Analysis

Breaking free from siloes: intersectionality as a collective action frame to address toxic exposures and reproductive health Rebecca Mandell, Barbara A. Israel and Amy J. Schulz

Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA

ABSTRACT There has been increasing interest in collaborative approaches between the environmental justice (EJ) and reproductive justice (RJ) movements to address the higher burden of toxic exposures and associated reproductive health outcomes in vulnerable com- munities. This study examined the collective action frames (CAFs) of advocates at the EJ/RJ nexus. CAFs highlight how advocates identify problems and solutions, and motivate action. The use of intersectionality was identified as a main CAF used in three key ways: breaking free from identity-based, issue-based, and move- ment-based siloes. First, interviewees described breaking free from identity-based siloes by identifying risks of toxic exposures that result from intersecting social locations (e.g. gender, race/ethnicity, income, immigration status) and by equally prioritizing multiple aspects of their identities as they engage in advocacy. Second, they described breaking free from issue-based siloes by develop- ing multi-issue agendas that address a complex web of interre- lated problems impacting health. Third, they described breaking free from movement-based siloes by developing cross-movement collaborations to address issues of mutual concern. Among multi- ple reasons given for cross-movement collaborations, advocates perceived them as valuable in order to disrupt social, political, and economic power imbalances that shape environmental reproduc- tive health inequities, as well as other health and social inequities. Based on these findings, we suggest that intersectionality is a master frame, and thus may be useful to advocates in other social movements addressing intersectional issues. Understanding an intersectionality frame can help to inform advocacy approaches to promote health and health equity, particularly those focused on policies and structural drivers of health.

ARTICLE HISTORY Received 31 July 2017 Accepted 3 December 2018

KEYWORDS Environmental justice (EJ); reproductive justice (RJ); collective action frames; intersectionality; environmental health; reproductive health

Background and significance

Toxicants in air, water, land, and consumer products are linked to adverse reproductive health effects, including fetal and infant development, fertility and timing of puberty onset (American College of Obstetricians and Gynecologists, Committee on Health Care for Underserved Women, American Society for Reproductive Medicine Practice Committee, & University of California San Francisco Program on Reproductive Health

CONTACT Rebecca Mandell [email protected]

SOCIAL MOVEMENT STUDIES 2019, VOL. 18, NO. 3, 346–363 https://doi.org/10.1080/14742837.2018.1556091

© 2018 Informa UK Limited, trading as Taylor & Francis Group

and the Environment, 2013; Wigle et al., 2008). Communities of color, Indigenous, and low-income communities often have both higher exposure to these toxicants, and greater susceptibility to them due to social and place-based stressors (e.g. racial dis- crimination, poverty) that may potentiate their harmful effects on health (Gallo et al., 2016; Hoover et al., 2012; Morello-Frosch, Zuk, Jerrett, Shamasunder, & Kyle, 2011). This ‘double jeopardy’ can result in population-based reproductive health inequities (Morello-Frosch & Shenassa, 2006).

Activists and funders have been interested in fostering collaboration between environ- mental justice (EJ) and reproductive justice (RJ) advocates to address these issues (Khan, 2009; Zimmerman & Miao, 2009). The EJ movement addresses disproportionate envir- onmental harm in communities of color, Indigenous communities, and communities of low socioeconomic status (SES) (Mohai, Pellow, & Roberts, 2009). The RJ movement expands the dialogue about reproductive health and rights to consider structural influ- ences and environmental conditions that shape the reproductive lives of women of color, Indigenous women and women of low SES (Price, 2010). These movements thus share an interest in healthy environments for marginalized populations.

Mounting scientific evidence linking chemicals with reproductive health concerns, and an increased incidence of adverse reproductive health outcomes in recent decades, have led a number of professional societies to call for stronger policies to protect the public from toxic chemicals, with an emphasis on disproportionately impacted popula- tions (American College of Obstetricians and Gynecologists et al., 2013; Di Renzo et al., 2015). More protective policies, particularly in vulnerable communities where harm may be most acute, are critical because individuals have a limited ability to avoid environmental exposures (American College of Obstetricians and Gynecologists et al., 2013). Policies that address structural determinants of health, such as social, economic, political and environmental factors, and their cumulative impacts, are essential to protect the health of communities with multiple risks (Gee & Payne-Sturges, 2004; Morello-Frosch et al., 2011).

