In This Episode
Think about your favorite place. Chances are you thought about how it looks — but not necessarily how it sounds. Sound is all around us, so constant that we often ignore it. But it turns out that sound can have serious implications for our health. Abdul breaks down the ways sound can shape our health. Then he sits down with Prof. Erica Walker, an epidemiologist who studies sound and health to understand more about sound’s health implications, and the inequities that so often shape the different sounds we’re exposed to.
TRANSCRIPT
[sponsor note] [music break]
Dr. Abdul El-Sayed, narrating: New evidence suggests that COVID may be spreading widely in white tailed deer with troubling implications for humans. The president of Stanford University resigns over allegations of data manipulation. Heat is gripping communities around the world with deadly consequences. This is America Dissected. I’m your host, Dr. Abdul El-Sayed. [music break] Do you hear that? No? If you’re someone who doesn’t have to live with the constant din of background noise in your community, consider yourself lucky or privileged. But chances are, no matter where you are or where you live in this world in 2023, it has a particular soundtrack. I lived in the Washington Heights neighborhood of Manhattan in grad school. That soundtrack, the overground subway and the fading sound of Dembow, the uniquely fast paced Dominican music that was so popular in the community. The suburbs may sound like mowers or leaf blowers in the distance. Alexandria, Egypt, where I spent so many childhood summers, the constant horns of seventies era [?], street vendors selling watermelon or prickly pear and the call to prayer. Today we’re talking about the public health implications of noise. For a long time we just assumed that noise was simply a nuisance, an annoying thing that occurred in the background of some of our lives. But here’s the thing about it, hearing is one of our only senses that we can’t turn off. And I want you to think through why? We are at our most simple, both predators and prey. If you think about it, for folks who have that sense, hearing is one of the only ones you can’t turn off. The other is smell. Both are absolutely critical to bagging that next meal or avoiding becoming some meal for another. A large part of our brains evolved to pay very particular attention to the sound we hear in the distance. You know that rustling in the leaves or that growling in the distance and we can’t turn it off because imagine our ancestors being hunted while they were sleeping. It turns out it’s a good thing that loud sounds wake us up. But modernity, well, that’s the consequence of all that time our ancestors and their progeny invested in controlling our surroundings. Most of the sounds we hear every day are the product of something predictable. We don’t have to say it, but how often does our brain notice the sound and then explain it away? Oh, that’s my alarm clock or oh, that’s the train. Oh, that’s the lawnmower. You get where I’m coming from here. But even though it happens subconsciously, it turns out that there’s a real cost to all that noise. It comes in the form of some of our hormonal wiring. The fact that even if our brain understands that the sound deluge of modernity is usually nothing to be worried about, it doesn’t stop it from triggering our stress hormones. The hormones that evolved to prepare our ancestors, who really had to worry about every single noise to fight or run. And over time, having our bodies in perpetual fight or flight mode leads us to all kinds of downstream health consequences. High cortisol, our long term stress hormone, is associated with heart disease, diabetes, stroke, certain cancers. And even if every landscape has its soundscape, it’s clear that not every soundscape is created equal. And just like place, exposure to sound isn’t evenly distributed, it turns out that even the soundscapes that we live in tend to be more dangerous for lower income and marginalized groups. Think about it, who’s more likely to be forced to live next to a noisy highway or a constantly buzzing transformer or a tornado siren? And that doesn’t even get us to the health of the hearing organ itself. Hearing loss is one of the few health challenges that is getting profoundly worse over time. To be sure, it’s a problem of our own making. To understand why, I want you to think about how much of your day you spend with the headphones or ear pods, you’re probably listening to this on in your ear. A few weeks back, I came across the work of Professor Erica Walker, an epidemiologist who studies the health impacts of noise. And I knew I had to have her on the pod to discuss her work on the health consequences of noise, hearing loss and the inequities in who is most likely to be affected. Here’s my conversation with Professor Erica Walker.
Erica Walker: Okay. It’s recording.
Dr. Abdul El-Sayed: All right. Can you introduce yourself for the tape?
Erica Walker: Yes. My name is Erica Walker and I’m the RGSS assistant professor of epidemiology at the Brown University School of Public Health.
Dr. Abdul El-Sayed: Professor Walker, we really, really appreciate you coming on the show. I um feel like I need to be extra noisy during this, this [laugh] podcast. And let me just start with the first bit of noise. Like I’m always a fan of professors of epidemiology, like my kind of people, so uh I appreciate you coming on. You study something really interesting because most of us, when we think about a place, tend to think about the visual features of that place and what’s fascinating is that we are very, very visual creatures. Look at the sort of proportion of our brain space, most of it is dedicated to uh visual processing, but our visual processing tends not to be the most emotional. Um. The most emotional, you know, in order is probably smell, then taste, then sound. And the part that we usually can’t turn off is the sound part. Right. I mean, you can you can close your eyes. You can, you know, in some respects, breathe through your mouth. You can decide not to taste something, but you can’t stop hearing. For the most part. You can try and cover your ears. But if it’s if it’s if it’s noisy enough, you’re going to get that sound. And, you know, when I when I think when somebody tells me think about the sound of New York City, you know I think about a screeching subway. When somebody says, think about the sound of some nondescript suburban community. I think about lawnmowers. When somebody says, think about the sound of the ocean, you know, it’s the canonical waves with the seagulls. And I take that somewhat for granted unless I’m cued to think about that. But that soundscape is so much a part of the places we live because we can’t shut it off. Now, one of the interesting pieces and I’m just sort of going off here is I have a I have a six month old. And we were recently in New York. And uh, you know, we live we live in a in a relatively small town. And we were in the city and she just couldn’t sleep because of the sound. And it was interesting because my wife and I have lived in New York and it took us, you know, a good several months to be able to fall asleep with, you know, the sound of um of Dembow in the background and, you know, the the train running up the one and, you know, people hanging out at all hours of the night. Um. But our six month old, right. She’s only been exposed to a certain thing. And you know no matter what we tried to do, we couldn’t shut it off. It was just an interesting reminder because her response to this was, is she would fall asleep and then something would wake her up and she’d be terrified. And I think um we take for granted that that initial emotion of scary sounds actually is something we have to force ourselves to stop paying attention to or not. And and that’s that’s why I was really compelled to to sit down with you, because you’ve been thinking about that from the jump. Can you tell us a little bit about what got you interested in studying soundscapes in relation to our health?
