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Your Environment. Your Health.

2015

Kenneth Oldfield and Roy Stover – Building Capacity for Native Americans in Hazardous Chemical Safety and Awareness

December 18, 2015

Kenneth Oldfield demonstrates the use of a chlorine containment kit.

Kenneth Oldfield (right), director of the WST, demonstrates the use of a chlorine containment kit to Native American hazardous materials response technicians.
(Photo courtesy of Kenneth Oldfield)

Kenneth Oldfield and Roy Stover collaborate to develop materials and deliver worker safety education and training through the NIEHS-funded Alabama Fire College Workplace Safety Training Program (WST).

The foundation and mission of the WST is based on a rich history. It started in 1987 in the University of Alabama at Birmingham (UAB) School of Business’ Center for Labor Education and Research, and moved to Alabama Fire College in 2011. “While the program began with a major university, the move to Alabama Fire College has been extremely useful in targeting different worker populations, especially first responders,” Oldfield stated.  

Roy Stover assists a trainee during a hazardous materials hands-on training.

Roy Stover, Native American training coordinator for the WST, assists a trainee during a hazardous materials hands-on training exercise.
(Photo courtesy of Kenneth Oldfield)

The WST offers hands-on, instructor-based training focused on topics such as emergency response, disaster preparedness, incident command, and methamphetamine, or meth, lab awareness targeting two primary populations: first responders, such as firefighters and law enforcement, and Native American tribes.

Although a large portion of the training offered by the WST is geared towards first responders, training for Native Americans is of particular interest for public health because they are an underserved, minority population.

Training Native American Communities: Partnerships, Challenges, and Best Practices

The WST builds the capacity for Native American tribal members and to recognize and protect themselves from hazardous chemical exposures encountered in workplaces and during emergency response operations. “Very often, the tribes and workers don’t realize the importance of this training until they experience it,” Oldfield and Stover explained. “The training provides a sense of awakening and awareness for them.”

Building on extensive professional backgrounds, Oldfield and Stover have the relevant experience needed to offer effective worker safety training.

Oldfield was encouraged to pursue the field of worker safety and education while taking hazardous waste operations and emergency response refresher courses as an industrial hygiene consultant. He became involved with the WST (then part of the UAB) in 1990 as an instructor, and currently serves as director and manager.

Stover, a veteran of the U.S. Air Force, taught courses on hazardous waste disposal and emergency response at other institutions before joining the WST in 2003 where he currently serves as the Native American training coordinator.

Partnerships with external organizations provide the WST with opportunities to offer training for Native Americans in various regions.  For example, a partnership with the Native American Fish and Wildlife Society (NAFWS), an international society with more than 250 member tribes, was initiated in 2000 when a Mississippi conservation officer recognized the value of hazardous materials awareness training for other conservation officers traveling to, and working in, remote tribal lands. This partnership has since enabled the WST to form relationships and provide training to numerous tribes throughout the U.S. Additionally, through a partnership with the California Tribal Emergency Response and Relief Agency, the WST has trained licensed first responders in northern California who respond exclusively to Native American communities and tribes throughout the state.

Oldfield and Stover described some of the unique challenges that they face in training Native American communities. “Some of the tribes are very remote, and reaching them can be difficult,” Stover explained. “Another challenge that is really unique is that tribes often function as a community with a certain amount of sovereign authority,” Oldfield added. “The authority structure and cultural aspects of the tribe determine how they interact and interface with local departments and other communities to receive mutual assistance and prepare for responses to hazardous waste or emergencies.” Although they have the potential to respond to hazardous waste and other issues, Native American communities often have limited resources and don’t always realize what training is available. To promote and increase the visibility of trainings that are offered, WST staff members attend regional and national conferences and send mass emails to tribal contacts. They also post articles in online newsletters such as the Eagle’s Nest, the official newsletter of the NAFWS.

Next Steps

Moving forward, Oldfield and Stover look forward to a partnership with the United South and Eastern Tribes (USET) which will provide more training opportunities for Native American tribes in the southern and eastern regions of the U.S., stretching from Maine to Florida. “We are really excited about this partnership, as most of our training thus far has been focused on the western and southwestern parts of the country,” Oldfield explained. “One thing that is currently lacking in the Native American community is training focused on the clean-up of meth lab hazardous waste that may be encountered in housing facilities,” Stover explained. Meth labs are a very common issue identified amongst Native American tribes and communities. Recognizing this need, Stover will develop training materials for a new course that focuses on safe practices, laws, and regulations surrounding meth lab clean up.

Ogonnaya Dotson-Newman — Helping Vulnerable Communities Achieve Environmental Justice and Sustainability

October 5, 2015

Ogonnaya Dotson-Newman

Ogonnaya Dotson-Newman, an advocate for environmental justice, is director of environmental health for West Harlem Environmental Action, Inc. (WE ACT for Environmental Justice).
(Photo courtesy of Ogonnaya Dotson-Newman)

Ogonnaya Dotson-Newman is passionate about linking issues of social justice with environmental health sciences and raising people’s awareness about this connection. Growing up in northern California, Newman witnessed the deep health and social impacts of toxic exposures on family members and the importance of activism to implement change in communities. As a teenager, she recalls attending an air quality campaign meeting with her aunt and being moved by discussions related to environmental justice issues in her aunt’s community. It was these experiences, among many others, that motivated Newman to pursue a career in environmental justice. “We live in a society that has justice, but is not necessarily just. Science resonated with me when I began to understand how it could be used to make positive change in communities,” explained Newman. “As an activist, I have the freedom to amplify discussions about environmental issues and utilize creative ideas to influence pragmatic change in communities, which is very exciting.”

Newman earned a master’s degree in public health from Loma Linda University, where she later worked as a research associate for the Office of Public Health Practice and Workforce Development. There, she explored methods of environmental health service delivery in New Mexico. This project focused on several issues related to water, air, and soil quality, as well as recreational area use. In 2008, Newman joined West Harlem Environmental Action, Inc. (WE ACT for Environmental Justice), where she now serves as the director of environmental health.

WE ACT is an organization that informs, educates, and empowers residents of Northern Manhattan on various environmental health and justice issues. Founded in 1988, WE ACT was one of the first environmental organizations in New York State to be led by African Americans. The organization serves as a trusted source of environmental health information for various underserved and minority groups in New York and does so by promoting community efforts on environmental issues and offering capacity building support for other community-based organizations. “Environmental justice is very expansive – there are a number of environmental threats that people of color and low income are constantly dealing with in our communities,” said Newman. “WE ACT brings advocacy, community organizing, and research together to address these threats.”

Newman works with her WE ACT colleagues to engage and educate communities on environmental health issues, such as healthy indoor environments, climate justice, community access to green resources, and green worker training initiatives. For example, Newman led a partnership with multiple stakeholders, such as local businesses and community development organizations, on the EPA-funded Community Action for a Renewed Environment (CARE) Collaborative to reduce community risk from toxic exposures related to solid waste, pests, and pesticides in Northern Manhattan.

Newman also collaborates with academic researchers to translate environmental health research findings into meaningful outreach materials for vulnerable communities. In fall 2014, WE ACT cosponsored the NYC Healthy Homes Summit with the NIEHS Core Center for Environmental Health in Northern Manhattan (Columbia University) and the Milano School of International Affairs, Management, and Urban Policy at The New School. The summit engaged government agencies and officials on discussions to address campaign strategies for improving housing and living conditions in NYC and served as the launch for the WE ACT for Healthy Homes Campaign that Newman directs. Other efforts with Core Center investigators have included development of an environmental public health report card for community residents and stakeholders in Northern Manhattan. The report card highlights information about a range of local environmental issues, such as pesticides, indoor air quality, and drinking water quality. The report card was generated using data from various sources, such as the NYC Environmental Public Health Tracking Portal, and a community-engaged process was used to determine the community grade. This collaborative process allowed residents from Northern Manhattan to provide input on prioritization and risk ranking for environmental issues. The risk ranking corresponded to the community grade: low risk (A), medium risk (B), and high risk (C). Newman also works with the Community Advisory Stakeholder Board of the NIEHS Columbia Center for Children's Environmental Health to develop tip cards that feature information about different environmental pollutants and exposures that impact children’s health. In addition, she serves on the educational committee for the Children's Environmental Health Network, where she assists colleagues with the review and distribution of outreach materials for programs such as Eco-Healthy Child Care®.