Social movements can play a valuable role in advocating for policies (Schulz & Mullings, 2006) that protect environmental reproductive health by addressing, for example, air pollution, chemicals in consumer products, and occupational safety. Cross- movement collaboration and cross-fertilization of thinking between the EJ and RJ movements may strengthen such advocacy efforts (Khan, 2009; Ross, 2009a; Zimmerman & Miao, 2009). Improved understanding of each movement’s respective frames may strengthen this collaboration (Khan, 2009; Ross, 2009a; Zimmerman & Miao, 2009). Loretta Ross, formerly with SisterSong Women of Color Reproductive Justice Collective, an RJ organization, noted:

Despite the many sites of overlap and common ground, for the EJ and RJ movements to come together to address environmental and reproductive injustices, we also recognize that the two movements do not necessarily share a common understanding of language and that many assumptions about framing and language exist that need to be teased out and explored in order for the groups to successfully partner and blend with one another. There remains a fair amount of work to be done to first achieve greater clarity about each movement’s terminology, language, triggers, sensitivities, and framing, and from there, to find places of intersection and the possibilities for collaboration (Ross, 2009a, p. 11).

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The above quote underscores the need for systematic, in-depth analysis of the under- standings and assumptions characteristic of each movement – characteristics that inform how they organize, advocate, and mobilize. Such analysis can identify synergies, as well as tensions that may need to be addressed to strengthen cross-movement collaboration.

Theoretical framework and research objectives

This study examined the collective action frames (CAFs) of advocates at the EJ/RJ nexus. The development of CAFs involves three core framing tasks: identifying a problem (i.e. diagnostic framing), conceptualizing potential solutions (i.e. prognostic framing), and motivating collective action (i.e. motivational framing) (Benford & Snow, 2000; Snow & Benford, 1988). CAFs are socially constructed. Thus, they are continually modified and adapted based on situational contingencies and offer new ways of viewing social problems and identifying possibilities for social change. Analysis of core frames can help to illuminate broad underlying themes embedded in diagnostic, prognostic, and motivational frames that construct meaning and shape opportunities for action.

This study sought to identify CAFs of advocates working to protect communities of color, Indigenous, and low-income communities from toxicants harmful to repro- ductive health, with the goal of understanding how these frames may shape cross- movement collaboration. This article focuses specifically on intersectionality as a particularly salient CAF that emerged from interviews with study participants, and examines the implications of this framework for cross-movement EJ/RJ collaboration.

While there is substantial research on collaborations within movements, scholarship on cross-movement collaborations is limited (Beamish & Luebbers, 2009), hindering under- standing of factors that shape its potential. This study examines cross-movement EJ/RJ collaboration, contributing to a small body of literature on the nexus between these movements with regard to toxic exposures (see Daniel, Herzing, & Lerza, 2012; Di Chiro, 2008; Khan, 2009; Hoover, 2017; Zimmerman & Miao, 2009). While researchers have separately examined CAFs of the EJ and RJ movements (Luna, 2010; Taylor, 2000), to our knowledge, this is the first academic study to analyze the CAFs of advocates engaged at the EJ/RJ intersection. Examining this nexus from the standpoint of social theory and qualitative inquiry can provide an understanding of how advocates push for social change in response to scientific evidence on environmental exposures. As Brulle and Pellow (2006) note, ‘It is important to build more significant links between research on environ- mental justice and the theoretical and empirical sociological literatures on social move- ments and environmental sociology to advance our understanding of the origins of and responses to environmental inequality’ (p. 117). This study helps to bridge that gap.

Methods: data collection and analysis

A qualitative, grounded theory approach was used, hallmarks of which are an iterative process of simultaneous data collection and analysis that are mutually informative (Strauss & Corbin, 1998). In 2014 and 2015, semi-structured interviews were conducted with a racially and ethnically diverse sample of thirty-six advocates across the United States (US) leading efforts to combine EJ and RJ work focused on US populations, and with four

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professionals in philanthropy who have supported work at the EJ/RJ nexus. Thirty-three interviews were conducted via phone and video chat and seven face-to-face, with partici- pants in twenty-three cities. The interview guide included a description of advocates’ work to protect vulnerable communities from harmful reproductive toxicants, including pro- posed solutions, strategies, allies and opponents; perceived underlying causes of issues; what participants see as unique about advocacy work that combines environmental and reproductive health; experiences with cross-movement collaborations; and perceived benefits and challenges of cross-movement work. Interviews with advocates continued until theoretical saturation had been reached. This refers to the point when the researcher is not discovering new information during the coding process, and collecting more data no longer appears productive (Strauss & Corbin, 1998). Interviews with funders were added to the study at the suggestion of several participants in order to supplement advocates’ perspectives, and were not intended to reach theoretical saturation. In-process, analytic memos were used to identify and explore theoretical possibilities emerging from the analysis, helping to generate insights and leads to inform the direction of subsequent fieldwork (Emerson, Fretz, & Shaw, 2011). Integrative memos were later included to refine, connect, and elaborate on themes and categories (Emerson et al., 2011). After determining the main themes, relevant quotes were organized into a code book that listed codes, sub-codes, and sample quotes to support the sub-theme.

