1. For Better or For Worse
Environmental Health Promotion in Support of Community Action
Dr. White has worked with PCR (People for Community Recovery), in Chicago, Illinois for the past 8 years; PCR in the forefront of EJ movement for > 30 years
Presentation overview – introduction; discuss the EJ movement; discuss research findings and their impact on PCR/community
Photo taken by youth in PCR’s photovoice program (will be throughout ppt) – Youth for Community Recovery
Eric S. Hall, MA, MCE
US Environmental Protection Agency
Brandi M. White, PhD, MPH
Medical University of South Carolina
Cheryl Johnson
People for Community Recovery

2. Dedication Hazel M. Johnson 1935 – 2011
In memory of Ms. Hazel M. Johnson and dedicated to all of the work of PCR (People for Community Recovery), in Chicago, Illinois
Hazel M. Johnson
1935 – 2011
Founder, People for Community Recovery (PCR)
Mother of the Environmental Justice Movement

3. Mission
Enhance the quality of life of residents living in communities affected by pollution through education and advocacy in an effort to coordinate local residents on issues of the environment, health, housing, neighborhood safety, and economic equity
EJ is an integrated component with other community concerns

4. Introduction to the Neighborhood (Study Area)
Grassroots efforts are critical in promoting EJ; Environmental Health Education (EHE) one strategy to mobilize residents
This study was done in collaboration with PCR to assist in assessing community awareness of and attitudes towards environmental risks, and in shaping community action
Community leaders recommend conducting a community-based environmental health assessment to inform action on improving environmental conditions, mitigating toxic exposures, and improving overall health

5. History of Chicago, Illinois, USA Calumet Industrial District
Pullman Car
By Unknown photographer [Public domain],
via Wikimedia Commons
History of Chicago, Illinois, USA
Calumet Industrial District
Dedication of
Altgeld Gardens, August 1945
Source: Chicago Tribunes Archives, Aug 27, 1945
Altgeld Gardens/Murray Homes:
Located next to the Calumet Industrial District (CID) – a region that was home to some of the largest steel companies, and other industrial manufacturers,
Area was a ‘Pullman’ community; part of a Pullman ‘company town’ from the late 1800s s; town used surrounding area as dumpsite for sewage waste
After WWII, the Chicago Housing Authority (CHA) built low-income housing for WWII African-American (AA) veterans in this location – Altgeld is one of the first public housing developments in Illinois, and one of the first and largest in the U.S.

6. Altgeld Gardens and Phillip Murray Homes
Chicago, Illinois, USA
By The Map Collection, University of Chicago Library, Christopher Siciliano, and Jeremy Atherton [CC BY-SA 3.0], via Wikimedia Commons
Public Housing Development, SE corner of Chicago; Calumet Industrial District (CID):
Rich history of community activism because of PCR (resident-led CBO: Community-Based Organization)
Dr. White began working with PCR during her masters (MPH) degree program; gained experience in community organizations, and learned social dynamics, politics, and interests of community organizations
By TUBS [CC BY-SA 3.0], via Wikimedia Commons

7. Altgeld Gardens and Surrounding Area
Photo by Graycor; Available at:
(Auto Plant: Represents 22% of Cook County toxic releases [2014])
Image courtesy of Herbert White, Jr (Steel Processing: air/soil pollution)
Image courtesy of Herbert White, Jr.
(Chemical Spills: soil/water/air pollution)
Photo taken by Youth for Community Recovery participant
(Illegal Discharge into River: water pollution/seafood uptake)
By brewbooks from near Seattle, USA (Airborne Chicago to Baltimore), via Wikimedia Commons
(Wastewater Treatment: water pollution/smell)
Image courtesy of Herbert White, Jr.
(Illegal Dumping: soil/water pollution)
Take a close look at the surrounding community… with 1 km buffer zones
Note: CERCLIS = Comprehensive Environmental Response, Compensation and Liability Information System (for EPA Superfund information)
**Neighborhood is next to a major interstate (I-94)**
Steel company within 1 km
Chicago Metropolitan Water Reclamation District (Sewage Treatment Plant) with open sludge beds across the street
Illegal dumping by construction companies (youth photographer)
Illegal dumping in river behind community - Residents fish here; water contains pollution
Chemical spills a concern - (late 1990s): Truck from a nearby facility released a toxic haze over a 3-mile stretch of interstate and community
Motor Vehicle Assembly Plant - Accounted for 22% of toxic releases in Cook County (2014)
(also there are nearby landfills)
Other:
polychlorinated biphenyls (PCBs) – banned; linked to cancer
Illegal disposal of electrical transformers by city contractor in the middle of the town, leaving PCBs in the soil – Resident’s garden
*Many chemicals in environment linked to adverse health outcomes…neighborhood is in a ‘TOXIC DOUGHNUT’
1 km = ~0.6 miles
Map in: Barzyk et al. Linking Socio-Economic
Status, Adverse Health Outcome, and
Environmental Pollution Information to Develop a
Set of Environmental Justice Indicators with Three
Case Study Applications. Environmental Justice.
2011 Sept;4(3):