Recently, as members of the research team, Newman and WE ACT staff worked with academic partners from the University of Pittsburgh, who used an EPA Science to Achieve Results (STAR) grant to explore methodologies for assessing and incorporating non-chemical exposures, such as psychosocial stress, into environmental health research. The investigators implemented a geographic information system (GIS)-based approach to examine spatial patterns between a range of social stressors and air pollution in New York City to understand better their combined effects on health. They also evaluated how social stress modifies the association between nitrogen dioxide exposure and emergency department (ED) visit rates for children with asthma. The methods used by the research team could be used to inform experimental design for epidemiological studies exploring the separate and combined effects of multiple urban exposures.

Highlighted Publications

  • Shmool JL, Kubzansky LD, Newman OD, Spengler J, Shepard P, Clougherty JE. 2014. Social stressors and air pollution across New York City communities: a spatial approach for assessing correlations among multiple exposures. Environ Health 13:91. [Abstract]

Rosalina "Rose" James, Ph.D. – Facilitating Tribal-Academic Partnerships

September 4, 2015

Rose James, Ph.D.

Rose James, Ph.D., supports development of tribal-academic partnerships, such as a community-planning group in Alaska composed of scientists and Yup’ik community members who participated in genetic studies. Here she is pictured with a member of that community-planning group.
(Photo courtesy of Rose James)

As a member of the Lummi tribe in Washington State, Rose James, Ph.D., has always had a strong connection to tribal communities. After focusing on lab sciences during her doctoral work, she decided to use her research skills and knowledge to improve the health of tribal communities through her own community-based research and by facilitating tribal-academic health research partnerships.

“It is really important to me that when scientists work with communities, particularly indigenous communities, that we strive to have two-way respectful conversations and learning,” said James, assistant professor at the University of Washington School of Medicine. “My own connection to tribal communities drives me to seek equitable distribution of the power and resources that go into partnerships between academic groups and communities.”

As a postdoctoral fellow, James conducted a community-based study to address a question posed by the communities with which she worked: What were the motivations for native women to use mammography services through their tribal breast and cervical cancer programs? Through this project, she learned that conducting research in tribal communities can be a lengthy but rewarding process.

As a native person and as a researcher, I don’t believe that we can solve anyone else’s problems. We can only be of service, and our service is being able to use research to answer the questions, apply the methods, and identify potential gaps and solutions. – Rose James, Ph.D.

She appreciated the community leaders’ level of engagement and awareness in the project. Before collecting data, she was required to give presentations to tribal boards. Before publishing any findings, she presented results to the communities and tribal boards involved in the study. This approach ensured that the women, screening program staff, and healthcare providers who participated in the study received the findings and could potentially use the information to address screening access issues.

More recently, James worked with an interdisciplinary team of researchers to establish a community-planning group (CPG) composed of Yup’ik people from communities that had participated in genetics research with the University of Alaska, Fairbanks’ Center for Alaska Native Health Research. The group included Yup’ik bi-cultural liaisons and scientists from the University of Alaska, Fairbanks and the University of Washington. The goal of the CPG was to learn community preferences about dissemination of genetic research information.

“We had a lot of meetings with this planning group over three years, and what we really accomplished was learning how to build respectful and bi-directional relationships among the research teams and community representatives,” James said.

James directs the Training Core and the Indigenous Genomics Alliance Core for the University of Washington’s Center for Genomics and Healthcare Equality and says that the Center has done much to move forward a national conversation about what community-based participatory research looks like in the context of genomics research. Through the Center, James published an important Genetics in Medicine paper that explores a tribal perspective on data sharing and the implications of tribal governments’ sovereign status on research agreements and data-sharing negotiations.

James was recently named co-director of the Community Outreach and Ethics Core (COEC) of the NIEHS-funded Center for Ecogenetics and Environmental Health at the University of Washington. About ten years ago, James was involved in a COEC project called Native Tradition, Environment, and Community Health (TEACH), which surveyed how Native American people define environmental health. This work led to many products designed by and for tribal communities to bring environmental health education to all generations, from children to elders. James and co-director Kelly Edwards will be working with an advisory team to help determine the next steps for the COEC and for Native TEACH.

Highlighted Publications

  • Trinidad SB, Ludman EJ, Hopkins S, James RD, Hoeft TJ, Kinegak A, Lupie H, Kinegak R, Boyer BB, Burke W. 2015. Community dissemination and genetic research: moving beyond results reporting. Am J Med Genet A 167(7):1542-1550. [Abstract]
  • James RD, Gold DE, St John-BlackBird A, Brown Trinidad S. 2015. Factors that influence mammography use among older American Indian and Alaska Native women. J Transcult Nurs 26(2):137-145. [Abstract]
  • James R, Tsosie R, Sahota P, Parker M, Dillard D, Sylvester I, Lewis J, Klejka J, Muzquiz L, Olsen P, Whitener R, Burke W, Kiana Group. 2014. Exploring pathways to trust: a tribal perspective on data sharing. Genet Med 16(11):820-826. [Abstract]
  • James RD, McGlone West K, Madrid TM. 2013. Launching native health leaders: reducing mistrust of research through student peer mentorship. Am J Public Health 103(12):2215-2219. [Abstract]
  • James R, Starks H. 2011. Bringing the “best science” to bear on youth suicide: why community perspectives matter. In: Achieving Justice in Genomic Translation: Re-Thinking the Pathway to Benefit (Burke W, Edwards K, Goering S, Holland S, Brown Trinidad S, eds.). New York:Oxford University Press, 180–196.

Karen Miller and Laura Weinberg – Bringing Breast Cancer Education to Underserved Groups

August 20, 2015

Breast cancer advocates, Karen Miller and Laura Weinberg.
Breast cancer advocates, Karen Miller and Laura Weinberg.

For more than 20 years, breast cancer advocates Karen Miller and Laura Weinberg have worked with communities on Long Island, New York and surrounding areas. Together, they facilitate breast cancer education and prevention efforts among diverse groups of women, including those who are underserved.

Miller and Weinberg collaborate as community partners with NIEHS-funded researchers at the Icahn School of Medicine at Mount Sinai. Miller and Weinberg’s expertise and years of experience with community groups and in disseminating information on breast cancer prevention to women have been essential in translating Mount Sinai research into meaningful information for communities.

Although motivated by differing experiences with breast cancer, Miller and Weinberg have a shared interest in breast cancer education and risk reduction, with a focus on environmental factors.

Miller’s breast cancer diagnosis in 1987 motivated her to gain a better understanding of the environmental causes of the disease and to begin educating other women. “I wanted to learn about the other causative factors of breast cancer, aside from familial risk,” she explains. In 1992, she founded the Huntington Breast Cancer Action Coalition, Inc. (HBCAC), a nonprofit, grassroots community organization dedicated to the eradication of breast cancer through education, awareness, and policy change.

Weinberg says that she was motivated to explore the causes of breast cancer after she noticed an alarming increase of breast cancer incidence within her Long Island neighborhood in the early 1990s. Through her own research and networking, she learned about studies exploring associations between breast cancer and environmental chemicals. Weinberg became president of the Great Neck Breast Cancer Coalition (GNBCC) in 2001, where she started reaching out to other advocacy and environmental breast cancer groups on Long Island, including the HBCAC.

Early in their partnership, Miller and Weinberg participated in the Long Island Breast Cancer Study (LIBCSP) by assisting researchers with a questionnaire, conducting community forums to gain attention for the project, and mapping breast cancer incidence on Long Island. This 10-year project started in 1993 and was funded by the National Cancer Institute (NCI) and NIEHS. LIBCSP studies resulted in a number of publications.

In 2010, Miller and Weinberg joined Mount Sinai’s Susan Teitelbaum, Ph.D., and Jia Chen, Sc.D., to represent the community perspective on a project studying whether environmental endocrine disrupting chemicals act during specific developmental windows and whether they exert effects independently or synergistically in breast tissue. This research was part of the Breast Cancer and the Environment Research Program (BCERP), which is funded by NIEHS and NCI. Miller and Weinberg made presentations on breast cancer and the environment, as well as advocacy, to a multitude of groups on Long Island and in Cincinnati.

In a recent collaboration, Weinberg and Miller worked with women from the Witness Project of Harlem to prepare them to educate underserved groups about breast cancer and the environment.
In a recent collaboration, Weinberg and Miller worked with women from the Witness Project of Harlem to prepare them to educate underserved groups about breast cancer and the environment.

More recently, Miller and Weinberg collaborated with Mount Sinai’s Barbara Brenner, Dr.P.H., to develop and implement Advocates Mentoring Advocates, a training program designed to prepare women from the Witness Project of Harlem to educate underserved groups about breast cancer and the environment. The Witness Project is a faith-based program focused on breast and cervical cancer education, primarily for African-American women.

