Talk about cancer: environment and health in Oceanpoint

Talk about cancer: environment andhealth in Oceanpoint

Andrea Whittaker*

Gender Relations Project, Research School of Paci®c and Asian Studies, Australian National University,ACT 0200, Australia

Based on an ethnographic study, this paper explores one Australian community's `popular epide-miology' of the role of the environment on health. Residents express concern about cancer risksdue to contamination from a land-®ll dump site and from radioactivity from previous mining ac-tivities. These concerns carry a range of meanings, not only regarding the threats to the physicalplace of Oceanpoint, but the social space the community occupies and the values they espouse.The perceptions of health risks in this location involve a contest over the cultural politics ofplace, the political economy of development and the sense of a former authentic `community'that is being lost and disempowered from controlling its future. # 1998 Elsevier Science Ltd.All rights reserved

Keywords: environmental health, risk, popular epidemiology, cancer, social construction of health, place

Introduction

The concept of the environment plays an increas-ingly important role within Australian social andpolitical life. There is a heightened feeling of vul-nerability to the risks from industry and technol-ogy and concern about the production, use,transport and disposal of chemical hazards. Thiscoincides with a growth of grassroots environ-mentalism and increased political activism on thepart of local communities on a range of issues.1

This paper concentrates upon a case study of thecommunity of Oceanpoint, a small Australiancoastal suburb with a population of 2715 people.Early in our anthropological ®eldwork on healthand primary medicine in this community, we weremade aware of several cases of cancer whichpeople attributed to contamination from a land-®ll dump site and from radioactivity from pre-vious sand-mining activities. The ways in whichthe people of Oceanpoint construct their dis-courses about environmental pollution and risksof cancer are the focus of this paper. It shows that

popular perceptions of health and risk areembedded in a sense of place and community.

An anthropological perspective of risk postu-lates that de®nitions of danger and risk are cul-tural constructs, in that we ignore some palpabledangers and exaggerate others (Douglas andWildavsky, 1982, p. 6). This paper examines thevalues and social environment which form partof the popular perception of risk and contami-nation in Oceanpoint. Studies of communitiesfacing environmental risks suggest that complexinterplay between a range of social, cultural andpsychological factors shapes people's perceptionsand reactions (Covello, 1983; Covello andJohnson, 1987; Edelstein and Wandersman, 1987;Fitchen et al., 1987; Hallman and Wandersman,1989; Elliot et al., 1993; Eyles et al., 1993).2

Edelstein and Wandersman (1987, p. 72)attempted to describe this social complexitythrough a meteorological motif of ènvironmentalturbulence' to describe the stressful disruptionfollowing a contamination event. A more sophis-ticated `social process' model of the impacts oftoxic exposures by Edelstein (1988, p. 10±15)describes a number of shifts in the perceptionsof residents of `contaminated communities'.

Health & Place, Vol. 4, No. 4, pp. 313±325, 1998

# 1998 Elsevier Science Ltd. All rights reserved

Printed in Great Britain

1353-8292/98/$ - see front matter

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*Corresponding author. E-mail: [email protected]

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These `lifescape shifts' invert many of the valuesformerly associated with the community and``profoundly a�ect[s] how they think about them-selves, their families, and their world'' (Edelstein,1988, p. 43). A prerequisite of these changes isthe belief, not necessarily the reality, that peoplehave been a�ected (see also Mo�at et al., 1995).3

This perspective has been further developed byEyles et al. (1993) in a study of a tire ®re inOntario. They highlight the ways in which resi-dents' world views are in¯uenced by the varyingforms of social organisation and underlying valuesystem. Their work most closely approaches theanthropological perspective used in this paperwhich concentrates upon what risk behaviourstell us about the social and cultural setting(Hallman and Wandersman, 1989, p. 43).Appraisal and management of risk and healthwithin communities is based upon what is subjec-tively valued as much as knowledge of objective`facts' (Eyles et al., 1993).

The concerns about cancer risks in theOceanpoint community carry a range of mean-ings, not only regarding the threats to the physicalplace of Oceanpoint, but the social space the com-munity occupies and the values they espouse.Thus the perceived threats to the health of resi-dents of Oceanpoint owe as much to represen-tational and symbolic realms as to materialevidence and the paper illustrates the disjuncturefrequently occurring between the two. As thepaper will show, cancer carries powerful signi®ersabout control and power in our society. The link-age of cancer to local environmental politics is apowerful symbol of the boundaries of the bodyand the community being breached by forces ofcapitalist development. The de®nitions of healthrisks in Oceanpoint thus involve a contest over thecultural politics of place, the political economy ofdevelopment and the social location of knowledgeand power. In this way Oceanpoint provides anexample of the ways in which places are rep-resented in discourse and how they are used asrepresentations in contemporary culture (Harvey,1993). It illustrates the intertwining of political±e-conomic power relations in the construction of aplace and in the constructions of health of thepeople who reside there (see also Eyles, 1985).

In the community of Oceanpoint described inthis paper, the reality of exposure to toxic wasteis ambiguous and has not been scienti®cally veri-®ed, however, the changes to the ways in whichpeople think about themselves and their healthare evident. Unlike many of the studies describedabove where a speci®c event or known contami-nation has occurred, the theories of causality pre-sented by Oceanpoint residents are retrospectiveconstructions explaining present day cancercases. This paper utilises Brown's (Brown, 1992)description of `popular epidemiology', to concep-

tualise the process through which lay peoplemake observations of health problems, form hy-potheses as to links between the health problemsand an environmental contaminant, seek infor-mation, and in some cases undertake politicalactivism. As Brown notes, laypeople and pro-fessionals have con¯icting perspectives on the in-vestigation and interpretation of environmentaland health data.

Anthropologists are confronted with multiplevoices and theories and sometimes contradictoryinformation regarding social phenomenon.Within this paper I have tried to retain some-thing of the puzzles, multiple voices and inconsis-tencies encountered in the attempt to exploreOceanpoint residents' talk about cancer. The dif-®culty in reconciling these into a single consistentframework mirrors the same di�culty residentshave in the formation of a single consensual the-ory or understanding of the distribution of thecases. It parallels the processes that residentshave as `lay epidemiologists' in the gathering ofinformation about deaths and illness inOceanpoint, peoples' various theories, and theformation of their understandings about theirrisk of cancer and other illnesses. The strength ofthe ethnographic method is the richness of detailand context obtained to enhance our understand-ing of people's knowledge and practices ofhealth.