Erica Walker: That’s not a beautiful story. It’s one that I’m really ashamed to tell. But, you know, it’s funny, I’ve always, I think since I’ve been very young, have been cued in to sound as probably being my primary sense. I don’t know. I have the last name Walker. So when it came to classrooms, I had to sit in the back [laugh] so I had to really concentrate to hear my teacher. So sound was just always something that it was just how I was able to to learn um due to where I sat in the classroom. And I also grew up in a in a rural town where you would think wouldn’t be inundated with sounds. But I lived next to two major highways and a railway, so it was actually quite, quite loud in my hometown. Um. But, you know, I moved off to the big city, forgot all of that stuff, and um became a working artist after I graduated from college and I moved into an apartment that was a basement level apartment, because it was the cheapest and one day well, this basement apartment was also my studio, so I made furniture and I was a bookbinder. And one day, this family moved in above me, and they had these two small kids, sorry. [laugh] And they ran across their floor, which was my ceiling for, like, 24 hours a day. And because my living arrangement was also my office space, I was there 24 hours a day, and I was exposed to that 24 hours a day. And through the process of trying to get them evicted, I mean, like, I just really wanted them to to to move out. Um. I was going to take them to small claims court. So I started gathering evidence like how loud they were, when it happened, I even took saliva samples and sent them off to a laboratory to be tested for stress hormones. But in that, in that process of trying to get rid of my upstairs neighbors, um ran across a really a bunch of interesting perspectives from other people that were dealing with similar issues or very different issues where they were all related to sound. And I got so obsessed with it that one of my really close friends was like, I really think that you should, like, take a chill pill, do something else uh maybe you would like this field called public health. And I was like, what is public health? And I read about it applied to public health schools. And I guess, like the rest is sort of what I’m doing now.
Dr. Abdul El-Sayed: So this this family, uh they were they were keeping you up at night, but they also kind of gave you a career?
Erica Walker: Yeah, I credit them. I wish I could email the guy and be like, hey, you changed my life. Um. It was a very miserable experience. Two years of nonstop uh assault. But yeah, you know, sometimes things happen for a reason.
Dr. Abdul El-Sayed: Hmm. Well, I’m sorry about that experience. And also sorry about the you know broader climate in which, you know, we are all uh asked and in circumstances uh to live in, in challenging positions where um, you know, we are oftentimes um you explained your circumstances, but in moments of low income, you think about what it means to put a whole bunch of people in relatively poorly built um apartment buildings where there is no sound insulation um and it can be such an undignifying experience for everybody involved. Right. And that’s–
Erica Walker: Correct.
Dr. Abdul El-Sayed: –you know that’s if you house have housing. Right. Um.
Erica Walker: Correct.
Dr. Abdul El-Sayed: So it’s something to, you know, to think about oftentimes. I think we when we’re in those circumstances, we always think about us relative to others. But, you know, it’s that it’s that broader context that forces us into these situations, which is, you know, entirely the subject of your of your research now. Can you tell us a little bit about what is noise pollution? You know, how do you think about it and how do you characterize it? How do you measure it?
Erica Walker: Yeah, so I first I always say that I study sound and communities tell me or individuals, concerned individuals, communities tell me what’s noise, uh noise is unwanted sound. And I just kind of go in the direction of where there are issues. So, you know, we think of sound as an audible wave that we process primarily through the auditory system. It’s something that we hear. Um. But when it comes to a threshold where an individual or community deems it to be something unwanted, that’s kind of where I step in because I kind of want to figure out well what is it? Where is it coming from? How long has it been there? Why is it there? Who’s exposed to it? How it’s impacting their health, um and how can we measure it in ways that actually accurately capture the experience or things that are important to me?
Dr. Abdul El-Sayed: And in terms of the the pathway from, you know, sound that becomes noise to health, what are the ways in which noise translates to to ill health?
Erica Walker: Yeah, uh it could be through sleep loss. Either you lose your the hours of sleep that you get or the quality of sleep that you that you get or most most commonly sleep loss. And just this mood disruption, you know, you sort of hear something, you process it as something that you don’t want to be exposed to and your body prepares um a response very similar to a fight or flight response or a similar response to if you were in a dark alley and out jumps a ferocious pit bull, your body’s like, either I’m going to fight this or I’m going to run away from it. So, you know, if you’ve ever experienced that flight or fight stress response, your body begins to prepare itself for battle. Your heart rate begins to increase, your stomach feels uneasy, you begin to sweat. Um. And that constant um that consistent stimulation of that stress response over a long period of time can lead to very serious negative health impacts from the cardiovascular to um mental health impacts.
Dr. Abdul El-Sayed: Hmm. What are some of the long range consequences that have been identified in studies about exposure to noise? Um. What are what are we seeing in folks with with chronic exposure versus those with less?
Erica Walker: Hypertension, myocardial infarction, cardiovascular related mortality, depression, increased medication use, uh lots of different things, you know, cognitive outcomes, especially in children, developmental outcomes, just a whole host of issues.
Dr. Abdul El-Sayed: Can I ask you what forms of noise are the most damaging? Because you could imagine a situation where there is a consistent din of noise, i.e. you know I live next to a busy highway, or uh I’m just in New York City where it’s just loud. Versus regular unpredictable sounds that over the course of the day are predictable, i.e. I live near a train station or I live near train tracks and the train is going to come. I don’t know when it’s coming, but I know it’s going to come and I hear that noise. It scares me for a second and I’m like, that’s just the train. And then over time I subconsciously start to tune it out. Like, which of these forms of noise uh exposure are the most are the worst for us?
