Grantee Research Project Results
2013 Progress Report: Analysis and Action on the Environmental Determinants of Health and Health Disparities
EPA Grant Number: NIMHD006Title: Analysis and Action on the Environmental Determinants of Health and Health Disparities
Investigators: Glover, Saundra , Wilson, Sacoby M. , Williams, Edith , Brandt, Heather , Zhang, Hongmei
Institution: University of South Carolina at Columbia , University of Maryland - College Park
EPA Project Officer: Hahn, Intaek
Project Period: August 1, 2011 through July 31, 2014
Project Period Covered by this Report: September 21, 2012 through February 28,2013
Project Amount: $669,258
RFA: Transdisciplinary Networks of Excellence on the Environment and Health Disparities (2012) RFA Text | Recipients Lists
Research Category: Environmental Justice , Human Health
Objective:
The objective of the research is to expand the capacity of the National Institute on Minority Health and Health Disparities (NIMHD)-funded Centers of Excellence (CoE) to engage communities of color impacted by health disparities with a focus on environmental justice and environmental health disparity issues within South Carolina. Also, to take resident expertise in environmental, social and behavioral science at the University of South Carolina-Institute for Partnership to Eliminate Health Disparities (USC-IPEHD) and University of Maryland (UMD) and an expansive community network to conduct environmental, community-based participatory and translational research focused on addressing environmental stressors in South Carolina. The activities proposed in this project will: 1) build a program to assess environmental health disparities in the state through data collected by the South Carolina Department of Health and Environmental Control (SCDHEC) Environmental Public Health Tracking (EPHT) Program; 2) assess community perception of environmental determinants of cancer risk and disparities in rural and urban communities in South Carolina using a mixed methods approach; and 3) engage and train members of community-based organizations that represent environmental justice communities and environmental health disparity populations in the use of the block assessment methodology to identify ecological stressors and intervene to address disparities in burden, exposure, and health.
Progress Summary:
Pilot Project 1: Assessment of Environmental Health Disparities in South Carolina
Beginning in September 2012 and continuing through the 6-month reporting period, the Project #1 team met biweekly. Analyses were performed on available environmental health data to assess disparities of environmental hazards in South Carolina and disparities in health risks between different populations based on sociodemographic profile including race/ethnicity and socioeconomic status and geography (rural vs. urban location). The team has primarily examined the disparities in exposure to air toxics in cancer risks in South Carolina using the National Scale Air Toxics Assessment (NATA). The team has assessed differences in cancer risk in relation to segregation, deprivation as indicated by the Townsend Index, and rural-urban area. We have expanded these analyses to include human receptor sites including schools, housing, and churches. In addition, Dr. Zhang has expanded efforts to assess racial/ethnic and SES disparities in the burden of Superfund sites, brownfields, and National Pollution Discharge Elimination System (NPDES) permitted facilities in the state of South Carolina. We have submitted several papers that were not published. We currently are revising these papers for submission to Health and Place, Social Science and Medicine, International Journal of Health Geographics, Environmental Justice, and the American Journal of Public Health.
A spatial database has been expanded to include not only locations of environmental hazards and locally unwanted land uses but also salutogenic and pathogenic infrastructure (check cashing locations, payday lenders, banks, schools, gas stations, grocery stores, fast food restaurants, pawn shops, liquor stores). Currently, we are performing spatial analyses to assess differences in concentration of pathogenic and salutogenic food infrastructure across the state of South Carolina at the census tract level. We are examining differences in concentration and access for different sociodemographic groups. We also are examining the distribution of liquor stores, check cashing facilities, pawn shops, and payday lenders in the state. This work will help us understand the spatial gradient of pathogenic and salutogenic infrastructure across census tracts with varying sociodemographic composition. These analyses also will include density and proximity measures for environmental hazards and locally unwanted land uses.
As part of our dissemination and translation to action efforts for Project 1, we are organizing a Charleston Area Pollution Prevention Partnerships (CAPs) conference for September 6-8, 2013. This conference will be an opportunity to present results of the Environmental Health Core (EHCORE) projects to local residents and stakeholders from across South Carolina and Region 4. It also will provide a space for concerned stakeholders to network and discuss ways that the data can be translated into action particularly by expanding capacity of the impacted community to be more involved in local environmental decision making.
A related dissemination and translation tool is being developed by members of Project 1 team. Dr. Jiang is working on a Public Participatory Geographic Information System (PPGIS) tool known as Environmental Justice Radar (EJRADAR). EJRADAR will allow residents to map data that has been collected as part of the project and other data available through secondary sources. The ability to visualize burden and exposure disparities and community concerns will help stakeholders use this information for new policies and environmental health improvements.
