Spending, Equity, Health Outcomes at Heart of TCI Debate

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Dr. Mark Mitchell was taking his daily walk around Hartford – the city where he had lived and worked for over a decade – when he felt a pain in his chest.

Mitchell was leading a relatively active and healthy lifestyle, but all four of the main blood vessels of his heart were partially clogged. 

Mitchell said he is the first person in his family to have coronary artery disease, and the first to have asthma. He is also the first person in his family to live in Hartford – he grew up in an outer suburb of St. Louis, where the air pollution was less severe than it is in his neighborhood near Hartford Hospital. 

“It’s not theoretical to me, it’s real,” said Mitchell – the former director of the Hartford Health Department and current professor of climate change, energy and environmental health equity at George Mason University. “I attribute it to the air pollution from living on a busy street for 30 years.”

“It’s not theoretical to me, it’s real,” said Mitchell – the former director of the Hartford Health Department and current professor of climate change, energy and environmental health equity at George Mason University. “I attribute it to the air pollution from living on a busy street for 30 years.”

How federal, state and local governments chose to route highways, build garbage incinerators, and locate energy plants decades ago has disproportionately affected the health Black and Latino populations for years, even after accounting for income disparities, according to a paper published Wednesday in Sciences Advances, a peer-reviewed journal published by the American Association for the Advancement of Science.

In Connecticut, the concentration of air pollution in the form of particulate matter is on average 27 percent higher for Latino residents and 30 percent higher for Black residents than for white residents, according to Maria Cecilia Pinto de Moura – senior vehicles engineer with the Clean Transportation program at the Union of Concerned Scientists.

This pollution, in the form of vehicle soot, industrial- and agriculture- and energy-sector air pollution is the leading environmental cause of premature death in United States.

The inequity is at the heart of a multistate pact, spending plan, and tax on gasoline and diesel fuel – together called The Transportation and Climate Initiative, or TCI.

Carol Platt Liebau, president of the Yankee Institute, a conservative-leaning policy nonprofit based in Connecticut, has called TCI a regressive tax that would result in $388.6 million per year in increased gasoline costs across the state. 

Advocates of the program have negotiated for half of revenues to be set aside for projects in communities with high levels of vehicle pollution, or that are underserved by public transportation. They say that money has the potential to start to address how the burden of that pollution has been placed disproportionately onto neighborhoods that are home to the most people of color.

Unseen costs

The South End of Waterbury is littered with brownfield sites, polluted land left by industries that once made a name for the city, and now characterize Waterbury in their absence.

Robert Goodrich, executive director of Radical Advocates for Cross Cultural Education – a group that mainly works to address educational disparities in Waterbury – said that children have to walk past those polluted sites and heavy commercial vehicle traffic every day on their way to and from the city’s community schools.

“They’re dealing with things they don’t even know they’re going to have in five or ten years, but it’s building in their systems now,” Goodrich said.

Kai Addae, of the Bradley Street Bicycle co-op in New Haven, mainly gets around the city using a bicycle. Addae said that most of her friends who ride bicycles regularly have been in a crash and understand some of the danger of motor vehicles, but long-term health of effects of sitting in traffic and breathing in vehicle exhaust are less visible and less understood.

“A lot of it is long-term, like I’ll find out in 20 years if breathing in all of this pollution is causing a problem,” Addae said. “We know about these micro-pollutants that cars give out and how dangerous that is. Certainly, when I’m sitting behind a car and smell the exhaust, I worry what it’s going to do to my body.”

Mitchell, whose life’s work is studying these issues, said his asthma and heart disease demonstrate the kind of damage from exposure to vehicle exhaust.

“A lot of it is long-term, like I’ll find out in 20 years if breathing in all of this pollution is causing a problem,” Addae said. “We know about these micro-pollutants that cars give out and how dangerous that is. Certainly, when I’m sitting behind a car and smell the exhaust, I worry what it’s going to do to my body.”

The link between air pollution and heart health may not seem obvious at first, but is now well established in the medical literature, including an EPA-funded, decade-long study by researchers at the University of Washington that revealed a link between air pollution and the buildup of plaque in the coronary artery – the exact condition Mitchell is now dealing with.

More apparent is the widespread problem of asthma in Connecticut. About 10.5 percent of people currently have it, according to data kept by the Connecticut Department of Public Health. But the rates of asthma aren’t equal – about 12.7 percent of Black adults and 12.2 percent of Hispanic adults have it, while 10.1 percent of white adults in Connecticut have asthma.

The disparity is higher in children. Eight percent of white children have asthma, while 16.1 percent of Hispanic children and 11.2 percent of Black children have asthma. 

While not accounting for disparities between populations of the use of emergency rooms for primary care, across Connecticut in 2019, there were 17,358 emergency room visits where asthma was the primary diagnosis, including 5,485 visits for children. Nearly half of those visits were patients from Hartford, Waterbury, New Haven, Bridgeport and New Britain. In Waterbury alone, there were 515 emergency room visits for children caused by asthma.

And those patients are clustered not just in the cities, but in a handful of census tracts within each city, DPH data shows.

Mitchell said almost half of the households in his neighborhood in Hartford didn’t own cars, but the large numbers of commuters to the city each day meant that he and his neighbors still suffered from some of the highest traffic-related air pollution in the state.

Hartford also serves the entire region by hosting the MIRA trash-to-energy plant and recycling facilities. While the localized pollution directly from these facilities is debated, hundreds of trucks each day haul trash into Hartford from other towns, releasing fine particulate matter from diesel exhaust.

