensive outdoor gear and white people out hiking as the kind of model of environmentalism. So, can you talk about how this was at odds with your experience and maybe some of the environmentalists that you do look up to and drive your work?

Brenda Trejo Rosas

Yeah, I think that was super at odds with my experience because just with my family, we spend a lot of time outside, you know? it doesn’t have to be outdoors, we just call it outside. Like going to college undergrad, a lot of people taking these hikes but you had to have all this fancy gear and shoes. And I didn’t really understand that. And I was like, “Oh, is this the barrier to go to this hike out here?” And then I learned it doesn’t have to be like that, you know? you can have very simple things to go out there. Yeah, some of the equipment is helpful, but it’s not necessary. And I think in my… I appreciate my department and I learned so much from it. But I think there wasn’t an emphasis of other environmentalists outside of American environmentalism, except they would call it southern environmentalism. Yeah, they included I think, like even the Chipko movement in India. I think the environmentalists that I look up to are, first and foremost, my family.

Brian Bienkowski

So I’ve been asking all of the fellows what is the defining moment or event that shaped your identity. So this could be personal, professional, just something that stands out in your mind that was a lightbulb moment of helping to kind of shape who you are.

Brenda Trejo Rosas

There’s many, of course. One that comes to mind right now is more of a relationship. And that relationship was my English teacher / literature teacher in high school –I’m used to calling everybody a professor, she wasn’t a professor– my high school teacher, Miss Courtney Morgan, she’s amazing. This was in Idaho Falls, Idaho, Skyline High School, shout out to them, shout out to. She was also the advisor of our newspaper, the West Side Story. And she was amazing. Actually, I met her through my older sister. When she was in high school and I was in junior high, she would stay late for late nights. And so I’d have to walk over there and be like, “Come on, let’s go home.” And that’s how I met [her], this way. She was like, “Oh, who’s this young person?” And maybe that’s when she started recruiting me into the newspaper. But she was amazing. She, and she agreed with this. Unfortunately, Miss Morgan passed away in early 2020. Now that I reflect on it, she had a great impact in my life that I didn’t even realize she was having at the time. And she did this to so many of us. I think she, one of the things is like she saw us, she heard us, she saw us and she gave us opportunities. And she let us develop our voices by giving us the newspaper. So what I did in the newspaper was [that] I was the Spanish page editor. And at that time, we were the only high school newspaper with a Spanish page. And so we would do it bilingual. So that was really cool. Because I didn’t have any other space to be myself, you know?

Brian Bienkowski

Yeah, what a touching relationship. It’s amazing how much of an influence a good teacher can have. And they’re just such under-appreciated pillars of society. So thanks so much for sharing that. And so now speaking of where you’re at today, so you’re focusing on… you’re a PhD candidate looking at disparities in environmental and occupational health. So tell me a little bit about [that]. We’re going to dig into some of the research that you’ve been involved in lately, but just kind of give us what your focus is on and why this field?

Brenda Trejo Rosas

Okay, yeah, I think, definitely folks should read my paper that I wrote for Agents of Change, because I think that’ll delve into it in terms of why did I decided to go into this field and it has to do with learning about a toxic waste dump being builtin Zimapán Hidalgo, Mexico, where my family is from. And it was built without the consent of the community, they faced repression for it, and we didn’t want that in the community. And so I wanted to learn, you know, like, how can people hear our voices? And then I reached out to the folks engaged in the movement, and I was like, “Hey, I’m out in Idaho. How can I help you all from here?,” they’re like, “well, Brenda, you can start by figuring out how the US deals with their toxic waste. Because I don’t think what’s being done here is the way that they would do it there, you know? can you find out what regulations they have?” And at that point, I was, like, 18 years old in undergrad. I had no idea, you know? I didn’t know where to look or anything. And so that’s why I started exploring environmental studies trying to learn as much as I could. And I was reflecting on that. And actually, today, I could! I could probably figure out where to look, who to ask, I have mentors, and I could also be like, “you know what? actually, in the US they do violate people’s [rights] – we actually don’t, we don’t have a right to a clean, safe environment.” So I would say they would violate that, but we don’t have that right legally, you know? um, so yeah, that’s why I went into it. And so yeah, I am proud of myself and the relationships that have gotten me to here.