Erica Walker: You know, that’s a really good question. I always say it’s the one that keeps you up at night. It’s the one that stresses you out. So and I always when it comes to to defining noise, I always defer to the individual or community that I’m working with because they’re the ones that are going to tell what is unwanted and what’s not how and why. But it’s whatever sound it is, no matter how quiet or how loud it is that sets off that flight or fight response response, that noise that stresses you out, that’s or it keeps you up at night doesn’t um allow you to go to sleep, restore your body. That’s the kind and it could be it could take on any form, actually.
Dr. Abdul El-Sayed: Hmm. And I’m immediately as a as a father of two children, five and under um the noise that stresses me out is [laugh] I hate to say it comes from the thing that I love most and hold most dearly, which is my children. And, you know whether it’s my–
Erica Walker: We have something in common.
Dr. Abdul El-Sayed: –hey so you right, like I mean that that [stuttering] I feel like you have a um a appreciation for that those parents of those toddlers now when you when you’re just like please stop, please, please stop.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: Um. And the number of times I say that in my mind, right. I know that saying that to a child who can’t process it is not going to do anything. But like, you know, in the middle of the night, you wake up and you’re trying to calm your child down. The overwhelming emotion is, please stop, please–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –stop this emotional terrorism. I don’t know why you’re doing this. [laugh] Um.
Erica Walker: That’s a good way of putting it, I like that term.
Dr. Abdul El-Sayed: But it’s like it just and it’s the it really is, it’s the noise. It’s like–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: You know, we could we could easily, I mean, there the number of times I [laugh] I catch myself trying to reason this out as like, we can address this all you–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –all that has happened is that you have soiled your diaper and I can fix this for you.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: Please stop making that awful noise.
Erica Walker: Yes. [laughter] Yeah. I mean, did you see that recent video that went viral where there was a guy on a plane and he’s basically just having a meltdown because there’s some loud kid um terrorizing the plane and it’s like on one hand, you really feel for this guy because I know you can reach that tipping point when you’re exposed to a sound that you can’t control. Um. But then on the other hand, I know that kids are small human beings who don’t who don’t yet, the only way that they can communicate is through that. And it’s kind of like a I’m kind of torn. [laughing]
Dr. Abdul El-Sayed: You know, it’s funny, the degree to which I have patience for um my child’s wailing decreases with time in large part–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –because it’s just like, you know better.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: Right so now when my five year old decides to have a tantrum, I’m like, hey, we did that for two years.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: You don’t you don’t get to do that anymore. Okay.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: You just don’t get to do that anymore. Um.
Erica Walker: Yeah, Yeah.
Dr. Abdul El-Sayed: Uh. Yeah, I haven’t I didn’t see the video, but I you know, I’ve been that person on that airplane and at the same time I’ve been the parent of that kid–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –on that airplane, and you’re, like, mortified that your child is–
Erica Walker: Yeah, it’s that person.
Dr. Abdul El-Sayed: –acting out on this plane, exactly you’re like, I’m so I’m so deeply sorry to all of you. But at the same time, yo, like what do you want me to do?
Erica Walker: Yeah.
Dr. Abdul El-Sayed: Kid needs to see their grandparents. [laugh]
Erica Walker: Yeah. Yeah. I mean, when we were growing up, our parents used to give us, like, NyQuil or something like when we get on the plane or a train or bus. Um. Yeah, and we would just sleep. [laugh]
Dr. Abdul El-Sayed: But what it, but what it highlights is that those things that can be the most stressful aren’t necessarily always odious. It’s just a sort of a function of our lives. And also if you just think evolutionarily the thing that babies do is cry because their survival and therefore your you know genetic inheritance depends on your um immediate emotional disturbance at this thing. And so that cry–
Erica Walker: Correct.
Dr. Abdul El-Sayed: Right, is is a really powerful, very odious tool. Here’s what’s actually really fascinating. Cats, when they um when they complain, they complain at the same decibel and um frequency as babies crying.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: It’s like this–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –incredible evolution.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: To force us to pay attention because we–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –absolutely hate that sound.
Erica Walker: Yeah. Yeah.
Dr. Abdul El-Sayed: I want to ask, um in studies. You know I. Part of this conversation is inherently ableist, and I want to address that because there are, of course, people who cannot hear for whom there is no um auditory noise or sound. Have there anybody, been any studies to look at the differences in um in emotional levels according to noise pollution among folks who are deaf? I mean, it strikes me that there’s a remarkable natural experiment happening right there. Obviously, deaf um people, because of our society, are not accommodated in certain ways, which creates a certain confounding uh exposure to stress. But I’m wondering if that’s been studied at all?
Erica Walker: So uh I spent a large part of my career actively avoiding the hearing loss literature just because I just it just didn’t speak to me. It’s kind of like when people wanted me to make children’s furniture and I really wanted to focus on adults. It was like it was something that didn’t appeal to me. So I actually like cut it out of my life. However, recently we have um we are working with high school students and we are doing an you know a cohort study in my home state and we work with high school students. And one of the first things that we noticed uh when we interacted with them is that they had those hearing devices that were up really loud. And for children of that age, they have already slight to moderate hearing loss in one or both ears. A lot of them are listening to um, you know, headphones or in one ear, like listening devices in one ear so they have, which is very remarkable than what we have seen previously. But um so that kind of got me into the hearing loss literature. But we’ve had focus groups with people who are hearing impaired and they still can hear, but they just hear things very differently. So some frequencies are exaggerated or a lot of the times to compensate they have to turn things up louder, which further damages their hearing. So, you know, they can still hear uh some of them can still hear unless they’re just, you know, profoundly deaf, but they just hear differently. And so, like I was saying, some things could drive them in– like drive them insane. Like if you have your volume on your TV down really low and there’s like a they can it actually it it some of them can process it as very loud, a lot of them are disturbed by things you wouldn’t even notice were on like um a refrigerator hum, you know things like that. You know they can so they just for those who can still hear but have, you know, moderate or extremely severe hearing loss in those that can still hear, hear, but they hear differently.
