Framing Environmental Health Decision-Making: The Struggle over Cumulative Impacts Policy

Little progress has been made to advance U.S. federal policy responses to growing scientific findings about cumulative environmental health impacts and risks, which also show that many low income and racial and ethnic minority populations bear a disproportionate share of multiple environmental burdens. Recent scholarship points to a “standard narrative” by which policy makers rationalize their slow efforts on environmental justice because of perceived lack of data and analytical tools. Using a social constructivist approach, ethnographic research methods, and content analysis, we examined the social context of policy challenges related to cumulative risks and impacts in the state of Maryland between 2014 and 2016. We identified three frames about cumulative impacts as a health issue through which conflicts over such policy reforms materialize and are sustained: (a) perceptions of evidence, (b) interpretations of social justice, and (c) expectations of authoritative bodies. Our findings illustrate that policy impasse over cumulative impacts is highly dependent on how policy-relevant actors come to frame issues around legislating cumulative impacts, rather than the “standard narrative” of external constraints. Frame analysis may provide us with more robust understandings of policy processes to address cumulative risks and impacts and the social forces that create health policy change.https://doi.org/10.3390/ijerph1808394

Framing Environmental Health Decision-Making: The Struggle over Cumulative Impacts Policy

Little progress has been made to advance U.S. federal policy responses to growing scientific findings about cumulative environmental health impacts and risks, which also show that many low income and racial and ethnic minority populations bear a disproportionate share of multiple environmental burdens. Recent scholarship points to a “standard narrative” by which policy makers rationalize their slow efforts on environmental justice because of perceived lack of data and analytical tools. Using a social constructivist approach, ethnographic research methods, and content analysis, we examined the social context of policy challenges related to cumulative risks and impacts in the state of Maryland between 2014 and 2016. We identified three frames about cumulative impacts as a health issue through which conflicts over such policy reforms materialize and are sustained: (a) perceptions of evidence, (b) interpretations of social justice, and (c) expectations of authoritative bodies. Our findings illustrate that policy impasse over cumulative impacts is highly dependent on how policy-relevant actors come to frame issues around legislating cumulative impacts, rather than the “standard narrative” of external constraints. Frame analysis may provide us with more robust understandings of policy processes to address cumulative risks and impacts and the social forces that create health policy change

Advancing and Promoting Community Health: Opportunities for Accountable Communities for Health and Community Health Centers

Executive Summary: Accountable Communities for Health (ACHs) are multi -sector, community-based partnerships that aim to address community health and social needs, and Community Health Centers (CHCs) provide important community-based healthcare services for underserved and medically vulnerable populations. Given the critical role that both ACHs and CHCs play in addressing health-related social needs and social determinants of health, a survey of ACHs on CHC engagement was conducted to better understand opportunities and challenges for CHC participation in ACHs. This survey, along with follow-up conversations with ACH and CHC representatives, confirmed that ACHs and CHCs are natural partners in the effort to advance community health by building multi-sector coalitions that address health-related social needs and social determinants of health. A majority of ACHs that responded to the survey reported CHC participation in their ACH under contract or other formal engagement, and CHCs frequently participate in ACH governance. Despite this level of participation, however, the research also revealed that the nature of this participation varies greatly, and strong partnerships do not always exist. This may be less because the ACHs and CHCs do not share the same vision for a community’s health, and more because of a need to build relationships, provide financial incentives, remove practical obstacles, and better define the shared value of such partnerships