A ®nal aspect considered in this paper is thepolitical activism undertaken by residents and thecon¯icts between di�erent forms of knowledgeheld by lay people and scientists this entails.Through their activism and in their talk, resi-dents of Oceanpoint articulate critiques of arange of institutions. These critiques constitute are¯exive challenge to modern institutions ofscience, industry and government as protectors ofpublic health and safety. They draw upon anotion of `community' and a�ective loyalty toplace as a repository of social and physical well-being that has been disrupted, invaded andrestructured by the powers of capitalist develop-ment (Harvey, 1993). The well-being of this ìma-gined' community is threatened as is the physicalwell-being of the residents.

Methods

This paper is based upon data collected for astudy on the cultural context of general practicein an Australian community (Whittaker, 1996;Whittaker et al., 1996). The study aimed to docu-ment the understandings, knowledge and prac-tices surrounding health and the utilisation ofgeneral practitioners and other health care provi-ders. This paper is based upon 88 transcribed in-depth interviews with residents of Oceanpointand material gathered within focus groups. Issues

Talk about cancer: A. Whittaker

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surrounding cancer and the environment was notelicited but arose spontaneously in the course ofinterviews and focus groups on people's healthexperiences and use of services (Fetterman, 1989;see Whittaker, 1996 for a full discussion of themethods). A range of informants from di�eringsocio±economic groups, age ranges, and sex wereobtained through purposive sampling throughlocal community groups.4 In-depth interviewsusually took approximately one hour in whichvolunteers were encouraged to talk at lengthabout their health and other aspects of their lives(Spradley, 1979; Gilchrist, 1992; Miller andCrabtree, 1992). These interviews were incorpor-ated into eighteen months participant obser-vation, studying the broader socio±culturalcontext of health in Oceanpoint from an ìnsi-der's' viewpoint (Jorgensen, 1989; Bogdewic,1992).5 Through this time I attended the meetingsof a variety of community organisations, includ-ing regular attendance at the monthly meetingsof the local environmental activist groupdescribed in this paper.

The setting

In order to understand the concerns expressedin Oceanpoint it is important to understandOceanpoint as a place, not only as it exists geo-graphically, but also as a social space.Oceanpoint is a discrete geographically de®nedarea, isolated from nearby suburbs by bushlandreserves and the ocean. The community is intern-ally di�erentiated with a wide range of householdtypes, socio±economic levels and phases of thedomestic cycle. These roughly correspond to laydemographic divisions. Firstly, there is the`¯at', the oldest part of Oceanpoint and biggestresidential cluster. It is the site of the formercoal mine which previously employed manymale residents, and community facilities suchas the Bowling Club, Surf club, communitylibrary and shops. It houses many of the blue-collar families who ®rst settled here, most ofwhom are now retired, as well as some youngerfamilies who ®nd the older housing a�ord-able. Residents of Oceanpoint consider `the ¯at'to be the `real' àuthentic' community, proud ofits working class background and values. It isalso the location of the majority of the cancercases discussed in this paper and the focus ofactivism.

`The blu� ' is a more prestigious subdivisionopened in the 1960s which houses a younger,more a�uent population of families with school-age and young adult children. There is also `thenew estate' to the North of `the ¯at'. Althoughthis subdivision opened in the mid-1980s it is stillcalled `new' connoting the distinctions made bylocals between the new residents and the old and

consists of about 100 households of young a�u-ent families.

Community, place, values

Notions of place collapse a range of social, politi-cal and spatial practices and identities (Harvey,1993). When residents talk about Oceanpointthey usually describe an idealised de®nition of`the community' in which di�erences are col-lapsed into a consensual vision of Oceanpoint asa small, parochial, geographically discrete `vil-lage' with a strong sense of community. Thoughnot always made explicit, this notion of commu-nity is usually expressed through references toattributes of `the ¯at' as an imagined àuthentic'Oceanpoint. This construction focuses upon thecontinuity of residence of many families acrossseveral generations, the di�erences between long-term residents and `newer' residents and nostalgicreferences to the past mining history and workingclass solidarity:

. . .even though I've lived here for twelve years I'mstill a new girl. Yeah, you must be born and bredhere [in Oceanpoint]. It's a close community, a cli-

quey community because we are sort of away fromeverybody. We are perceived as a fairly safe littlecommunity, everybody knows just about everybody

else (Elaine, 40 years, resident of `the ¯at')

Well [Oceanpoint's] more or less been just a villageby the sea and everybody knows everybody else, aquiet community. And it was more or less a joke,

like to get to Oceanpoint you've got to go over thedrawbridge, across the moat and the crocodiles outat the swamp. There's only one road to [the neigh-

bouring suburb] and one road to Newcastle . . . andwe've more or less had it like a castle I supposeyou could say . . . (Male, 49 years, resident of `the

blu� ')

Residents' take pride in what they see as valuesretained in Oceanpoint which have been lost insurrounding suburbs, some joked that ``you turnyour clock back ten years'' as you descend downthe hill past a bush reserve into Oceanpoint. Inparticular, residents of Oceanpoint describe `the¯at' as a special locus of old-fashioned valuesand a neighbourly way of life, where `èverybodyknows everyone else'' and many people are re-lated to each other through inter-marriage. Thisìmagined' community of Oceanpoint is a `safe'and quiet community compared to the anomie ofmodern suburbia.

Oceanpoint started as a mining settlement on`the ¯at' with two mines, the last of which ceasedoperations in 1992. This mining heritage broughtwith it a sense of solidarity as most of theresidents of were either mining families or in


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some way connected to the mine when it wasoperational. As Merv, a retired miner of `the ¯at'stated:

My grandfather and my father were all miners . . .Like my grandfather he had six sons and I think®ve of them were in the coal mines. Then all my

uncles, my father had three sons and we all endedup in the coal mine . . . Like we were just a miningfamily, that was all.

Likewise, most community organisations cantrace their origins to the mining days:

Everything in the place goes back to the mine. Likethe library, the Bowling Club. Everything was builtby the miners so there's that real tradition there

(Stan, 45 years, resident of `the ¯at')

Cecilia, 64 years, from `the ¯at', recalled whatlife was like as a member of a mining commu-nity:

Like all mining communities everyone was veryclose . . .Everyone knew everyone else and under-stood the circumstances that our husbands were

working under. And it was marvellous.

The closure of the mines brought unemploy-ment and economic hardship to a number offamilies in `the ¯at'. An extract from a focusgroup discussion of middle-aged women, alllong-term residents of `the ¯at' reveals their per-ceptions of the impact of the closure:

Belinda: ``Since the pit's closed down three of themen have committed suicide. I don'tknow how many marriages have brokenup or been in stress. It just becomes adreadful circle where's the man's goingalong . . .being past it and nobody wantsto employ him and all this . . .so it doesput a lot of pressure on him.''