Brian Bienkowski

That leads me nicely into the next question. So you were recently a senior author on a paper called “Pervasive structural racism and environmental epidemiology,” which kind of speaks to this body of literature that you were just mentioning. So you’re now part of that, of course. And you wrote, one of the lines was, “health research reduces race to a mere data point, and avoids the social dimensions of health, and thus fails to improve population health for all.” So I think that one line summed up a lot of the paper for my small brain, the non-scientists brain, and I really liked it. So can you talk about this issue, and maybe some of the solutions that you and your co-authors put forward to not have this be ignored? And not have this be the case in health research?

Brenda Trejo Rosas

This article also came out of the COVID, 19 pandemic, and she given me space in her lab to voice what I was feeling. They’re like, “No, we can’t keep this going and stuff.” And so this paper comes out of that. And the lab and everybody, they’re amazing. So, yeah, I like that sentence, it talks about, you know, it’s something I remember actually asking one of my professors in a data analysis class, you know, like, “I don’t understand, we’re using race as a categorical variable. But race is a social construct. So what does this tell us? like, is there something biological? I don’t understand why are we using it like this?” And she… I don’t remember like what they answered, but I wasn’t content with the answer. And I think it continues on. Also, you can look at a lot of literature in environmental health where white is the norm, the default. Even if you look at race as a categorical variable, you have all these different races/ethnicities also, and there can be a mix of them. But one that you’re definitely sure to find in that mix is white. And other ones can actually be “non white,” you know? so like, Okay, what is the default here? but rarely, actually, yeah, very rarely, you’ll have people explain… Actually, I can’t think of a public health journal, but that doesn’t matter, because I don’t know everything, right? But most of them don’t tell you how they’re using race, you know? It’s like, “oh, we measured race.” Okay. And so I’m like, “Okay, so, alright, you’re measuring it. But what’s it a proxy for? What is it a proxy for? What are you? What does it tell you?” And that was never answered in my classes. So if we’re going to use it, and we do see disparities, you know, differences when you’re looking at things through different races. But that’s not the whole story, you know, and it’s like super simplified, and unfortunately, because of the history of the US, and a lot of medical history too, people don’t understand it either, [people] that are using it. But most of the times they think there’s biological reasons, you know, that, “Oh, because you’re this race, you’re going to have worst health outcomes” and stuff like that, but it doesn’t work like that. RaceCISM is very real, it’s a system, it doesn’t have to be individual. There’s a structural system that shapes the reality of many people in this country specifically, and I’m pretty sure around the world, and that impacts your health. To me, it’s very, it’s kinda like, it’s just walking, right? Because it’s part of my life and my experience and my community’s experience, you know? And now I’m in the position where I’m trying to get other folks to explain it, to understand it. I think it can make people uncomfortable. What I see is people, many people, not all people, of course, are not comfortable with being wrong, you know? like, wrong is like the worst thing you could be, you know? and wrong means that you’re learning, and wrong doesn’t define your character. And you can change after that. We should always be learning and changing. Our culture is always doing that, you know? the planet is always doing that. So I think there needs to be like more humility, and accountability, and more acceptance of the learning process, you know? we’re not always going to be right. And so okay, we’re doing it this way, let’s be accountable, know that that has had an impact, and let’s move forward. But genuinely move forward to change how we address racism in the field and other systems of oppression.

Brian Bienkowski

That’s true for research, it’s true for journalism. You get people that have… part of what you said is true on the individual level, just people not wanting to be wrong, not wanting to change. But it’s also true on a systems level. Where, you know, the way I think of media a lot, the way media has operated for decades, which is how they operated, and [they’re like] “we know how to do this,” [they’d say] “well you worked at a newspaper, you know the structure.” But you know, now people are saying, “Well, hey, maybe that’s not enough,” you know, now we’re in this age where facts don’t matter, and post truth and all that, so journalism needs to change, we need to adapt. And research [is] the same thing, you did the same, not you, but the broader you, the field, did the same thing for so many decades of “this is how we research, these are the data points we look at, we spit out a study, we get a grant, we get tenure, we go on with our lives.” And so to change that is difficult. But you know, I know folks like you are pushing the change and changing a system obviously, is a challenge.