8. Environmental Hazards
Hazardous Waste Site: Facility that treats, stores, or disposes of hazardous waste
Superfund Site: Uncontrolled or abandoned place where hazardous waste is located that is hazardous to human health
Toxic Release Facility: Facility that manufactures, processes, or uses significant amounts of toxic chemicals
Brownfield Site: Area where hazard waste was once disposed and may be a target for new development

9. Within 1km (~1/2 mile: 0.625 mile)
Map in: White BM, Hall ES, Johnson C. Environmental health literacy in support of social action: an environmental justice perspective. J Environ Health Jul-Aug;77(1):24-9.
Within 1km (~1/2 mile: mile)
34 hazardous waste sites (red boxes)
1 Superfund site (fuchsia triangle)
Within 3 km (<2 miles: miles)
123 hazardous waste sites (red boxes)
4 Superfund sites (fuchsia triangles)

10. Photo taken by Youth for Community Recovery participant
PCR – had a reason to be concerned about the impact of the surrounding environment on her community’s health
The young girl is pointing to a wall dedicated to people who have died; many of illnesses
Chicago Tribune photo by E. Jason Wambsgans

11. Infant Mortality Rate (IMR) and low birth weight are linked to toxic environmental exposures, especially traffic-based air pollution
Disproportionately high levels of other conditions – stroke, diabetes and different types of cancers
Proximity to hazardous facilities and exposure to air pollution are both strong contributors to stroke incidence and mortality rates
Diabetes – availability of healthy foods
Growing body of research that demonstrates environmental influences on cancer (Environmental Tobacco Smoke [ETS], arsenic, chromium, cadmium, polycyclic aromatic hydrocarbons [PAHs], PCBs)
Source: Chicago and Riverdale data from the City of Chicago Data Portal, Public Health Statistics – Selected Public Health Indicators,

13. “If you looked at all the people that have been living out here
“We always have been surrounded by chemicals and the water over there is polluted.
We’ve got a landfill over here.
We’ve got steel mills over here…
We’re in the middle of a waste dump.”
“If you looked at all the people
that have been living out here
that are dying from cancer, that’s
not a coincidence.”

14. Image from Wiki Home, Barack Obama and Community Organization;
Available at:
“Toxic Wastes and Race in the United States: A National Report on the Racial and Socio-Economic Characteristics of Communities with Hazardous Waste Sites”, Commission for Racial Justice, United Church of Christ;
Available at: and
1979 – Hazel Johnson began her crusade for EJ in her community and other communities by fighting for a clean environment
1980s – a young college graduate worked with PCR to get some community organizing experience; he worked on removal of fiberglass from housing in Altgeld and the surrounding area; went on to become the 44th President of the U.S.
EJ – began as a grassroots movement; seminal document, “Toxic Wastes and Race in the United States: A National Report on the Racial and Socio-Economic Characteristics of Communities with Hazardous Waste Sites”, Commission for Racial Justice, United Church of Christ (Public Data Access, Inc.), 1987;
weblink (Chicago State University):
weblink (Bridgewater State University):

15. Environmental Justice
The fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies
EPA’s definition

16. US Executive Order 12898
Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations
Sec To the greatest extent possible… each Federal agency shall make achieving environmental justice part of its mission by identifying and addressing, as appropriate, disproportionately high and adverse human health or environmental effects of its programs, policies, and activities on minority populations and low-income populations…
Sec Each Federal agency shall conduct its programs, policies, and activities that substantially affect human health or the environment, in a manner that ensures that such programs, policies, and activities do not have the effect of excluding persons (including populations) from participation in, denying persons (including populations) the benefits of, or subjecting persons (including populations) to discrimination under, such, programs, policies, and activities because of their race, color, or national origin.
Efforts of PCR and other organizations around the nation…
President Clinton signed EO (celebrated 22-year anniversary a few months ago)
February 11, 1994

