506 research outputs found

    Combining community-based research and local knowledge to confront asthma and subsistence-fishing hazards in Greenpoint/Williamsburg, Brooklyn, New York.

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    Activists in the environmental justice movement are challenging expert-driven scientific research by taking the research process into their own hands and speaking for themselves by defining, analyzing, and prescribing solutions for the environmental health hazards confronting communities of the poor and people of color. I highlight the work of El Puente and The Watchperson Project--two community-based organizations in the Greenpoint/Williamsburg neighborhood in Brooklyn, New York, that have engaged in community-based participatory research (CBPR) to address asthma and risks from subsistence-fish diets. The CBPR process aims to engage community members as equal partners alongside scientists in problem definition, information collection, and data analysis--all geared toward locally relevant action for social change. In the first case I highlight how El Puente has organized residents to conduct a series of asthma health surveys and tapped into local knowledge of the Latino population to understand potential asthma triggers and to devise culturally relevant health interventions. In a second case I follow The Watchperson Project and their work surveying subsistence anglers and note how the community-gathered information contributed key data inputs for the U.S. Environmental Protection Agency Cumulative Exposure Project in the neighborhood. In each case I review the processes each organization used to conduct CBPR, some of their findings, and the local knowledge they gathered, all of which were crucial for understanding and addressing local environmental health issues. I conclude with some observations about the benefits and limits of CBPR for helping scientists and communities pursue environmental justice

    A community-engaged infection prevention and control approach to Ebola.

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    The real missing link in Ebola control efforts to date may lie in the failure to apply core principles of health promotion: the early, active and sustained engagement of affected communities, their trusted leaders, networks and lay knowledge, to help inform what local control teams do, and how they may better do it, in partnership with communities. The predominant focus on viral transmission has inadvertently stigmatized and created fear-driven responses among affected individuals, families and communities. While rigorous adherence to standard infection prevention and control (IPC) precautions and safety standards for Ebola is critical, we may be more successful if we validate and combine local community knowledge and experiences with that of IPC medical teams. In an environment of trust, community partners can help us learn of modest adjustments that would not compromise safety but could improve community understanding of, and responses to, disease control protocol, so that it better reflects their 'community protocol' (local customs, beliefs, knowledge and practices) and concerns. Drawing on the experience of local experts in several African nations and of community-engaged health promotion leaders in the USA, Canada and WHO, we present an eight step model, from entering communities with cultural humility, though reciprocal learning and trust, multi-method communication, development of the joint protocol, to assessing progress and outcomes and building for sustainability. Using examples of changes that are culturally relevant yet maintain safety, we illustrate how often minor adjustments can help prevent and treat the most serious emerging infectious disease since HIV/AIDS

    Housing Conditions in Palestinian Refugee Camps, Jordan

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    This paper evaluates the quality of housing in a Palestinian refugee camp in Jordan. More than two million registered refugees live in Jordan, most of whom living in thirteen refugee camps established in the late 1960s following the Arab-Israeli conflict of 1967. Many of these camps are characterized by poor living conditions and associated health, social and environmental problems. However, there is scant empirical evidence regarding the quality of the housing in these camps. This paper addresses this gap by reporting on the findings of a questionnaire survey of 382 household units in Baqa’a Camp, the largest of the camps. The quantitative survey was triangulated by a series of extensive fieldwork visits to the area. Findings reveal that the housing in the camp is generally substandard. Poor structure and maintenance are key problems and this paper identifies and discusses various challenges, political and practical, that stand in the way of housing improvements. The paper concludes by suggesting that new models of ownership and responsibility need to be forged between the stakeholders in order to break the current stalemate of inaction

    Slum Sanitation and the Social Determinants of Women’s Health in Nairobi, Kenya

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    Inadequate urban sanitation disproportionately impacts the social determinants of women’s health in informal settlements or slums. The impacts on women’s health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls’ health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements

    Engaging with community researchers for exposure science: lessons learned from a pesticide biomonitoring study

