Stephanie Lovinsky-Desir, MD: The Power of Education and the Importance of Helping People

January 8, 2024

Dr. Stephanie Lovinsky-Desir had many reasons for pursuing the distinguished, ambitious path that has led her to become a pediatric pulmonologist and landed her at Columbia University, including suffering from asthma herself as a child and realizing that her condition was intimately wedded to environmental circumstances. This has given her a compassion for patients that illuminates her personality and makes her a delight to speak with. She shares how the fundamental values she gained from her Haitian-immigrant parents have undergirded both her success and her service to others. She brings passionate dedication to her direct care for patients and parents and inspires young people to pursue science and improve their world while doing it. We discuss her path, work, community, insights, books, and the work we are doing together on the Children’s Health Protection Advisory Committee to the EPA (CHPAC).

This interview has been lightly edited for length and clarity.

JMK: Good morning, Stephanie! So good to see you.

SLD: I am blown away by this project you are working on. It’s so incredible to share your obviously very challenging story and life experience. I just wanted to say that I really admire how you come from a story that is obviously very challenging, opening yourself up to this vulnerability. The little bit that you shared in your email sounds like it has the potential to really raise awareness.

JMK: Thank you so much for that. One thing I'm learning is, everyone has stories, and so many of them show the real costs that we are all paying for the contaminated world that we're living in. So thank you. It is difficult to share about Katherine, but she was brilliant. She wanted her life to matter. And so I feel like this is something I can do. I don't want any other children to suffer. I noticed in your bio you suffered from asthma as a child and that that's part of the inspiration for why you're doing what you're doing, which I think is wonderful.

SLD: It's so funny, because I think as a pediatrician, I have the space and the platform to really interact with kids in a way that hopefully will inspire them in the future. And I often tell people, you know when you are doing work that's close to home or close to personal experience, it has so much more meaning. My life experiences are clearly what brought me to what I'm doing today. And so as you say, this improves the quality of life for many people. I'm hopeful that this work that I'm doing can expand access and really improve health more broadly.

JMK: Yes, I could not agree more. I’ve been working really long hours on this project, but when you have that sense of purpose, you can do a lot. So I appreciate you taking time out of your busy schedule for this, and I am really enjoying getting to know you through the CHPAC as well.

SLD: It’s funny because, this is one of our early meetings, and I’m not a lead (Pb) researcher. Yes, my science is not in this space, but still, being involved in this charge question on lead and bringing my own lens to it has been great – I’ve learned so much.

JMK: And I’ve veered into the humanities and only come back to my science background recently, so you’re several steps ahead of me!

My first question we've already started talking about – what first prompted your interest in children's environmental health, like your experience with asthma? I wondered if you want to tell me that story in a little bit more detail, or anything else in your childhood or early training.

SLD: Okay. I was born of immigrant parents. My family comes from Haiti; my parents didn’t graduate college, but I have just been reflecting. There were two key tenets in our house: the power of education and the importance of helping people. My mom very much emphasized that we needed to do well in school, while my dad was the one who would say, I will give you the coat off my back, I will do anything for others. So growing up in this household, I experienced a lot of emergency department visits and hospitalizations with recurrent respiratory infections. I had asthma and recurring ear infections, so I was exposed to the medical field early on as a sick child. My mom loves to tell this story about how I told her when I was just five years old – and it’s funny because my daughter is going to be five next week –Mommy, I am going to be a doctor when I grow up. I realized that doctors had this superpower of not only making children feel better, but making their parents feel better too. For whatever reason, that just resonated with me, and I wanted to learn how to have that superpower. So that’s what brought me to medicine.

