ARRA IMPACT REPORT:
Health Disparities


Public Health Burden
Environmental exposures and disease impact all sectors of the US population; however, vulnerable populations (children, elderly, low socioeconomic status, immigrant populations, etc.) are more likely to suffer from disproportionate environmental exposures and health risks. Given the historical and socio-political context of many of environmental health disparities, a holistic approach that involves community engagement, skill building, participatory research, and intervention strategies is essential.

Capacity Building
Effective partnerships to address environmental health disparities depend on each partner possessing effective collaboration skills. Community groups must understand the research process and connections between environmental exposures and adverse health outcomes. Likewise, researchers and health care professionals must possess an appreciation for community knowledge and an ability to communicate in a culturally appropriate fashion. Policy makers also need to understand how their decisions impact the environment and potentially the health of certain populations, especially the most vulnerable.

The American Recovery and Reinvestment Act (ARRA) supported several grants that built the capacity of communities to address environmental health disparities:

  • Through the Air Pollution Outreach, Education, and Research Capacity Building in Alaska Native Villages project, eight local community coordinators have been hired and trainedThe project engaged Tribal and community members and school personnel in education and research activities. Through their activities the team has been able to increase knowledge of indoor air quality issues and related respiratory health outcomes among high school students, teachers, and Tribal and community members in several Alaska Native villages. The project has also identified environmental health concerns of importance to community members, and rates of respiratory disease in children. 1
  • The goal of Assessment of Local Environmental Risk Training (ALERT) to Reduce Health Disparities was to build the capacity of environmental health researchers and community-based organizations to actively participate as equal partners in air quality research and develop their skills to effectively communicate risks and research findings to community members. The project conducted two 4-day Train-the-Trainer workshops for community residents and researchers. 47 of the trained community residents completed 19 subsequent workshops within their communities that resulted in a total of 350 residents being trained in environmental health and community-based participatory research.2
  • Understanding Trends and Patterns in Well Water Contamination in North Carolina: The University of North Carolina at Chapel Hill, as part of a supplement to the Superfund Research Program, collaborated with the North Carolina Department of Health and Human Services (NCDHHS) to understand trends and patterns in well water contamination in North Carolina. Through their analyses of over 60,000 geocoded well locations, this group was able to more accurately assess spatial and temporal arsenic trends in both monitored wells and estimates at unmonitored locations across North Carolina. The geocoding methods developed in this study data enabled a comprehensive report of over 4000 yearly arsenic measurements with geographical coordinates from 1998 to 2007 and over 10,000 from 2008 to present. A notable result of this study is the surprisingly high levels of arsenic (up to 806 µg/L) that were detected in some homeowners' domestic wells. More than 1436 (2.25%) of wells exceeded the EPA standard. Some of the top-ranked counties identified here as most frequently exceeding the EPA maximum contaminant level have not previously been highlighted in nation- or statewide studies. By ranking based on percentage of population at risk the project was able to identify counties where county-level well monitoring programs may be cost-effective.3

Environmental Justice (EJ)
Many communities are affected disproportionately by policies that add to their environmental and public health burdens. Often such communities do not have the resources or the ability to document these disproportionate exposures and their effects. Consequently, collaborative partnerships with academic researchers can empower community residents to participate, understand, assesses and communicate research findings to reduce harmful exposures and improve the health of their community.

  • PCB Contamination & Fish Oil: In the Norton Sound region of Alaska, the majority of the residents of these villages are Inupiat and Yupik, indigenous people who depend on the harvest of wild foods to sustain them and their ways of life. To assess dietary exposures, community researchers collected several hundred samples of the diverse species that are important in the traditional diet. Rendered oil samples contained the highest PCB concentrations, ranging from 200-450 ppb in seal species. For unlimited fish consumption, EPA’s risk-based consumption limit for PCBs in fish is 1.5 ppb to avoid excess risk of cancer. Since the Yupik people sustain cultural ways of life that rely on traditional foods, dietary exposure is likely a significant source of the PCBs, particularly rendered oils and blubber. This ARRA-funded project enabled researchers to work with community leadership on Saint Lawrence Island to develop, submit, and receive funding for a collaborative research project that will help eliminate and reduce exposures.4
  • The Community Mapping of Environmental Hazards and Barriers in an Immigrant Population project successfully engaged with Vietnamese communities in California to identify and characterize neighborhood-level environmental hazards and health access barriers to inform efforts for addressing their health disparities. Community agencies and community members were trained to conduct community audits (both qualitative and quantitative environmental data) in their residential and work neighborhoods. The research team implemented the audit in four counties (Alameda, Marin, Orange and Santa Clara). 66 Vietnamese community auditors conducted a total of 276 audit street segments, including 134 businesses (48.6%) and 142 residential (51.4%) segments. Community auditors noted their participation helped increase their awareness around environmental hazards and have voiced interest in continuing these efforts. Comparisons between the community-collected snapshot data to governmental monitoring data for traffic and black carbon helps to inform how well existing secondary data can capture local environmental hazards. Of particular interest, community-collected black carbon data emphasized the roles of geographic scale, time scale, and timing of measurements. Based on the outcomes of this ARRA-funded project, the team is exploring the use of this data collection method in the City of Oakland.5

Contributing NIH Institutes & Centers

  • National Institute of Environmental Health Sciences (NIEHS)

  1. 1RC1ES018400-01 - WARD, ANTHONY JOHN - UNIVERSITY OF MONTANA - MISSOULA - MT
  2. 1RC1ES018121-01 - WALLACE, STEVEN PAUL - UNIVERSITY OF CALIFORNIA LOS ANGELES - LOS ANGELES - CA
  3. 5P42ES005948-17, http://www.ncbi.nlm.nih.gov/pubmed/21982028 - SWENBERG, JAMES A - UNIVERSITY OF N CAROLINA AT CHAPEL HILL - CHAPEL HILL - NC
  4. 3R25ES014308-04S1 - MILLER, PAMELA KAY - ALASKA COMMUNITY ACTION ON TOXICS (ACAT) - ANCHORAGE - AK
  5. 5RC1ES018349-02 - REYNOLDS, PEGGY - CANCER PREVENTION INSTIT OF CALIFORNIA - FREMONT - CA