Brenda Trejo Rosas

It happens though. I think it reminds me of… one of my majors in undergrad was cultural anthropology. And so in the courses that I took, we had to learn the history about the field. And they had what they called “armchair anthropologists,” where they literally sat on what they describe as the veranda, like anthropologists, and watched the other people. So there was a differentiation between people and other, you know? and I know people use, like, “armchair epidemiologist” or something, but I don’t know if they’re aware that that was used, well I don’t know, but it was used in anthropology to describe those anthropologists. And so the anthropologists had to sit down, you know, they came up as a field, you know? they came up with new methods that they use, and I think some of those methods could be very useful in epidemiology. For example, understanding your positionality and self-reflexivity, you know? like, you’re not just a researcher that is researching. Who you are, how systems of power and oppression influence you and how people engage with you, is going to inform your research, you know? and so anthropologists have the practice of right at the beginning, you know, like, it’s kind of like, what do they call it? Disclaimer? I don’t know. [It’s similar to] what they do in public health with conflict of interest, you know, it’s kind of their version of conflict of interest – our version is weak, I think – where they talk about, like, This is who I am, these are my identities, and that’s how that could have influenced my relationships with participants, or studying this, you know? but it’s like a strength and a weakness, you know? and so you just put it forward. So, I think, knowing about that history, about how a whole field could change, you know? gives me hope that public health and environmental health, environmental epi can change as well.

Brian Bienkowski

Excellent. Yeah, I totally agree. And I’m glad to hear a little bit of optimism because it does seem like there are some cracks in the foundation. And maybe it’s just the people I’m speaking to and around, but it seems like there’s people trying to shake the system for the better. And this study was not the only thing that I saw you’ve worked on recently. You were part of, speaking of COVID, you were part of the COVID-19 healthcare worker survey. I mean, we’ve all seen what’s going on with healthcare workers the last few years. I know, I have multiple health care workers in my family and my partner’s family, and what they’ve gone through the last few years is nothing short of traumatic in just about every case. So tell me about the survey. What did you ask, what did you find out?

Brenda Trejo Rosas

I do have a connection with healthcare workers, you know? my sisters are in health care, they live in different states. And I just, I think at the beginning of the pandemic, my mentors in Environmental and Occupational Health have trained me well, to understand what PPE is – personal protective equipment – , and the hierarchy of controls, you know? of what interventions can be used in a certain context. And seeing that healthcare workers didn’t have this PPE to protect them just frightened me, you know? and I wanted my sisters and other health care workers and other family members to be safe and they weren’t. I was hearing all these stories about how some employers didn’t believe in COVID-19 or retaliated, because they wanted to advocate for themselves and use PPE. And it was different all over the map, actually, because there wasn’t a federal response. So I know, like, one of my sisters is in a state where they, from the get-go, were protecting their health care workers the best that they could, including providing PPE, and using telemedicine, if that was feasible. And then another sister, that was not the case, you know? and she didn’t learn about some opportunities until later. So yeah, and then I was like, “Okay, well, we need to find out…” I talked to Dr. David Michaels, and I’m like, “Hey, I’m very concerned about health care workers, and how can we find out you know, how many of them are getting COVID-19?” and all these things. And so he suggested places that I should look and that were reporting like COVID-19 cases, and none of them… There were actually some state departments, early on into the pandemic, health departments that were reporting by occupation and reporting health care workers. Of course, these were under reported, but some of them had [this data] others didn’t. And so I think, from the beginning, and from, like, my training that I have in public health, I’m like, “Oh, it would be important and useful to do this.” But it wasn’t being done. And the stories of healthcare workers weren’t being told. And there wasn’t a place I could go to that was reporting on, you know, are they getting PPE? Are they being trained on how to use PPE? What are they being told? Or in terms of like, COVID-19? What do they think, you know, what is their experience? And so, with Dr. David Michaels, we and other folks at GW and and other folks that Dr. Michaels knows, that works with workers, healthcare workers; I think some unions also, so they represent the voice of these workers. We came up with this survey, and it’s completely anonymous. And what we found, I don’t have the report in front of me, but we could share the report later. But in general, there were, there was… I think, for me, one of the most powerful results from the study was the voices of the health care workers because there was a space where we asked them, you know, to share about their experience. And they did, you know? and even going through the responses can be traumatic in terms of them being made fun of, being retaliated against for advocating for themselves, not having a space to share what’s going on. I know there were some healthcare workers of color who mentioned that health care workers of color were less likely to have PPE. And then also there was a hierarchy in terms of like, maybe doctors would have more access to PPE than other folks who work in the healthcare setting, like, folks that – I’m not a person that works in the healthcare setting so I don’t remember the name– but I think they’re transporters, they transport the patients, they would be less likely to have PPE. Or some folks with medical degrees wouldn’t see the patients and would have nurses see the patients instead. So yeah, there were a lot of things that don’t seem right and seem influenced by power, you know, who has power in this context? And how are they using that power? Now, there were employers and other people who do have power, who may have higher power through higher educational attainment, who did advocate for their workers, you know? and so some of the health care workers share that as well. So we did come out with a report. I encourage people to look at it. And it’s on Excuse me. It’s so unfortunate, that is still the case, we’re still not listening to health care workers.