Thanks to BCERP Opportunity Funds, Miller and Weinberg were able to mentor and deliver training to the Witness Project of Harlem team using interactive workshops on topics such as exposures to personal care and household products and the associated breast cancer risks. After the training, the Witness Project women created their own presentations on breast cancer and the environment and disseminated this information in their communities. The training workshops were also pulled together into a toolkit that others can use.

The BCERP program has made important contributions to understanding risks for breast cancer. However, the involvement of community partners like Miller and Weinberg has ensured that the findings of research are appropriately translated and shared with affected people. In addition, their advocacy, based on the BCERP research findings, is leading to positive policy changes that may protect individuals from exposure to environmental factors that heighten breast cancer risk. They have truly been “community partners” in research.

Highlighted Publications

  • Brenner B, Evans S, Miller K, Weinberg L, Rothenberg A, Martinez C, Jandorf L. 2015. Breast cancer and the environment: reaching multicultural communities; Advocates Mentoring Advocates. Environmental Justice 8(4):117-125. [Abstract]
  • Teitelbaum S, Chen J, Miller KJ, Weinberg L. 2013. Breast cancer risk: timing and environmental exposures. Cancer inCYTES Magazine 2:2. [Full Text]
  • Osuch JR, Silk K, Price C, Barlow J, Miller K, Hernick A, Fonfa A. 2012. A historical perspective on breast cancer activism in the United States: from education and support to partnership in scientific research. J Womens Health (Larchmt) 21(3):355-362. [Abstract]
  • Miller KJ. 2013. Prevention is the cure. Cancer inCYTES Magazine 2:1. [Full Text]

Jose Antonio Tovar-Aguilar, Ph.D. — Improving Working Conditions for Farmworkers

June 23, 2015

Jose Antonio Tovar-Aguilar, Ph.D.
Tovar presented a poster featuring his work involving CBPR and farmworker communities during the 2012 American Public Health Association Conference in Seattle, Washington. (Photo courtesy of J. Antonio Tovar-Aguilar)

Ranked as one of the most hazardous occupations in the United States, agriculture poses great risks to the health of workers. However, many farmworker communities often lack awareness about these health risks.

Jose Antonio Tovar-Aguilar, Ph.D., is a medical anthropologist with a unique perspective on the impacts of environmental health and disease among farmworker communities. As a pesticide and poison investigator for the Florida Department of Health, he reviews occupational cases of acute pesticide exposure and performs outreach and education for affected communities. Tovar has extensive experience in community-based programs and social marketing methods to prevent disease and injury, primarily among Hispanic and Creole farmworker communities in Florida. Tovar notes that these communities are often faced with many socioeconomic and labor disadvantages due to immigration, poverty, limited education, and low literacy. “Anthropology and community-based participatory research (CBPR) methods are very similar in that each considers community members and scientists as equal partners for research,” explained Tovar. “Both methods consider community members and scientists as experts with similar objectives, but distinct knowledge to address local health issues.”

Tovar is actively involved with the Farmworker Association of Florida, a grassroots organization that empowers and responds to workplace and environmental justice issues that impact farmworkers and low-income communities. In 2011, the organization responded to concerns in the Immokalee community related to severe developmental issues in children of female tomato workers and connected the families to individuals who could provide legal assistance.

“It is important to combine research and education to inform policy change for farmworker communities – the best way to do this is with scientific evidence.”– Antonio Tovar, Ph.D.

 

While managing the Florida Research Prevention Center’s Partnership for Citrus Workers Health project, Tovar directed a campaign to prevent eye injuries among citrus harvesters. Eye injuries are very common among citrus harvesters because of a variety of work-related hazards, such as sand and debris. The campaign used a community-based preventive marketing approach, a combination of CBPR and social marketing strategies, to promote increased use of personal protective equipment (safety glasses) among citrus farmworkers. “Social marketing offers an effective approach to overcome the barriers of behavior change, but it is important to understand your target population,” said Tovar. They found that trained community health workers were effective in promoting the adoption of protective eye wear and providing first aid skills among citrus harvesters.

Through the NIEHS-funded Research to Action program, Tovar teamed up with researchers from Emory University, the Farmworker Association of Florida, and the Farmworker Health and Safety Institute on a project to promote healthy pregnancy and protective behaviors among female farmworkers in central Florida. “There is growing scientific evidence that farm work and pesticide exposure impacts the health of developing children,” Tovar explained. The researchers performed a study to assess female nursery and fernery workers’ extent of exposures to heat, ergonomic stressors, and agricultural chemicals. They also used information from focus groups and surveys to learn about the women’s perception of work hazards and exposures. Levels of urinary pesticide metabolites were used as biomarkers of exposure. They found that some women were underestimating the exposure risks associated with their jobs. They also found a self-reported increased risk of respiratory illness during the first year of life for infants whose mothers worked in ferneries.

Web-based training tool -  children and pesticides
Example graphic from Web-based training tool that shows how children are commonly exposed to pesticides

Using findings from their study, the researchers developed a culturally acceptable, Web-based training tool for female farmworkers of reproductive age: La Salud Prenatal de las Trabajadoras Agricolas (Pregnancy Health for Women Farmworkers). The training tool consists of interactive presentations with graphics, as well as educational videos, and is divided into sections focused on topics related to reproductive health, fetal development, ergonomics, pesticides, heat stress, and associated health effects. A role-play tool was developed to evaluate the effectiveness of the training to educate the women. The role-play tool provides women with different scenarios to act out so they can begin to gauge and strategize ways to overcome various issues they may face during work. The Farmworker Association of Florida recently secured two small grants from private-sector companies to train over 300 female farmworkers in three rural communities in Florida. Originally, the training was open only to women; however, at the women’s request, it was later offered to their significant others.

Moving forward, Tovar and colleagues will be performing a CBPR study to expand on findings related to combinations of heat stress and pesticide exposure among male and female fruit and vegetable harvesters and nursery workers in various Florida locations. Tovar notes that the symptoms of pesticide exposure are very similar to heat stress. The researchers will collect quantitative (biological samples) and qualitative data (surveys) from these populations to examine further how heat stress impacts farmworkers and whether these effects differ based on age, gender, crop, weather conditions, and time spent working in the field.

Highlighted Publications

  • Runkle J, Flocks J, Economos J, Tovar-Aguilar JA, McCauley L. 2014. Occupational risks and pregnancy and infant health outcomes in Florida farmworkers. Int J Environ Res Public Health 11(8):7820-7840. [Abstract]
  • Tovar-Aguilar JA, Monaghan PF, Bryant CA, Esposito A, Wade M, Ruiz O, McDermott RJ. 2014. Improving eye safety in citrus harvest crews through the acceptance of personal protective equipment, community-based participatory research, social marketing, and community health workers. J Agromedicine 19(2):107-116. [Abstract]
  • Flocks J, Vi Thien Mac V, Runkle J, Tovar-Aguilar JA, Economos J, McCauley LA. 2013. Female farmworkers’ perceptions of heat-related illness and pregnancy health. J Agromedicine 18(4):350-358. [Abstract]
  • Runkle JD, Tovar-Aguilar JA, Economos E, Flocks J, Williams B, Muniz JF, Semple M, McCauley L. 2013. Pesticide risk perception and biomarkers of exposure in Florida female farmworkers. J Occup Environ Med 55(11):1286-1292. [Abstract]
  • Monaghan PF, Forst LS, Tovar-Aguilar JA, Bryant CA, Israel GD, Galindo-Gonzalez S, Thompson Z, Zhu Y, McDermott RJ. 2011. Preventing eye injuries among citrus harvesters: the community health worker model. Am J Public Health 101(12):2269-2274 [Abstract]

Daniel Madrigal, M.P.H. – Making Environmental Health Information Accessible for All

June 19, 2015

Daniel Madrigal, M.P.H.
Daniel Madrigal, M.P.H. (Photo courtesy of Daniel Madrigal)

Daniel Madrigal, M.P.H., has long been interested in health communication. Before enrolling in the University of California, Berkeley’s Master of Public Health program, he worked as a health communicator in the area of HIV prevention. While a graduate student, he started working for UC Berkeley’s Center for Environmental Research and Children’s Health (CERCH), an NIEHS-funded organization that collaborates with community partners to address environmental exposures and reduce childhood health risks.