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    A major challenge in biomonitoring studies with members of the general public is ensuring their continued involvement throughout the necessary length of the research. The paper presents evidence on the use of community researchers, recruited from local study areas, as a mechanism for ensuring effective recruitment and retention of farmer and resident participants for a pesticides biomonitoring study. The evidence presented suggests that community researchers' abilities to build and sustain trusting relationships with participants enhanced the rigour of the study as a result of their on-the-ground responsiveness and flexibility resulting in data collection beyond targets expected

    Peri-urbanism in globalizing India: a study of pollution, health and community awareness

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    This paper examines the intersection between environmental pollution and people's acknowledgements of, and responses to, health issues in Karhera, a former agricultural village situated between the rapidly expanding cities of New Delhi (India's capital) and Ghaziabad (an industrial district in Uttar Pradesh). A relational place-based view is integrated with an interpretive approach, highlighting the significance of place, people's emic experiences, and the creation of meaning through social interactions. Research included surveying 1788 households, in-depth interviews, participatory mapping exercises, and a review of media articles on environment, pollution, and health. Karhera experiences both domestic pollution, through the use of domestic waste water, or gandapani, for vegetable irrigation, and industrial pollution through factories' emissions into both the air and water. The paper shows that there is no uniform articulation of any environment/health threats associated with gandapani. Some people take preventative actions to avoid exposure while others do not acknowledge health implications. By contrast, industrial pollution is widely noted and frequently commented upon, but little collective action addresses this. The paper explores how the characteristics of Karhera, its heterogeneous population, diverse forms of environmental pollution, and broader governance processes, limit the potential for citizen action against pollution

    Environmental contributions to disparities in pregnancy outcomes.

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    One of the most persistent disparities in American health status is the pronounced difference in birth outcomes between non-Hispanic black and non-Hispanic white women. Poor pregnancy outcomes have a substantial impact on mortality, morbidity, and health care costs. Increasing evidence indicates that environmental exposures are associated with poor birth outcomes. This paper reviews the latest research on how environmental exposures affect pregnancy outcomes and then discusses how these exposures may be embedded within a context of significant social and host factor stress. The analysis suggests that environmental, social, and host factors are cumulatively stressing non-Hispanic black women and that this cumulative stress may be a cause of the persistent disparities in pregnancy outcomes

    Evaluating advance peace in Fresno, California: An interrupted times series analysis of a community-based gun violence intervention.

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    BackgroundGun violence is a critical public health issue, contributing to the disproportionate burden of health inequities among racially and economically marginalized populations. Advance Peace, a community-driven gun reduction program that integrates street outreach workers to interrupt conflicts with trauma-informed programming to provide mentorship and support for young people at the center of urban gun violence, may be a strategy to reduce gun violence and build healthy communities. We assessed whether the implementation of Advance Peace in Fresno, California was associated with a reduction in gun-related violence, including homicides and assaults. We hypothesized that post-implementation of Advance Peace, there would be a reduction in both gun-related homicides and assaults.MethodsLeveraging crime statistics from the Fresno Police Department on gun-related homicides and assaults between January 2014 and June 2023, we evaluated the impact of Advance Peace programming, implemented beginning in July 2021, on gun violence in Fresno. Descriptive analysis assessed average gun violence rates over time. We used interrupted time series models to assess the rates of gun violence associated with the implementation of Advance Peace in Fresno.ResultsIn Fresno, there was evidence of a reduction in crime rates following the introduction of Advance Peace intervention. Two years post-intervention, there was a 46% decrease in the rate of all gun-related crimes, including both homicides and assaults (rate ratio: 0.54, 95% CI: 0.36-0.81). The intervention was also associated with a reduction in the rate of gun-related homicides (RR = 0.45, 95% CI: 0.21-0.95) and the rate of gun-related assaults (RR = 0.58, 95% CI: 0.38-0.89).ConclusionFindings from this study demonstrate that Advance Peace may be an effective strategy to reduce gun violence
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