Pub Date : 1900-01-01DOI: 10.7551/mitpress/12136.003.0008
In 2002, rates of childhood lead poisoning in certain highrisk neighborhoods in Rochester, New York, were more than ten times the national average. In the context of failing schools, child poverty, and high crime rates, local advocates coalesced around the idea that addressing lead in older housing could make a difference in children’s lives— and the community’s wellbeing. The resulting Coalition to Prevent Lead Poisoning (CPLP) focused its efforts on promoting systems changes to prevent lead exposure. CPLP worked to develop awareness of the problem, support for policy change, and a framework for a costefficient local lead law. Although many older cities have similar lead problems, Rochester is one of the few that has successfully passed and implemented a housing law to prevent lead poisoning. The lead law includes provisions for reporting and data sharing, which CPLP leveraged to monitor implementation and adaptation over time. In addition to the law, CPLP fostered collaboration between community, government, and academic partners to sustain, support, and adapt Rochester’s lead poisoning prevention efforts over time. A decade on, lead poisoning rates in Rochester have decreased more than twice as steeply as those in the rest of upstate New York. This case demonstrates how bringing together diverse stakeholders and reframing the problem of lead poisoning from a “health issue” to a “housing issue” were key to developing a new, locally appropriate solution to a longstanding problem. 4 The Coalition to Prevent Lead Poisoning: Promoting Primary Prevention in Rochester, New York
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Pub Date : 1900-01-01DOI: 10.7551/mitpress/12136.003.0005
nessed environmental injustice in graphic detail. Lowincome people— predominantly African Americans— suffered most from this crisis, were underserved by disaster response efforts, and recovered more slowly. Many residents were permanently displaced. As researchers, agencies, and the media searched for explanations, it became clear that historical patterns of land use had put lowincome communities and people of color in harm’s way (Levitt and Whitaker 2009). Lack of resources limited the ability of marginalized communities to recover. Multiple vulnerabilities including chronic disease, mental health issues, and addiction compounded the effects of the disaster on these populations. According to Bates and Swan (2010, 21), “Katrina swept away the ‘traditional belief’ that natural disasters are equally devastating on populations and do not discriminate in terms of what is destroyed.” Longstanding policies and practices created the environmental disparities that lay at the root of the hurricane’s disproportionate impacts on these communities (Pastor et al. 2006; Levitt and Whitaker 2009; Pardee 2005; Wailoo, Dowd, and O’Neill 2010). Decades of land use and economic development decisions led to concentrated poverty in areas at high risk of flooding. Housing policies failed to provide safe housing, particularly for communities of color. Lack of transportation resources limited the mobility of poorer residents. These and other environmental conditions— such as lowincome residents’ lack of access to affordable and nutritious foods, preventive health care, and opportunities for physical activity— contributed to the high rates of chronic disease and the poor health status of these same communities, reducing their resilience to environmental disaster. 1 Changing Local Systems to Promote Environmental Health and Justice
以生动的细节描述环境不公。低收入人群——主要是非裔美国人——在这场危机中遭受的损失最大，他们在灾难应对工作中得不到充分的服务，而且恢复得更慢。许多居民永久流离失所。随着研究人员、机构和媒体寻找解释，很明显，土地使用的历史模式已经把低收入社区和有色人种置于危险之中(Levitt和Whitaker 2009)。缺乏资源限制了边缘化社区的恢复能力。包括慢性病、精神健康问题和成瘾在内的多重脆弱性加剧了灾难对这些人口的影响。根据Bates和Swan(2010, 21)的说法，“卡特里娜飓风一扫了‘传统信念’，即自然灾害对人口的破坏性是一样的，并且在破坏的程度上没有区别。”长期的政策和实践造成了环境差异，这是飓风对这些社区造成不成比例影响的根源(Pastor et al. 2006;Levitt and Whitaker 2009;Pardee 2005;Wailoo, Dowd, and O 'Neill, 2010)。几十年的土地利用和经济发展决策导致贫困集中在洪水高风险地区。住房政策未能提供安全的住房，特别是有色人种社区。交通资源的缺乏限制了贫困居民的流动性。这些和其他环境条件——例如低收入居民无法获得负担得起的营养食品、预防保健和体育活动的机会——造成了这些社区慢性病发病率高、健康状况差，降低了他们对环境灾害的抵御能力。1改变地方系统，促进环境健康和正义
{"title":"Changing Local Systems to Promote Environmental Health and Justice","authors":"","doi":"10.7551/mitpress/12136.003.0005","DOIUrl":"https://doi.org/10.7551/mitpress/12136.003.0005","url":null,"abstract":"nessed environmental injustice in graphic detail. Lowincome people— predominantly African Americans— suffered most from this crisis, were underserved by disaster response efforts, and recovered more slowly. Many residents were permanently displaced. As researchers, agencies, and the media searched for explanations, it became clear that historical patterns of land use had put lowincome communities and people of color in harm’s way (Levitt and Whitaker 2009). Lack of resources limited the ability of marginalized communities to recover. Multiple vulnerabilities including chronic disease, mental health issues, and addiction compounded the effects of the disaster on these populations. According to Bates and Swan (2010, 21), “Katrina swept away the ‘traditional belief’ that natural disasters are equally devastating on populations and do not discriminate in terms of what is destroyed.” Longstanding policies and practices created the environmental disparities that lay at the root of the hurricane’s disproportionate impacts on these communities (Pastor et al. 2006; Levitt and Whitaker 2009; Pardee 2005; Wailoo, Dowd, and O’Neill 2010). Decades of land use and economic development decisions led to concentrated poverty in areas at high risk of flooding. Housing policies failed to provide safe housing, particularly for communities of color. Lack of transportation resources limited the mobility of poorer residents. These and other environmental conditions— such as lowincome residents’ lack of access to affordable and nutritious foods, preventive health care, and opportunities for physical activity— contributed to the high rates of chronic disease and the poor health status of these same communities, reducing their resilience to environmental disaster. 1 Changing Local Systems to Promote Environmental Health and Justice","PeriodicalId":414150,"journal":{"name":"Bridging Silos","volume":"183 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116110675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.7551/mitpress/12136.003.0007