17. (USA-Mexico Border Region)
Crow Nation,
Montana
Yakima Valley,
Washington
Harlem, NYC,
New York
Flint, Michigan
Milwaukee,
Wisconsin
Salt Lake City,
Utah
Washington, DC
Kansas City,
Missouri
Los Angeles,
California
North Charleston,
South Carolina
San Elizario, Texas
(USA-Mexico Border Region)
Altgeld Gardens is not alone - This map shows communities that have been an EPA’s EJ Showcase Community, received a EPA EJ small grant, or where there are active EJ groups.
Region 2: Harlem, NY – Predominately Black and Hispanic community next to a sewage treatment plant; EJ group called West Harlem Environmental Action (WE ACT)
Region 3: Washington, DC (7th and 8th wards) – Low income/minority communities with degraded infrastructure, poor access to environmental and other amenities, high asthma rates, child lead exposure
Region 4: Jacksonville, FL – Low income/minority communities with a number of Superfund sites, Brownfields, vacant, abandoned lots, properties with suspected contamination and impacted waterways
Region 5: Milwaukee, WI
Region 6: Port Author, TX – Predominately Black and Hispanic communities surrounded by multiple environmental hazards that include chemical plants, refineries and a hazardous waste incinerator
Region 7: Kansas City, MO – Low-income communities with increased exposure to environmental hazards and poor housing conditions
Region 8: Salt Lake City, UT
Region 9: Los Angeles, CA – Reduce pollution from goods movement and industrial activity
Region 10: Yakima Valley, WA – Reduce environmental home health stressors in the Latino and tribal communities; primary focus on reducing exposure through contaminated private well drinking water
Source:
Jacksonville,
Florida
Chickaloon
Native Village,
Alaska
Port Arthur,
Texas
Image by the National Atlas of the United States (public domain)

18. Environmental Health Promotion in Support of Community Action

19. Source (Journal Article)
White, B. M., Hall, E. S., 2015, “Perceptions of environmental health risks among residents in the ‘Toxic Doughnut’: opportunities for risk screening and community mobilization”, BMC Public Health 2015, 15:1230, DOI: /s y, URL: PDF of article:

20. Environmental Health Promotion
Community Engagement
Environmental Education
Risk Education
Health Education
GOALS
Build trust in the communicator
Educate the community
Encourage community action to mitigate/prevent exposures
Environmental Health Promotion (EHP):
increase the awareness of hazards
allow community members to address environmental injustice concerns.
Includes:
Environmental Education
Health Education (covering health promotion and behavioral change)
Risk Education (most effective when partnered with local knowledge)
To develop effective EHP material, engage community members in its development
Community-engaged Research:
can help in tailoring interventions and programs by communicating clear environmental health messages to communities with EJ concerns
has been used to create or inform environmental health education campaigns to communicate environmental health risks
Source: Sauvé L, Godmaire H. Environmental Health Education: A Participatory Holistic Approach. EcoHealth Nov;1(2):SU35-SU46.

21. Study Aims Understand beliefs and knowledge of environmental hazards​
Determine levels of trust regarding federal/local agencies and community groups providing public health messages
Identify strategies to mobilize residents
Jonathan Miano/The Times

22. Methods
Focus group participants completed survey -- Descriptive statistics generated using SAS
Audio recordings transcribed and uploaded in qualitative data management program
Identified themes and subthemes; Noted salient quotes
Administered Respondent Validation survey (follow-up survey with a different group of residents)

23. Results

24. Linkage of Results to Future Efforts
Community:
Focus group demographics
Issues of concern
Risk ranking
Trust in government
Primary sources of environmental information
Understanding results - important in developing:
Health promotion/education (programs, material)
Partnerships (govt, industry, academia, NGOs, etc.)
Public health policy

25. Focus Group Demographics
Characteristic
Study Participants
Riverdale Community
Numerical Value %
Total 42 -
9,809
Age (years)
Median
49.0
20.5
Average
45.1 (±13.5) NA
Gender
Female 26
61.9%
5,524
56.5%
Male 16
38.1%
4,285
43.5%
Race/Ethnicity
Black/African American 41
97.7%
9,495
96.8%
Hispanic 1
2.3%
314
3.2%
Education
High School (HS) Graduate 23
54.8%
6,121
62.4%
Not HS Grad 19
45.2%
3,688
37.6%
Marital Status
Never Married 24
57.1%
3,266
33.3%
Married 18
42.9%
6,543
66.7%
Employment
Unemployed 15
35.7%
3,286
33.5%
Employed 27
64.3%
6,523
66.5%
Health Status
Fair or Poor
Better than Fair or Poor
Six focus groups were conducted with 42 current residents, almost all of whom were AA.

26. Identifying Community-Specific Concerns
Poor air quality
Outdoor: Near roadway pollutants, Industrial emissions
Indoor: Asthma triggers, Environmental tobacco smoke
Land contamination
Illegal dumping
Landfills
Urban gardening
Environmentally-related illnesses
Cancer incidence
Maternal and child health
Safe consumer products
Pesticide use
Household cleaning products
Fish consumption advisory
Erin Massey/MEDILL

27. Ranking of Environmental Health Risks
Top 3 Social Hazards
Crime (#1 overall)
Drugs (#2 overall)
HIV/AIDS (#9 overall)
Top 3 Physical Hazards
Dumping (#3 overall)
Landfills (#4 overall)
Chemicals (#5 overall)
For the focus group survey, crime, drugs, the dumping of hazardous waste, and landfills were seen as posing the greatest risks to the participants’ community. Environmental health risks were not limited to just physical risks, but also included social risks such as crime and police brutality.