Dr. Abdul El-Sayed: Wow. So that that that is that is really fascinating. In some respects um for folks who are not hearing impaired, the uh processing of sounds that are tuned specifically for folks who are not hearing impaired allow them to be processed more clearly, if I understand what you’re saying. And then for hearing impaired folks, some of these sounds that we um those of us who are not hearing impaired can tune out becomes particularly noxious. It’s interesting my my, uh my wife Sarah hates the sound of white noise, cannot stand it. [gasp] And she just needs to turn it off. So whenever there’s like a fan um a um a cooking fan on, for example, she just needs to have it off. The other one that bothers her is the sound of a television when it’s on mute.
Erica Walker: Yeah, yes.
Dr. Abdul El-Sayed: Right and it has a really high pitched–
Erica Walker: Yes.
Dr. Abdul El-Sayed: –hum.
Erica Walker: Yes.
Dr. Abdul El-Sayed: Um. And so it’s a really interesting, right, these sounds that we somewhat take for granted I mean, think about white noise by definition is something you turn on. It’s interesting, right? You’re turning up a baseline din so that you do not hear the episodic sound of something else. Right. And that’s what we used for example, for my daughter in in New York, we just turn on really, really loud white noise. And it drove my wife crazy.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: Um.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: Which is it’s a really interesting point in so far as it changes the the the rhythm almost of what you’re um what you’re exposed to. I want to also ask you just about inequities. Right. One of the things that anybody who’s looked at the relationship between any kind of environment and health immediately starts to appreciate is that noxious stimuli are not evenly distributed, and neither are people. And if you look at the distribution of noxious stimuli and people, almost always poor folks and marginalized folks um uh tend to be concentrated in the places with the highest levels of noxious stimuli. Right. And because of our country’s um uh racist history, that tends to mean that you’re talking about concentrations of low income Black folks in the places that are the most noxious, whether you’re talking about air quality, whether you’re talking about risk of uh automotive injury, whether you’re talking about um uh the quality of roads, uh whether you’re talking about access to to food and health care. All of these things tend to be distributed this way. Can you tell us about about the distribution of noise?
Erica Walker: Yeah. Um. So before I did my pit stop in Public Health, I first started with urban planning, which really opened my eyes to the way our cities are laid out. So I think that by design, intentionally so, we have created these really poor urban planning policies that essentially put all the people we don’t want to necessarily interact with in areas that are undesirable. So or in areas that are undesirable, we decide to dump all of our uh acoustical trash. So that means that, well, a train or a highway can run through a very poor neighborhood, or we can put the the the H– We can have an HVAC system or some sort of uh transformer that is really loud and annoying in a poor neighborhood. Or we could plan for all of the nightclubs and entertainment districts to be in poor communities. So I think that we have intentionally designed our cities to put the people who don’t have the power to to advocate for more or better um in in the most undesirable areas of our city, or we put the most undesirable elements or in our city, in those neighborhoods that house those people, including myself, like I lived in a very unambiguously designed community where the community was intersected by a railway and the Black people lived on one side of town and the white people lived on the other side of town, and on our side of town was a creek that flooded all the time and then literally an open sewer lagoon. So with that would you put an open sewer lagoon in a community with wealthy white people? The answer is no for many reasons, um because their their perceived value in society is higher. And they know that if you proposed to put a sewer lagoon, they’re going to come out and and protest that heavily. Um. So for me, it all start, it starts and ends with poor uh, poor urban planning policies.
[AD BREAK]
Dr. Abdul El-Sayed: What does mitigation look like? Right it um, [laughter] at some point, there is always going to be noise and–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –um the question of how we A.), Mitigate that noise, but B.), evenly distribute that noise. What does that look like? How should it look? What is urban planning to address noise pollution actually look like?
Erica Walker: It looks like going back and really taking a look at all of these policies in place that has put these kinds of things in these in these marginalized communities and repair that. Right. So um, you know, if you if you put a major highway through a poor community, you need to now go back and mitigate that by sound walls or, um you know, soundproof windows. I don’t know you you need to mitigate that that that poor planning practice. But then going forward, you need to be very intentional about the acoustical environment when you were planning how to put things um in our cities like where you’re going to put them, who you’re going to put them next to, um etc.. And then, you know, there’s this talk of reparations. You know, I’m not going to get into that because I’m not, you know, like, I don’t know, I don’t like to talk about things I don’t know much about. Um. But I think there is some sort of repair that needs to happen for all of that harm we’re, and we’re just talking about noise. But usually where there’s noise, there’s other things too, lurking in the background. There’s probably poor water quality, there’s probably uh horrible visual pollution, there’s probably terrible air quality, the soils probably horrible. So it’s so like everything is in a bubble and in a in a, in a in a concentration around in these community. So noise is just one aspect of that. And one could argue it’s the canary in the coal mine, but then you need to go back and prepare for those uh for those mistakes [laugh] quote unquote, “mistakes” that have been made in urban planning.
Dr. Abdul El-Sayed: You know, one analogy that’s that keeps coming to mind. And, I’m you know, I’m from Michigan, so cars are always in the top of mind. But, you know, we don’t appreciate that a muffler literally is meant to muffle the sound of an engine. [laughter] And what people don’t appreciate is like, if you took a muffler off an engine, it is extremely loud, right? Uh.
Erica Walker: Oh yeah.
