It’s a small news story which hasn’t been well reported, and I might have missed it except that I happened to stumble upon it in 2009 and then I started following it. Starting in 2007, 6 babies out of 20 born in an 18 month period in Kettleman City, California were born with cleft lips or cleft palates. Some environmental activists started to cry foul, pointing to a hazardous waste facility near Kettleman City as a possible source of contamination which might be linked with the seemingly high rate of cleft lip and palate.

Cleft lip and/or palate occur in about one in every 700 births. Six out of 20 babies sounds unusual, right? Wrong, according to the California Department of Public Health, which says: “They’re all different and they suggest, or it doesn’t really suggest that they have a common cause. Because in general, we think each kind of birth defect has a different set of causes together that may be responsible. (source)”

This may well be true. Sometimes clusters do happen randomly and there are no causes. And it can be difficult to pin down all of the potential causes and environmental factors. But when you have a town with a hazardous waste facility as a major employer and unusual things start happening, it seems like there might be a correlation which is worth investigating. Even though the town is small. Even though the hazardous waste facility has a lot of political clout.

And do environmental exposures necessarily cause identical changes in fetal development? If being “all different” is an argument to rule out an environmental contaminant, why is it that babies born to women who took thalidomide during pregnancy were also “all different”? Certainly, they shared commonalities, but they were also very distinct from each other; taking thalidomide during pregnancy didn’t guarantee only one outcome. Seeing cleft lips and/or palates in 6/20 babies born in an 18 month period would seem to suggest that there is a common thread linking those mothers and that there is a chance that a cluster phenomenon is occurring.

The thing about Kettleman City is that it’s troubling, demographically. Almost 93% of the population identifies as Hispanic or Latino. Roughly 44% of the population lives below the poverty line. There are some serious income disparities; there’s a $16,619 median income for men versus a $10,179 median income for women. It’s a poor, primarily Spanish speaking community.

And that makes alarm bells ring in my head, because if there’s one thing California is very, very good at, it’s ignoring the needs and concerns of low income Californians. Even if the cleft lips and palates aren’t being caused by the Waste Management facility, I think that they are clearly a cause for concern and that more investigation might be a good idea. If it’s not the Waste Management facility, there might be other environmental factors going on. If this kind of thing was happening in an area like Marin, which is predominantly white, English speaking, and wealthy, there would be an uproar accompanied with demands to find out what is going on, and why.

Of course, Marin would also never house a hazardous waste facility, because there are numerous low income communities in California upon which such facilities can be foisted. In fact, some communities will welcome the extra income and the presence of a large employer who does things like donating to the schools. Low income communities in California literally compete for toxic waste from wealthy California communities.

As abby recently pointed out, “poverty has the greatest negative impact on health.” In her post, she discussed the increased risk of environmental exposure to harmful substances for people living in poverty, and that’s really highlighted across the United States, not just in California. The dirty but necessary things we have in this country, like industrial facilities, hazardous waste dumps, manufacturing facilities, and so forth, are predominantly located in poor communities.

In the Bay Area, for example, the refineries are in Richmond, not Berkeley or San Francisco or Marin, all wealthier communities. The manufacturing facilities in Oakland happen to be in Oakland’s poorest communities, not up in the Oakland Hills, where wealthy residents live. Set up an epidemiology map and overlay it on a map of communities coded by income and the way they match up is nothing short of eerie. If you are poor in the United States, you are more likely to be living close to a source of environmental toxins because it is all you can afford.

I lived on top of a Superfund Site in the Bay Area, and now I live a block away from a severely contaminated former industrial site. I wipe dioxin-laden dust off my bookshelves every day because it blows and blusters in through every crack in my house. I didn’t live in either of these sites by choice, I live in them because it is what I can afford. If the choice is between living on top of ground contaminated with dioxins, PCBs, lead, and radioactive materials and living nowhere at all…what would you choose?

And when people in these communities start to get sick, when clusters do start appearing, it is ignored. Or people are told that they knew about the danger (not true) and that they could have avoided it (by what, moving? Where?) and that the community is responsible for cleaning it up (with what money?) and sending the toxic materials somewhere else (another, poorer community, perhaps?). My neighboring town of Willits, heavily contaminated with chromium by Remco, fought for years to address the issue until the cause was taken up by Erin Brokavitch.

For every Erin Brokavitch in the world, there are 100 other towns which need help. Like Sierra Vista, Arizona, where there’s a leukemia cluster baffling and infuriating local residents while government representatives insist that there are no environmental causes. What’s happening in Kettleman City is repeated at varying degrees of scale all over the United States and it’s rarely reported or discussed.