Madrigal worked for five years as CERCH’s Community Outreach Coordinator, focusing on environmental hazards to the Latino farmworker community as part of the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a longitudinal birth cohort project. CHAMACOS investigates exposure to pesticides, along with other chemicals like flame retardants and bisphenol A (BPA), in California’s Salinas Valley; examines how those exposures are related to health outcomes; returns that information to the community; and works with community partners on strategies for reducing exposure.

The CHAMACOS research is often technical and written for scientific publication. Thus, Madrigal stripped study findings down to their most important elements and delivered an understandable and contextually appropriate message to the predominately Mexican-American farmworker community. Having been educated about their exposures, community members became receptive to the strategies for reducing those exposures, and Madrigal relayed the community’s perspectives to the researchers so they could produce practical and relevant guidelines. Those guidelines included washing fruits and vegetables, keeping work clothes outside of the home, and changing out of work clothes before playing with children.

The impact of this outreach has extended beyond the Salinas Valley. “We are seeing a growing awareness of the impacts of the pesticides and other chemicals…not limited to the community we work in,” notes Madrigal. The outreach has helped lead to policy changes, such as new flame-retardant standards in California and proposed EPA changes related to chlorpyrifos.

Madrigal is passionate about connecting environmental health research to the larger public and sees the growing importance of this work as scientists find more connections between small exposures and adverse health outcomes. “I think that the public is going to be aided by those of us who can really break down the science and communicate why environmental health research matters.”

In March 2015, Madrigal left CERCH to begin working as a health educator for the California Environmental Health Tracking Program. In his new position, he will continue developing ways to make environmental health information accessible and practical for the residents of California.

Catherine Karr, M.D., Ph.D., M.S. – Bridging Environmental Health and Pediatrics

June 4, 2015

Catherine Karr, M.D., Ph.D., M.S.
Catherine Karr, M.D., Ph.D., M.S.

Anyone who has suffered respiratory irritation or distress when the Air Quality Index climbs above 100 knows that our environment plays a very important role in our health. However, environmental health is an underappreciated component of primary care, including pediatrics. Many primary care providers simply do not have the training to address their patients’ environmental health concerns.

Catherine Karr, M.D., Ph.D., M.S., is one of the physicians working to rectify this situation. After college, she served as a Peace Corps volunteer in West Africa and saw firsthand the connection between environmental conditions and people’s health. Afterwards, she started working in the field of public health but came to feel that she did not know enough about the disease process and how individual-level disease intersected with population-level health. Thus, she took a break from her doctoral program in epidemiology, entered medical school, and eventually became a board-certified pediatrician.

As a physician scientist, Karr is interested in better understanding the connection between environmental exposures and children’s health among agricultural communities in Washington State. She served as the Principal Investigator for the NIEHS-funded Aggravating Factors of Asthma in a Rural Environment project, which sought to determine the environmental factors that trigger asthma symptoms in farmworkers’ children. While we know from the CDC that 9.3% of U.S. children have asthma, the data regarding rural and farmworker asthma incidents are sparse. Thus, projects such as this fill in some important gaps, and the researchers found that indeed, an increase of PM2.5 levels was associated with increased asthma symptoms among study participants.

Currently, Karr leads the new Home Air in Agriculture – Pediatric Intervention Trial, also funded by NIEHS. This study seeks to address the problem of indoor air pollution (and resulting pediatric asthma) in a low-income agricultural community. Most of the studies regarding the connection between indoor air and pediatric asthma have focused on urban settings, but the same factors apply in rural areas: poverty; dilapidated housing with mold, moisture, and pests; and the infiltration of outdoor pollutants into indoor space. In rural communities, we also see the increased use of wood-burning appliances for heat. In this new project, researchers will measure the effect of supplementing an asthma-related educational intervention with High-Efficiency Particulate Air (HEPA) filters.

Karr also serves as director of the Northwest Pediatric Environmental Health Specialty Unit (NW PEHSU), based at the University of Washington. PEHSUs comprise a nationwide network of clinicians and researchers who provide medical consultation, train healthcare providers on environmental health issues, distribute materials to the general public, and promote environmental health as an integral part of pediatrics. Karr speaks during Grand Rounds and noon conferences at clinical sites throughout the Northwest region, including rural communities, to help connect research with everyday clinical practice. In this face-to-face training, she hopes to enhance the confidence and capability of healthcare providers so they can identify environmental health problems and incorporate related prevention messages into routine primary care.

The CDC reports that “asthma prevalence increased from 7.3% in 2001 to 8.4% in 2010.” According to Karr, we do not know exactly why this is the case since asthma is a complex disease with many factors—genetic, environmental, and social—that work in concert. However, researchers are starting to ascertain what causes asthma and what can make it worse. Karr’s research with agricultural communities and engagement with clinicians are important contributions to this larger public health effort.

Highlighted Publications

  • Loftus C, Yost M, Sampson P, Arias G, Torres E, Vasquez VB, Bhatti P, Karr C. 2015. Regional PM2.5 and asthma morbidity in an agricultural community: a panel study. Environ Res 136:505-512.[Abstract]
  • Armstrong JL, Fitzpatrick CF, Loftus CT, Yost MG, Tchong-French M, Karr CJ. 2013. Development of a unique multi-contaminant air sampling device for a childhood asthma cohort in an agricultural environment. Environ Sci Process Impacts 15(9):1760-1767.[Abstract]
  • Roberts JR, Karr CJ, de Ybarrondo L, McCurdy LE, Freeland KD, Hulsey TC, Forman J. 2013. Improving pediatrician knowledge about environmental triggers of asthma. Clin Pediatr 52(6):527-533.[Abstract]
  • Paulson JA, Karr CJ, Seltzer JM, Cherry DC, Sheffield PE, Cifuentes E, Buka I, Amler RW. 2009. Development of the pediatric environmental health specialty unit network in North America. Am J Public Health 99(Suppl 3):S511-S516. [Abstract]

Dina G. Markowitz, Ph.D. - Bridging the Gaps in Science and Environmental Health Education

May 15, 2015

Dina G. Markowitz, Ph.D.

Dina Markowitz, Ph.D., is the Director and Founder of the University of Rochester’s Life Sciences Learning Center - a unique center that emphasizes hands-on learning to inspire science literacy and education throughout the greater Rochester area and beyond.
(Photo courtesy of Dina Markowitz)

Although Dina G. Markowitz, Ph.D., is a molecular biologist by training, she states that her “greatest joys come from working with teachers and students to promote science education.” Markowitz’s involvement with the Environmental Health Sciences Center at the University of Rochester has broadened her interests in science education and also has helped her realize the limited view of environmental health in classrooms. Markowitz’s primary focus involves creating and evaluating enrichment programs and tools that target biomedical and environmental health science education. She has extensive experience developing and coordinating science education and outreach programs for students, teachers, and the general community focused on a wide range of disciplines, including genetics, microbiology, immunology, and environmental medicine.

As the Director and Founder of the University of Rochester’s Life Sciences Learning Center (LSLC) (active since 2000), Markowitz directs numerous programs for local schools, summer science camps, and science teacher workshops in order to promote the use of hands-on, inquiry-based curricula to teach students. As a unique, science inquiry center, the LSLC uses hands-on learning to inspire science literacy and enthusiasm for students and community members throughout the greater Rochester area. The LSLC sponsors outreach programs, such as “LSLC Field Trips” and “LSLC On the Road,” which offer middle and high school students the opportunity to learn and use basic lab skills within fully equipped labs at the University of Rochester or in classrooms at their schools. The LSLC also offers a wide variety of online curriculum materials focused on topics such as neuroscience, cancer biology, nanoparticles, and environmental health. The online lessons feature different hands-on components that have been extensively field-tested – some examples include the “Kidney Crisis” (general biology) and “Family Secrets” (genetics/bioethics) modules. According to Markowitz, “these programs are exceptionally effective, with the online lessons becoming more popular due to school budget cuts on field trips.”

Markowitz also promotes education for science, technology, engineering, and mathematics (STEM) disciplines. “Promoting STEM disciplines is important because most students don’t realize how many careers actually require basic STEM skills,” said Markowitz, who also works with graduate students to help prepare them for teaching in STEM disciplines. Markowitz is a member of the steering committee for the Center for the Integration of Research, Teaching and Learning (CIRTL) at the University of Rochester, which collaborates with a broad network of other CIRTL institutions to influence graduate preparation in teaching and learning. CIRTL is an NSF-funded consortium driven by the mission to use graduate education as a leverage point for developing national STEM faculty to be effective in teaching diverse student audiences. “Graduate students in science programs or medical school are often not exposed to any teaching practices, and CIRTL aims to enhance these students’ teaching skills,” said Markowitz, who is currently mentoring a graduate student who will design a “teaching as research” project to explore effective methods for teaching undergraduates.