I didn’t know I was going to be a pulmonologist until my residency training in social pediatrics in the South Bronx. We had a very high asthma rate, and part of this social pediatrics training included learning more about the communities in the neighborhoods and environments where the people that we take care of live. We did a walking tour of the South Bronx, and I was first exposed to the idea of environmental justice and the idea that the community where the children I cared for lived was causing them harm. There were waste transfer stations in this teeny-tiny neighborhood, tons of diesel truck traffic polluting the air. It’s in this community called Hunts Point in the South Bronx that sees a huge burden of traffic-related air pollution and has some of the highest asthma and asthma mortality rates. It was there in my first year of residency that I thought, oh! There’s a link here to what I experienced – there’s a need here for someone to be advocating and addressing this environmental justice issue. So that is what brought me to a pulmonary fellowship.

JMK: That’s a great story! Now, where did you grow up?

SLD: I grew up in Westchester just outside of New York City (NYC). We lived in a town called New Rochelle – we ended up there because there was a huge Haitian immigrant population there – the grandmothers came, and then they brought the kids. I am one of those people who haven’t left NYC much, and so I talk about my NY bias because I lived here and have done all my training here. I left for four years for undergrad at the LaSalle University in Philadelphia, and then I came right back to New York.

JMK: Wow! And then to end up at Columbia – that must have been a dream come true!

SLD: Yes. I don’t have this Ivy-League pedigree. My father had a high-school education and came to this country and first worked as a janitor and then an HVAC technician at Iona College. He had been there for 20 years by the time I was ready to go to college. My parents said I could go to Iona for free. But I said that I wanted to be a doctor, and they didn’t have a good pre-med track. My mom had a co-worker who knew she had a daughter going to college and gave her a book that had the top 500 colleges in the U.S. – and that’s literally how we figured out where I was going to go. We just went through book and picked schools that seemed small enough and close enough. I didn’t come into undergrad or medical school with this background of people who had navigated the system before, and so to end up at an institution like Columbia, and to end up being a leader – it’s hard to believe. But it’s great to have had that opportunity.

JMK: Amazing. We try to give our first-generation students a little more attention, because we know that they don't necessarily have parents at home who know how to tell them, now you need to apply. Now you do this. So that is an incredible story. So, you didn't grow up necessarily in an area that was more polluted. It’s just that it clicked for you when you saw the South Bronx and how heavily polluted that place was.

SLD: Exactly right. I talk about this a lot in the work that we’re doing on social environmental risk factors for asthma. Some of it is air pollution. Some of it is social circumstances, like what kinds of exposures are in the home environment. My parents didn’t smoke, but we had rodent exposures; we lived in low-income housing for a while until my parents were able to get on their feet and buy a home. So a lot of those environmental factors likely contributed to my asthma, not just the air pollution per se, but the milieu of environmental exposures that people who come from under-resourced families experience.

JMK: I can well imagine. I think one of my exposures that predisposed my daughter to cancer was organophosphate pesticides sprayed heavily in a huge apartment complex we lived in during grad school. They just spray as much as they can, and as you know, that can be a predisposing factor. You have the pests, which are an asthma risk – because cockroaches are a risk, right? And then you also have the treatment for the cockroaches or the rodents.

SLD: I struggle with this because I take care of patients at Harlem Hospital – they don’t have a pulmonologist, so I go there once a month. A lot of my families live in public housing, and so they’re dealing with pest control issues, trying to mitigate those pest and pesticides exposures. Also, many of them will get a cat or a dog to help to decrease rodents. And then you find out the kid is allergic to the cat. Do you give away the cat? Families are between a rock and a hard place trying to figure out what is the lesser of two evils. It’s such a disservice the way we treat families who need public assistance as second-rate citizens who don’t deserve quality living spaces. It’s heartbreaking because there are so many institutional and structural factors that are rooted in racism that have contributed to this inequity of resources in our neighborhoods and communities. That’s what is making people sick.

It's so unfortunate – this caste system that we end up living in in the U.S. I am grateful that I am in a position to have a platform and to speak out so maybe people will listen, and maybe people will hear it. Maybe it will click in people’s heads that this is something we are doing to people. But I don’t know.