Dr. Abdul El-Sayed: An automotive engine without a muffler is extremely, extremely loud. And a muffler is a piece of equipment we deliberately put on a engine to keep it quiet. And–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: You know, you think about a nice car right they they’re not usually. I mean, nobody makes a super loud luxury, you know, Mercedes or BMW now yeah there are some [?] cars that deliberately aren’t meant to be loud, but even that is because you’ve got, like a fancy muffler that’s supposed to really get that right that right acoustic it’s, you know, interesting with electric cars. They’ve now designed sound making pieces that are both in part about safety, because if you can’t hear the car coming, that’s a problem. But also it’s about just the joy of the sound of the car, right?
Erica Walker: Yeah. Yeah.
Dr. Abdul El-Sayed: Um. But like this notion of of the money we spend to control sound and who gets that money spent on them and who doesn’t. Right. You talked about–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –sound walls uh on a highway or, you know, just just uh distances. Right. In terms of how far you can zone from a highway–
Erica Walker: Exactly.
Dr. Abdul El-Sayed: –tends to be different on one side of the tracks like you talked about versus on the other. And um these are choices that are made about about um about what what you are required to do when it comes to urban planning that tend to be about the ability, like you said, for some people to leverage their power and prestige to change public policy. And some people who don’t have that ability and–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –sound is just like you said, just one of those pieces. Um. Has has there been uh efforts, you know, in different parts of the country to actually address this noise pollution? Have there been efforts to go back and say, you know, as part of the inequity that was created when we built this railroad or highway here, we are going to go back and invest in um sound walls or go back and invest in um, you know, offering subsidies to homeowners to uh install soundproof glass, has there have been any effort to do this?
Erica Walker: I’ve never heard I don’t want to speak because I haven’t read every piece of literature in the country, but I don’t think so. I mean, because it’s very expensive. Um. I remember a pretty wealthy community that I was working with, um in in Massachusetts they were arguing to get a sound wall and they were given the runaround. So I just can’t imagine uh no. I don’t think so. I’ve never heard of it because, I mean, think about it, though like, if you you know, you know you’re going to you’re going to need highways, you’re going to need entertainment venues, you’re going to need restaurants. You’re going to need things that are loud in a city. Right? Where are you going to put them? You’re going to put them in the place where people aren’t going to either they’re not going to feel empowered to say anything, or they just don’t have the time to think about that based on the other stressors in their life. So you’re going to put them in those kind of communities because that is the most efficient strategy. I’m not saying it’s the most it’s the moral or right strategy, but no one’s going to change the uh mechanism that rewards efficiency and and and uh yeah, no one’s going to change that. So I don’t expect that. And I would be surprised if that did happen.
Dr. Abdul El-Sayed: Hmm. Can you tell me why we like the sound of some noise and not others? So, you know, I personally am someone who loves the sound of rain. I really–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –enjoy it when I hear it. It puts me at ease, even though the rain is kind of dangerous, right? I mean–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: –objectively speaking, if it’s raining and I got an issue with my roof or, you know, I something is outside water can damage a lot of things, but I enjoy the sound of it. Ocean, right? My my family’s from Alexandria in Egypt. And so the sound of the ocean for me is, you know, it’s like it’s like reminds me reminds me of a certain sense of home. Um. Why do we like some of these sounds? I mean, you can’t turn them off, right? And so one of the points of that that we’re kind of getting at is the ability to control sound. And, you know, you really can’t turn off some of those sounds. Um. Why is it, though, that some of these sounds are soothing, even though, you know, if you just think about it, these are noise we can’t control that just exists.
Erica Walker: Yup. I think it could be something psychological, right? Like it it it brings you back to a place that resonates with you, either consciously or subconsciously. I think sometimes it’s because it’s something that we can control, you know, like so I may not like white noise. I don’t put in my I don’t put white noise in my headphones and go for a run, but it’s something that I can control and it’s something that can empower me to not have to listen to things that I can’t control. So I think some of them are coping mechanisms, um power strategies. And I also think that, you know, some of them are just enjoyable. Like I personally, I love listening to people. Like the ASMR videos where people eat in the microphone. I love that. Now would I want to go to a restaurant and sit next to a guy that’s smacking like, I don’t know, I love ASMR videos. I love hearing people eat food. It’s just it’s very soothing for me. So there’s something about that that soothes my spirit. And so I think there’s just a many different reasons why a person uh responds positively or negatively to a sound.
Dr. Abdul El-Sayed: Hmm. That’s I mean, it’s fascinating. Um. I am someone who really enjoys the sounds of big cities.
Erica Walker: Me too.
Dr. Abdul El-Sayed: And I like I like that feeling of having all that clutter. And almost in some respects, it makes me feel, uh, it makes me feel anonymous.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: In a weird way. Like I can just get lost in this crowd of people, which is ironic because, you know, there’s all kinds of other people who are like, there with you. But that is there’s something happening and I can get lost in that thing happening. Um.
Erica Walker: I like that.
Dr. Abdul El-Sayed: And, you know, and and I think it’s is an interesting question because the experience of the sound of the city uh when we lived in New York was very different, when we lived in Washington Heights, which is a lower income part of Manhattan versus when we lived um in, you know, in midtown, which was a very different um location. And it’s that, you know, it’s it’s that question of, you know, does the subway run underground or overground where you are? Um.
Erica Walker: Mm hmm.
Dr. Abdul El-Sayed: How close is your window to that subway? And then um, you know, there’s the question of all of the other, you know, random noises that are that are made. So like when you have centrally cooled buildings in a particular part of town, they don’t make much noise. But in the summer in parts of the city, all you hear is the din of air conditioners, right? Um.
Erica Walker: Yeah. Yeah.
Dr. Abdul El-Sayed: And those those, those those sounds qualitatively differ. I want to switch back to your least favorite part of this um conversation about hearing loss, because I just think it’s you know, it really is going to be a pretty profound epidemic for folks of our generation and beyond, in large part because–
Erica Walker: Absolutely.