Life science education as a whole is very important, but there is a very limited view of environmental health education in school-based learning. We are working to expand that view. – Dina G. Markowitz, Ph.D.

Markowitz is now partnering with Katrina Korfmacher, Ph.D., Director of the Community Outreach and Engagement Core at the University of Rochester’s Environmental Health Sciences Center, on a small business technology transfer (STTR) grant to develop hands-on science kits that focus on various environmental health topics. These science kits are designed to facilitate the integration of environmental health science activities into secondary school classrooms and teachers’ existing curricula. Each kit focuses on a different environmental health issue, such as lead poisoning, water quality, or breast cancer, with an emphasis on concepts such as dose-response relationships and effects and prevention of environmental exposures. Eight different prototypes of the science kits are being pilot tested during the spring semester of 2015 by 32 teachers across the country so as to evaluate the effectiveness of the kits in a variety of classroom settings. Teachers are extremely eager to try out the new environmental health kits – almost 700 teachers applied to be pilot testers. In coming years, larger scale field tests will be used to collect pre- and post-evaluation data from students to determine how well they learned using the science kits. This innovative project uses a unique combination of educational approaches to help teachers incorporate hands-on activities in the classroom and increase students’ understanding of environmental health science concepts. This STTR project involves collaboration between the University of Rochester and Science Take-Out, LLC, a small business startup founded in 2008 by Markowitz. Science Take-Out previously had been awarded NIH small business innovation research (SBIR) grants, which have been used to develop and commercialize science kits based on curriculum materials initially created through Markowitz’s NIH Science Education Partnership Award (SEPA) grants. While the SBIR/STTR award in STEM education is novel to NIEHS, it is a valuable grant mechanism for creating products that engage and educate young students in environmental health sciences.

Highlighted Publications

  • Markowitz DG, Holt S. 2011. Simulating science: manipulative models and small-scale simulations that promote learning of complex biological concepts. The Science Teacher. 78(5). [Abstract]
  • Markowitz DG, Dupré MJ, Holt S, Chen S, Wischnowski M. 2008. BEGIN partnership: using problem-based learning to teach genetics and bioethics. American Biology Teacher. 70(7):421-425. [Abstract]
  • Markowitz DG, DuPré MJ. 2007. Graduate Experience in Science Education: the development of a science education course for biomedical science graduate students. CBE Life Sci Educ. 6(3):233-242. [Abstract]

Allan C. Just, Ph.D. – Addressing Children’s Environmental Health in Vulnerable Populations

April 24, 2015

Allan C. Just, Ph.D
Allan C. Just, Ph.D., is an environmental epidemiologist and postdoctoral fellow in the Harvard School of Public Health. He is a 2014 recipient of the NIEHS Pathway to Independence Award. (Photo courtesy of Allan C. Just)

Allan C. Just, Ph.D., is a postdoctoral research fellow in the Harvard School of Public Health’s Department of Environmental Health. As an environmental epidemiologist with a primary focus on children’s health, he explores how the interplay of prenatal exposures and epigenetics impacts children’s health. Partnering with researchers in the Children’s Environmental Health and Disease Prevention Research Center and the Superfund Research Program at Harvard University, Just’s research focuses on how environmental exposures affect various child health outcomes, including asthma, autism, and obesity. He notes that his increasing awareness of the developmental origins of health and disease (DOHaD) concept sparked his interest in children’s environmental health. DOHaD stems from the idea that prenatal and early-life environmental exposures can alter development in a way that leads to disease and poor health later in life – or, as Just comments, “that the root of lifetime health or illness begins prenatally.”

In 2012, Just earned his Ph.D. in Environmental Health Sciences at Columbia University. During his graduate tenure, he worked with Robin Whyatt, Dr.P.H., and others in the Columbia Center for Children’s Environmental Health to explore associations between prenatal exposure to phthalates and childhood asthma in an urban cohort in New York City. Prior to studying at Columbia, he worked as a research assistant and IT manager at the Silent Spring Institute under the direction of Julia Brody, Ph.D. At Silent Spring, he collected information about home exposures to endocrine-disrupting chemicals in an environmental justice community impacted by refineries in Richmond, California. The research team worked closely with community members to discuss their concerns and to report back results from the study. “My work with the Silent Spring Institute gave me an appreciation for community-based participatory research and an early understanding of the significance of community engagement in environmental health research,” explained Just. These experiences allowed Just to see firsthand how important community engagement is to environmental public health, and they have served an important role in preparing him for his current research projects and engagement with international communities.

As a 2014 recipient of the NIEHS K99/R00 Pathway to Independence Award, Just will receive mentoring and financial support to pursue new research questions. The award is supporting his research to use innovative epigenomic approaches to determine how prenatal exposure to phthalates and bisphenol A can alter the fetal epigenome and how these changes influence the risk of childhood obesity. This research will include the analysis of umbilical cord samples and health outcome data from PROGRESS and PRISM, two urban cohorts of mothers and children that face health disparities in Mexico City and Boston/New York, respectively. This interdisciplinary project will use approaches and expertise from various disciplines, including environmental and epigenetic epidemiology, pediatrics, and biostatistics. “I am very fortunate to have a great team of mentors who offer both formal and informal guidance, and whose collaborations contribute to my research goals,” he said.

Allan C. Just, Ph.D. and colleagues
Allan C. Just, Ph.D. (second from left) and colleagues stand in front of the National Institute for Public Health in Cuernavaca, Mexico. While there, they met with researchers and policy makers to discuss approaches that can be used to address air pollution exposure in Mexico City. (Photo courtesy of Allan C. Just)

Just is actively involved in research collaborations to address concerns about exposure to air pollution and fine particulate matter (PM) in Mexico City. Since Mexico City is part of a basin surrounded by mountains, levels of exposure to air pollution are very high, but there is very little information about the types of exposures that are occurring. Just and colleagues are constructing a model that links air pollutant data collected by NASA satellites with a person’s residence to determine his/her level of PM exposure from 2004 to the present. In November 2014, Just and his colleagues traveled to the National Institute of Public Health in Cuernavaca, Mexico, where they met with scientists and policy makers to present the model as an approach that can be used to address air pollution concerns in Mexico City. Moving forward, the research team will work with investigators involved in the Mexico National Survey of Health and Nutrition to combine data from the air pollution model and health survey in order to quantify health impacts associated with exposure to air pollution in the area. They also will use the data to determine whether particular groups or neighborhoods face increased susceptibility to these exposures.

Just offers some critical advice for young investigators interested in pursuing a career in environmental health research in academia. “It is very important for young investigators to find good mentors, as they play an incredibly important role in terms of guidance. It is equally as important for a young investigator to identify mentors that share their same enthusiasm and energy regarding interests in environmental health research.”

Highlighted Publications

  • Braun JM, Wright RJ, Just AC, Power MC, Tamayo Y Ortiz M, Schnaas L, Hu H, Wright RO, Tellez-Rojo MM. 2014. Relationships between lead biomarkers and diurnal salivary cortisol indices in pregnant women from Mexico City: a cross-sectional study. Environ Health 13(1):50. [Abstract]
  • Raz R, Roberts AL, Lyall K, Hart JE, Just AC, Laden F, Weisskopf MG. 2015. Autism spectrum disorder and particulate matter air pollution before, during, and after pregnancy: a nested case-control analysis within the Nurses’ Health Study II Cohort. Environ Health Perspect 123(3):264-270. [Abstract]
  • Karwowski MP, Just AC, Bellinger DC, Jim R, Hatley EL, Ettinger AS, Hu H, Wright RO. 2014. Maternal iron metabolism gene variants modify umbilical cord blood lead levels by gene-environment interaction: a birth cohort study. Environ Health 13:77. [Abstract]
  • Whyatt RM, Perzanowski MS, Just AC, Rundle AG, Donohue KM, Calafat AM, Hoepner LA, Perera FP, Miller RL. 2014. Asthma in inner-city children at 5-11 years of age and prenatal exposure to phthalates: the Columbia Center for Children’s Environmental Health Cohort. Environ Health Perspect 122(10):1141-1146. [Abstract]
  • Just AC, Whyatt RM, Perzanowski MS, Calafat AM, Perera FP, Goldstein IF, Chen Q, Rundle AG, Miller RL. 2012. Prenatal exposure to butylbenzyl phthalate and early eczema in an urban cohort. Environ Health Perspect 120(10):1475-1480. [Abstract]

Related Link

All About Phthalates (Podcast)
Phthalates are a family of chemicals used in many plastics and scented products. Recent research has linked prenatal and early childhood phthalate exposure with a variety of adverse health effects. In this podcast, we explore the latest scientific findings and offer tips on how to reduce your exposure.