JMK: I could not agree more. Researchers at Columbia went into public housing and instituted integrated pest management (IPM), and they saw an increase in birth weight of almost a half pound when they got rid of the organophosphate pesticides. What you said about how we are doing this to people: we are very directly poisoning children from before birth, and you know that low birthweight predisposes children to so many complications and consequences later in life. So yes – I could not agree with you more, and I don’t think people realize.

SLD: I think we all kind of live in our own bubble. Right? People who are navigating disadvantaged circumstances on a regular basis are at a disadvantage. Think of Maslow’s hierarchy of needs. They are not always the people who are galvanized to make a difference on a larger level because they are either trying to raise kids or go to school. This is why I hold these grass-roots organizations in such high esteem – because I feel like these are the organizations that are made up of people in communities and neighborhoods, really trying to send that message out to people who live in the same communities and neighborhoods. We Act for Environmental Justice here in NYC is a big one that advocates for improved air quality and environmental exposures. Peggy Shepherd is the President of the organization, and it’s about educating people. Otherwise, you don’t realize what the environment is doing to your health. This is the group of people who really need to be advocating for change. On the flip side, we need allies in academia, people who may not be from the communities that are disadvantaged but who understand what is happening and are able to have a voice on a larger platform. It really has to happen on both ends.

JMK: I think that is a wonderful way to say it. This project has been extraordinary as I have talked to all these people who are committed to helping children and who understand what is happening. We could do better. And we could make children healthier and happier from the start and set them up for success. We have an organization similar to what you’re describing here in the Chicago Region – Faith in Place – I did an interview with them a year or two ago. We need someone to communicate in every community.

SLD: We have to empower community organizations and help support them. I signed up for the part of the CHPACcharge question that talks about community engagement because it is important to provide easily accessible resources to communities because they are on the front lines and can help figure out how to make the impact more meaningful.

JMK: Yes – that is such a great insight.

Okay. You have done so much. Of all the work that you have done, what things would you say you are proudest of?

SLD: Academic medicine is hard – especially at an institution like this one. In order to do real research, you need funding. It’s a bit of a game to be able to write a proposal, to be able to sell someone else on this idea that this is meaningful and impactful, that the science is important, and that it’s really going to change things. It takes forever – to write, to be reviewed, and then to get funded – so I feel like I have been in a rat race the past decade or so, chasing funding. In the last two to three years, I’ve pivoted to work more with community, and so I have started meeting with an organization called Futures Ignite – which started as Friends of WHEELS, a school here in Washington Heights. The organization tries to empower students to learn more about the sciences – but also empower them to combat environmental injustice. It helps students of this local high school with a campaign that they call the Clean Air, Green Corridor project. Their goal is to advocate to their local legislators to pedestrianize the street that is adjacent to their school – and other schools. Their school is right near the George Washington bridge – highly trafficked – so the air pollution is not great.

They want to plant trees and stop traffic and reduce air pollution. So one of my proudest things is learning how to work with students and bring the science we have been doing in our own research team to help them advocate for what they want to do. This past summer we did a pilot project where we had the students wear personal air pollution monitors. They sampled PM2.5 as they were walking around in their neighborhoods. They participated in the summer program at the Clean Air Green Corridor Lab, where they were collecting air, soil, and all kinds of environmental samples in the parks and neighborhoods around where they live. We have a grant that is pending to expand the project to more students. A big piece of what I was excited about is that we are not only collecting data from students; we are also giving it back to them for their advocacy efforts. This idea of being a scientist who is really impacting students in a community is different from just doing a science project and publishing. I think that’s what makes me feel super proud because I see how we can have a direct impact in the community. Being able to use science to inform legislation on the national level is important as well. But on a community level, it’s been really nice to create these partnerships and do some meaningful work.

JMK: That’s wonderful! In getting to change, it seems like we have to work from the bottom up and the top down, and you really have to come from both directions in our complex society. I bet some of those students are so inspired by getting to work with you.