In addition, sixty-seven documents (e.g. organizational reports, website content, brochures, newsletters, policy briefs) were analyzed. These texts were selected to learn more about initiatives that participants mentioned in interviews, and also about their organizational messaging on EJ/RJ issues. Documents were acquired directly from participants, and also online via organizational websites. Following each interview, a brief demographic questionnaire was administered. Member checking entailed dis- tributing a summary of the interpretation of emerging themes to participants, providing an opportunity for validation or further discussion of findings before finalizing the analysis (Lincoln & Guba, 1985).

Interviews and documents were analyzed with an inductive open coding process to identify concepts, followed by focused coding in which the most significant or frequent codes were kept to categorize the data. A constant comparative method was used, which entailed comparing data with data, data with codes, and codes with codes to identify similarities and differences (Thornberg & Charmaz, 2011). The data was managed with NVivo software.

Where explicit permission was received, participant names and affiliations are used. Quotes were de-identified where such permission was not granted.

After the study was complete, participants received a written summary of findings and an invitation to attend a webinar in which findings were orally disseminated.

Results and discussion

Intersectionality: a primary collective action frame

A key study finding was that ‘intersectionality’ is a primary CAF described by many advocates to understand and address toxic exposures harmful to reproductive health in vulnerable communities. Intersectionality, a term popularized by Kimberlé Crenshaw

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and rooted in Black feminist scholarship (Bowleg, 2012), is defined by Bowleg as a theoretical framework positing that multiple social categories (e.g. race/ethnicity, gender, sexual orientation, class) converge at the micro level of individual experience, reflecting multiple interlocking macro, social-structural systems of privilege and oppres- sion (e.g. racism, sexism, heterosexism, classism). It has been used as a foundation for theory, education, and activism (Gaard, 2011). In the study sample, this framework was particularly prevalent among advocates who identified strongly with the RJ movement, reflecting its particular centrality to that movement (Price, 2010).

In the following sections, we examine the content of an intersectionality frame, which entails breaking free from identity-based siloes, issue-based siloes, and move- ment-based siloes.

Breaking free from identity-based siloes

Nourbese Flint, Program Manager at Black Women for Wellness in Los Angeles, California, explained how an intersectional RJ framework enables her to address a central challenge in advocacy work – reduction to a single identity – by allowing her to engage multiple aspects of her identity:

[With] the civil rights movement, women – particularly Black women – were having to put their race in front of their gender [and] in the feminist movement, Black women and women of color were supposed to put their gender in front of their race. [. . .] RJ is really that kind of spot in between where women can be both women and whatever other identity they bring to that. [. . .] and they don’t have to put one in front of the other first. You don’t have to choose.

In the context of environmental reproductive health, understanding intersections of identity has helped advocates such as Nourbese to highlight a host of issues, and to educate and activate others to address them. For example, advocates are raising awareness regarding adverse reproductive health outcomes associated with toxic hair relaxers used by many Black women under pressure to conform to European beauty standards (inter- sections of race and gender); the toxic effects of scented feminine hygiene products used disproportionately by Black and Latina women due to both cultural norms and corporate advertising campaigns targeting them (intersections of race and gender); and occupa- tional exposures to toxic beauty products among nail salon workers, and pesticides among farmworkers (intersections of race, gender, SES, and immigrant status).

Nia Martin-Robinson, Eastern Region Organizing Manager for the Sierra Club’s North Carolina chapter, described herself as an EJ activist who does her work through an RJ frame. She noted that an intersectional frame frees her from artificially compart- mentalizing different aspects of her identity, which she felt strengthens her as an advocate. She discussed the inclusivity of the RJ movement, as well as other recent movements (e.g. Black Lives Matter, Fight for $15):

We’re creating the kinds of comprehensive and holistic space that people can bring their whole selves to. So I can show up to a [rally] and say, “I am a Black queer woman living in the South,” and understand that all of those things and all of those identities impact me and my ability to participate in this work in a certain way.

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Her reflections are consistent with scholarship highlighting important connections between collective identity and social movement participation (Benford & Snow, 2000; Gamson, 1992a). Gamson (1992a) notes, ‘Participation in social movements frequently involves enlargement of personal identity for participation and offers fulfill- ment and realization of the self’ (p. 56). Advocates such as Nourbese and Nia described intersectionality as a framework that allows them to bring multiple aspects of their identities to the process of shaping social movements, thus creating a more holistic platform to meet their needs.

Numerous participants highlighted gender as a key aspect of their identities by focusing on toxicants and women’s health. While a framework focused on women can be applied to both vulnerable communities and the broader population, when applied to women within vulnerable communities, it helps highlight interactions between gender and other social locations (e.g. race/ethnicity, income, immigration status).