Marti Lindsey, Ph.D. — Making Environmental Health Information Meaningful to All

April 8, 2015

Marti Lindsey, Ph.D., is committed to helping people understand how the environment can affect their health. As Director of the Community Outreach and Education Program (COEC) of the Southwest Environmental Health Sciences Center (SWEHSC) at the University of Arizona (UA), she collaborates with basic and clinical scientists to integrate public health outreach and translational opportunities with environmental health sciences research. She draws upon her past experiences as a psychiatric social worker and librarian to share environmental health information with students, teachers, Native American communities, and the general public.

Headshot of Marti Lindsey
A leader in the field of environmental health literacy, Marti Lindsey, Ph.D., helps people better understand local environmental health issues so they can take action to improve their environments and live healthier lives.

Lindsey’s interest in environmental health outreach is based on health literacy principles. Her passion for effective health communication started at a health fair in 2002 when she found that many of the outreach materials she helped to create had been discarded. This spurred Lindsey and longtime partner, Tucson Water, to evaluate the materials in an effort to understand why people were not reading them, and how they could be improved. Ever since, Lindsey has been committed to identifying best practices for effective material development, such as using plain language, so that environmental health messages are meaningful and actionable to all.

Under Lindsey’s guidance, the COEC develops materials and conducts outreach and education activities related to SWEHSC research topics, such as arsenic exposure, asthma, and chemical exposures, as well as other health issues related to air toxics, water contamination, pesticides, and hazardous waste. In recognition of her outreach efforts, Lindsey received the 2013 Society of Toxicology (SOT) Public Communications Award. This award recognizes an individual who has made major contributions to broadening the awareness of the general public on toxicological issues through any aspect of public communications.

One successful outreach approach Lindsey helped develop is the information walk, a multi-station approach for teaching the public about environmental contaminants. Each station in an information walk covers a different topic area, from general principles of environmental health and toxicology to specific information about how contaminants can enter and cause damage to the body. “Information walks use a tiered approach to information which allows people to choose how much and what they want to learn about a topic,” explained Lindsey. The COEC has successfully used information walks to teach community members about asthma and allergies in schools and at public events for tribal audiences.

Marti Lindsey speaking to a class
Lindsey (center, red shirt) speaks to a class of Native American students about environmental health issues. (Photo courtesy of Marti Lindsey)

Lindsey also leads the COEC’s efforts to develop strong partnerships with tribal communities. Lindsey’s personal experiences with Native Americans — she is married to a Cherokee and lived on the Navajo reservation in northern Arizona for many years — gives her a special insight into the Native perspective about science and the environment. She uses this knowledge to help tribal communities address their environmental issues, especially those tied into the research themes of the SWEHSC. Lindsey has also developed a set of guiding principles  for establishing and maintaining research partnerships with Native American communities. “Tribal partnerships grow by patiently listening to the community’s needs and questions,” Lindsey explained, “The most important thing a tribe can take away from my presence at a meeting or gathering is to know that the Center is a resource for them.” 

She also values the importance of collaborating with other COECs who work with tribal communities. By partnering with the COEC at the University of Washington (UW) on the Native Environmental Health Stories project, Lindsey was able to learn even more about tribal knowledge of environmental health issues. The outcome of the collaboration with the UW COEC is the new magazine, Indigenous Stewards, which was created to give tribal communities a platform to begin to discuss environmental issues in their own communities. A limited number of hard copies of Indigenous Stewards were printed in April 2015, and the magazine will be available online early Summer 2015.

Getting students interested and engaged in environmental health research is another of Lindsey’s interests. To this end, she serves as Co-Director of the UA Keep Engaging Youth in Science (KEYS) program. KEYS is a summer internship program that provides talented high school students hands-on research experiences in UA laboratories. Since KEYS began in 2007, more than 85 UA faculty members have mentored 232 student interns, with 51% of the students coming from backgrounds underrepresented in science careers.

What’s next for Lindsey? In 2015, Lindsey began working on a project funded by Tucson Water to develop and test various risk communication strategies. The goal of the project is to provide Tucson Water with a toolkit of validated risk communication approaches they can use to help residents understand water contamination issues stemming from a nearby Superfund site as well as a number of emerging contaminants. Over the course of the five year project, Lindsey and her team will use communication strategies they’ve found to be successful in the past as a template for developing new materials specific to the community’s water contamination issues. They will then use focus groups and surveys to determine whether the materials successfully communicate exposure and risk messages. 

Katrina Smith Korfmacher, Ph.D. – Addressing Environmental Health and Policy Needs of Communities

March 20, 2015

As a policy scientist, Katrina Smith Korfmacher, Ph.D., explores how environmental health knowledge is created, communicated, and used, and how these processes are affected by the values of different stakeholder groups. As the Director of the Community Outreach and Engagement Core (COEC) at the University of Rochester’s Environmental Health Science Core Center, Korfmacher focuses on community engagement and translating environmental health research to help inform relevant policy at the local, state, and federal levels. Her primary efforts are directed towards building partnerships within and surrounding Rochester, New York to address environmental health issues like lead poisoning and hydraulic fracturing, and considering the role of community groups in the policy process. She has initiated other outreach programs and responded to community needs including concerns about risks from air pollution, the consumption of Lake Ontario fish, and environmental contributors to obesity.

Korfmacher sampling for lead

Korfmacher sampling lead dust on a home porch (March 2010) as part of a HUD-funded study to test lead levels on residential porches in a Rochester neighborhood.
(Photo courtesy of Adam Fenster)

Korfmacher is actively involved with educational outreach activities that promote lead removal and healthy homes through systems change approaches. Although several federal and state laws have helped reduce the rates of lead poisoning within the last three decades, it still remains a significant environmental health risk, particularly in low-income, urban neighborhoods with older houses. Serving on the Rochester-based Coalition to Prevent Lead Poisoning’s Executive and Governmental Relations Committees, Korfmacher helped to bring together diverse community stakeholders to pass local lead ordinances in Rochester. She is continuing to follow-up with lead issues in the Rochester communities, including partnering with the National Center for Healthy Housing, the City of Rochester, and Action for a Better Community in recent assessments of lead dust on residential porches. She notes that “this study has some pretty interesting policy implications because there has never been a porch lead-dust standard.”

Korfmacher also works with the Rochester Healthy Homes Partnership to reduce environmental hazards in the home.  Between 2006 and 2009, she partnered with community groups to operate an interactive Healthy Home museum that educated over 3,000 visitors about home environmental health risks such as lead, injury hazards, asthma triggers, chemical poisoning, and radon. The Healthy Home Museum was used to demonstrate low-cost methods for reducing hazards, such as dust mite covers for beds and pillows.

Policy science involves the use of multidisciplinary frameworks for problem solving – this is a good approach for making progress on complex local environmental health issues. – Katrina Smith Korfmacher, Ph.D.

Korfmacher highlights the importance of building partnerships with other COECs to address environmental health concerns that are of regional or national interest. In collaboration with COECs at the University of Cincinnati and University of North Carolina at Chapel Hill, Korfmacher conducted a prospective needs assessment to integrate community leaders’ input into the unconventional natural gas development (UNGD) environmental health research agenda. The assessment emphasized that the inclusion of community concerns at the outset of the UNGD research agenda will help to inform decision making and policy that ultimately protects public health. The COECs conducted interviews with community leaders, landowners, government representatives, educators, and environmental activists across three states (New York, North Carolina, and Ohio) where UNGD was expected to expand over the next several years. Interviewees’ responses emphasized concerns related to various exposures (e.g., water and air), quality of life, health care burdens, and the health and economic impacts of UNDG on vulnerable populations. Korfmacher mentions a major take-home point from this assessment is that “current research and decision-making institutions are not sufficient to integrate, model, adapt, monitor, and communicate information in ways that can address these diverse community concerns.” The COECs identified a need for new frameworks to involve communities in the UNGD research agenda and policy process.