We have had a few challenges building the environmental health infrastructure with South Carolina Department of Health and Environmental Control. We will use no-cost extension time to work on this objective of the project by hiring part-time staff to build the relationship with SCDHEC and joint environmental health infrastructure.
Pilot Project #2: Assessment of Environmental Determinants of Cancer Risk and Disparities
To determine community members' perceptions of how their environment affects their health and contributes to health disparities, specifically related to cancer, Project #2 includes two main research methodologies: implementation of Photovoice (i.e., documentary photography) and administration of an environmental health survey. The promise of a mixed methodology approach will entail the integration of qualitative and quantitative data to explore perceptions of environmental health risks related to cancer and as contributing factors to health disparities in our two communities, Orangeburg County and Metropolitan Charleston. Our work builds on existing relationships with these communities and connects to the other two projects that are part of the environmental health supplement.
Our actual activities have remained consistent with our planned deliverables; however, our timeline was adjusted to allow for additional time to analyze and interpret Photovoice data to inform development of the environmental health survey.
Orangeburg Photovoice data have been the foundation for the creation of a summary report and manuscript in preparation. An abstract on Orangeburg Photovoice findings was prepared and submitted to the American Public Health Association for the 2013 Annual Meeting. We are preparing a booklet of Photovoice findings, as determined by the Community Action Board, to accompany dissemination activities in the community and facilitate conversations about how the environment impacts health. Additional dissemination activities will include exhibits of the photos to increase saliency of the environment and health and facilitate engagement.
Initial analysis and interpretation of Metropolitan Charleston occurred on September 13, 2012, for the meeting on October 6, 2012. An abstract on Charleston Photovoice findings was prepared and submitted to the American Public Health Association for the 2013 Annual Meeting. Next steps include preparing a manuscript on Charleston Photovoice results as well as submitting additional abstracts as appropriate. In addition, as with the Orangeburg County Photovoice activities, dissemination also will occur in community settings and result in action steps for which the community members can use the results for action.
Preliminary Photovoice findings informed environmental health survey items and future action plans for addressing environmental concerns that impact health. We began with the Metropolitan Charleston survey, and submitted the survey and modified procedures to the USC IRB for review and approval. The first administration of the survey will occur on March 8, 2013, at the Black Expo in Charleston. We will work with the Community Action Board in Orangeburg to review the Charleston survey and make appropriate modifications for Orangeburg. We anticipate submitting the revised survey and procedures for Orangeburg to the USC Institutional Review Board (IRB) by the end of March 2013 for administration to begin in April 2013.
Pilot Project #3: Training of Community Members to Assess Ecological Stressors and Environmental Disparities Using the Block Assessment Methodology
Project #3 team met three times (November 13, 2012; December 4, 2012; and January 15, 2013) during this quarter to discuss future CBA training and data collection, data entry and data analysis.
On Friday February 8, 2013, we hosted CBA training for students at Claflin University in Orangeburg, South Carolina. The training was held from 4:00 to 5:00 pm. The training was an abbreviated version of the Community Block Assessment (CBA) training, divided into two parts. The first part, which took place on February 8, included a Powerpoint defining Community Block Assessment, why it is important and the process for conducting CBA. The second part will take place on Friday, March 22, 2013 (the day before the data collection). It will include the outside practice of completing the surveys and use of the GPS units and cameras. This also will provide the volunteers with an opportunity to ask questions. Twelve students attended the training on February 8, 2013. These students represented a cross-section of majors and classifications. They were recruited by English professor, Dr. Melissa Pearson and Biology professor, Dr. Gloria McCutcheon. Volunteers will receive incentives for their participation in this process: $25 for the two-part training and $50 for an 8-hour day for data collection. Students will receive the money at the close of data collection.
This training of students at Claflin University was intended to expand the amount of CBA data collected for Orangeburg County. This second round of CBA data collection is scheduled for Saturday, March 23, 2013. A tentative data collection date is Sunday, March 24, 2013, provided the trained students are available. The goal for this round is to collect social and physical features data for 30 street blocks in Holly Hill, South Carolina. Holly Hill was chosen by the Orangeburg Community Advisory Board (CAB) as a second location of environmental interest for Orangeburg County.