SLD: I hope so. This summer was so fun! We did this project: I had a high-school student, an undergraduate student, and a medical student on my team, and we went into this high school and worked with 15 high-school students. There is so much energy in our youth – so much capacity. They have so much power to make change. That is where power sits. It doesn’t sit with senior editors of journals in academic institutions. It’s with people who are experiencing this world, and they are the ones who are going to come up with creative solutions. I love hearing about EPA’s work with young people who are engaged in environmental justice (NEYAC) – it’s so much more exciting that way.

JMK: I love working with my students. I do tell them that we can’t wait for them to be in positions of power. However, they have the power of their voice right now. They have the moral authority to say, we don’t want our world destroyed.

SLD: Getting them to care about it is the first step; as we said before, people generally live in their own bubbles. If they don’t appreciate why it is important, it’s difficult to get them excited and motivated to do something about it. I didn’t know that when I was their age. It blows me away. I love working with this group of students.

JMK: That sounds like so much fun in addition to being purposeful and positive.

It’s really tough, as you know, to be a parent and to be raising kids in a world where every child is born pre-polluted, exposed to toxic environmental chemicals. And you have to communicate to patients and parents all the time. So what do you say to parents about the implications of your work? How do you frame that?

SLD: Among my patients, most have asthma – so this is the difference of being a subspecialist. They are coming to me because something is wrong. They are already thinking about what is causing this. That gives me an entry point to have discussions about things in the environment that could be triggering symptoms in the child. I feel like when we talk about environmental factors, this is bread and butter for pediatric pulmonologists. Every new patient we see, part of the evaluation concerns what your child could be exposed to in their environment that could be contributing to these symptoms. It feels easier for me to frame it in that way.

What’s hard is trying to help people to reduce exposures, especially when they are limited in resources. I try to help identify resources in people’s communities that are easy to tap into to help with mitigating exposures. NYC’s Department of Health has a really nice program called NYC Healthy Homes. The goal of that program is if there is any child who has asthma and exposure to rodents or mold, they will remediate those exposures. City officials help families work with landlords to help reduce exposures. But to your point about pesticides, I’m not entirely up to speed on what strategies they use, and some of that might include harmful pesticides. I can’t even speak to that directly – how much are the health department or landlords aware of a safe way to reduce pests in the household?

JMK: The short answer is boric acid bait traps, as far as safer pesticides that will reduce roaches.

SLD: I don’t know what they are using. There are so many steps to think about!

JMK: Yes, everyone thinks someone else has taken care of this because it should be taken care of. And I think it's something that's fallen through the cracks – no pun intended – and of course, the pesticide industry wants less attention to these studies that show that their products cause harm.

SLD: I will say, the Health Department helping to navigate this landscape for families feels like a much safer avenue than the strategies that we know that family could use on their own without a lot of knowledge. It is worth putting some effort into making sure methods are safe. Like you said, you just expect that people are doing the right thing, but I would imagine that the Health Department is up to speed on the safest strategies and is helping landlords to implement them. But I don’t know that for sure.

JMK: It is wonderful, as you say, that there are some resources for parents because yes – people would always have an anxiety of being kicked out rather than landlords having to fix what is wrong.

DLS: Landlords just don’t do it; they give people the runaround. Until the official from the Health Department says, you actually have to fix the leaky pipe – you can’t just paint the wall – they just won’t.

JMK: That’s really hard. Have you ever had parents who have more resources have a conversation about moving? Because a parent with a kid with asthma might think about that as a solution. We moved. We were near a highway intersection with a lot of diesel traffic, and after my daughter was diagnosed, we moved further from the roads. But we had enough money to do that.

DLS: I have families ask me that all the time – if they should move. I have a patient who says, “you know, my son’s asthma is so much better when he spends the summer with his grandparents in the south. Do you think that is related?” It is. It might be related. But not everyone has the means to make a change. I offer that as an option, but I tend not to bring it up first because you just don’t know what resources people have. But if it’s brought up, or the conversation lends itself to that sort of recommendation, I definitely include it.

JMK: I think that's wise.