Nia noted the absence of a gendered lens within her previous EJ advocacy circles. She described how this changed when she attended a meeting convened by SisterSong. There, a representative from Women’s Voices for the Earth (WVE), an organization in Missoula, Montana that amplifies women’s voices when addressing toxic exposures, presented a gender frame. Nia observed:

I was coming [to the conversation] as an environmental justice advocate who felt like when we had conversations in EJ about vulnerable populations, we never really talked about women as a vulnerable population, and that felt like a really important thing. [. . .] When we talk about low-income people, are we talking about the fact that women make up huge majorities of the poor, not just in this country, but around the world? How are we breaking down these groups? How are we taking a look at people of color, Indigenous people, low-income people, and thinking one step further to say who are the groups inside of here who are being disproportionately impacted? There were times when I tried to bring this up, thinking, how do we talk about women’s issues here? And I’ve been told at times that I’m being petty or divisive, like there was no need to take it that much further – as long as we were looking at this race frame it was not necessarily needed to talk about gender also.

Nia’s comments place the vulnerability of women within an intersectional analysis, highlighting the disproportionate impact of environmental harm on women due to economic marginalization. They speak to her perception of encountering resistance within the EJ community, where she feels that others view the ‘race frame’ as sufficient, and that it is unnecessary to also explicitly consider the influence of gender. While Taylor (2000) notes that EJ is ‘the first paradigm to link environment and race, class, gender, and social justice concerns in an explicit framework’ (p. 542), Nia’s experience aligns with analyses suggesting that EJ work typically focuses on race and class with less emphasis on gender (Buckingham & Kulcur, 2009).

Men’s reproductive health is also impacted by toxic chemicals (Jensen, Bonde, & Joffe, 2006) and advocates are raising awareness about issues such as reduced sperm count, lower testosterone levels, and testicular cancer. However, participants were overwhelmingly concerned with the unique vulnerabilities of women. More than one participant referred to ‘woman as the first environment,’ a term coined by midwife Katsi Cook, because the first environment that a fetus comes into contact with is a woman’s body (Cook, 2007; Silliman, Fried, Ross, & Gutierrez, 2004).

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In addition to biological reproduction, organizational documentation (see Carmen & Waghiyi, 2012), also highlighted concerns that toxic chemicals can compromise cultural reproduction in Indigenous communities. This can occur if people are forced to interrupt cultural practices (e.g. fishing) to avoid exposures, if infertility rates increase and reduce the number of children to whom culture can be transmitted, or if children are not developmentally capable of learning their heritage (Carmen & Waghiyi, 2012). While cultural interruption impacts entire communities, we found a strong emphasis on the effects on women (particularly pregnant and nursing mothers). This challenge to cultural continuity can impact both individual identity (through loss of traditional roles that may be central to one’s sense of self) and community identity.

These findings support work by Hoover (2017), who argues that intersectionality has helped to inform the development of both EJ and RJ, and explores the intersection of these frameworks in forming the concept of ‘environmental reproductive justice (ERJ).’ Developed by Katsi Cook along with others in her Akwesasne community and in other Indigenous communities, ERJ focuses on the relationship between environmental con- tamination and both biological and cultural reproduction. Findings are also consistent with previous assertions about gender by the RJ movement. Gurr (2011) maintains that ‘Reproductive Justice activists and scholars specifically locate the bodies of women as one lynchpin between environmental pollution and community wellness, arguing that the impacts of pollution on women’s bodies differs in important ways from the impacts on men’s bodies, and further that the impacts of pollution on women’s bodies has particular consequences for the community at large’ (p.724).

Breaking free from issue-based siloes

Intersectionality was also used as a framework for understanding connections across issues. Participants’ analyses, described below, parallel previous efforts by social move- ments to move beyond single issues in order to achieve more ‘comprehensive critiques of power and more comprehensive forms of action’ (Carroll & Ratner, 1996, p. 602).

The Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR), located in Denver, Colorado, describes their intersectional work on their website as: ‘[. . .] looking at not just reproduction, but also at other movements, issues and constituencies including LGBT [Lesbian, Gay, Bisexual, and Transgender], racial justice, economic justice, disability and other areas where people may be marginalized or may experience discrimination or barriers to their rights and liberties.’ In this framing, a multi-issue agenda is key to operationalizing an intersectional approach.

Miriam Yeung, Executive Director of the National Asian Pacific American Women’s Forum (NAPAWF) in New York City, describes intersectionality as a multi-issue framework in her organization’s nail salon advocacy work:

[. . .] we have always thought that our nail salon advocacy work was really close to the heart of our mission and close to the way we do our work, which is intersectional and multi- issue, because it’s such a rich topic that allows us to talk about environmental justice and economic justice and immigrant rights, and immigrant access and reproductive health, rights and justice, and workers’ rights.

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Miriam grounds her comments in an intersectional analysis that examines multiple dimensions of inequality operating together to structure risk, in this case, of exposure to toxic chemicals among nail salon workers. In addition to being an important issue in and of itself, toxics ‘allows’ NAPAWF to discuss other social issues of concern to their constituency. This ‘multi-issue’ use of an intersectionality frame can offer advocates from different organizations a way to identify common issues, providing a foundation for collaboration.

