Community priorities in a landscape of environmental lead contamination: Intersectionality of poverty, well-being, and environmental contamination

Abstract

Kabwe, Zambia, is known in the global health world for its high concentrations of environmental lead and associated high blood lead levels in children, and thus it is a key region for exploring the intersections of human health and well-being (United Nations Sustainable Development Goal, SGD #3) and environmental health (SGD #12 and #15). Despite multiple efforts to remediate lead from the landscape, lead contamination remains pervasive in some Kabwe neighborhoods. Our study examined to what extent lead remediation was also a priority for community members. Using open-ended oral surveys with 49 household heads as well as ethnographic observational notes, we found that while lead is a concern, it is just one of many concerns. Indeed, economic concerns outweighed other concerns (SGD #1 and #6). Because community buy-in is vital to any global health intervention, these results suggest that externally defined intervention goals, such as lead remediation to address environmental toxicity, may be more successful if interventions also incorporate locally salient concerns. We conclude by arguing that social scientific studies of community members’ perspectives and concerns should be prerequisite to global health interventions. In the context of Kabwe, intervention efforts that incorporate solutions to address local concerns about poverty (SDG #1) and economic opportunity (SDG #6) may result in improved community cooperation with environmental remediation efforts, and thereby improved likelihood of sustainable environmental remediation.