“You can measure the amount of particulates in the air today and predict how many people are going to die from heart disease,” said Mitchell.

Waterbury has its own major trash facility, the F&G waste transfer station that brings dozens of heavy, diesel trucks into the South End daily. In 2017, F&G sued the city so it could more than triple the amount of waste it accepted each day over objections of residents and the city’s Planning and Zoning Commission.

“We fought like hell to stop it,” Goodrich said. “Any time it gets over 75-80 degrees, the stench is just horrible – and that’s just one facet of pollution that exists in the South End.”

“Visiting nurses were saying that it was the apartments that were facing the highway that have the highest number of people with severe asthma, and the most emergency room visits and hospital visits for asthma attacks,” Mitchell said. 

According to Mitchell, particulate matter is much higher near highways. Even a few feet away can make a difference, and the risk of certain diseases decreases dramatically about 1,500 feet away, he said.

Mitchell recalled the high rates of asthma among residents of the now-shuttered New Haven housing project, Farnam Courts, located directly adjacent to Interstate 91 and Grand Avenue. According to Mitchell, particulate matter is much higher in the vicinity of highways. 

“Visiting nurses were saying that it was the apartments that were facing the highway that have the highest number of people with severe asthma, and the most emergency room visits and hospital visits for asthma attacks,” Mitchell said. 

At the time, the New Haven Housing Authority didn’t allow air conditioning units for the building, and there was a two-year waiting list for the housing, he said.

“The people who were there, no matter how sick they were, they could not afford to move,” Mitchell said. “They didn’t have the option of moving, no matter how often they went to the emergency room.”

The goals of TCI

According to Mitchell, the main way that TCI can address the pollution is by speeding up the adoption of electric vehicles. Electric garbage trucks and buses in particular could have a significant impact on reducing diesel emissions in Hartford, he said.

“There’s a lot of opportunity with the TCI to invest – if we can get some businesses to convert their fleets to electric, if we can get electrified trucks, garbage trucks.”

Mitchell said that previous environmental justice efforts in the state legislature have only slowed the growth of these disparities by giving communities more input in how facilities that could be major sources of pollution are considered.

But with TCI, the scale of the promised investments, and the promise to reduce emissions, Mitchell said, has the potential to reduce those disparities.

At the same time, opponents have questioned another way the TCI could reduce emissions – by making it more expensive to drive gasoline or diesel powered vehicles, pushing drivers more quickly into electric vehicles.

Proponents including DEEP Commissioner Katie Dykes and state Sen. Christine Cohen, D-Guilford, co-chair of the Environment Committee, say that isn’t the intent of the TCI. 

“That’s how it works,” he recently told CT Examiner. “Capping a per-gallon cost in the first year does not change the fact that the program by design seeks to make gas too expensive for people to afford.”

Opponents including Senate Republican leader Kevin Kelly say a program that meaningfully reduces pollution can’t accomplish that goal without meaningfully increasing the price of gasoline for consumers.

“That’s how it works,” he recently told CT Examiner. “Capping a per-gallon cost in the first year does not change the fact that the program by design seeks to make gas too expensive for people to afford.”

Sen. Gary Winfield, D-New Haven said at a recent virtual forum hosted by the Commission on Women, Children, Seniors, Equity & Opportunity, that he came into the conversation skeptical of what the program would do for the communities that bear the largest burden from pollution.

At the time, he said he was the only Black person in the room at these discussions. But Winfield said he became a supporter of the program as the conversation grew to include more Black and brown people from the most heavily-impacted communities.

“As we’re looking at a piece of legislation, we should think about the fact that that legislation doesn’t get passed unless the people who are affected are in agreement,” Winfield said.

One significant change has already been made to the bill, increasing the amount of TCI revenues that are overburden by pollution or underserved by transportation from 35 to 50 percent.

Advocates told CT Examiner it isn’t the last change that needs to be made before the bill is passed. For one, they say the terms “overburdened and underserved” need to be defined. They are also calling for monitoring and metrics to evaluate how much pollution is being reduced in targeted communities.

“Often they say, ‘Go out and grab your people from Waterbury,’” Goodrich said. “Well, they have to work, they have to provide childcare. If they miss a day of work, that means they have to decide whether they can make their car payment or provide a quality meal to their children, and that’s inherently unfair.”

Another key debate is how to construct an advisory board that is meant to represent people living in those “overburdened and underserved” communities and help determine how TCI funds are spent.

Goodrich said that giving the board adequate resources and the space to create its own process are essential. He said the board will need to govern itself as an independent body, be able to set compensation for members, and have the funding for the tools and resources to measure pollution and understand the impacts it has on people’s lives.

“Often they say, ‘Go out and grab your people from Waterbury,’” Goodrich said. “Well, they have to work, they have to provide childcare. If they miss a day of work, that means they have to decide whether they can make their car payment or provide a quality meal to their children, and that’s inherently unfair.”

Goodrich also said that, in order for the process to work, state agencies must respect local residents’ knowledge and viewpoints that are often dismissed or ignored, making them feel “less than.”

“That represents all of the historic harms and traumas that are associated with living in conditions like in the South End of Waterbury, where you don’t have access to jobs, you don’t have a good public school system, and there’s lots of air pollution and commercial vehicle emissions,” Goodrich said.

If equity is really important in TCI, Winfield said, it will take lawmakers following up and looking at how the program is actually working and how the money is being spent.

“Honestly, we’re going to have to see how good of a job we do there, because that is a place where we often fail,” Winfield said at the forum.


A previous version of this story incorrectly identified State Sen. Christine Cohen’s hometown as Clinton rather than Guilford.