Kimberly InezMcGuire, a self-describedmovement leader at the EJ/RJ intersection located in Washington, DC, described the need to look beyond traditional reproductive rights issues (e.g. abortion, contraception) to other issues that impact a woman’s reproductive life:

Reproductive justice advocates have always said we need to be as concerned with the right to become a parent, the right to have children if you so choose and to parent those children as we are with the right to end or prevent the pregnancy. To me, working to eradicate toxic chemicals that unquestionably threaten that fertility and, therefore, the right to parent of those communities most affected – who we know are people of color, low-income people – doing that work demonstrates commitment to the full spectrum of reproductive choices that a person might make.

Her analysis stresses the broad array of issues that impact reproductive choice, high- lighting the particular constraints on meaningful choice in vulnerable communities. It moves beyond ‘identity’ to encompass specific attention to underlying structural forces, such as toxic environments, that affect health. It exemplifies the use of ‘intersectionality’ both in the sense of breaking free from issue-based siloes, and in the integration of race, class, and gender in understanding structural factors that shape risk.

Victoria (pseudonym) commented on the benefit of a holistic multi-issue frame for understanding how ‘nuanced’ and ‘complicated’ life is:

The issues that you face in your day to day intersect with one another and so by addressing multiple issues that affect communities at one time as opposed to forcing people to choose to center their advocacy around one thing is more responsive to the way that we view the world and the way that we experience the world around us.

Her comments underscore the need to consider the web of factors impacting health, the challenges inherent in attempting to separate these factors from one another, and the importance of approaching policy development with a wide angled lens that situates people and communities within a complex web offering multiple leverage points for change. This perspective is consistent with fundamental causes theory in public health (Link & Phelan, 1995). Fundamental causes theory refers to processes through which SES and other social factors place individuals ‘at risk of risks’ for morbidity and mortality by shaping access to resources to avoid these risks. The theory contextualizes risk factors by determining how people’s life circumstances impact their risk level. For example, people of low SES are less likely to have the resources to live in areas with fewer sources of pollution, thus increasing their risk of toxic exposures and associated reproductive harm. Fundamental causes, such as SES, are linked to multiple disease outcomes through multiple mechanisms (Link & Phelan, 1995; Phelan, Link, & Tehranifar, 2010). Thus, identifying common denominators (e.g. classism, racism) that cut across multiple inequalities may allow advocates to collaborate across issues to address underlying social inequalities that drive health outcomes.

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Breaking free from movement-based siloes

A final theme was that of working across social movements. This theme builds upon the idea of breaking free from issue-based siloes. While it is possible to advocate for a multi-issue agenda within movements, breaking free from issue-based siloes can also lay a foundation for cross-movement collaboration.

Miriam characterized social justice movements as ‘too siloed.’ Her organization’s website identifies cross-movement building strategies as critical to an intersectional approach. The majority of advocates interviewed identified with more than one social movement. Beyond EJ and RJ, these included environmental health, mainstream envir- onmentalism, the reproductive rights movement, labor, immigrant rights, women’s health, racial justice, economic justice, the toxics movement, the green movement, and the peasant’s movement. This substantial diversity creates rich collaborative potential.

Organizations and foundations have orchestrated a number of discussions, as well as joint policy advocacy and awareness-raising campaigns, to convene advocates in dif- ferent social movements engaging in EJ/RJ work, including work on toxics. For example, SisterSong and the Women’s Foundation of California have brought together EJ and RJ advocates to dialogue (Khan, 2009; Ross, 2009b). CAFs are the result of negotiated shared meaning (Gamson, 1992b). By coming together, advocates can negotiate the scope of a shared frame, including decisions about the types of issues to include on their agenda, and ways to form arguments consistent with the pre-existing goals and values of both movements.

Activists such as Kimberly framed the issue of toxics as situated at the intersection of multiple concerns, with the potential for serving as the basis for a multi-issue agenda that can, in turn, facilitate cross-movement collaboration. Kimberly described her efforts to generate interest in cross-movement collaboration:

I have spoken to reproductive health audiences about all of the ways in which chemicals are very harmful to reproductive health, making the case that if you are in the business of protecting reproductive health, you ought to be in the business of eradicating toxic chemicals that are a direct threat to sexual and reproductive health and fertility. [. . .] I have also spoken in environmental settings, once again raising awareness and making the case for environmental groups that are already engaged in toxics advocacy that it’s important that they understand that these chemicals hurt communities of color, they hurt low-income people. [. . .] a lot of bridge-building kind of work.