Dr. Abdul El-Sayed: –you’re right, Like I don’t go anywhere without a pair of AirPods in my pocket, right? You know, like phone, keys, wallet. And for me, it’s like phone, keys, wallet, AirPods. Right? And um and I consistently have my AirPods on. And I know that I’m one of the first generations in history that’s been able to have consistent, constant sound in my ears–
Erica Walker: Yup.
Dr. Abdul El-Sayed: –at direct level. That wasn’t a thing that you could do, you know, not more than 40 years ago. And so, you know, I think about the level of hearing loss in my my dad’s generation um and the generation before him. And then I think about uh about the kind of hearing loss that we’re going to have. And it like you said, it’s already um it’s already bearing out. About just how bad are we is that hearing loss right now in younger generations? And what does that mean for the future?
Erica Walker: It’s pretty bad. So like I said, so I for the past year, I have a research intern, a research assistant who is in my home state of Mississippi, measuring hearing loss in high school students. Um. So in middle school and high school students. And she’s following them over a period of time. So she just did her first panel of students, um I guess her first cohort she’s enrolled. And we’re talking about children as young as 13 years old, having profound hearing loss uh in either one or both ears. Usually it’s one ear and it’s usually the ear that they’re using to talk on the phone or listening to music and when so we we give them hearing screenings. But then we also, like measure the volume in their what they’re listening to and they’re listening to levels, 100 decibels. And like if you–
Dr. Abdul El-Sayed: Wow.
Erica Walker: –use OSHA or [?] OSHA, or [?] um hearing conservation levels, at that sound level with hearing protection, you should only be exposed to that for, you know, 30 minutes, 15 minutes, an hour. And these kids who are listening, like when we asked them, well, how long are you listening to this for? And they’re like, you know, all day, like literally all day. The only time they don’t listen to it is when they’re in the shower. And then when they–
Dr. Abdul El-Sayed: Wow.
Erica Walker: –go to bed, they turn on the speaker, put it right next to their uh nightstand and listen to that. So we’re beginning to see hearing loss that is astronomical in comparison to my generation.
Dr. Abdul El-Sayed: Wow. That is uh that is that is nuts. And I think about, you know, when I was younger, I used to enjoy music at quite a lot louder than I do now. It is interesting, actually. You know, I always wondered why, like uh older folks when I was really young, why older folks didn’t enjoy the mu– like music at that level.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: And that and now that I’m you know nearing 40 and in the situation where I hear really loud music, I’m like turn that down.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: Why is that so loud? You just you can’t even hear it. Um. [laugh]
Erica Walker: Yeah.
Dr. Abdul El-Sayed: But. But you know, when you when you create that norm it’s a real problem. And I’m wondering if the manufacturers of these products don’t have a role to play here. Right. Um.You know, with the technology you have available, you in theory, could make self delimiting um headphones where they just over a certain period of time will not play at a certain level a lot higher than than um than what you what you ought to be exposed to. Has there been any effort to um to hold them accountable for this?
Erica Walker: I hope not. I know like so as a [laugh] as a researcher who actively monitors a cohort of people throughout their lives, who actively puts sensors up in communities, um who actively works against uh these community networks and tries to collect data to support communities as they deal with their uh issues. I that just sounds real big brother to me. So like I always have to find this balance. Um. This is just the way things are. This describing the harms and letting people [?] I say that my role as an epidemiologist, especially one that’s that studies noise issues, is to provide everyone with a basket of goods where if they chose from that basket of goods, they have the options to maximize their health and well-being. But I don’t want to put anything in that basket of goods that leaves that control away from them. Um. So I don’t know. It sounds like a good idea, but it just sounds a little big brother. [laughing]
Dr. Abdul El-Sayed: Let me um.
Erica Walker: I wouldn’t want that.
Dr. Abdul El-Sayed: Let me no I hear you and let me let me push back just because I think–
Erica Walker: Yeah. Yeah.
Dr. Abdul El-Sayed: It’s there’s an analogy in our history that’s worth um engaging with, which is cars. Early on, um the way that cars were built, they were built to protect the car. Right. So–
Erica Walker: Yeah.
Dr. Abdul El-Sayed: If a car got in an accident, it wasn’t about protecting the human inside the car. It was about protecting the car and. The level of quality control in terms of parts meant that you know you had a sort of a level of um obsolescence that was built into the car they they wanted this thing to break down. So you had to get a new one pretty quickly. Um. And then there was a whole consumer rights movement that really fundamentally shifted what cars were built to do. The requirement, for example, that every car had a seatbelt and that you had to wear one. Uh. The requirement that cars had to meet particular safety standards. Because part of the issue is that I don’t know that when you’re talking about 13 year old children, they actually think through what the long term consequences of listening to very loud music is. And I think if you talk to them 30 years on. And you say, hey, now you’ve you’ve really you’ve got profound hearing loss and you’re not going to hear in full detail the sound of your your daughter’s cooing. Do you wish someone would have done something to protect you from that really, really loud sound you had in your ear all day? I think most of them would say, yeah, I wish I did because I didn’t know. You know what I mean? And so–
Erica Walker: Yes.
Dr. Abdul El-Sayed: I think there’s this world where we’re told that everyone’s a perfect consumer and that they’ll make their choices as they are. But I worry that, particularly when you’re talking about kids, because this is who you’re talking about, right, who tend to be the most exposed, that there is not that agency to be able to make really good decisions. And I worry that it’s assumed that these things are safe because you’re not feeling the consequences of them today, even though you’re going to feel the consequences of them later. And, you know, there’s a world where you could do this, where you could turn off the governor, for example, which is to say, now listen, you know, if you want to listen to this as loud as it goes, we could do that. But at baseline, right. You have to choose against that.
Erica Walker: Yeah yeah.
Dr. Abdul El-Sayed: Right. Um. Rather than, you know, you’re just you can play it as loud as you want and suffer the consequences later. And, you know, whatever it was your choice. Right. And I–
Erica Walker: Yeah yeah.