28. “I believe there are enough laws to control environmental risks.”
Level of Trust
“I believe there are enough laws to control environmental risks.”
Many participants did not believe federal/local agencies were adequately protecting their health, nor did they trust government agencies.
-60% did not believe there are enough laws to control environmental risks.
-64% did not believe the government will do something about a serious health problem.
“When there is a really serious health problem, the government will do something about it. Until they tell me about a specific problem, I don’t have to worry.”

29. Sources of Environmental Information
“I’ve never seen nothing where they were saying they were out here for a discussion with people or to inform people about anything… They not doing a good job at informing people about anything.”
Dominant Source %
People for Community Recovery 67
Television 60
Friends & Relatives 45
US EPA 41
Illinois Department of Health 36
Chicago City Health Department 31
Chicago Housing Authority 24
“I can see the water pollution people. They take a sample of the water. They’re testing it to see how much pollution is in the water, but we don’t get no information about it. We don’t get no feedback on the results, how much chemicals is in the soil.”

30. Environmental Health Promotion Material
Provide information on the long-term health effects of toxic exposures
“What I want to know is, is this going to hurt my health in the long run? I maybe can’t feel it right now, but I want to know years from now what affect it’s going to have on me.”
One PPT suggested creating a network – train respected residents from the neighborhood who know how to talk to other residents (what language to use so its understandable), what kind of respect to show, how to engage them, and how to make them feel comfortable to ask questions
Create a network where residents educate one another
“We need to form subgroups or subcommittees… and focus on certain areas where we want to gather information and become sort of experts, not experts, but doing research.”

31. Building Partnerships
Build partnerships with other organizations and local industry
“They need to build true partnerships because communities of color don’t have the resources… If we had the ability to see the interconnectedness of all the elements that we fight for, whether it’s housing, violence, or industrialization in your neighborhood, we would be more effective.”

32. Summary of Findings
Build trust in the communicator by using existing health communication channels:
Community organizations, social network
Increase community capacity to address environmental injustice concerns through education
Establish partnerships with organizations invested in the community and region

33. Community Action
Findings from this study assisted PCR’s environmental campaigns, health education campaigns, and prioritization of environmental health hazards for remediation; been a catalyst for social justice

34. Activism through Visual Artistry Youth for Community Recovery
Photovoice program
Focus on employment opportunities for youth development
Pulitzer Prize-winning photographer from the Chicago Sun-Times (John White)
Student exchange program with students in Paris
Activism through Visual Artistry Altgeld Garden's Environmental Justice Photovoice Club is a program designed to teach youth about environmental justice issues in their community. Youth are encouraged to use photography to share their personal stories, expose societal and environmental injustices, and to garner support for issues that affect their community. PCR's Photovoice Club also has a partnership with Le Mete, a non profit in Paris, France. Using online media and social networking sites, youth from each organization share their experiences with one another.  
Images from:

35. Community Activism Landfill Expansion
The Environmental Justice Alliance of Greater Southeast Chicago (PCR is a member) prevented the expansion of neighboring landfills
Their organized efforts convinced the governor to sign legislation to ban any expansion of landfills in the area
Images from PCR, available at:

36. Community Activism Coal Plant BRANDI
PCR is a Founding Member of the Environmental Justice Alliance of Greater Southeast Chicago, a coalition of local organizations dedicated to improving the environment and health of residents on the Southeast side of Chicago
Prevented the siting of a coal gasification plant near the community
“Congress shall make no law…abridging…the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”
Images from the Sierra Club Scrapbook, available at:

37. Altgeld Gardens Community Revitalization Plan
GOALS
Improve environment and reduce toxic exposures
Preserve affordable public housing
Increase employment opportunities
Increase access to educational opportunities
Draft plan - Renewed focus on reducing pollution in the area; providing job opportunities – creating sustainable communities
Shepherded by PCR and conducted in coordination with Architects for Humanity - Stakeholders include PCR, industry, educational institutions
Iterative process that began listening to the communities, the residents and their hopes and dreams for the future and their children and the kind of community they desire, listening to the agencies that can provide help.

38. Future Community Goals
Develop and evaluate community health worker intervention
Establish Hazel M. Johnson Community Center to provide valuable space for job training, community education, and advocacy for environmental justice (PCR)
Establish green and sustainable business ventures (PCR)

39. Disclosure Statement The authors have no relevant financial or nonfinancial relationships to disclose.
Disclaimer Statement The United States Environmental Protection Agency through its Office of Research and Development collaborated in the research described herein. It has been subjected to Agency review and approved for publication. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.