By strategically identifying and recruiting advocates poised to care about the impact of toxicants on reproductive health in vulnerable communities, Kimberly is ‘frame brid- ging,’ a frame alignment process in which organizers connect with new stakeholders who they think will support their issue, given their ideological orientation regarding other issues. Bridging can take place between a movement and individuals that it aims to recruit, or across social movements (Benford & Snow, 2000; Snow, Rochford, Worden, & Benford, 1986). Her audience, comprised of advocates who are already focused on reproductive health problems but who are either not making the connection with toxics or not incorporating this connection into their advocacy agenda, reflects substantial untapped potential. Bridge building work that transitions these groups into intersectional approaches could strengthen cross-movement momentum around toxics.

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Advocates identified cross-movement collaboration as a valuable organizing strategy that can help them to: expand bases of support; gain new perspectives; share resources, information and expertise; and facilitate broad-based progressive change. It is perhaps this last benefit that commands the most attention. By joining together across move- ments, advocates perceive that they may stand a better chance of disrupting social, political, and economic power imbalances that can perpetuate health inequities.

Nia noted that bridging issue and movement siloes could help advocates on the left to more effectively ‘fight back’ against rightwing organizations, such as the American Legislative Exchange Council (ALEC), that already use a multi-issue strategy. These points were echoed by Amy Weintraub, Health Policy Associate for West Virginia Focus: Reproductive Education and Equality (WV FREE):

We actually must work together if we are going to have a movement that is sustainable and that can really operate effectively in the face of a very well-organized, well-funded conservative movement. We can no longer exist in silos of LGBT movement, reproductive healthcare movement, environmental justice, racial justice. We are going to have to start crossing those justice barriers because the right certainly has done that with their whole ‘gays, guns, and God’ thing that they have been doing for the last several decades with a lot of success. We are going to have to unify in that sort of way too. [. . .] It will mean to a degree, people will have to give up their silos, and that’s scary. [. . .] [The right has] somehow – not ‘somehow’ – they strategically have packaged these things as one unit and that if you are a good Christian, you are going to oppose all or be for all of these things.

These comments are consistent with arguments by Silliman et al. (2004), who suggest that in response to the rightwing’s successful organizing campaigns against reproduc- tive rights, the leftwing needs ‘a broad grassroots strategy capable of reaching across social movements and linking health and reproductive rights to other social justice issues’ (p.16).

This framing strategy can be categorized as frame extension, a frame alignment process defined as: ‘[. . .] depicting an SMO’s [Social Movement Organization’s] inter- ests and frame(s) as extending beyond its primary interests to include issues and concerns that are presumed to be of importance to potential adherents’ (Benford & Snow, 2000, p. 625). Combining issues within their agenda that are of importance to their constituency may activate a broader base.

Others noted that toxics can be part of a frame extension strategy, linking it with social issues such as RJ, workers’ rights, economic justice, immigration, and racial justice to form a broader progressive coalition. This idea of narrow and broad agendas marks an important distinction between efforts to build coalitions to reduce exposure to specific toxic chemicals (a narrow orientation), and cross-movement efforts that aim to reduce toxic exposures and achieve widespread social change in the process (a broader orientation). Alex Gorman Scranton, Director of Science and Research at WVE, noted that her organization mobilizes women by ‘[. . .] finding ways for women to take what we believe is in their inherent interests and needs and desires and finding ways to get those voices out so that they are heard more strongly.’ She compared this strategy to other groups that might say ‘We really want to get bisphenol A out of baby bottles or whatever. Oh, we need some women spokespeople to do this.’ Both approaches can reduce toxic exposures, but the former also aims to fundamentally change gender- related power imbalances while the latter uses women as a means to an end. Similarly,

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broad-based coalitions addressing toxics from an intersectional perspective can extend their influence beyond the intersection of toxics and reproductive health to challenge social, political, and economic power imbalances that contribute to numerous inequi- ties. In this way, issues such as toxics can serve as a catalyst for widespread progressive change, particularly when addressed within the context of social movements that embrace intersectional analyses and approaches.

Figure 1 below depicts the relationship between cross-issue and cross-movement work that advocates described, with toxics acting as an intersectional issue that facil- itates cross-movement collaboration.

Frame disputes in intersectional movement building

Benford (1997) describes the need to examine framing processes and dynamics, includ- ing conflict during the development of CAFs. Towards this end, we discuss frame disputes, or disagreements over objectives, strategies, and tactics to reach a shared goal (Benford, 1993). Some of the very same characteristics that can be assets to cross- movement efforts, such as joining new constituencies together and bringing different perspectives to the table, can fuel frame disputes. Disputes over prognoses and reso- nance were apparent in the data.

Prognosis disputes were described regarding whether to focus toxics policies on vulnerable populations or the population at large. Many advocates argued for a focus on vulnerable populations because, as Kimberly said, ‘mainstream approaches may or may not help them.’ For example, a participant noted that passing a bill to label flame retardants would not help poor people if they cannot find non-flame retardant products.