Author: ``So that closure of the mine put a lot ofpressure on the community?''

Belinda: `Ì mean that pit was the town in a way.''

Gloria: `Ìt was like throwing a wet blanket rightover the town really.''

With these changes has come a range of newerresidents who are outside the dense social net-works of more established families. Althoughsome newer residents have become part of thesenetworks through their involvement in commu-nity organisations, the majority remain externalto them. These divisions of insiderhood and out-siderhood are summarised by Murray, 50 years,resident of `the ¯at':

Quite a few people have come here in the past fewyears, with the new estate being developed and thatsort of thing and I don't think all of those sort ofpeople sort of mix in with the rest of the commu-

nity. A lot of them seem to lead fairly isolated livesin their own little suburbs . . .But most of the people

who have been here for some time . . .know eachother pretty well and around [the ¯at] everyoneseems to know one another, don't they.

The social equality of the past when nearlyeveryone was working in the mines was visiblyapparent in the homogeneity of the housing.Today in `the ¯at' red brick workers' housesevoke that mining past. Long-term residents aresensitive to the di�erence in status and classre¯ected in the new housing styles in the newhousing subdivisions:

I don't know whether there's a feeling of them andus, you know . . . because they [people in `the newestate'] have got these whopping big houses (Maud,

74 years, from `the ¯at')

These changes and the disjuncture they rep-resent from an idealised ìmagined' community ofOceanpoint form the context for the experienceof health and well-being among residents. Theapparent idealised unity actually glosses over acommunity fractured by increasing social div-isions between wealthy newcomers seeking apeaceful, safe beachside location and workingclass long-term residents, struggling with thedecline of employment opportunities. Fears overcancer resonate with wider issues of power andcontrol over capitalist development.

The encroaching development of Oceanpoint isa common theme in all residents' descriptions ofthe place. Long-term residents couple this with anostalgia for the way things were in the pastwhen the mine was operating. Long-term resi-dents of `the ¯at' have witnessed considerablechange to their small community: the growth ofluxury housing on `the blu�', the sandmining ofOceanpoint beach throughout the 1960s whichchanged the beach-front, the closure of the minesand resultant unemployment of many men,removal of many of the old mine buildings toallow the development of a light industrial zonebehind the community,6 the growth of the mobilehome parks and the development of the `newestate' subdivision.

A range of further developments are proposedfor the Oceanpoint area. In 1996, land clearingbegan for another housing estate on the old minesite. Eleven separate urban residential develop-ments are proposed involving 3000 blocks ofland to the North and South of Oceanpoint.These developments are mainly residential butinclude some industrial land and some relocata-ble homesites (Newcastle Herald, 4 May 1994).Signi®cantly, one of the developments approvedconverts former colliery land into a housing sub-division.7 As Stan, 70 years from `the ¯at', com-mented:


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The township has grown enormously over the lastten years . . . with the colliery [residential develop-

ment] ®nishing there's going to be more couple hun-dred more houses so it's going to be a big, bloodybig place.

Newer residents of `the blu�' and `new estate'are wary about the proposed new developmentsfor fear they will impinge upon the quiet andsmallness of the township, the very reasons whythey moved into the area.

If the [new development] goes ahead it will spoil thearea entirely because it will be overdeveloped; there

will be too much (Francis 50 years, resident of `theblu�')

Oceanpoint is unique. Its unique in the sense that

for many many years it has been isolated. Nowdevelopment is encroaching on Oceanpoint and it'sgoing to lose it's identity (Chris, resident of the`new estate').

Talk about cancer

No-one's in a hurry, everyone's friendly, lots of

fresh air. It's just a whole healthy lifestyle (Julie, 31years, from the `new estate')

In 53 (60%) of the 88 taped interviews, peoplespontaneously made some comment about therole of the environment and their health. As inthe case of Julie above, new residents remark onhow Oceanpoint is a healthy place to live,emphasising the fresh sea breezes and absence ofair pollution, as well as the relaxed lifestyle. Ben,a resident for twelve months in one of the mobilehome parks summarised the sentiment:

Within Oceanpoint itself we are very fortunate.We've got a lovely ocean, it's got to be healthy. I

mean the fresh sea breeze, no pollution as in motorcar [pollution] like Sydney . . .You've got trees outthere, you've got the ocean breezes, it should in the-ory be very healthy I'd think, wouldn't you? It'd

have to be pretty healthy living here. (Ben, 52years)

Such descriptions highlight how communityde®nitions of health encompass not only aspectsof the physical body, but also the social situ-ation, `way of life' and the physical environment.Newer residents describe Oceanpoint as an inher-ently healthy environment.

Yet longer term residents from all areas ofOceanpoint provide a di�erent image ofOceanpoint. Their descriptions invert the imageof a healthy environment to emphasise the hid-den dangers to health behind the seeminglyinnocuous natural surroundings. In response tothe question, `Àre there any health issues that

you think are important to this community?''these informants responded with a range of en-vironmental concerns.

The most pressing concern centred around aseries of cancer-related deaths. Twenty-three(26%) of the 88 taped interviews mentioned thecases of cancer in Oceanpoint spontaneously ando�ered a range of explanations for the incidenceof the disease. Many of these people questionedwhether our community health study really had acovert agenda as an o�cial investigation of thecancer cases. The images of Oceanpoint thatthese residents evoked was that of a communityunder threat from hidden toxins. These long-termresidents o�ered variations of the following nar-rative from Linda, 36 years, who was born in`the ¯at' and is now bringing up her own familyon `the blu� ':

I was sitting here with my sister the other day andwriting down these names within a couple of years

span of [my brother's] age and Oceanpoint's such asmall area, there's been six or seven boys all diedfrom cancer . . .They would have been in their late

twenties, early thirties. Like it's been a couple ofyears now but it's been so many of them . . .I knowall of the residents especially the long-term ones

have all thought, you know, in such a small areathis is just unbelievable that such a large, youknow, proportion of the fellows have died fromdi�erent you know, from di�erent cancer related

things.

In addition to these male deaths all on `the¯at', people mentioned the cases of two youngwomen from `the ¯at', one who died from cancerand another who survived leukaemia. Only onecase was not located on `the ¯at', the death of ayoung girl from leukaemia who lived in the `newestate'. The community's reactions to thesedeaths have been manifold. One communitygroup raised funds across twelve months for can-cer research in memory of the young girl whodied with leukaemia. Each year a sur®ng compe-tition is held in the name of one of the youngmen who died. He also had a local park namedafter him. In these ways these cases have becomepart of a communal memory.

