This researcher says we need to change how we think analyze public health risk assessments

How did a childhood in Mohave County lead to a career in public health? Jenna Honan wasn’t sure at first, but has since figured it out.

Honan grew up in Kingman, Arizona, and is now a public health researcher at the University of Alabama at Birmingham.

She recently wrote a paper for the Journal of Exposure Science and Environmental Epidemiology, called “On why environmental justice must continue to guide public health research.” In it, she argues the public health system should rethink how it evaluates risk, and who is subject to that risk.

The Show spoke with Honan earlier and started with how much of her childhood and her own personal health experiences have shaped the kind of work she does now.

Full conversation

JENNA HONAN: I grew up in an era where we were really always outside as kids. And so I absolutely loved the desert. But there were things that — I was always warned by my dad about flash floods. And so I was absolutely terrified of flash floods.

And because of that fear, I studied them. I would go to the library and I would read about monsoons and what that meant for our types of soils and living next to a wash. And so that really is what fostered, I would say, my interest in environmental science.

For me, the personal health problems — so just to orient your readers a little bit, I started menstruating very young. I was 9 years old. I had a hysterectomy eventually a few years ago. And so I’ve always had some some issues with reproductive disorders, but I never really made a full connection personally between environmental science and my health exposures, right? My exposures that have led to different health outcomes.

MARK BRODIE: So at what point did it sort of click for you that some of the health issues that you have dealt with throughout your life can be traced back to environmental health issues from your childhood?

JENNA HONAN: Yeah, I think, you know, one of the things about growing up in a place where it’s somewhat normal to not be in tiptop shape is that you kind of get used to it and you don’t really question it. It’s just sort of how it is, and I think sometimes it’s even a joke like, “Oh, there there must be something in the water,” right?

But the thing that’s interesting about it is that every woman in my family has experienced some kind of reproductive disorder or or metabolic disorder. And you could very easily say like, “Oh, that’s just got to be a genetics problem.”

But then so did my neighbors, and so did my teachers. And so it was just one of those things where my health and my interest in environmental science were really pretty divorced for me because I didn’t recognize that it wasn’t it wasn’t common.

And so when I started studying environmental science at the graduate level, that was the first time I really went, “Hey, what what actually is in the water though?”

And so the actual personal connection for me though didn’t happen until I was almost done with my Ph.D. I had participated in a workshop, a research training workshop in the Marine Biological Laboratories in Woods Hole, Massachusetts, and it was specifically about endocrine-disrupting chemicals.

And I had done my dissertation on a chemical called perchlorate, which is it’s a byproduct of things like rockets and fireworks and basically anything cool that explodes, right? And we knew that Lake Mead was polluted with perchlorate for decades, and I was specifically looking at the relationship between exposure to this chemical and then the types of health outcomes that we might expect from that — things like thyroid disorders or, again, metabolic dysfunctions, things like diabetes or obesity, and then reproductive disorders like mine, right?

And so I was presenting this this work to a group of really incredible scientists and doctors, and I pulled up this map of Arizona to show them Lake Mead and I was moving my pointer down towards the Colorado River, and there’s Kingman. It’s just hanging out right next to this big contaminated lake. And so, I think I probably went silent for maybe like three seconds, which is kind of a long time when you’re actively giving a presentation, but that was really the first time that I was like, “Oh, wait. That’s kind of strange. I wonder.”

MARK BRODIE: Like it just hit you right then.

JENNA HONAN: It just hit me right then. And that was really what inspired me to write this this article.

MARK BRODIE: So let me read something that you wrote toward the conclusion of this piece. You say, “Environmental health disparities exist as predictable consequences of how we conduct risk assessments, how we blanketly define acceptable risk and how we implement environmental policy.” It sounds like what you’re saying is like these are all very predictable and preventable situations.

JENNA HONAN: You know, that’s really tricky. Prevention is obviously the focus of of public health, but it is, I would say, somewhat naive to think that it would be feasible to have 100% protection for all the contaminants for everyone all the time.

Maybe that makes me a cynic, but I think really the discourse is around how we define protection. And I think a lot of times when we do these types of risk assessments, we’re really missing the context of the people who are behind the numbers.

And it’s one thing that I think is hard about health risk assessments is a lot of times they’re retroactive. So we do these assessments when we know that there might be a problem. So I would say in the U.S., we we love to say innocent until proven guilty, right? And it’s kind of the same for for pollution.

So we have to prove that something is bad or or leading to health problems for anything to really happen. And so the burden of proof for what’s making people sick is really on the people who are getting sick. Whereas in places like Europe, you have to prove that something’s OK before industry can start using it.

So something like that would be, I think, really really useful for us to transition to in terms of protection for people.

MARK BRODIE: Well, it’s interesting because one of the things you write, and I’ll have to paraphrase this, is that, even if an entity says, “Oh, this is 95% safe,” that 5% for whom it might not be safe, based on the population, can be millions and millions of people.

JENNA HONAN: Right, exactly. And it’s it’s really hard because you think, you know, if I get a 95 or a 99% on a test, I am doing great, right? Mom’s proud. But really the biggest problem is that that percentage is also not equally distributed among everyone, right?

We know that certain areas don’t have to worry about their water quality, whereas some areas it is an ongoing problem that is it’s really hard to find the resources to fix it. And so it’s really it’s really about figuring out who is in that 5%, why they’re in that 5%, and what can we do if we really want to help everyone? Reaching that 5% is the piece that’s missing.

MARK BRODIE: What kind of response have you gotten to your research, to maybe what you’ve written from some of your family members and the other folks back in Kingman? Like folks who were sort of affected by what you’ve been writing about and researching?

JENNA HONAN: I would say most of the the conversation has still come from the academic side of my world. It is extremely difficult, even as someone from the community, to grab the attention from people who are even most affected by this research. You are competing with so many other variables.

I certainly haven’t gotten any hate mail, which is good. I I just I think it’s really hard. People have a lot of decision fatigue and conversation fatigue, and things are just really really kind of messy right now. So it’s, yeah. I just think it’s really competitive, very competitive field.

MARK BRODIE: Jenna Honan grew up in Kingman. She’s now a public health researcher at the University of Alabama at Birmingham.

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