Community and Family Conflict

SMTDs are woven with numerous threads of uncertainty. For example, the disaster emerges over a long period of time; the health consequences emerge slowly and fol­low a lengthy latency period; and as a result of long latency from exposure to diagnosis, disease causes may not be obvious.

The Pervasiveness of Conflict. As people noticed the high rates of respiratory disease in Libby and became aware of its toll in terms of mortality, advocates emerged who attempted to draw agencies’ attention to what later became recognizable as a community­wide disaster. W. R. Grace became the target of numerous lawsuits, most of which were settled with nondisclosure agreements. The uncertainties inherent in the disaster were fur­ther enhanced by (a) multiple interest groups benefitting from maintaining such uncertain­ties in order to deny the existence and/or seriousness of the disaster (e.g., the company, local businesses, and politicians), at the same time that (b) other interest groups, such as health care professionals focusing on ARD, the EPA, and ATSDR, claimed that a hor­rible disaster cost hundreds of lives and made potentially thousands of others sick. This left a community questioning nearly every aspect of the disaster.

Every conversation, across the stakeholder focus groups and interviews, invoked the con­cept of conflict. One of few areas of con­sensus among research participants was that the community response to the disaster was characterized by conflict. Language reflect­ing conflict included terms such as “us and them,” references to “sides” of conflict, “polar­ization,” “tension within the community,” “controversy,” “split,” “very divided,” “a real separation between factions,” “divisiveness to the community,” and “contentious” (Cline et al., 2010). This language points to conflict characterized in bipolar terms rather than as a continuum of points of view. As one ARD participant said, “There’s no middle gray mat­ter.” These conflicts emerged as the disaster became increasingly visible; clearly the conflict predated the research. Although they had been warned of community conflict, the researchers were not prepared for the omnipresence and palpability of that conflict and its degree of relational toxicity.

By the time the research began, community advocates had long since emerged and been stereotyped. Not simply substantive conflict, demonizing stereotypes fueled stigmatization of the advocates and people with ARD akin to stigmatization of people with AIDS early in the AIDS epidemic. In fact, several research participants drew parallels between responses to people with AIDS and community responses to people with ARD. Discussions implicitly invoking stigma were rampant. Clearly, con­flict had gone beyond substance to divide the community into “us” versus “them.” In light of these dynamics, it is perhaps not surprising that people with ARD commonly reported failed relationships with family, friends, and church members over asbestos-related issues (see Orom et al., 2012).

The Value of—and Necessity for—Multiple Levels of Analysis. Entering Libby, the inves­tigators were generally aware of conflict but were naive about its pervasiveness, palpabil­ity, and toxicity.

Analyses at the stakeholder level (people with ARD, family of those with ARD, and non-ARD people) cast light on the specific conflicts raging in the community and why those conflicts were avoided in everyday inter­action. No one denied the existence of conflict, but the toxic social environment that emerged around the disaster led most people to avoid addressing these issues openly. Due to that avoidance, what constituted a safe environ­ment in which to voice opinions was not readily recognizable. Clearly, many people— regardless of their stakeholder position—did not know who had ARD. ARD participants were surprised to find people they knew in the focus group room who also had ARD. Discussions uncovered social connections whereby participants informed each other of others they knew had ARD or had died from ARD. The effect of the stigmatization on the style of response to conflict was obvious: Avoidance is protective. One family partici­pant said of another, “She is my neighbor and I had no idea what she was dealing with” (everyday challenges of a spouse’s ARD).

Analyses at the individual level shed light on the personal challenges of living with this ongoing disaster. These analyses identified who is stigmatized and by whom, what over­arching disaster theme is held by whom, and personal coping strategies and psychosocial adjustment issues. Personal accounts con­firmed the overall strategy of conflict avoid­ance. Open interpersonal conflict appeared to have occurred rarely and often only “by acci­dent” (e.g., when a person with ARD was con­fronted, by someone who did not know the first person’s disease status about the “bogus” nature of the disease, and chose to argue openly, “No, you’re wrong”). Fortunately, because of known sensitive legal and political contexts, the research plan was designed with an eye to applied ethics.