Dumps, radioactivity and popularepidemiology

Residents posit a range of theories concerningthe incidence of cancer in Oceanpoint. Withinthis `popular epidemiology' (Brown, 1992) thereis no single consensual theory and residentsstruggle to reconcile a range of suspected causes.Central in this process has been the actions ofa number of community organisations inOceanpoint who have been lobbying and


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protesting to government departments and thecompanies involved regarding this issue anddisseminating information through publicmeetings and media releases, a process which willbe discussed later.

The ®rst main explanation of the cause of thecancer cases concentrates upon the local dumpsite and the possibility of the water table andlocal creek being contaminated by the leaching oftoxins from the dump. The Oceanpoint tip coversan area of 10.5 hectares at an altitude of 80mabove sea level. Representatives of the local en-vironmental group have stated that it is one ofthe highest tips in the state of New South Walesand that the recommended height of such facili-ties is no higher than 30 m (The Post, 6 July1994). Although the tip was closed in 1994,leaching from the site remains a concern for resi-dents. At a 1994 meeting of the local environ-mental group, members noted that in the 23years of the tip's operation there may have beenillegal dumping of toxic wastes and reputedlyhave found evidence of the dumping of car bat-teries at the site. In many interviews, people men-tioned that in the past local children regularlyplayed in one of the creeks that runs through thecommunity and this is believed to be a possiblesource of exposure to carcinogenic substances.As Diane, 33 years, a resident for over 20 yearsstated: `àll the little kids went and swam becauseit was just like a little running paddle pool. Butof course I wouldn't let them swim in it now''.

A second possible cause identi®ed by residentsconcerns the sandmining that took place upthroughout the 1960s along a long stretch ofbeach adjacent to the community. A tailingsdump was left in the dune area that was ownedby the company which leased the land to thesandmining operation. Requests for informationfrom the company involved by members of theenvironmental group revealed that these tailingscontained a high concentration of monazite con-taining radioactive thorium (238Th). There areconcerns that the breakdown of this thorium hascontaminated the water table with radiation. InOceanpoint there are many private water boreson `the ¯at'. These bores are used primarily forgardening purposes although in some householdsthey are used to supplement the primary watersupply and it is feared that the exposure to radi-ation through the water was responsible for can-cer. The accounts of people directly a�ectedillustrate the concerns and speculations of manyin the community.

Gwen's account

Gwen, 65 years, a resident of `the ¯at', lost her42-year-old daughter Susan with a brain tumourafter treatment for breast cancer. A friend ofSusan's was also diagnosed with leukaemia,

although she survived. Gwen listed seven youngresidents who have also died from cancer andsuspects contamination from sandmining contrib-uted to these cases:

The number of cases of cancer in Oceanpoint andlike you wonder what caused it. Like we've hadother friends that have lost their sons that have

died with cancer and they were all about the sameage as Sarah, like in their early forties . . . We per-haps think it might have been connected when the

rutile [sandmining] was down here. Now these kidsall swam in the surf. Whether there's any connec-tion, we don't know. Also in the creek . . . . This ®rst

creek they used to go in . . . Anywhere there waswater down there, they were in it, from when theywere little, little kids, so we don't know whether

that has anything to do with it or not

The idyllic beach environment in which herchildren played is now de®ned as a source ofthreat, the notion of Oceanpoint as a safe com-munity in which to raise a family is inverted:

It makes you wonder why, like she was a perfectlyhealthy girl . . .Now when we ®rst came here thirty-

two years ago the doctor that was here, you knowwe went down to see him ®rst when we had thekids and he said `Òh, the best place in the world tobring up kids''

There have been shifts in the ways in whichthis family perceives their home and themselves.Gwen no longer assumes the good health ofother members of her family:

Now my son, there's nobody played with it morethan what he did down there and at the momenthe's still alright but he's only thirty-six years old

and we're just hoping he will be alright

Deidre's account

Deidre, 64 years, described her 31-year old-sonPaul as ``such a healthy boy'', who, ``just wentdown so fast it was incredible''. Eight years agohe su�ered a range of illnesses until he was®nally diagnosed with leukaemia. He died eightmonths later:

The day he had his exploratory surgery his matewas buried from cancer. Two doors up from herewas another young man who had cancer and the

street behind us another young man. I think theeldest would've been thirty-®ve . . .They all died withcancer within twelve months and to me that's a ter-ri®c coincidence. I really, it really made me think.

They were going to do an investigation and wenever knew, it just sort of died out

Deidre and her husband suspect that a localcreek where their son played may be implicatedin the cause of the cancer. They suggest either


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the waste water from the former coal mine site,sandmining, or the dump as possible sources ofcontamination. However, they also accept theidea that their son's death may be part of a nor-mal distribution of cancer within the community:

They used to reckon the creek come from the [coal-mine] pit . . . and the kids used to swim in the creek

and all. Well, then it was supposed to be the rutile,that was supposed to be contaminated. But thatdoesn't always ®gure either because the young man

that died two doors up had come from in thecountry somewhere and he hadn't grown up inOceanpoint . . .There's a lot of people died inOceanpoint of cancer, a heck of a lot. Older people

and young ones. But then again I think it's becausewe're a small community and you hear about it. Imean, obviously it happens in other places but you

don't hear about it so much

Although she is aware of talk concerning ano�cial investigation of these deaths, Deidre isresigned to the fact that she will never receivefurther information to clarify her questions andspeculations about the causes of her son's leukae-mia. Neither she nor Gwen are members of thelocal environmental group although they areaware of the group's activities.

The processes of hypothesis formation andspeculation continue. While no resident in ourinterviews dismissed the possibility of an environ-mental contaminate as a cause, some expla-nations such as that of Mary, 44 years, a longtime resident of `the ¯at' exemplify the ways inwhich knowledge about these cases is constructedand evidence weighed up. Her opinion most clo-sely resembles the o�cial epidemiological assess-ment of the situation, that the distribution ofcancer cases in Oceanpoint may be normal andonly seem high due to the close knit nature ofthe community:

One time I think the people in Oceanpoint werescared, I think because of the dump, I think they

thought the dump was a real issue to worry about.It could be still. Even the doctors are a little bit sus-picious about it, di�erent doctors. Like our doctoris a little bit suspicious about the dump and he

reckons something to do with the seagulls feedingat the dump and then going back to the beach con-taminating things he thought. But at one time there

were two boys that I went to school with bothdying of cancer and another fellow, he was thesame age but he wasn't actually a person who lived

here all his life where the other two had, and, youknow, people were starting to really talk then, but Isort of thought that too. And when you stop and

think about it Oceanpoint's such a small area andwe all know each other whereas if it was in say, [aneighbouring suburb], my girlfriend lives out there,like, they sort of only know the next door neigh-

bours and a couple near them. They wouldn't knowthe people at the back, or the people around in the

next street, so they virtually wouldn't think of itthat way, whereas we all hear of every single onethat got it.