That really goes to my next question, which concerns parents. There can be a lot of guilt and fear around these topics, and I think for practitioners, having the conversation can be very difficult. For my internship for the Masters in Public Health, I shared information about Children’s Environmental Health (CEH) with 210 clinics – pediatricians, OB/Gyns, and family practices. I didn’t get a lot of pushback, but a few said that they didn’t want to make parents feel guilty, and I wondered if that's something you have to balance as well.

SLD: This is less related, but smoke exposure: we have to counsel families all the time when they smoke. For many, it’s a coping mechanism for managing very challenging circumstances, so that may be one space where I deal with the guilt. Honestly, I think most parents just want good for their child. For most parents, that’s paramount for them. Talking to them about health threats is not to make them feel guilty, but to equip them so that they can do something that can improve the health of their child.

JMK: And with asthma, you might see immediate results.

SLD: That’s what nice about asthma – we can do something – we can equip parents with knowledge to make them feel comfortable to manage. That’s how I see my job – to educate them about the exposures and provide them with the strategies to help reduce symptoms. That’s what is fun about my job.

JMK: Also, you get to see cute little kids. My children are all grown, and I miss that so much!

The next question is about policy. Especially on the CHPAC, we’re learning more about how these things work. And I just wondered: from your perspective, if you could single-handedly recreate U.S. policy regulating environmental chemicals, what would such a policy look like? And how do we change going forward? 

SLD: This is tricky because I feel like an imposter in the policy space. I spent my whole career just focused on taking care of patients. It’s only now that I am asking, what is the bigger picture and how do we make some changes? One of the biggest things I wish we could address is housing policy. It’s a huge issue. The Color of Law talks about how we created a segregated society, and how the policies that have gone into public housing and zoning laws, imminent domain, and redlining have contributed to focusing poverty into small inner-city communities that are really, really poor neighborhoods – and how to dismantle or unpack or redistribute all of those resources. Many of the environmental triggers that we know contribute to childhood asthma have been concentrated in what we call the inner city. And it has so much to do with housing policies. So one area to fix is housing and creating equitable housing opportunities. I think that might reduce densely populated living quarters that are under-resourced and that cause people to have to go to extreme measures to reduce allergen exposures in their homes, and things like that, but that also may contribute to air pollution exposures. We live in these urban canyons where there is high traffic.

We talked about this in our CHPAC question regarding lead and identifying lead hotspots. It’s not just identifying spots that are at high risk of high exposures, but identifying what the policies are to really flood those spots with resources. So if there could be some policy or change in terms of how we distribute resources to the communities that are most disadvantaged, I think that might have the biggest impact in terms of health quality and reducing health disparities among children.

I thought of another one: we don’t do a great job in this country of supporting families with young children. We have a work force dependent on two parents working, and there aren’t good ways of supporting small children in the home.

JMK: It’s terrible.

SLD: It’s embarrassing what we expect young moms and families to do to survive. A lot of that pressure, especially for those without economic means, forces families to put children in circumstances with greater risk because we don’t have great support. So policies around support for families with young children could go a long way.

JMK: Absolutely. You know what you were saying about who has the time and the resources to make change and advocate? Well, not people who are under-resourced, but also not people who are parents of young children, because you're just so busy and you have to spend the time on them. And we need to make life easier – easier to raise healthy children.

SLD: We need to make life easier to raise healthy children. That’s exactly right! All of the shortcuts that we have to take in order to make sure we can feed our kids – and all the rest: the options become smaller and smaller when you are so taxed by other pressures. So we have to make it easier.

JMK: So many other wealthy countries do better, as you know. Right?

SLD: Absolutely.

JMK: So the central question that I'm occupied with in the previous book I wrote and with this one is the same. These are two very different books, very different projects, but they address the same question. If we know that we are destroying the climate on which much all life depends, and we know that we are poisoning our children, and that there are solutions ready at hand, why are we not putting those in place, or in shorter terms, how can we be this stupid?

