Blaming the Southern Victim: A Case in Italy

Why is so much attention being drawn to lifestyle risks in places where the risk of developing cancer due to environmental factors has already been established?

Toxic refuse has been illegally disposed of for a long time (potentially since the late 1980s) in Campania, a territory in Italy known as Terra dei fuochi (‘Land of fires’). In the province of Taranto further south, Ilva steelwork owners were put under house arrest in 2012 for their systematic violations of emission limits for several pollutants, including the carcinogenic chemicals known as dioxins and benzene. Despite active protest against the pollution and its ill effects on public health, the Italian minister of health announced in 2014 that lifestyle changes are needed to reduce cancer incidence in the Terra dei fuochi.

View of the Ilva in Taranto.

View of Ilva steelwork factor in Taranto.

Generic Lifestyle Advice

The minister of health’s attention to lifestyle as way to promote health is not surprising. There is a widespread focus on lifestyles as the cause of disease in contemporary health discourse. However, this rhetoric is problematic because it serves to turn disease risk into an individual problem, one that each person is supposed to be able to remedy on her or his own, thereby limiting the role of the greater society and the State, at best educating the public through campaigns against so-called undesirable behaviors.

Healthy lifestyles are a mantra in public discourse, especially when it comes to warding off certain types of cancers. Women are told, for example, that they may be able to prevent breast cancer if they just limit their consumption of fatty foods, alcohol and tobacco, exercise regularly, plan their pregnancies at a young age, and breastfeed their babies. While these are indeed known risk factors in breast cancer, the vast majority of breast cancer cases cannot be explained by these risk factors alone.

Generic lifestyle advice has limited efficacy against breast and most other cancers, but lifestyle messaging is simpler and more expedient than communicating the more complex, systemic factors that contribute to disease. What’s more, sociologist Phil Brown strongly argues that the transformation of disease risks from a collective problem to an individual behavior allows for the obfuscation of responsibility on the part of industry and the political system.

Landfill in the Province of Caserta

Landfill in the Province of Caserta

Environmental Injustice

Activists have challenged the default linkage between lifestyle and cancer, pointing instead to the role of involuntary exposures to toxic substances. Such exposures are not fortuitous. In fact, environmental injustice, as a structural approach to evaluating environmental damage, focuses on cases in which specific geographic areas suffer a higher exposure to health-damaging pollution. All too often they cluster in areas inhabited by populations that are stigmatized or lack resources and power.

The causes of environmental injustice can be linked to the ‘Southern Question’ – that is, the structurally unequal relationship between northern and southern Italy that has marked the country’s history since its unification. The economic asymmetry between the south and the north of the country makes the south more vulnerable and more exposed to situations of environmental pollution, and the stigmatization of the southerners makes it easier to blame them for health problems derived from environmental conditions.

In 2004, an article in The Lancet Oncology by Senior and Mazza called three municipalities in Campania vertices of a ‘triangle of death’ with a high incidence of mortal cancers. A 2014 epidemiological study (the Sentieri study) shows higher cancer incidence in Taranto and Terra dei fuochi, and an excess of mortality of 20 percent or more for the municipalities of the Terra dei fuochi compared to the whole Campania region.

Two Steps Forward, Two Steps Back

Demonstration against Ilva pollution.

Demonstration against Ilva pollution. Basta translates as ‘enough.’

Over the years, grassroots movements formed against the pollution in southern Italy, particularly that caused by Ilva steelworks. In 2010, the Procura (equivalent to the public prosecutor’s office in the UK) of Taranto began an official investigation of the factories. In 2012, the Procura released an environmental legal report showing that the Ilva was responsible for environmental degradation; an accompanying epidemiological legal report highlighted a correlation between the factory’s pollution and an increase in oncological, circulatory, and respiratory diseases. The owners of Ilva were put on trial and taken into custody, and plants directly linked to the pollution were seized. However, the still active Ilva factory sits at the heart of the local economy, where levels of unemployment are high. As the polluter is one of the major employers in the area, resistance to pollution becomes particularly difficult.

Drawn from “Blaming the Southern Victim: Cancer and the Italian ‘Southern Question’ in Terra dei fuochi and Taranto” by Cinzia Greco, published in ANTHROPOLOGY TODAY. Vol. 32, No. 3, JUNE 2016. URL: http://onlinelibrary.wiley.com/doi/10.1111/1467-8322.12255/full

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