Local community activism

Local community organisations have mobilisedover a range of issues in Oceanpoint's recent his-tory. From its earliest mining days and stemmingfrom the traditions of the trade union movement,Oceanpoint has had a local Progress Associationwhich attempted to improve the quality of lifefor members of the community and dealt withsuch matters as the development and mainten-ance of parks, the improvement of public facili-ties and lobbying the council for kerbing andchannelling. In 1986 a sub-committee of theProgress Association formed to speci®callyaddress the issue of the dump. The dump wasdue to be closed and another site near the com-munity was proposed. Residents did not want thesecond site and so the local Council delayed theclosure of the old site. Newer residents of the`new estate' were frustrated as they had built inthe area on the assurance that the dump was tobe closed. The leader of the sub-committee was aformer trade union organiser:

To ®ght this dump situation was a matter of callingpublic meetings, which we did, and lobbying the

council and that, so we decided to form a sub-com-mittee [of the Progress Association] and the sub-committee was very active with twenty or thirty

people . . .and everybody was up in arms because allof these people had come here on the new estatethey had assurances that the garbage dump wasgoing to close . . . and that was the start of [the

local environmental group] (Bill, 74 years, residentof `the ¯at')

It was during this period that the deaths fromcancer occurred. In this way, they became part ofthe public discourse on the local environment.Although the group initially formed to pursue asingle issue, this soon evolved to include a rangeof issues perceived to threaten the local environ-ment or quality of life of residents, includinghealth:

. . .and then we started to ®nd out that the di�erentthings where the environment was going wrong, likethe sewer out to the ocean, . . .Leachate, we didn't

know what leachate was and a lot of people didn'tknow what leachate was before we brought it to thefore . . .and we kept ®ghting there and then to get a

transfer station [for garbage]. And then out therewas that great big heap of monazite . . .and we haddeputations on those . . .so we've been ®ghtingthem . . .


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In a study of communities a�ected by toxicwaste problems such as Love Canal, Brown(1992, p. 269) notes that there are a number ofstages of citizen involvement some of whichapply also to Oceanpoint. Firstly, a group ofpeople notices separately both health e�ects andpollutants and form hypotheses as to the connec-tion between them. These observations becomeshared and residents form more cohesive groupswho research and talk to government o�cialsand scienti®c experts about the health e�ects andoften enlist the help of public health o�cials orexperts. Finally, in response to community press-ure, government agencies conduct o�cial studies,which he notes usually ®nd no associationbetween the contaminants and health e�ects. Thereaction of the community is to bring in theirown experts to conduct a study, pursue legal liti-gation and press for corroboration of their ®nd-ings by o�cial experts and agencies.

The Oceanpoint case follows this general pat-tern, although no legal litigation has been pur-sued. Initially formed due to the failure of thelocal Council authorities to ful®l a promise toclose down an unsightly and smelly dump whichthe community had endured for decades, theircause became linked with the apparent cluster ofcancer cases. Search for an explanation led toresearch by the group and a series of lettersrequesting information from the local authorities.Suspicions became acute with the discovery ofthe monazite dumping site. Apart from letterwriting, public meetings, lobbying and a mediacampaign, one of the actions of the local en-vironmental group was to enlist the support of alocal general practitioner to approach the PublicHealth Authorities to investigate the incidence ofcancer in the community. In doing so they wereenlisting the local doctor's help in the `de®ni-tional struggle' over knowledge and recognisedhealth professionals' access to control of infor-mation that is accorded scienti®c legitimacy.

The local doctor began her own investigationinto the cancer cases by recording the incidenceof cases with red dots on a map of Oceanpoint.As she states:

It was very clear that they were on `the ¯at'. Ishowed this to the Public Health Authorities whosort of raised their eyebrows and didn't really

address [it]

Through this we see the attempt to present thelocal discourse in a form acceptable to medicalauthorities. The doctor's account also shows theenormous gap between scienti®c requirements forthe de®nition of risk and the `lay epidemiology'of the community. While she accepts the responsefrom the epidemiologists, the doctor remainsconcerned:

Well, what I was told then [by the Public HealthUnit] was that cancer is a very common illness any-

way. And that is certainly true. But certainly stat-istics are really interesting to deal with and I amstill a bit lost in that myself. It is still stored in my

mind. I have viewed some statistics that werereleased in the last couple of years looking at ratesof cancer in local government areas and certainly

there were no blips appearing in this area on any-thing of major signi®cance . . . But I can certainlyunderstand people's concerns when they have breast

cancer, the lady two doors down has had it and oneover the back fence had it. There is certainly issuesof that and it is clearly more on `the ¯at' than uphigher . . .It is not absolutely resolved in my mind.

The account from the local doctor draws atten-tion to the expectation that she act as an inter-mediary between àuthorities' and the communityon health matters. It also reveals the extent towhich the local doctor shares the discourse andunderstanding of local residents. However, thedoctor recognises the need for `scienti®c' veri®ca-tion of the situation.

In response to the community and the localdoctor's concerns, the Public Health Unit of thelocal Area Health Service undertook an analysisof the incidence of common cancers and leukae-mia for a 5-year period from 1984 to 1989 in thelocal government area compared to the State ofNew South Wales (P. Lewis, Cancer in LakeMacquarie, unpublished report of the HunterArea Health Service, Public Health Unit,Newcastle). The report stated:

The [Local Government Area] was found tohave a signi®cantly higher rate for all cancersamong males compared with NSW. Males in[the Local Government Area] have rates oflung cancer, cancer of the prostate and my-eloid leukaemia that are slightly higher thanthose for NSW. These di�erence were not stat-istically signi®cant. These data o�er someassurance, as there is no excess of all types ofleukaemia, a�ecting both sexes, which may beexpected if there were a signi®cant environ-mental exposure. As [Oceanpoint] is only asmall part of [the Local Government Area] asmall increase in these types of cancers wouldbe more di�cult to detect over a short periodof time . . . . At this point in time these data donot provide evidence to support any moredetailed investigation of the incidence of can-cer in the [Oceanpoint] area . . .