SLD: I feel like it’s interesting. The COVID pandemic opened my eyes to how egocentric people can be. Unless it’s actually in front of them, it’s hard for many people to care about it. There is a bit of a knowledge gap –some people are just not as aware of this because we are working in these spaces, and this is part of our calling and what we do. So that knowledge gap certainly needs to be filled. But also, I just don’t think people like when I say that the pandemic made me think about this more. It’s because I saw a lot of people who weren’t immediately impacted by COVID because they could work from home and move out of the city into their suburban homes and had nimble schools or home schooling, and so they were less impacted. So they cared a little less about the health disparities.

The people who were most affected and had high mortality rates, especially in NYC – multigenerational households where one person had to leave the home to work and infected the whole household: that part of it, I don’t think people cared as much about. I think that’s why we haven’t made a big enough stance on this because it hasn’t directly impacted enough people who have the power to make change.

Another example I think about in the medical space is a disease like cystic fibrosis (CF). CF is a disease that tends to affect affluent families -- families across the gamut, but the majority of patients we end up seeing are from more affluent families who have created a foundation called the CF Foundation, who have fundraised like crazy and have invested in scientists to essentially create a cure. And now we have a cure for CF because of families of kids affected by this horrible, horrible illness. Now, the genes that are at the heart of this cure, the CFTR modulators, are oftentimes not available to minoritized patients because they may not carry those genetic mutations. But then I think about diseases like Sickle Cell or lupus that predominantly affect people of color, and there is not as much of a galvanizing movement because people just don’t have the resources to gain funding for the science that will cure those diseases. So I think a big part is that, in terms of climate and environmental health, the people who have power need to be more closely affected by the exposures that are poisoning our children. Until they see and experience it, I don’t think they are going to be as motivated to do something about it. It becomes a grassroots movement, a little bit here, a little bit there.

JMK: There are real health disparities with leukemia – Latinx patients are more likely to be affected because more of them are farmworkers – but overall, the leukemia rates can be higher among white, more affluent populations, and I can't help but think that maybe it's because richer people can afford to poison their lawns and poison their children. I think often, people feel artificially insulated and safe if they are well-to-do, and they need to see that their children are notprotected. So it's so hard, because you want to talk about health disparities and how unjust that is. And you hope that that injustice will motivate people. And yet you also have to hit them at home; you have to say, “but you're not protected.” Right? So that's hard to message.

SLD: Yes. And people just have to want to help other people, right? This goes back to the two core values my parents always taught me – about education and helping people. Maybe it feels like we’re moving towards that, but I have this feeling that people are so focused on helping themselves and their families. Our government and these conversations we are having about who is going to be leading the country: are we going to be led by people who are focused on helping themselves and people who look like them – or those who care for everyone?

JMK: One of my favorite books I read during the last project was Robin Wall Kimmerer’s Braiding Sweetgrass. If you ever have a moment, I highly recommend it.

SLD: Yes – I’ve read it! It’s a beautiful book.

JMK: I teach it for the first time in Environmental Literature this Spring, and one of my favorite phrases is “all flourishing is mutual.” You can't just help yourself. If you're going to take care of yourself, you have to take care of your community and your environment. That's how we are as human beings. Oh, I'm glad you’ve read that, too! A lot of people I care about – that's their new favorite book, too.

SLD: Another book that resonates and has a similar message is The Sum of Us by Heather McGhee.

JMK: I've heard of it but haven't read it.

SLD: It's a good one, too. It also talks about like how, when we elevate things from our communities, everybody benefits. The divisiveness that we've moved towards has really been hurting everyone, when we should be working as a collective to elevate everyone.

JMK: It’s a similar message, absolutely. There's another book – Broken Ladder by sociologist Keith Payne – that talks about how inequality makes everyone in a society more unhappy. It makes rich people –  even in a controlled lab environment – into jerks, to use the polite word, and it makes people who are on the bottom end of the ladder feel bad about themselves. It’s very descriptive about countries like Norway where there is less inequality. I have a friend who's Norwegian, and one of the reasons they're such a happy society according to happiness research is because they don't have as much disparity in equality, incomes, and outcomes. And that just makes everyone happier.