Dr. Abdul El-Sayed: That’s the thing that I worry about, which is, I you know, when you’re talking about kids and their long term hearing loss about decisions that they make when they’re 13 and they’re pressured to like, listen to the music extra, extra loud.
Erica Walker: Mm hmm.
Dr. Abdul El-Sayed: I don’t know that they’re making the best decisions and that they even can make the best decisions for themselves.
Erica Walker: So that’s where education comes in. Like when I was a young kid, I didn’t recycle. I think like when I grew up in the eighties, no one recycled, um but no one [laugh] put a sensor in my trash can to make sure I separated things umm and made sure I was recycling properly. I went to school, they had educational programs that taught us about the benefits of recycling, and I found that to be like, I had this my own eureka moment that made me believe in the movement to where it was just. And I thought about ways to recycle other things, you know, like, so I was just recycling we were at that time, we were just doing glass, cans and that’s it. But then even myself, with my creativity, I was able to think about, well, maybe we can recycle other things too. But if I was if there was some mechanism that was forcing my hand um in a way that I wasn’t being educated about why they’re forcing my hand, I’m also I’m going to do something because someone’s telling me to do it, but I’ll never be able to have the education and gener– to generate the creativity to move beyond that. So I don’t know. I think that education and that’s one of the things that we do in the schools, we educate them, we show them the correlations and we hope that they make better decisions. But I kind of go on the less Big Brother, more uh education, and we saw that during COVID. I know like as public health people, we saw that force wasn’t necessarily the best way to get people to uh appreciate the benefits of the vaccine. But I think that what we found was most um beneficial was, you know, educating people about uh what the vaccine was as opposed to just mandating it. Um. So, I don’t know, education plays a big role in what people decide to do.
Dr. Abdul El-Sayed: Yeah, I um, I, of course, will never disagree with you about education, but I also think that there’s a role there’s a role for for um for setting a baseline expectation. And I don’t think that, you know, banning loud headphones is really the way to go. But I do think that um making sure that folks have a sense you know in the in the the product itself, a sense of what the risks are of this. Right. Because especially when you’re talking about long term consequences for short term joy, that’s where things sometimes that that becomes a real challenge. I mean, you think about smoking, for example, right? It is, from what I understand, joyful to smoke in a short period of time. The long term consequences are what you really worry about.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: And humans are not very good at addressing the discounting of the future.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: Especially, you know, 13 year old humans who are listening to their favorite song. Um. I want to ask you, you know you’ve been doing some really great work around noise, sound in Mississippi. Can you talk to us a little bit about that?
Erica Walker: [laugh] Yes. So during Covid, when the world got quiet, except in certain locations, which is ano– I’ve been waiting for somebody to talk to me about that like what happened during Covid where there’s this, like weird thing where there were some areas of our country that were really quiet and some areas of our country that were really loud, but during Covid, I kind of had like a eureka moment because a reporter reached out to me and she was like, Erica, it’s so quiet out here. You know, everyone’s staying at home. How quiet is it? And, you know, I went outside my neighborhood and I was like, wow, it’s really quiet. It’s so beautiful. Um. But I lived in a pretty nice neighborhood at the time. And so I remember that evening, one of my former students, because before I was a starving artist, I was also a high school teacher, and one of my students reached out to me and she was like, Erica, I know you’re doing noise test noise stuff but I live in a neighborhood where there’s this incessant firework activity um and it just turned into this big thing where across the country, you know, a lot of Black and Brown communities were inundated with firework noise. So during that time, I had this sort of epiphany that if I’m not focusing on the right places, I’m going to miss the the the the the true story. Like, if I had only focused what was happening just outside of my door, I would have missed this whole other issue that was negatively impacting people like me across the country. So I just kind of got fed up with doing work via community noise lab um in areas where everything was just set up for success. Everything looked the same. Everyone felt empowered. Um. There are there was great sources for data. Everything worked because everything was made to work. And I was like, this would never work in a place like my home state of Mississippi. And for me, in order to be successful, it should work. Your ideas should work when it’s supposed to work, and they should still work when they’re not supposed to work. So for me, Mississippi, my home state with lots of um environmental issues, I feel like if my strategies, my research strategies are successful, then we need to try them out in Mississippi. And if they aren’t successful, I will learn a lot and I’ll be able to create more accessible, um effective tools. So I’m just going back to my home state to grapple with noise, which is a significant issue, but then kind of looking out and seeing how it’s connected to other environmental issues and how are they connected and how were they distributed in communities?
Dr. Abdul El-Sayed: I really appreciate that. And I think, you know, it’s important to understand that when you’re talking about something that is not evenly distributed, you know your own experience demonstrates that you’ve really got to go where the consequences are. And this fireworks activity is a really important um reminder of that. You know, I think anyone who’s got small children knows that, you know, July 4th is such a terrible day because they can’t sleep. But then, you know, for folks who have been traumatized by things that sound like fireworks, guns, right. This this becomes a real noxious stimulus if one of the pathways of noise pollution is that it causes stress because your mind has to process what is the sound?
Erica Walker: Correct.
Dr. Abdul El-Sayed: Should I be worried about it? And if it sounds like a gun, you should be worried about it, even if it’s just a firework.
Erica Walker: Correct. And that was a huge issue that came out when this sort of random firework activity happened the summer of like the summer following the stay at home advisories. I think that was the summer of 2020. And it just seemed suspiciously like it happened only in Black and Brown communities. And for me, the question is, why did that happen? Like I said, that’s a that I can go down conspiracy theory territory with that. But I think the main thing that that whole experience made me realize is that even as a Black woman who I thought was connected to the struggles of my community, I was led down a wrong direction by a journalist’s prompt. And then what I could see only outside of my own community. And that really scared me because I always thought of myself as an accessible, you know open minded researcher. And here I was being led down this incorrect path by a journalist and what was outside of my own backyard.