Advocates also argued that focusing on vulnerable populations is beneficial to society at large. Jose Bravo, Executive Director of the Just Transition Alliance, said: ‘I want you to understand that once we deal with the issues that we believe are disproportionately affecting [vulnerable] communities, society as a whole will benefit because those [issues]

Figure 1. Relationship between multi-issue and cross-movement work.

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are the worst of the worst.’ For example, targeting 99-cent stores, which sell a disproportionate number of toxic products and are disproportionately located in communities of color and low-income communities (Taylor, 2015), was seen as critical because cleaning up the dirtiest side of the supply chain could benefit all consumers.

Frohlich and Potvin (2008) point out that the benefits of population-level inter- ventions are not always equally distributed. If those with lower risk benefit more, such interventions can inadvertently increase health inequities. They assert that these unintended consequences take place because population approaches do not address the fundamental causes of disease that account for different distributions of risk of exposure between different subpopulations. They argue for interventions that combine population-based approaches with ones specifically targeted towards vul- nerable populations. Yet, advocates such as Jose are making a different argument – that an intervention constructed to benefit vulnerable populations is simultaneously good for the population at large, such that there is no need to create two separate interventions.

At the same time, though, it is unclear if the kinds of stricter policies needed to simultaneously protect vulnerable populations and the public at large would win politically against corporate lobbies and unsympathetic politicians (two major obsta- cles to reform mentioned by participants) that want less stringent standards. This dilemma was captured by the second major type of frame dispute documented in this study – disputes over frame resonance. Benford (1993) describes this kind of dispute as being about ‘how reality should be presented. [. . ..] Which rhetorical strategies are likely to strike a responsive chord and thereby mobilize the greatest number of people? Should framing activity that undermines ideological purity be allowed?’ (p. 679).

Advocates in this study disagreed about whether to focus on the population at large or on vulnerable populations when trying to gain political support. For example, Victoria was among those who felt a focus on vulnerable populations would not generate adequate support for reform, ‘I think that as with, unfortunately, a lot of issues, until people who have money and power see that issue as impacting them, a lot of action won’t be taken.’ Monica Simpson, Executive Director of SisterSong Women of Color Reproductive Justice Collective, was among those who argued for focusing on vulnerable communities, ‘Whenever you are able to really break it down and have people see [. . .] the impact that this is having on the most desperate communities, I think that’s what actually moves the needle a lot faster.’

Klandermans and de Weerd (2000) state that collective action ‘requires some collective identity or consciousness’ (p. 69) and Snow and McAdam (2000) argue that a ‘shared sense of “one-ness” or “we-ness”’ (p. 42) is typically seen as central to the essence of collective identity. The disparate racial and ethnic compositions of the justice and mainstream movements that coalesce at the EJ/RJ intersection may make a collective sense of ‘we’ more challenging. If advocates vary in the extent to which they identify with vulnerable populations, resonance disputes may arise if this influences how willing they are to compromise on ideological purity in order to increase resonance among policymakers most concerned about the popu- lation at large.

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Conclusion

Benford and Snow (2000) assert that framing ‘denotes an active, processual phenom- enon that implies agency and contention at the level of reality construction. [. . .] it involves generation of interpretive frames that not only differ from existing ones but that may also challenge them’ (p. 614). By advancing an intersectional frame, advocates construct a narrative that stresses the interrelated nature of problems and the need for solutions that address them simultaneously. Its diagnostic content emphasizes that identity-based characteristics (e.g. race, gender) jointly shape risk of exposure, and that communities face intersecting social issues that act together to influence environ- mental reproductive health. The frame’s prognostic content underscores the need for solutions that address identity-based intersections that elevate risk of toxic exposures; simultaneously address multiple, intersecting community issues; and promote cross- movement collaboration to more effectively change the status quo. Its motivational content aims to reduce environmental reproductive health inequities and improve other related health and social inequities. This framework contrasts with siloed approaches that fracture identities into discrete characteristics and consider them separately, attack problems by isolating and addressing their constituent parts one by one, and mobilize supporters within the confines of their own movements.

Advocates are employing frame alignment strategies to create an intersectional advocacy agenda that can unite a broad range of movements. They are frame bridging by engaging untapped audiences with similar ideological orientations, arguing that if they care about reproductive issues, then they should care about environmental issues, and vice versa. Simultaneously, they use frame extension by folding toxics and repro- ductive health into an expansive platform comprised of multiple issues (e.g. immigrant rights, workers’ rights, economic justice) that can attract a wider base.

Benford (2013) notes that: ‘Whereas most collective action frames are context specific [. . .] a master frame’s articulations and attributions are sufficiently elastic, flexible, and inclusive enough so that any number of other social movements can successfully adopt and deploy it in their campaigns’ (p. 1). Terriquez, Brenes, and Lopez (2018), who identified use of an intersectionality CAF among Latino undocu- mented and queer activist youth, suggest that intersectionality ‘has the potential to develop as a “master frame”’ because it is ‘an inclusive, broad, and flexible frame that can be deployed by different populations advocating for a range of causes’ (p. 273).