Brian Bienkowski

Before I get to my last question. My second to last one is, you talked about this a little bit before about some of the ways you’re optimistic about the field, you know, some directions we can go. I just wonder if you could just expand about that. What are you optimistic about when you think about the field of environmental health and justice? What are some things you’re seeing, people you’re watching? What are some of the things that give you hope?

Brenda Trejo Rosas

Brian, I think the Agents of Change in Environmental Justice program for sure. I think that is a rock for my hope right now in the field, in terms of learning about the work that other scientists are doing to address environmental injustice in our world. So yeah, I think that’s super important and it gives me hope, it makes me feel less alone. And it helps me see that there’s a lot of relationships that might not be highlighted elsewhere, and research of folks that are doing numerous of things to make the field and address environmental injustice, make the field better and address environmental injustice. So yeah, I think that’s definitely one. The other is through social media and following some of these folks, I learned about other people too, you know? and their research and so that gives me a lot of hope. Like I think about Dr… I think, I may pronounce it wrong. So bad. But Dr. Chandra Jackson, and she studies health inequities in the environment. And she came to GW where I’m a candidate and talked about sleep disparities and how their environment impacts sleep, then she did like a whole history and she used terms that… she used racism, you know? she used systems of power and privilege to explain what’s going on, to contextualize how that’s impacting sleep disparities. And so she, to me, she is a powerhouse, you know? it’s super competent and knows what she’s talking about and explains it. And I envision moving forward that folks will be using the terminology that she’s using and doing research the way that she’s doing research to address environmental injustice. Yeah.

Brian Bienkowski

Great. Well, thanks so much for that answer. I promise listeners that we do not ask, I do not ask that question so people say Agents of Change, but it is really an honor that you do mention it. And you know, for me, too, it is a source of optimism for me too. I’ve covered science as a journalist for more than a decade, and just seeing the breadth of people out there, who are doing science outside of the same people you see in the media being quoted all the time, is a source of optimism. And I totally agree. So Brenda, we’ve reached the end, and I’ve been asking everybody this question, what is the last book that you read for fun?

Brenda Trejo Rosas

There’s two.

Brian Bienkowski

There’s two. All right.

Brenda Trejo Rosas

One is called “Trejo.” So it’s by Danny Trejo. I don’t know if you’re familiar with Danny Trejo?

Brian Bienkowski

Everybody’s familiar with him even if they know it or not!

Brenda Trejo Rosas

Yeah, he’s amazing! And so his book is really awesome too, you know? it talks about trials and tribulations in his life, and how he has used that to make change and to help other people, you know? and he focuses a lot on relationships and nourishing those relationships. And yeah, it’s just an amazing book. I actually listened to the audiobook, and it’s read by him. So it’s really cool to have to be listening to Danny Trejo narrate his book. And then the other one that I just finished also an audiobook, I’m very into audiobooks, because I like to listen and move around. Is… what’s it called? It’s… I think it’s “White tears and brown scars, how white feminism betrays women of color.” And so, yeah, that one is a really good book, too. It can be heavy, but for me, I found it very validating about my experiences as a woman of color. And hearing about, you know, why some of the things that we experience happen historically. And so it just really opened up my eyes about these things. And I think for anything to improve, we have to bring to light some things that aren’t working. And so I think that book helps bring that to light, you know? And, yeah, so I hope that’s a hopeful note, Brian.

Brian Bienkowski

yes, yes, definitely. You know, I was listening to a podcast, I want to say it was over last summer. Last summer I was listening to and Danny Trejo was on talking about his book. And for those who don’t know, if you just do a quick search of Danny Trejo, you will know who he is because you’ve seen him in a zillion movies often playing a bad guy. But I really want to check that out! both of those books sound really great, and I appreciate you sharing those.