public health and managing the environment. Although one of the main goals of environmental management is to protect human health, there are significant gaps in the current system’s ability to identify, prevent, or address health hazards resulting from cumulative environmental exposures at local scales. At the same time, the public health community has become more aware of how social, economic, and environmental health determinants contribute to the health problems facing our society and particularly to the health disparities facing lowincome urban areas and communities of color. The widely recognized paradox of the U.S. health care system is that it spends more per person than any other country, and yet its health status is worse than many countries that spend far less on health care (Brink 2017; Fox 2016). The diseases that dominate health costs and drive health inequities are chronic conditions like obesity, diabetes, and heart disease. These same diseases are influenced by factors including people’s education, income, and environment. Such social determinants of health may affect health directly through increasing people’s exposure to environmental hazards, crime, and poor nutrition or indirectly by shaping individual behaviors and people’s access to preventive services and care. Social determinants of health, in turn, are shaped by policies, systems, environments, and institutions outside the purview of the health care system. Recognition of the importance of social determinants of health has encouraged public health professionals to work toward changing policies that shape social, economic, and environmental conditions. This “Health in All Policies” (HiAP) approach encompasses a range of environmental policy 3 Building Bridges: Systems Approaches to Local Environmental Health Problems
{"title":"Building Bridges: Systems Approaches to Local Environmental Health Problems","authors":"","doi":"10.7551/mitpress/12136.003.0007","DOIUrl":"https://doi.org/10.7551/mitpress/12136.003.0007","url":null,"abstract":"public health and managing the environment. Although one of the main goals of environmental management is to protect human health, there are significant gaps in the current system’s ability to identify, prevent, or address health hazards resulting from cumulative environmental exposures at local scales. At the same time, the public health community has become more aware of how social, economic, and environmental health determinants contribute to the health problems facing our society and particularly to the health disparities facing lowincome urban areas and communities of color. The widely recognized paradox of the U.S. health care system is that it spends more per person than any other country, and yet its health status is worse than many countries that spend far less on health care (Brink 2017; Fox 2016). The diseases that dominate health costs and drive health inequities are chronic conditions like obesity, diabetes, and heart disease. These same diseases are influenced by factors including people’s education, income, and environment. Such social determinants of health may affect health directly through increasing people’s exposure to environmental hazards, crime, and poor nutrition or indirectly by shaping individual behaviors and people’s access to preventive services and care. Social determinants of health, in turn, are shaped by policies, systems, environments, and institutions outside the purview of the health care system. Recognition of the importance of social determinants of health has encouraged public health professionals to work toward changing policies that shape social, economic, and environmental conditions. This “Health in All Policies” (HiAP) approach encompasses a range of environmental policy 3 Building Bridges: Systems Approaches to Local Environmental Health Problems","PeriodicalId":414150,"journal":{"name":"Bridging Silos","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130627091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.7551/mitpress/12136.003.0011
{"title":"Local Environmental Health Initiatives: The Impacts of Collaboration","authors":"","doi":"10.7551/mitpress/12136.003.0011","DOIUrl":"https://doi.org/10.7551/mitpress/12136.003.0011","url":null,"abstract":"","PeriodicalId":414150,"journal":{"name":"Bridging Silos","volume":"240 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132273276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.7551/mitpress/12136.003.0012
This book examines three local initiatives to promote urban environmental health equity by changing policies, systems, and environments. The initiatives developed to address diverse environmental health problems: lead hazards in rental housing in Rochester, New York; the built environment in Duluth, Minnesota; and goods movement around the ports of Los Angeles and Long Beach, California. In each case, stakeholders confronted a longstanding environmental health inequity. All three built collaborative efforts across disciplinary barriers and leveraged multiple sources of knowledge. They also built their partners’ capacity and influenced how local decisions are made in ways that are likely to foster future reductions in health disparities. This chapter highlights the common themes across all the cases, reflects on the potential to disseminate lessons learned in other communities, and suggests how similar efforts might be supported elsewhere in the future.
{"title":"The Promise of Local Environmental Health Initiatives","authors":"","doi":"10.7551/mitpress/12136.003.0012","DOIUrl":"https://doi.org/10.7551/mitpress/12136.003.0012","url":null,"abstract":"This book examines three local initiatives to promote urban environmental health equity by changing policies, systems, and environments. The initiatives developed to address diverse environmental health problems: lead hazards in rental housing in Rochester, New York; the built environment in Duluth, Minnesota; and goods movement around the ports of Los Angeles and Long Beach, California. In each case, stakeholders confronted a longstanding environmental health inequity. All three built collaborative efforts across disciplinary barriers and leveraged multiple sources of knowledge. They also built their partners’ capacity and influenced how local decisions are made in ways that are likely to foster future reductions in health disparities. This chapter highlights the common themes across all the cases, reflects on the potential to disseminate lessons learned in other communities, and suggests how similar efforts might be supported elsewhere in the future.","PeriodicalId":414150,"journal":{"name":"Bridging Silos","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129758610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.7551/mitpress/12136.003.0006
{"title":"Standing Silos: Public Health and Environmental Management","authors":"","doi":"10.7551/mitpress/12136.003.0006","DOIUrl":"https://doi.org/10.7551/mitpress/12136.003.0006","url":null,"abstract":"","PeriodicalId":414150,"journal":{"name":"Bridging Silos","volume":"506 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123068259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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