Dr. Zeke McKinney: The Intersection of Environmental and Medical Justice

Despite the initial excitement we felt for the interview project, Zoom fatigue weighed heavy on both of our minds as we dialed in to talk to Dr. Zeke McKinney for the first time in person. We knew relatively little about him: simply that he was a professor at the University of Minnesota and he had some knowledge in the medical field. So few expectations were set. He still managed to pleasantly surprise us, however; his laid-back yet knowledgeable presence put us both at ease and cleared our exhausted minds. The topics discussed were new and intriguing to us. His fields of study as an occupational physician and research investigator were ones that we (and I’m sure most people) had never heard about, but it was soon made clear that they are vital and interesting positions. It also has given him a unique perspective and experience in terms of environmental justice; as a person of color in the medical field, he had many interesting insights to share.

Background

Dr. McKinney knew he wanted to be a doctor since he was a little kid. He was always interested in the idea of going to medical school and he was fascinated by learning how to wield medicine to help people. He has a familial connection and some familiarity to medicine; his mother was a nurse. Dr. McKinney went to the University of Illinois at Urbana-Champaign and earned his Bachelor’s of Science in Computer Science. Dr. McKinney explained that, although unusual, knowing about programming has helped him a lot in the field of health informatics and has allowed him to better problem-solve using IT skills. He eventually enrolled in medical school at the University of Minnesota and achieved his childhood dream of attaining his Doctorate of Medicine. He also earned his Master of Public and Environmental Health at UofM. Dr. McKinney said that until graduating from medical school, he had never even heard of occupational medicine, which is the field he currently works in. He gained exposure to environmental and occupational medicine during his time as an intern at Hennepin Medical Center. He continued down this path because he found a need for this practice and to be able to treat issues or “play detective” as he puts it.

There’s no question that Dr. McKinney has had to work hard and devote a lot of time to his work to be successful in his field, but it’s his roots that drive him. He noted, “Growing up in Minneapolis made me recognize the disproportionate impact of infrastructure and environmental hazards on BIPOC communities.” McKinney described how the inequities are reflected everywhere in Minneapolis, especially in the water. If you stand on the Lowry Bridge between North and Northeast Minneapolis, you can see the pollution reflected in the Mississippi.  Environmental contamination varies significantly at different points of the river in the Twin Cities, and in more gentrified areas where more space is allotted to greenspace (such as parks), rather than to industry, water pollution levels in the river are lower. Injustices ingrain themselves in all aspects of the environment, and large corporations and governmental entities can no longer hide them. We want to highlight this and emphasize that it’s so important to acknowledge the injustices inflicted on communities around us. It’s comforting to know that doctors like Zeke McKinney aim to bridge some of those gaps and disparities that exist in medicine by actively serving BIPOC communities but by also acknowledging systemic issues and working to combat them.

Work

One common theme threads through Dr. McKinney’s work: he is devoted to investigating and identifying problems that exist before they cause much issue. He always aims to prevent the worst and nurture the best. Dr. McKinney is passionate about being able to investigate his patients’ social determinants of health to identify and target health issues brought on by work or environmental factors. Social determinants of health are the set of conditions in which one lives, works, plays, or learns that have an affect on health and health risks, as well as quality-of-life outcomes.  Dr. McKinney’s official title is Occupational, Environmental, and Preventive Medicine Physician. Currently, he works as a physician at HealthPartners in Anoka, Minnesota. On a daily basis, he sees patients who come to him for treatment related to chronic or acute illnesses brought on by work or their surrounding environment. During our interview, Dr. McKinney told us that he found it extremely important to incorporate medical ethics and justice into his work. This is because he acknowledges that BIPOC communities have continuously been discriminated against within medicine and the healthcare system and he wants to use his position to change that.

Dr. McKinney believes the biggest barrier to healthcare access is health insurance. The disparity between White and BIPOC people covered under a health insurance plan is staggering, and there has always been discrimination against BIPOC communities in health. The disparity between White and BIPOC people covered under a health insurance plan is staggering, and there has always been discrimination against BIPOC communities in health. He described issues like race-based medicine and lack of representation in medical occupations, which are products of a systemically racist system. These forms of discrimination perpetuate the “othering” of BIPOC communities and lead to health disparities that are astonishing. These barriers are systemic because they are a product of many other inequities thwarted upon BIPOC people that intersect and work together to further alienate people with different identities. Dr. McKinney made connections between the polluted and under-resourced communities of North Minneapolis and compared that to the trend in patients he sees on routine. A lot of the patients he treats from this area suffer from asthma or other respiratory issues, as well as the development of other risks that come with living next to hazardous waste and industrial facilities. This discounts the values of medical ethics that all doctors should practice, and that Zeke utilizes to dismantle racial and ethnic disparities in medicine.