SLD: Yes – the divisiveness is hurting all of us. I just added it to my Audible.

JMK: So this question is about the future. When you look into your crystal ball, what do you think will be the status of children’s health in the year 2050? It sounds like a long time, but it’s not.

SLD: Just 25 years from now! So who are going to be the parents of the children of 2050? They are going to be our kids. How old are your children?

JMK: My youngest is 21.

SLD: Mine are 5, 9, and 11. One thing that I am inspired by is that in my lifetime, I have seen a lot more leadership from women and mothers. And so I think by allowing – or requiring, as we were talking about before – two parents to work most of the time, many in the workforce are working mothers. So I think that as we move into positions of leadership and have more platforms and a say about what happens, I think we are more capable of thinking through a lens of what that means for our children. Maybe it’s sexist – the reason why is historically, women in this country tend to be the primary child raisers. And I’ve experienced it even in my own household. My partner is more engaged than his father or my father were in child rearing, but I think a lot of that persists – or maybe we are paying more attention. Millennials are doing this so well because they are navigating two-parent households and working and figuring it out. I think this gives me hope that people will prioritize children’s environmental health more than it has been historically.

I am also inspired by our improving air quality. Overall, exposures have been improved through legislation that has been super effective and meaningful. I am hopeful that people will be more engaged with how we can improve the quality of the environment for our children because we are in positions to make some of those changes. It’s slow work, though – I wish it could be faster.

JMK: Me too.

SLD: But it’s not. So we have to be able to look back on recent and longer-term successes and use that as motivation to keep doing this work.

JMK: Yes. I couldn’t agree with you more. And I do agree with you that women see things differently. We have these children. Even just biologically, we invest so much. And then, I don't know about you. But I wasn't even sure I wanted to be a mom, but biological magic hit me the moment she was born. It was so powerful! And of course, men also bond with their children. Biology doesn’t always work in women’s favor, but if sometimes it does, that’s good.

SLD: I was just having this conversation with my sister recently. When you are growing a human person inside of you – what kind of crazy magic is that? It’s our personal magic! I also feel encouraged by seeing more women in positions of power that can really bring meaningful change. That’s where the change is going to happen.

JMK: I agree. We have a lot of personal heroes who are women in environmental health.

So the last question is, I like to turn the tables and ask if you have any questions for me about my experience or about the project.

SLD: Yes, I am very excited to hear. What do you envision? I feel like you gave me a taste of what the project is going to be from the email, but that was a month and a half ago. You have probably made a lot of progress in your interviewing, so what do you see this shaping out to look like? And then I'm also really curious to hear a little bit about your journey in this interviewing process and meeting with different people. How has that shaped what you think this work product is going to look like?

JMK: I'll start with the last question first because it has been an amazing experience! I cannot believe how many people have so generously said yes to me. I'm learning so much and gaining insights. The purpose of this is to put the big picture together, and I really feel I am gaining that. I am using an ethnographic method. I'm trained in literature, and I have a background in science. But I'm borrowing that method from the social sciences, to ask about people's stories, to analyze those stories, and to try to assemble a larger picture. And one reason I wanted to answer this part first is you said you're so interested in housing, and I'm going to be talking to Dr. Dick Jackson on Friday. I don't know if you already know him, but I will try to remember to send you a link to a lecture that he gave. I haven't talked to him yet, but he's really big on this question. My plan is to blog a fairly full transcript of these interviews, more for the inside crowd, I suppose, and to have a record. I've been shortening them a little bit because some are very long. But Dick Jackson’s interview might be interesting for you to read, and just to know him, because he has all these resources and has been interested in housing for a long time. He said some of the same things that you did. That’s what this project is turning into.

