Sanitation Inequity and the Cumulative Effects of Racism in Colorblind Public Health Policies

• Published date: 01 May 2018
• Author: Jennifer S. Carrera,Catherine Coleman Flowers
• DOI: http://doi.org/10.1111/ajes.12242
• Date: 01 May 2018

Sanitation Inequity and the Cumulative

Effects of Racism in Colorblind Public

Health Policies

By Jennifer S. Carrera* and Catherine Coleman flowerS†

abStraCt. A majority of Lowndes County, Alabama, residents live without

properly functioning, legal, basic sanitation infrastructure. We describe

the contemporary racialization of sanitation inequality in the county. We

trace structural dimensions of race in land tenure through the heir prop-

erty system, housing availability, and public health enforcement. Our

analysis shows how cumulative effects of colorblind policies overlain on

explicitly racist foundations operate to establish public health sanitation

law as a persistent mechanism of producing racial stratification.

Introduct ion1

In 2002 Terrence and Sandra Fields2 faced jail time for being in viola-

tion of the Alabama state health code on the sanitary handling of sew-

age. Their property, described by reporters as being a “compound,”

consisted of roughly an acre of land, five trailers, and as many as 18

family members, including children. The Fields lived with a makeshift

sewage handling system (referred to as “straight piping”) where a PVC

pipe directed sewage from the homes into a ditch. From here, effluent

flowed through the ditch and into a lagoon, roughly 100 yards away.

For two and a half years the Fields found themselves in court in front

of Judge Terri Bozeman, District Judge for Lowndes County. Judge

Bozeman stated that she initially had sympathy for the family but

when she learned that children lived on the property, her sympathy

waned. Bozeman ordered the Fields to install a properly function-

ing, permitted septic system in 60 days or face jail time and eviction

from the land that they owned. The Fields were told by the health

department that a septic system that would meet the needs for all five

homes on the property would cost between $40,000–$50,000. When

The The Americ an Journal of Economics and Sociolog y, Vol. 77, Nos. 3-4 (May-Septemb er, 2018).

DOI: 10 .1111/ajes.122 42

© 2018 American Journ al of Economics and Sociology, Inc

*Corresponding author. PhD, Michigan State University. Email: jcarrera@msu.edu

†MA. Alabama Center for Rural Enterprise, Equal Justice Initiative. Email: cflowers@eji.org

942 The American Journal of Economics and Sociology

60 days passed and no septic system had been installed, Terrence told

the judge: “You can kill me, bury me, put me in jail. The situation is

going to still be there when I get out.” The Fields were among 37 fam-

ilies that in early 2002 were identified by the Lowndes County Health

Department as being in violation of the Code of Alabama, Section

022-026-001, and who were threatened with jail time for not having

properly functioning septic systems on their property.

Today, the residents of Lowndes County, Alabama, are critically

underserved by sanitation systems because of high rates of poverty

and challenging soil conditions. Residents within 50 to 90 percent of

households in Lowndes County live with failing or completely absent

septic systems. To manage household sanitation many rely on buried

55-gallon drums as holding tanks, “straight piping,” open cesspools,

or broken and leaking septic systems. When residents are too poor

to install advanced treatment systems that cost thousands of dollars,

typically in the range of $15,000 to $20,000 for a single home, they

face eviction, fines up to $500 per day, and arrest. This cost needs to

be understood in relation to property values in the area. In Lowndes

County, the median price of a house owned by black residents is

$45,400 (U.S. Census 2000), whereas the median value for mobile

homes, regardless of race, is $23,900 (U.S. Census 2016). In many

cases, families live in trailers that cost less than $10,000. The septic

system can easily be more costly than the residence.

As well, a recent study found a startling prevalence of soil trans-

mitted helminths, including hookworm, roundworm, and parasitic

amoeba, in human fecal samples (McKenna et al. 2017). More than

one-third of participants tested were found to be positive for microor-

ganisms commonly associated with the poor sanitation conditions of

low-income areas in developing countries.

Access to basic sanitation is recognized as an essential human right

by the United Nations, falling under the Millennium Development Goal

on Ensuring Environmental Sustainability. It was officially declared a

distinct right by the U.N. General Assembly in 2015. Throughout im-

poverished rural areas in the United States, this is increasingly being

recognized as a right denied. In this article, we consider the implica-

tions of sanitation denial in Lowndes County, Alabama. We show how

a cumulative, enduring process of racially excluding populations in