Korfmacher believes that healthcare reform affords some interesting opportunities to reach a broad range of people and build on environmental public health efforts. Her COEC is currently working to integrate environmental health messages in group prenatal care and nurse home visiting programs for high risk mothers. Korfmacher notes that “health care providers generally receive very little training in environmental health during nursing or medical school. The biggest challenge is getting prenatal care providers and facilitators to appreciate the importance and relevance of environmental health information for high risk pregnant women, to understand the information well enough to be comfortable communicating it, and to connect with community resources to which they can refer women and their families for support in environmental prevention measures.”

Highlighted Publications

  • Korfmacher KS, Aviles K, Cummings BJ, Daniell W, Erdmann J, Garrison V. 2015. Health impact assessment of waterway decisions. Int J Environ Res Public Health, 12(1): 300-21. [Abstract]
  • Wilson J, Dixon SL, Jacobs DE, Akoto J, Korfmacher KS, Breysse J. 2014. An investigation into porch dust lead levels. Environ Res 137: 129-35. [Abstract]
  • Korfmacher KS, Elam S, Gray KM, Haynes E, Hughes MH. 2014. Unconventional natural gas development and public health: toward a community-informed research agenda. Rev Environ Health 29(4): 293-306. [Abstract]
  • Korfmacher KS and Garrison V. 2014. Partnering to reduce environmental hazards through a community-based “Healthy Home Museum”: education for action. Environmental Justice 7(6): 158-65. [Abstract]
  • Korfmacher KS, Suter BJ, Cai X, Brownson SA, Dozier AM. 2014. Environmental risks and children’s health: what can PRAMS tell us? Matern Child Health 18(5): 1155-68. [Abstract]
  • Korfmacher KS and George V. 2012. Educating refugees to improve their home environmental health. J Public Health Manag Pract 18(5): 469-73. [Abstract]
  • Korfmacher KS, Ayoob M, Morley R. 2012. Rochester’s lead law: evaluation of a local environmental health innovation. Environ Health Perspect 120(2): 309-15. [Abstract]

Tap Bui – Empowering Communities to Bounce Back after Deepwater Horizon

February 25, 2015

Tap Bui, right, a community organizer at the MQVN Community Development Corporation, uses “power mapping” to educate community members.

Tap Bui, right, a community organizer at the MQVN Community Development Corporation, uses “power mapping” to educate community members.
(Photo courtesy of Tap Bui)

The Deepwater Horizon oil spill was a disaster for the Gulf Coast, and the Vietnamese community was hit especially hard. Approximately 40,000 Vietnamese work in the region, and a third of those work in the seafood industry.

In the face of this crisis, lifelong Louisiana resident Tap Bui started working for the MQVN Community Development Corporation (MQVNCDC). From the beginning, her office was inundated with community members who were very concerned about the spill, especially since it coincided with the beginning of fishing season. They were worried about a diminished seafood supply, whether the fish would be safe to eat, and threats to their livelihood. “At that time,” according to Bui, “no one knew that the fishing season was completely gone for the entire year.”

Having been active in her New Orleans community for nearly a decade, Bui knew that she had to jump into action. She helped to organize a town hall meeting with the goal of helping others understand the issues of concern, while building a sense of community, identity, and hope. The meeting made clear that a large segment of the Vietnamese fishing community faced significant language barriers. Though many are not proficient in English, the vast majority of oil spill notices were published in that language. Thus, MQVNCDC started providing translation services, such as interpreters at key community events, so that people could understand better the health risks and concerns stemming from the spill. In addition, MQVNCDC hosted interpretation training sessions focused on translating key terminology and providing safety information to the Gulf fishing industry. Ultimately, 15 people received training, and many were hired by BP to serve as interpreters.

A power map illustrating the claims process for the Deepwater Horizon compensation fund
A power map illustrating the claims process for the Deepwater Horizon compensation fund.
(Photo courtesy of Tap Bui)

In order to empower the Vietnamese community to participate in the compensation fund that BP set up after the spill, MQVNCDC worked with a pro-bono legal organization to create a “power map” that educated people on how the claims process worked. The map included pictorial representations of key figures (e.g., Kenneth Feinberg, the former administrator of the compensation fund) and processes (e.g., claims approval/rejection, litigation, etc.). While many in the Vietnamese community initially thought they would need to beg for every nickel and dime, the exercise demonstrated that BP had a legal obligation to compensate those whose livelihoods were negatively affected by the spill. Bui reminded people: “This is not money you should be begging for; this is money that’s owed to you.” MQVNCDC then trained others to conduct their own mapping sessions.

Currently, MQVNCDC is working with Tulane University to implement the Transdisciplinary Research Consortium for Gulf Resilience on Women’s Health (GROWH) study. Using community-based participatory research (CBPR) methods, the study focuses on (1) how the Deepwater Horizon oil spill has affected reproductive-age women, (2) how real and perceived exposures differ among reproductive-age women, (3) how community resilience can be built through disaster mobile health, and (4) how best to translate the science back to the community. In addition to working with the study team as a liaison to her community, Bui is an active participant in the Deepwater Horizon Research Consortia’s Steering Committee and Community Outreach & Dissemination Working Group.

Bui has worked successfully with people affected by the Deepwater Horizon oil spill—facilitating cultural competency, empowering communities, and building a sense of hope—and remains committed to continuing this work into the foreseeable future.

Highlighted Publications

  • Wennerstrom A, Bui T, Harden-Barrios J, Price-Haywood EG. 2015. Integrating community health workers into a patient-centered medical home to support disease self-management among Vietnamese Americans: lessons learned. Health Promot Pract 16(1):72-83. [Abstract]
  • Wilson MJ, Frickel S, Nguyen D, Bui T, Echsner S, Simon BR, Howard JL, Miller K, Wickliffe JK. 2015. A targeted health risk assessment following the Deepwater Horizon oil spill: polycyclic aromatic hydrocarbon exposure in Vietnamese-American shrimp consumers. Environ Health Perspect 123(2):152-159. [Abstract]

Mitchel Rosen, Ph.D. – Keeping Workers and Emergency Responders Safe

February 2, 2015

Mitchel Rosen, Ph.D.
Mitchel Rosen, Ph.D., instructs a student on the correct use of personal protective equipment (PPE). (Photo courtesy of Mitchel Rosen, Ph.D.)

According to the Occupational Safety and Health Administration, in the United States, “4,405 workers were killed on the job in 2013.” This works out to an average of “85 a week or more than 12 deaths every day.” These figures are a stark reminder that even with the advances in workplace safety over the decades, we still have a lot of work to do to ensure people can return home safe and sound after their shift.

Mitchel Rosen, Ph.D., has been involved with occupational safety and health (OSH) and worker training for almost three decades. In 1987, while working on his master’s degree in public health, he conducted fieldwork under the supervision of Audrey Gotsch, Dr.P.H., of the University of Medicine and Dentistry of New Jersey (which has since merged with Rutgers). During her career, Gotsch oversaw programs that trained thousands of workers in OSH, and it was under her guidance that Rosen became interested in the field. In 1988, Gotsch hired him to serve as Project Coordinator for the Hazardous Waste Training Center, and he has been there ever since.

The real important thing is that the workers who are doing the jobs—whether it’s a ‘green job’ or hazardous waste or whatever you want to call it—that it’s a safe job. … We’re providing the safety training so people can go home at the end of the day and be with their families and not have to worry about injuries or illnesses. – Mitchel Rosen, Ph.D.

Rosen currently serves as the Principal Investigator for the NIEHS-funded New Jersey / New York Hazardous Materials Worker Training Center, which (a) trains people on how to protect themselves when handling hazardous waste and responding to disasters and (b) provides green jobs training to members of underrepresented groups. According to Rosen, the Center strives to help workers develop a big-picture view of the challenges they face. Rather than focusing solely on narrow tasks, workers need to ask themselves: What are the hazards that I will encounter at a site? What are the risks? What do I need to do to protect myself? Workers, including (or especially) emergency responders, need to slow down and act deliberately in order to stay safe.

The Center’s trainings include exercises and skills assessments that measures students’ takeaway knowledge. For example, during the 40-hour Hazardous Waste Training, students participate in a Mock Hazardous Waste Site Assessment Project. Each person is assigned a role (e.g., project manager, member of the entry team, etc.), and instructors can see whether students make appropriate decisions based on the inputs they receive from the exercise. In addition, the Center asks its students to name a change that they will make in their work, based on the training they have received; the Center then follows up in three months to ask whether they actually implemented that change.

Aside from the NIEHS Center, Rosen wears many other hats. For example, he directs several projects for the NIOSH-funded New York and New Jersey Education and Research Center, which provides both graduate and continuing education in the field of OSH. One of the projects involves looking at OSH in a holistic fashion, recognizing that a worker’s health and safety do not boil down to just her physiological condition or her workstation’s ergonomics. A variety of factors and disciplines (e.g., medicine, industrial hygiene, etc.) come into play.