The initial project, which I've wanted to do for a long time, is to combine and really tell, in the vein of Sandra Steingraber’s Living Downstream, both the personal story of children who are suffering the diseases and pain, the cost of our polluted environment – and the researchers and the healthcare providers and the activists, and even some lawyers and policymakers and politicians to look at this big question. How is it that we say we love our children before all else, to use Greta Thunberg's words, and “yet we are stealing their future before their very eyes”? I feel that is true and not just for climate change, but for environmental chemicals. We're not valuing what we say we value. So how is this happening? Really, truly, how is this happening? And how can we change things? I want to shine a bright light on what that cost is. Unfortunately, I think it's necessary.

I teach a four/four load, and so my ambitious date for this project is August 2025. Now, one thing I was just talking about to Mark Miller, and he put a bug in my ear about, is maybe writing something sooner than the book project that I'm headed towards. I’m at work on an article that I hope to shop around at some of the better news outlets. I feel like all of the people I am talking to have so much to share.

Not only that, but it's so inspiring. You get into this world of children’s environmental health, and you see the horrific truth of how we are treating our children. It is not right as a society, how we are treating children, and especially those who are experiencing health disparities and being disadvantaged before day one. That is just not right.

And yet, then I'm finding this world of people who care and who are brilliant, who are dedicating their talents to the right thing. And I just feel like some of the divisiveness in our society is because we don't have a lot of great heroes among the people in the public eye. It seems like a lot of them are selfish, malevolent, cynical, or worse, as you know. We need people we can look up to, and I think you are one of those people. I know you're that for those high schoolers and undergrads and medical students, and that's the bright side of this project – to shine a light on the people who are doing the right thing. And we need more of that. And I think if people know that some very smart, good people are already at work, they will be more willing to do their part.

SLD: Yes. I love that – that's wonderful! I love the multi-faceted view of the project. I think that's such a huge strength. Thinking of your question about children's health in 25 years, I feel like this millennial generation is the one that really needs to hear this story and be galvanized because they're the ones who are going to make a huge difference. Our kids.

JMK: I hope so. I love teaching global environmental health and sharing this information. At first, my students are depressed and shocked, but then they feel that, yes, but I could do something about this. And so I want to get this book into the curriculum as well, I hope.

SLD: If you get more success stories out there, then it does tend to motivate people.

JMK: I want to get the academic book out because those are the circles I'm in, and that's what I think I can do. And then, I certainly wouldn't rule out more popular writing about it as well, and maybe a textbook or something that's very usable. Because I do want students to understand what is going on and how they can be part of changing it.

SLD: Do you know, Andrea Elliott's book The Invisible Child?

JMK: No!

SLD: It's about poverty in New York City. Maybe two years ago, it was my Christmas gift to everyone. Elliott started by doing a series of articles for the New York Times and built it out and ultimately wrote a book about her following this young woman. So the idea of small snippets of it coming out in the lay press before the full book comes out – I think that is a great strategy.

JMK: It’s ambitious. It's easier for an academic to get an academic book. But if you don't try, then you're clearly not going to, and I do think the story is compelling.

SLD: So yes, and you have to try – that's absolutely right. That's the first step. Well, thank you for allowing me to be part of this. It’s such a cool project, and I’m excited to see where it goes.

JMK: Yes. Summer 2025 is my own deadline. But also, part of the ethnographic method is to let things unfold. Very clearly, the people I am talking to are going to help shape what that book eventually is, and what other side projects come along. It's such a privilege to be part of the CHPAC, particularly given what you're saying about the interdisciplinary aspect. We have true interdisciplinarity around this really important question.

SLD: Yes, it's great. The last two years have been really fun, but as I told you, I feel very imposterish. But I have a vantage point that might be unique and brings a perspective, and honestly, I think all these different perspectives and vantage points are needed.

JMK: I feel like I am among the least of its members, but yet, I teach at Benedictine University, and in the Benedictine Rule, even the youngest and the least among the monks is supposed to speak up and be heard because they may have something to share.

SLD: I love that!

JMK: Thank you so much, Stephanie – it is just a delight to talk with you, and I hope you have a wonderful week.

SLD: You too. Please continue to keep me posted.

JMK: Sure will. Bye!