There are some potential di�culties associ-ated with examining rare health events, par-ticularly if working with small populationsover short periods of time. In such situationsit becomes di�cult to distinguish between ane�ect of an environmental exposure, and thebackground rate of a particular condition.


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Because of the small size of the communityand the recency of the events, the situation inOceanpoint is not readily amenable to measure-ment by epidemiological methods. Thus by scien-ti®c standards Oceanpoint is de®ned asunproblematic unless after many more years itwill be possible to show statistical signi®cance.This report did little to assuage the fears of thecommunity nor convince them that the cancercases they witnessed were normal. Residents werenot satis®ed by the use of a large postcode areain the statistical methods and rather than inter-preting the ®nal statements on the limitations ofepidemiological methods as such, interpreted the®ndings as obfuscation and remained scepticaland suspicious of the agenda behind the report:

A lot of people have died with cancer and therewas a big push a couple of years ago to have the

Health Department view this area, because theyused to do rutile mining down on the Beach. Andthe whole problem was that a lot of people who

passed away with some form of cancer whether itbe tumours or whatever were in the age bracket ofbetween about 30 to 45. And anyhow, they ®nally

got the health department to come. But the HealthDepartment said `Òh No'' and they used the post-code area . . . and instead of just studyingOceanpoint in depth, or the amount of people who

had died they said no, over all in the population itis not, it means it is no worse, no better than any-where else (Graham, 41 years, resident of `the ¯at')

The doctor was also involved in arranging thePublic Health authorities to test bore watersamples throughout the community to check forradioactive contamination from the monazitedump. Despite the low readings recorded, thedoctor and residents remain wary of the water'ssafety:

And the questions raised were `Ìs this OK to useon your gardens?'' Well, probably yes. `Ìs it OK to

use in swimming pools?'' because there was a sug-gestion that that might have been happening andmy query `Ìs it OK to spray on your vegetableswhich you are subsequently going to eat?'' There

were measurements done around town and most ofthem came in quite low . . . . But one person raised,what about them using it in their swimming pool?

It's evaporating and they are topping it up. Arethey creating a gradually increased amount in thepool? Nothing much more has come of that. And

then of course there is the concern about the lea-chate from the dump coming down into the borewater. I must admit that if I lived here I don'tknow that I would use bore water (Dr Smith, 39

years)

A key issue in these con¯icts is the di�erencebetween lay forms of knowledge and professional

ways of knowing (Brown, 1992; Gill and Picou,1989, p. 94).8 The knowledge of residents a�ectedby environmental disasters is frequently dismissedas anecdotal, unscienti®c and uncontrolled non-knowledge. Beck (1992) has suggested that theenvironmental hazards of a post-industrial so-ciety usually only exist in terms of the scienti®cknowledge about them. The control of knowl-edge becomes a key factor in the de®nition, regu-lation and legitimation of risks.

Meanings of cancers

Cancer retains feared connotations in Oceanpointas one older resident of `the ¯at' stated ``Cancer.It's such a horrible word I can barely bringmyself to say it'' (Aileen, 70 years). It remainsassociated with a slow, painful death and somepeople said they would rather die by any causeother than cancer. As Balshem writes:

Cancer is a bad fate, in the face of whichour bodies are permeable a�ording us no pro-tection in the physical and moral world.Because of cancer, our bodies contain and aretied to a force wider than the individual bodyand not subject to individual control(Balshem, 1991, p. 162).

Understandings of the aetiology of cancer pri-marily focus on factors outside of individual con-trol. As a number of studies have shown, theprevention and causation of cancer is commonlyattributed to environmental pollution or otherfactors outside of individual control such as gen-etics (Balshem, 1991; Kagawa-Singer, 1993).Because of their mining experience, residents arefamiliar with the role of asbestos and coal dustin the development of lung cancer. In addition,the mass media is replete with stories concerningthe carcinogenic properties of di�erent substancesand with news regarding pollution from themany heavy industries in the region. These ideasform the basis of the common understanding ofthe causes of cancer as something that isexplained through contact with substances thatare carcinogenic. The occurrence of cancer in theyoung, an ùntimely death', creates concern thatthey may all have been exposed to somethingwithin the environment they grew up in.

Residents of Oceanpoint articulate metaphori-cal linkages between their fears of cancer andfears of a way of life threatened by capitalistdevelopment. Speaking of public resistance totoxic waster contamination, Walker writes: `Ìnthe community, as in our personal lives, one kindof concern may be hidden in the language ofanother'' (Walker, 1989, p. 245). The process ofdecline from cancer serves as an apt metaphorfor loss of control (Sontag, 1978). As Balshemnotes (Balshem, 1991), loss of control is a central


321

issue for the post-industrial working class and acentral issue for everyone in the postmodernworld. The issue is ampli®ed for members of thecommunity of Oceanpoint, particularly thepeople of `the ¯at', who experienced the greatestdisruption when the closure of the local mines,combined with industrial restructuring in the re-gional manufacturing economy, changed funda-mental aspects of the local and regional identity.But to fully understand the meanings behindthese discourses one must also look at the localconditions. Despite the beauty of the beach andsurrounding bushland, people in Oceanpoint livenear an unwanted waste dump, former coalmineand a poorly planned industrial estate. Long-term residents watched as former sandminingdevastated the natural environment. They see thecreeks and coastal heath spoiled as developmentfurther encroaches onto the natural surrounds.These jeopardise the very values that constitutethe ìmagined' community of Oceanpoint; quiet-ness, safety and solidarity, `knowing everybody'.They invert feelings about the security of thehome, community, and place-identity (Edelstein,1988). Douglas and Wildavsky (1982) argue thata risk perception is a sign of intention to protectcertain values and their accompanying insti-tutional form. The perception of health risks inOceanpoint involves a contest over the culturalpolitics of place, the political economy of itsdevelopment and the sense of a past àuthenticcommunity' that is losing control over its future.

In a study of an unsuccessful health educationcampaign on cancer in an inner-city workingclass suburb in Philadelphia, Balshem suggeststhat the community's discourse about causes ofcancer minimised individual lifestyle practicessuch as cigarette smoking and repositioned thediscourse of cancer control in a wider context oftheir subordinate class position and material en-vironment. Her analysis suggests that residents'talk about the role of fate and cancer is a formof everyday resistance and `àn important mech-anism in the construction and maintenance of thevalue ascribed to local tradition'' (Balshem, 1991,p. 154). Similarly, in Oceanpoint, I propose thatinherent to the actions of the environmentalgroup has been the struggle for power to allowresidents to secure their future and protect them-selves from perceived threats to their socialand physical well-being, whether this be withregard to possible toxic wastes, proposed housingdevelopments, or pollution of the naturalenvironment. In this way through their talkabout cancer, residents articulate links betweenplace, their subordinate position of power andthreats to the lifestyle, well-being and values ofthe community. Unlike the fatalism of peopledescribed in Balshem's study, residents inOceanpoint respond to the incidence of cancer

with letters, meetings, media releases and politicallobbying in opposition to the forces believedresponsible.