Dr. Abdul El-Sayed: Hmm. It’s a it’s a really important reminder about the risk of being held hostage to our own bubbles. And–
Erica Walker: Yeah, absolutely.
Dr. Abdul El-Sayed: And it happens–
Erica Walker: Absolutely.
Dr. Abdul El-Sayed, narrating: –intellectually. It happens, you know, as as researchers, as activists, uh you know, as a public servant, you assume the world looks like what your world looks like.
Erica Walker: Yeah.
Dr. Abdul El-Sayed: And you know, and, you know, I think I think both you and I have the experience of living in circumstances that are not the same as the ones that we’ve always lived in and–
Erica Walker: Correct.
Dr. Abdul El-Sayed: –the ones from which many of our people come from. And–
Erica Walker: Correct.
Dr. Abdul El-Sayed: Even then, you can start to forget that the world doesn’t always look this way, um–
Erica Walker: Correct.
Dr. Abdul El-Sayed: Yeah, it’s a it’s a really, really important insight and I really appreciate you sharing it and um and so much insight about the risk of noise pollution and and sound, um even though you like it, you know, it can can sometimes hurt you. Uh. Our guest today was uh professor sorry um our guest today was Professor Erica Walker and she is the RGSS assistant professor of epidemiology at Brown University. Um uh. Professor Walker, I really appreciate you making the time. Thank you so much for sharing your insights and your perspective.
Erica Walker: Same. Thank you for having me. It’s really nice to meet you. I love meeting new people, so it’s really nice to meet you.
Dr. Abdul El-Sayed: The privilege was mine. I hope you’ll come back. [music break] As usual, here’s what I’m watching right now. New research from the FDA shows that people transmitted SARS-CoV-2 to white tailed deer at least 100 times in 2021, and early 2022. And get this, deer transmitted it back to humans at least three times. The findings, published in the journal Nature, suggest the possibility that SARS-CoV-2 has established a new reservoir host in deer. Remember, coronaviruses routinely hang out in animals. And the most likely hypothesis regarding its initial spread into humans is through a raccoon dog. The implications here should be worrying, as I’m sure you and your immune system know, this virus mutates quite easily, and the fact that it’s spreading in deer suggests that it has a whole other playing field. Unvaccinated and unbothered by quarantining or other public health measures in which to continue to evolve. And that simply increases the probability of a new variant that could evade our immune responses emerging from within the deer population. Not saying it’s going to happen, just saying it could happen. In a shakeup that hits to the core of health science, Stanford President Marc Tessier-Lavigne will resign over a report regarding allegations of data tampering involving 12 research articles on which he was an author dating back to before he was president of Stanford University. The report was issued in response to allegations that the renowned neuroscientist had knowingly engaged in research misconduct. The panel did find that misconduct, but concluded that Tessier-Lavigne was not directly involved in it, though he did act slowly to correct it. Beyond being simply the most salacious story in science right now, it’s also a reminder of how the process works. The whole premise of science, after all, is radical transparency. Though the findings of the report do clear Tessier-Lavigne of directly manipulating data, the consequence of failing to meet the bar even after malfeasance was discovered, will cost him one of the most coveted jobs in academia. But the findings should also implicate the publication industrial complex itself. One of the big challenges that we have in science is that so much of it is relegated in the academy, and the academy for far too long has rewarded research publications over everything else. There are two challenges here. The first should be obvious. The push for speed and volume makes this kind of malfeasance simply more likely. The second is more insidious. Science requires replication, trust but verify, you could say. But you can’t get tenure verifying you’ve got to do new stuff. And because there’s no reward for verification, it just doesn’t get done. Which means that our entire scientific enterprise has become more brittle. Rather than testing and retesting our foundations, we often build upon old material that isn’t always sound. As this example demonstrates. Beyond one university president losing his job. I hope that this situation forces a broader conversation about how the incentives of universities may contribute to this kind of situation. Finally, stay cool out there, folks. We’ve been experiencing the hottest summer in recorded history. In Phoenix, they’ve had 24 straight days of 110 degree or hotter weather. That’s a record and it’s also deadly. In fact, heat waves are the deadliest of all weather events. They kill more people than hurricanes, tornadoes, and floods combined. And that makes sense if you think about it. We are warm blooded, which means we need our body temperatures to be exactly 98.6 degrees. We can’t deviate much or we suffer the consequences. But here’s the problem. It’s a lot easier to warm yourself up when it’s cold than it is to cool yourself down when it’s hot. Add layers to conserve body heat, move around to generate heat, burn something to benefit from the stored heat inside it. But getting cooler, there’s only so much clothing you can take off after all. The body overheats quite easily and our natural defenses, like sweating, are only minimally effective. Sure, we’ve invented things like air conditioning, but it’s expensive. Too many folks in our country simply can’t afford it. And burning that much energy to keep us cool? Well, it just contributes to the problem that’s leaving us so hot in the first place. Because all of this should remind us that climate heating isn’t a distant worry. It’s already here. That’s it for today. On your way out, don’t forget to rate and review the show. It really does go a long way. Also, if you love the show and want to rep us, I hope you’ll drop by the Crooked store for some America Dissected merch. [music break] America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producers are Tara Terpstra and Emma Illick-Frank. Vasilis Fotopoulos mixes and masters the show. Production support from Ari Schwartz. Our theme song is by Taka Yasuzawa and Alex Sugiura. Our executive producers are Leo Duran, Sarah Geismer, Michael Martinez and me. Dr. Abdul El-Sayed, your host. Thanks for listening. [music break] This show is for general information and entertainment purposes only. It’s not intended to provide specific health care or medical advice and should not be construed as providing health care or medical advice. Please consult your physician with any questions related to your own health. The views expressed in this podcast reflect those of the host and guests and do not necessarily represent the view and opinion of Wayne County, Michigan, or its Department of Health, Human and Veterans Services.
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