This more holistic perspective will serve the future of OSH well. Rosen credits the staff of the NIEHS Worker Training Program (WTP) with expanding the field of hazardous materials training so that it can be applied to new situations (e.g., Hurricane Sandy, the Ebola outbreak) and new audiences (e.g., volunteers / citizen responders). We now need to look at disaster response in a broader, community-oriented fashion, and the lessons that WTP grantees have learned will guide that response for years to come.

Highlighted Publications

  • Rosen MA. 2012. Impact of NIOSH education and research centers on workplace practice. [Dissertation]
  • Rosen MA, Caravanos J, Milek D, Udasin I. 2011. An innovative approach to interdisciplinary occupational safety and health education. Am J Ind Med 54(7):515-520. [Abstract]
  • Bandera C, Marsico M, Rosen M, Schlegel B. 2006. Wireless just-in-time training of mobile skilled support personnel. Proc SPIE 6250. [Abstract]

Alexandra Anderson – Engaging Young People in Environmental Health

Alexandra Anderson
Alexandra Anderson (left) and Amanda Paez (right), who helped facilitate Youth Advisory Board meetings, with board members Rachael Cornejo, Samantha Wilson, and Shelby Aszklar at the 2014 Honor Thy Healer Awards. (Photo courtesy of Alexandra Anderson)

Alexandra Anderson values the unique perspectives of adolescents and has always enjoyed working with this age group. As leader of the Youth Advisory Board for the Cohort of Young Girls’ Nutrition, Environment, and Transitions (CYGNET) Study, she is developing and implementing creative ways to engage the study participants in environmental health.

Prior to her role with the Youth Advisory Board, Anderson worked with adolescents as a youth mentor and tutor for victims of domestic violence with The Violence Intervention Program. She was also curriculum director for the Obesity Prevention in Neglected Neighborhoods (OPT-INN) program, which served low-income, minority adolescents living in South Central Los Angeles.

The CYGNET study is part of the Breast Cancer and the Environment Research Program, which is funded by NIEHS and the National Cancer Institute. The study aims to identify developmental, lifestyle, and environmental influences on the timing of puberty by following 444 girls in the San Francisco Bay Area. CYGNET, which is led by Lawrence Kushi, Sc.D., at the Kaiser Permanente Division of Research, enrolled girls 6 to 8 years old who are now 14 to 17 years old. By following these girls, scientists hope to understand better why there is a trend toward girls entering puberty earlier, which is a risk factor for breast cancer.

Two years ago, Anderson and her colleagues recruited about 25 study participants to join the CYGNET Youth Advisory Board. Although the board began as a way to get feedback from the girls regarding study materials and activities, Anderson wanted to make the meetings more engaging and felt that the girls should gain something from the experience. Thus, she and other facilitators began teaching the Youth Advisory Board about environmental health research and the research process.

During the board’s second year, Anderson and the other facilitators engaged the girls in a photo-voice project. For this, the girls applied what they had learned about environmental health by going into their communities, schools, and homes and taking pictures where they saw environmental health issues, such as chemicals in their personal care products or traffic they experienced driving home. This project is now displayed as an art exhibit that shares the Youth Advisory Board’s perspective on environmental health in the Bay Area.

Anderson believes that using different types of media is the best way to reach adolescents, who are exposed constantly to media through their televisions, smartphones, and computers. The photo-voice project drew on her previous experience as program assistant for the University of Southern California (USC) Annenberg Norman Lear Center’s Hollywood Health & Society program, where she helped provide accurate information for health storylines on television and promoted inclusion of environmental health storylines in comic books.

Adolescents have a unique perspective and are also the generation in which you can make the most difference. It is harder to change the habits of adults, but when you work with young people you can build on what they will be doing for the rest of their lives. – Alexandra Anderson

As the Youth Advisory Board enters its third year, the facilitators plan to train the girls in peer-education models to enable them to share their environmental health knowledge with groups in their communities. The board also will be open to more members of the cohort, and Anderson is excited to teach even more girls about environmental health.

Anderson says it has been amazing to see the girls grow in their interactions with each other and gain confidence in public speaking. The girls have been interviewed by NPR, the local ABC television station, the San Francisco Chronicle, and the Marin Independent Journal. She hopes that this exposure to research will inspire some of them to consider careers in science, technology, engineering, and math fields.

In May 2014, Anderson and research advisors who helped her run the Youth Advisory Board received the Community Breast Cancer Researcher Award in recognition of their work (video). The award was part of the Honor Thy Healer Awards presented each year by Zero Breast Cancer, a community-based organization dedicated to prevention and finding the causes of breast cancer through local participation in scientific research. Anderson said that the awards ceremony was a special opportunity to share recognition with the girls, some of whom attended the event. She feels the CYGNET project would not be as successful without the board’s input, which helped increase retention and response rates.

Alexandra has a Master of Public Health degree with an emphasis in Global Health and Health Policy from USC, where she was a USC Institute for Global Health Student Fellow, as well as a Clinton Global Initiative University Commitment to Action Award Winner.

Highlighted Publications

  • Miller LC, Appleby PR, Christensen JL, Godoy C, Si M, Corsbie-Massay C, Read SJ, Marsella S, Anderson AN, Klatt J. 2012. Virtual interactive interventions for reducing risky sex: adaptations, integrations, and innovations. In SM Noar, NG Harrington (eds.), eHealth applications: promising strategies for behavior change. New York: Routledge.
  • Appleby PR, Briano M, Christensen JL, Anderson AN, Storholm ED, Ananias DK, Miller LC, Ayala A. 2010. The disparate roles of ethnicity and sexual orientation in predicting methamphetamine use and related beliefs and behaviors among MSM. Ann Behav Med, 39(Supplement):s52.

Joe Taylor - Building Community Resilience through the Arts

Joe, Taylor
Joe Taylor speaking at the NIEHS Deepwater Horizon Research Consortia stakeholder meeting, held February 22-23, 2013 in New Orleans. (Photo courtesy of Andy Kane, University of Florida)

January 07, 2015

Joe Taylor is Executive Director of Franklin’s Promise Coalition, an organization in Apalachicola, Florida that partners with a network of researchers and community organizations using creative tools, such as community drumming, visual journaling, and square dancing, to promote health and build resilience.

Communities struck by disasters often are challenged by high levels of uncertainty, a loss of trust, and social dysfunction. Taylor and his team are addressing these challenges as they work with the University of Florida’s Health Impact of Deepwater Horizon Spill in Eastern Gulf Coast Communities grant. The grant is part of the NIEHS’s Deepwater Horizon Research Consortia, a $25 million program examining the effects of the oil spill on human health in the Gulf Coast.

While the overall program seeks to address a broad range of issues, ranging from stress to exposure to contaminants in seafood, Franklin’s Promise Coalition is focused on reducing the knowledge gap between researchers and communities by (1) engaging the affected population in developing solutions, (2) developing resources that bridge socioeconomic lines, and (3) building broad social networks to promote resilience.

Taylor’s path was shaped by his 15-year career as a civilian employee for the U.S. Air Force, followed by a career as a Florida businessman – wherein he saw a major disconnect between the business world and his community. In response, he started volunteering for a food pantry and other community projects, and he eventually was asked to serve as the Executive Director of Franklin’s Promise Coalition.

Taylor and a partnership of researchers and community organizations are looking at barriers to resilience within the community as part of the University of Florida’s oil spill research effort. One example of their work was an arts symposium that was recently convened to build relationships and promote conflict resolution and anger management. Community members and a variety of stakeholders gathered to sing gospel music, hold a drumming circle, square dance, and create visual art. These kinds of activities have been proven to facilitate relationships so that individuals with differing perspectives build trust, have productive conversations – and get things done.

Speaking of the power of these activities, Taylor notes, “The way you go through the dance, you meet, you touch, and engage with different people – and it builds [a sense of] community. It breaks down barriers, and you begin to develop those relationships with people you didn’t really know before.”

For example, these activities brought together researchers, the fishing community, and other stakeholders to clarify misperceptions about the decline of oyster populations in the Apalachicola Bay. In addition, these activities create a space to discuss potential solutions, such as diversifying the local economy with alternative seafood products.

While highlighting their program’s success, Taylor points out the broad applicability of their activities: “The work that happens while building strong social networks and…a broad set of relationships among a diversity of people – that’s the solution to almost any issue.”

Highlighted Resources