Anonymous government authorities, industriesand developers appear in this discourse as thepowerful `they' who control decisions about thefuture of the community:

They always tried to dump everything in the

Oceanpoint area I think because we've been out ofthe way and you know, we haven't always had alouder voice to kind of combat things . . . . You

know anything and everything no-one else wantedin [the district] they always tried to put here. And Imean we've ended up with the dump, we ended up

with an [sewerage] outfall. It's been a real shame . . .You get tired of having everything dumped on youand trying to do something about it and no-one lis-tens to you. As I said the concerns about the cancer

deaths, throughout the monazite and radioactivity,and the dump, no-one could give an answer orcould really seem to give a care about it, especially

in the authorities (Theresa, 39 years, resident of the`new estate' and member of the environmentalgroup)

As the statement from Theresa above recog-nises, not every suburb has to be concernedabout tips, mines and sewerage out¯ows. As inthe past when the blue collar workers ofOceanpoint faced increased risks of death anddisability in the mines, so now the community iskeenly aware of the unequal distribution ofhazards in their area, and have attempted toaddress their lack of power to in¯uence decisionsthrough local political activism:

It's a long-term thing . . .Like we've been ®ghting allthese things since 1986 and you get recognition byall the politicians and the councillors and that

you're not just a squeaky wheel and they'vegot . . .they answer you, you know. And we're prettygood, we get good access to the Councillors, to the

members of parliament and they listen and sort ofdo something . . . and of course we're recognised bythe . . .Community and Land Management [govern-ment authority] and the National Landcare

[national conservation authority] and TotalCatchment management . . . The Water Boardrecognises us, yeah we've made a lot of contacts

which I think is doing the town good. We keep aneye on developments, we formed a precinct commit-tee and when a big development application comes

in, something like the mine [residential develop-ment] over here we call public meetings and letpeople know what is going on (Bill, 74 years, resi-dent of `the ¯at' and leader of the environmental

group)

Bill, the charismatic leader of the environmen-tal group, is a former trade union organiser from


322

the mining days. He uses his union experience inorganising, lobbying and protesting, and exploitshis links within the Labour Party in his nego-tiations with politicians, local government auth-orities, bureaucrats and developers.

The experiences of people in Oceanpoint di�er,yet are drawn together in a partial overlap ofinterests on the issue of the environment andhealth. Although only a small number are activemembers of the environmental group, manymore support the e�orts of that group and par-ticipate in public meetings or articulate theirawareness and concerns about capitalist develop-ment in Oceanpoint and its consequences for thecommunity's health and well-being.9 Long-termresidents, especially those on the ¯at, bring to thestruggle their experience of industrial decline, lossof employment prospects and disempowermentalong with a desire to protect their notions ofcommunity identity and autonomy inOceanpoint, built on a heroic mining past andthe values of working class unionism and solidar-ity. Newer residents of `the blu�' and `new estate'bring their concerns about their children's health,their experience of the broken promises of localgovernment, the immediate threats that furtherindustrial or residential development poses totheir quiet and safe lifestyle and property values,and green consciousness of the value of the en-vironment.

Conclusions

Although the waste dump is now closed, themonazite removed, and the Public Health Unitreports no statistical signi®cance in the incidenceof cancer in Oceanpoint, residents remain uncon-vinced and mistrustful of local government auth-orities, industries and development. The localgovernment is described by some members of thelocal environmental group as uninterested in thecommunity's concerns and as actively stallingand obstructing one member, Diane, 33 years, inher attempts to gain access to council recordsregarding the dump site. Most residents are una-ware of the existence of the Public Health Unitreport and those who are ®nd the epidemiologi-cal language confusing and see the limitations ofthe statistical analysis as an attempt to placatethe community without really investigating theirclaims. The industries and developers who havepolluted the environment and propose new devel-opments for Oceanpoint are also viewed withscepticism and mistrust. The community mem-bers' criticisms challenge the legitimacy of localgovernment institutions, questioning their claimof serving the public interest and their ability toplan and manage the community's future (seealso Gerlach, 1987).

The Oceanpoint case expands the work of anumber of authors on environmental contami-nation. First, it shows many similarities with thesocial process model described by Edelstein(1988) and developed by Eyles et al. (1993) intheir study of the e�ects of a tire ®re near a com-munity in Ontario. Their process model describesthe common anxiety and uncertainties associatedwith a particular event or perceived risk andrelates these to the outcome (continued uncer-tainty or a return to normality). As in these stu-dies, Oceanpoint also reveals a range of complexinteractions and relations between di�erent mem-bers of the community (Edelstein, 1988). In par-ticular, Edelstein's discussion of the shifts inrelation to a sense of place are pertinent to thereactions of Oceanpoint residents. Long-termresidents' sense of Oceanpoint as a place and asa community has fundamentally changed andresidents showed di�ering levels of anxietydependent on what they believed to be the levelof their family's exposure and a sense of indigna-tion at what is perceived to be developers' andgovernment indi�erence to their concerns. Unlikethe cases described by Edelstein (1988) and Eyleset al. (1993), residents in Oceanpoint were notspurned into action on the basis of a dramaticevent or con®rmed toxic exposure, illustratingthe saliency of notions of place and identity inlay constructions of health. Medical anthropol-ogy rarely considers the importance of culturalvalues of place in peoples' experience and notionsof health.

Secondly, Brown's model of popular epide-miology and the di�erences between lay under-standings of the incidence of disease andprofessional scienti®c epidemiological investi-gation is useful to our understanding of theOceanpoint case (Brown, 1992). This case studyhighlights that the development of such lay con-structions of causality is one fraught with di�er-ence, con¯icting theories and uncertainty. It alsoillustrates the con¯ict and competition for legiti-macy between lay ways of knowing and pro-fessional forms of knowledge.