Dr. McKinney’s role as a physician is a large part of his life, but he finds it important to devote time and energy to other facets of his work as well. He works as an Affiliate Associate Professor in the Division of Environmental Health Sciences at the University of Minnesota, though we did not delve too deep into this topic. He also told us that right now, he is the Co-Investigator on the AstraZeneca COVID-19 vaccine trials. This has been taking up a lot of his time, seeing as trials are an important way of ensuring the safety of a drug or vaccine for all people. He finds it important to be able to analyze the data from the trials and make sure there are no discrepancies that would put people at even more risk.

Environmental Justice and Activism

As one of only a few Black male occupational physicians in the state of Minnesota, Dr. McKinney feels a certain level of responsibility to treat people fairly and uphold standards of environmental justice. He is especially focused on medical ethics and medical justice, fields focused on  equal treatment for people from all social and economic categories. He feels that if a person needs medical attention, no matter their race, ethnicity, or socioeconomic status, he has a “responsibility to do something about that”. This field and his personal responsibility have thrown him headfirst into topics of environmental justice.

Dr. McKinney became part of the Environmental Justice Advisory Group (EJAG) for a year when it first opened in 2016. This group was formed by a diverse group of people who wanted to provide feedback and recommendations to the Minnesota Pollution Control Agency (MPCA) concerning environmental justice. Through his work with EJAG, Dr. McKinney became more aware of the environmental injustices surrounding Line 3. First, he noticed that many minority voices within the organization and within the Stop Line 3 movement were not heard, in part because Line 3 was advertised as a project that would bring jobs to northern Minnesota. This led to opposition being “muted” and having “no impact on (Gov. Walz) passing these permits”. In his time with EJAG, Dr. McKinney also noticed that the MPCA was claiming to take environmental justice seriously, but in reality, they were standing aside in the fight against Line 3 along with other environmental justice issues. When another member initiated a group resignation to protest the MPCA’s approval of Enbridge’s Line 3 water quality permits in November of 2020, Dr. McKinney joined in and resigned.  He stated that ultimately, he had to stand in solidarity. He had more reasons to leave than to stay.

Recently, as he has been working with the COVID-19 vaccine and its medical trials, Dr. McKinney has observed more instances of environmental and medical injustice. He claims that the biggest barrier to BIPOC and other disadvantaged groups is access to health insurance; the quality of care and coverage varies wildly between companies. However, other huge problems exist, including a lack of representation in the field and the discriminatory practice of race-based medicine. There are also barriers to other groups in terms of stigma, Dr. McKinney says. This is mainly true for mental health problems, tobacco use, and obesity. Overall, a lot of systematic problems exist. The fact that Dr. McKinney is aware of them and is actively fighting against them is promising and inspiring; it shows that good people still exist even within flawed fields.

His work with EJAG and in the medical field has led Dr. McKinney to have some good insights and advice into what others can do to join the fight for environmental justice. His primary advice was to look at the historical context of modern movements: what has led up to today’s events and why? He also recommended that we work locally. Many fights can be fought close to home, and sometimes that closeness makes the fight more meaningful. Dr. McKinney emphasized that an activist should get something out of it themselves; he is always asking himself “What do you want to get out of it?”. The local fight is especially relevant in Minnesota, because MN has worse health inequities than any other parts of the country.

Overall, Dr. McKinney is determined to contribute to the fight for environmental justice. He hopes that enough pushback will be generated He imagines a world where “equity isn’t an issue because we reduce the barriers for equity becoming a problem.”to make waves and support minority groups affected by environmental and medical issues. He explained that while there is already some things being done to fix environmental problems, many of the solutions are centered in white areas. Little funding and help is given to BIPOC communities. He wrapped up his talk with an especially powerful statement: he imagines a world where “equity isn’t an issue because we reduce the barriers for equity becoming a problem”.