During this quarter (February 1, 2013), we also hired a research assistant to enter all of the social and physical features data already collected into a database. Prior to this, surveys were organized by site and data type. Because the data collection process includes a paper/pen survey, the data must be entered into a database. For this project we are using SurveyMonkey as the data management program. Data entry of both physical and social features was completed for North Charleston by the February 28, 2013 deadline. Data entry for Orangeburg data will begin after the March data collection session.
In addition to the surveys, longitude/latitude coordinates and photos of non-residential physical features were part of the CBA data collection. This information was entered into an Excel spreadsheet and each photo was downloaded from each camera and saved as a .JPEG file labeled by site and given a unique number. The next step for this part of the data collection is rating of the condition of the physical feature. This will take place in the next quarter (a description of this process is below).
Team #3 also developed an analysis plan for the North Charleston data during this quarter. The team agreed to start with the social features analysis of North Charleston. The deadline for analysis completion is March 31, 2013. Data will first be exported to Excel and cleaned (removing any duplicates, adding of dates/times, recoding where necessary, etc.). The data then will be emailed to Dr. Zhang for further statistical analysis. Indices for adult behavior, youth behavior, and social disordered behavior will be created and compared with other aggregated demographics features (at the census tract level) of the area (e.g., poverty, racial composition, age composition, etc.). In addition, Dr. Jiang will apply spatial analysis to the outcomes.
Future Activities:
Pilot Project #1
March 2013
- Meet with community partners to discuss development of the EJRADAR tool and planning of the Fall CAPs conference.
April 2013
- Continue analyses with NATA dataset, review neurological and respiratory risk data, and continue planning the CAPs conference.
May 2013
- Begin analyses of NATA neurological and respiratory risk data for South Carolina, expand development of the EJRADAR tool to include data for entire state of South Carolina, and continue planning the CAPs conference.
June 2013
- Submit manuscripts for NATA assessments using neurological and respiratory risk data for the state of South Carolina, continue planning the CAPs Conference, which will include presentations related to work of EHCORE including Projects #1-3.
July-August 2013
- Continue analyses of salutogens/pathogens data, link to data from CBA (Project #3), develop and submit manuscripts on salutogens/pathogens analyses, pre-launch EJRADAR, which will include some of the EHCORE data, and continue planning of the CAPs Conference.
September 2013
- Host the CAPs conference at Trident Tech in Charleston, South Carolina, September 6-8, 2013.
Pilot Project #2
February 2013 Present
- Analyze and interpret Photovoice data.
- Continue writing manuscripts on Photovoice results (will continue throughout project period).
- Draft and finalize environmental health survey/revisions.
- Finalize survey in Teleform or Qualtrics.
- Pretest survey
- Submit final version for USC IRB approval
- Continue preparation of publications on Photovoice activities. Submit additional abstracts for presentation during the next 6-month period.
March-August 2013
- Begin environmental health survey Metropolitan Charleston (fielding period: March-August 2013).
- Manage the data.
April 2013
- Complete the Orangeburg Photovoice booklet.
April-September 2013
- Begin environmental health survey Orangeburg (fielding period: April-September 2013)
- Manage the data.
August 2013
- End survey Metropolitan Charleston | Data management
September 2013 - February 2014
- Complete the Orangeburg survey and manage the data.
- Analyze and interpret the survey data.
- Prepare a manuscript (will continue throughout project period).
- Integrate Photovoice and survey data to inform next steps in collaboration with community partners.
- Prepare future research grant applications to support next steps.
Pilot Project #3
March 2013
- Collect additional data where gaps exist for both North Charleston and Orangeburg.
April 2013
- Collect ratings for the physical features in North Charleston.
- Enter all CBA data collected for North Charleston, Orangeburg and Holly Hill.
- Analyze social and physical feature data for North Charleston.
June 2013
- Draft at least two manuscripts for the North Charleston CBA data.
Journal Articles:
No journal articles submitted with this report: View all 24 publications for this projectSupplemental Keywords:
salutogenic and pathogenic infrastructure; environmental hazards in South Carolina; Superfund sites; Brownfields; Photovoice (documentary photography), environmental health survey, community-based approaches, community block assessment, Geographic Information System, GIS, spatial analysis, environmental justice, EJ, environmental health disparities, cancer risk, neurological risk, respiratory riskRelevant Websites:
Coordinating Center of Excellence in the Social Promotion of Health Equity through Research, Education, and Community Engagement (CCE-SPHERE):
http://www.sc.edu/CCE-SPHERE/
Progress and Final Reports:
Original AbstractThe perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.