Thirdly, Oceanpoint provides another exampleof the form of community organisation thatdevelops in response to suspected contamination.Edelstein and Wandersman (1987) suggest thatsuch crises may encourage the growth of neigh-bouring and a sense of community and thegrowth of a temporary organisation that formsexpressly for the duration of the crisis. In a fewcases, organisations that grow out of these issuesmay make the transition to becoming anticipat-ory organisations (Edelstein and Wandersman,1987, p. 106; see also Finsterbusch, 1989; Rich etal., 1995). In the case of Oceanpoint the environ-mental group has made a successful transition toa more permanent community organisation main-


323

taining its activities and broadening its scope toinclude a range of local issues. Furthermore, asnetworks with other similar groups have grown,the Oceanpoint group has become a�liated in anumber of regional and national environmentalmovements and has been a�orded greater legiti-macy in local and regional government organis-ations.

Finally, this case study has gone beyondmodels of behaviour to re¯ect upon the culturalmeanings in the fears expressed by residents.Fears concerning cancer in Oceanpoint are linkedto feelings about access to power in society.Members of the community experience this lackof power on many levels, from the disregard byauthorities of their concerns, to their inability tocontrol and prevent the capitalist development oftheir community and the subsequent changes totheir lifestyle and pollution of their air, waterand soil. The criticisms, mistrust and loss oflegitimacy of modern institutions articulated bymembers of the Oceanpoint community is anexample of what Beck terms `postmodern re¯ex-ivity' (Beck, 1992). Ideas about risk related tocontamination are especially politically re¯exivein that they force communities to question andmistrust the very foundations of modern indus-trial society; industry, government, developmentand science, as benevolent protectors of socialwell-being. More broadly, the case of Oceanpointreminds us that issues of health and well-beingare always located within speci®c social, histori-cal and political contexts which in¯uence the in-terpretation of risks and the ways in whichpeople act upon them. In this case, health iscentral to a contest over place, community,knowledge and the restructuring of relations ofpower.

Acknowledgements

The author wishes to thank the members of the community ofOceanpoint for their participation in the study. To protectcon®dentiality, the name of the study site and of all residentsused in this paper are pseudonyms. The Oceanpoint studywas funded by a General Practice Evaluation Program Grantfrom the Commonwealth Government of Australia. At thetime of researching this article the author was employed atthe Discipline of General Practice and the Department ofSociology and Anthropology, University of Newcastle. Shewishes to thank Assoc. Prof. Linda Connor, Dr ShelleyMallett, and the anonymous reviewers for their helpful com-ments on this paper. Other members of the Oceanpoint studyteam included Prof. A. Reid from the Discipline of GeneralPractice, University of Newcastle, Assoc. Prof. L. Connor,Department of Sociology and Anthropology, University ofNewcastle, Dr A. Sprogis, Hunter Urban Division of GeneralPractice, Assoc. Prof K. Robinson, Research School of Paci®cand Asian Studies, Australian National University, and Ms S.Freeman, Discipline of General Practice, University ofNewcastle. Mr B. Missingham worked as research assistantfor a period on the study. The team would also like to thankMs L. Petrovic and Mrs M. Boden for their administrativesupport.

Notes1Incidents such as the dumping of hazardous waste at LoveCanal in the United States and the resulting health e�ects tothe communities living around it and contamination of othercommunities with PCBs linger in the public imagination andbreed distrust of public o�cials, industry and scienti®c experts(Paigen, 1982; Fowlkes and Miller, 1987; Nash and Kirsch,1986). In Australia, similar incidents of contamination of com-munities give people reasons to fear the safety of their local en-vironment (McPhillips, 1995).2A range of factors that a�ect the perception of danger of arisk have been identi®ed, for example, the catastrophic poten-tial of the risk and its potential harm to future generations, thetime period in which e�ects appear, familiarity with the cause,and whether the risk is voluntary or imposed. In addition, atthe community level, socio-demographic factors may also in-¯uence the reactions of a community. The presence of smallchildren within the household, lower socio-economic statusand home ownership may contribute to increased distress.Organisational a�liations, community dynamics, institutionalcontext, ideology, social interactions with family, friends andneighbours along with personal identi®cation with the con-taminating industry, economic concerns about livelihood andproperty values all in¯uence how a community will react.Hallman and Wandersman (1989) list the various factors thathave been found to in¯uence risk perception which are too nu-merous to list here.3Edelstein (1988, p. 48) documents ®ve consistent changes inlifescape within the communities he studied. As will be seenlater in this paper, all of these apply in some degree to theOceanpoint case: (1) a reassessment of the assumption of goodhealth; (2) a shift to pessimistic expectations about the future,resulting from victims' perceived loss of control over forceswhich a�ect them; (3) a changed perspective on environment;it is now uncertain and potentially harmful; (4) an inversion ofthe sense of home involving a betrayal of place. What wasonce the bastion of family security is now a place of danger.Having chosen to live there, the person is now deprived of thechoice of leaving; (5) a loss of the naive sense of trust andgoodwill accorded to others in general; speci®cally, a lost beliefthat government acts to protect those in danger.4The full study involved a qualitative ethnographic approachincluding 112 in-depth interviews, health diaries and sevenfocus group discussions. This paper uses 88 of these interviews.The other 24 interviews of the study involved people outside ofthe community or were very speci®c in their focus and there-fore were inappropriate for the analytic purposes of this paper.The large sample size re¯ects the attempt by the research teamto cover a range of people of various ages, social status andsex for the study on the social and cultural context of generalpractice services in this community. To obtain this sample,community organisations such as the local Bowling club,Parents and Citizens group, Playgroups and Kindergartensand local Lions Club were contacted and informed about thestudy. Volunteers were then recruited for in-depth interviewson their perceptions and experiences of health and generalpractice services. They were then asked to assist in the recruit-ment of other informants their social networks. In addition,some interviews were recruited through walking around thecommunity and requesting interviews and then asking infor-mants to assist with recruiting other people.5Two of the research team members lived in the community,one had been a resident for 8 years and the author of thisarticle resided in the community for 18 months.6The light industrial estate was started in 1955 to provide localemployment opportunities for those made unemployed withthe closure of the ®rst mine. However, residents stated that itfailed to provide jobs for local men and that most people whowork there now are from outside the community.7An illustration of the tension this subdivision caused was thata group of community members fought the council and develo-pers over the retention of the historic colliery buildings. The


324

community group was successful and it was ®nally agreed torestore and retain the buildings as a feature of the new sub-division.8See Gill and Picou (1989, p. 94) for further discussion ofreasons for lack of consensus among scientists, governmento�cials, industry executives, public health o�cials and the laypublic in such cases.9The group displays many of the characteristics of citizens'groups described by Quarantelli (1989).

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Talk about cancer: environment and health in Oceanpoint