Our research suggests that an intersectionality CAF possesses these characteristics, evidenced by its versatility with regard to issues, movements and identities. First, it covers a wide range of issues within environmental reproductive health (from hair relaxers to industrial waste). While the scope of this research focused on toxics and reproductive health, the intersectionality frame is applicable to many other issues. For example, women’s marches in 2004 and 2017 – two of the largest marches in US history – used intersectional, cross-movement platforms that identified a range of social justice issues as women’s issues (Chenoweth & Pressman, 2017; Women’s March on Washington, 2017; Luna, 2010; Roberts, 2004; Vagianos, 2017). Additionally, many social movements come together under the umbrella of an intersectional frame, includ- ing both justice and mainstream movements. This lends credence to assertions that master frames allow diverse groups to unite around common political struggles

358 R. MANDELL ET AL.

(Tarrow, 1992) and that cross-movement activism is linked with use of a broadly resonant master frame (Carroll & Ratner, 1996). Lastly, the frame affirms multiple identities. Contrary to Epstein’s (1991) assertion that organizing politics around defending identities ‘forces people’s experiences into categories that are too narrow and also makes it difficult for us to speak to one another across the boundaries of these identities-let alone create the coalitions needed to build a movement for progressive change’ (p .25), the intersectionality frame creates spaces for advocates with many different identities who unite around the common experience of marginalization and oppression.

Gerhards and Rucht (1992) hypothesize that master frames have greater mobilization potential when the issues within the frame are more plausibly connected, and when they encompass a wide range of problems that create leverage points for many groups to use the frame. An intersectional CAF provides plausible linkages between a wide array of societal issues through interrelated systems of oppression, such as racism, classism and sexism. This structural framing of an injustice is common in cross- movement activism (Carroll & Ratner, 1996). These causes provide a root linkage for many of the issues addressed by advocates at the EJ/RJ intersection, thereby enhancing the potential to successfully unite diverse constituencies and effect change. The poten- tial efficacy of intersectional framing is also reflected in prior research, which has found that cross-issue and cross-movement alliances can be more effective than single-issue and within-movement efforts in accomplishing policy reforms, systems change (Daniel et al., 2012), and social change (Roberts & Jesudason, 2013), and that advocates who link diverse ideas and movements are influential in progressive, coalition politics (Di Chiro, 2008).

Bowleg (2012) has noted a lack of public health research on intersectionality, and has called for more attention to this area to better understand and address health inequities. Mullings and Schulz (2006) have argued that the social science literature on intersec- tionality needs to more concretely identify ways in which intersections of race, class, and gender manifest in people’s daily lives, and ways in which these inequalities intersect in specific contexts to shape health. This analysis contributes to filling in these gaps by demonstrating ways in which advocates are using intersectionality as a core analytic and organizing principle, and as a master frame with significant mobilizing capacity. Intersectional CAFs that critically analyze and seek to disrupt inequities grounded in race, class, gender, and other social categories have the potential to strengthen movements promoting health equity, both through specific actions (e.g. policy change) and transformational social frameworks.

Acknowledgments

The authors would like to thank the study participants whomade this research possible by graciously sharing their time and insights. They are also grateful to Marie O’Neill, Cynthia Summers and Louis Graham for their thoughtful input on the research described in this article. Additionally, they want to acknowledge the University of Michigan’s Rackham Graduate School, Graham Sustainability Institute, Institute for Research on Women and Gender, and Riecker Graduate Student Research Fund at the Center for the Education of Women, which provided fellowships and grants to partially support this work.

SOCIAL MOVEMENT STUDIES 359

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Rebecca Mandell is a researcher at Arbor Research Collaborative for Health. She received her PhD from the Department of Health Behavior and Health Education at the University of Michigan School of Public Health. Her training and expertise include improving health and health equity through policy, community-based approaches, and multi-level interventions. She holds an MS in Society, Human Development and Health from the Harvard School of Public Health and a BA in Romance Languages from Harvard University.

Barbara A. Israel is a Professor, Department of Health Behavior and Health Education, University of Michigan School of Public Health. Her research focuses on the social determinants of health inequities using a community-based participatory research (CBPR) approach. Since 1995, she has worked with community and academic partners to establish and maintain the Detroit Urban Research Center, and its affiliated CBPR partnerships, engaging in multiple basic etiologic research and intervention research projects aimed at increasing understanding and addressing health inequities in Detroit.

Amy J. Schulz is Professor, Department of Health Behavior and Health Education at the University of Michigan School of Public Health. She received her PhD in Sociology and her MPH in Health Behavior and Health Education from the University of Michigan. Her research focuses on social determinants of health including social and physical environmental contribu- tors to racial, ethnic and socioeconomic health inequities. Since 1998, her research has focused on use of community based participatory approaches to promote social and environmental justice.

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