The Community Engagement, Environmental Justice, and Health (CEEJH) Laboratory mission is to educate impacted communities about environmental justice and health issues. Through technical assistance and collaboration, communities are empowered to address environmental injustice and environmental health disparities.
The CEEJH Laboratory was founded by Dr. Sacoby Wilson, assistant professor in the Maryland Institute for Applied Environmental Health, in the Fall 2011. CEEJH's primary focus is to provide engagement to highly and differentially exposed populations and underserved communities. Our work has included the development of and participation in partnerships with community-based organizations, environmental advocacy groups, health practitioners, and policymakers (federal, state, and local government) to reduce local contamination, improve environmental quality, and enhance community health and sustainability.
CEEJH advances environmental justice by developing community-university partnerships, using the community-based participatory research (CBPR) approach, community-owned and managed research (COMR) principles, and the Collaborative-Problem Solving Model (CPSM) with a focus on equitable planning, healthy zoning, and sustainable community development. Currently, CEEJH has partnerships with community groups in North Carolina and South Carolina and has trained impacted residents and helped to become citizen scientists using the CBPR framework.
CEEJH is building partnerships in Maryland with community-based organizations and environmental advocacy groups on agricultural pollution in the Chesapeake Bay, exposure disparities for fishermen and residents in the Anacostia Watershed, air pollution issues in South Baltimore, and environmental health disparities in DC. In addition, the CEEJH team has provided outreach and education to teachers and students on Chesapeake Bay contamination, related human health issues, and climate change using the STEMH pipeline development model.
CEEJH acts as a Community Outreach and Engagement Core for the Maryland Institute for Applied Environmental Health. See following figure:
The primary goals of CEEJH are to:
- Serve as the link between the University of Maryland and community-based organizations, environmental advocacy groups, health professionals, educators and students, and policymakers on identifying environmental agents and environmental health issues in the District of Columbia-Maryland-Virginia region.
- Place specific focus on the environmental health issues associated with contamination of the Chesapeake Bay, Anacostia watershed, Eastern Shore (Choptank River) and other regional waterways, such as exposure to PCB, mercury, and arsenic contamination through fish consumption.
- Use the community-based participatory research (CBPR) framework, collaborative problem-solving model (CPSM) principles, and partnerships with diverse community-based organizations and stakeholder groups to address human health risks and environmental issues defined by stakeholders particularly members of underserved populations, and to empower these populations through education, outreach and capacity-building
- Provide outreach and education to teachers and students on environmental health and environmental justice issues, including Chesapeake Bay contamination, related human health issues, and climate change using the Science, Technology, Engineering, Mathematics, and Health (STEMH) pipeline development model.
- Development or participation in partnerships with federal, state, and local government, and other policymakers to reduce environmental contamination in this region, understand the role that environmental health policies and planning and development has on driving environmental injustice and environmental health disparities, and work with these policymaker to use environmental justice principles to human health, enhance quality of life, and provide economic benefits to disadvantaged and underserved communities and regions.
Dr. Sacoby Wilson, MS, PhD; Assistant Professor and Program Director
Dr. Chengsheng Jiang, MS, PhD; Spatial Analyst
Laura Dalemarre, MPH; Program Associate
Kristen Burwell, MPH, Doctoral Student, Graduate Assistant
Rianna Murray, MPH, Doctoral Student, Graduate Assistant
Maryland Environmental Health Disparities Project
Maryland grapples with many of the same health disparities facing states across the country. Although Maryland has the 3rd highest median household income and the 2nd highest number of primary care physicians per capita in the country, it also ranks 43rd in infant mortality, 28th in obesity prevalence, 31st in diabetes prevalence, 35th in cardiovascular deaths, 32nd in cancer deaths, and 33rd for geographic health disparities. These statistics point to the possibility of significant health disparities within the state. The Maryland Plan to Eliminate Minority Health Disparities by the Office of Minority Health and Health Disparities in Maryland (2010) lists racial/ethnic disparities in all-cause mortality, heart disease, renal disease, hypertension, obesity, HIV/AIDS, and asthma. Combined, congestive heart failure, hypertension, and asthma cost an excess $15 million in Medicare among the African American population in Maryland. Additionally, all-cause mortality rates among those who identify as Black or African American are higher than all-cause mortality rates of Whites in 20 of the 23 Maryland counties where the age-adjusted rate could be calculated.
The aforementioned disparities may be due to environmental factors. Three of the four counties in Maryland with the highest percentages of minorities (Baltimore City, Charles County, Montgomery County, and Prince George's County all have more than 50% minority residents compared to less than 30% in the state of Maryland) also have the highest total environmental releases (Charles, Prince George's, and Baltimore City). The University of Wisconsin County Health Rankings lists these three counties 11th, 15th, and 24th, respectively, for overall health in Maryland out of 24 counties total. When taking into account physical environment factors including particulate matter, ozone days, access to recreational facilities, access to healthy foods, and fast food restaurants, Prince George's County ranked 18 of 24 counties in 2010 and 23 out of 24 in 2011 and 2012.
We are currently performing statistical analyses to assess the spatial distribution of environmental hazards, pollution-intensive facilities, and noxious land uses at the county and census tract level in the state of Maryland to obtain evidence of environmental injustice. We are using ArcGIS 10.1 (ESRI, Inc., Redlands, CA) to assess the spatial distribution of local sources of pollution in state of Maryland. We hypothesize that minority, low SES, and low education populations at the county level will have a higher concentration of pollution sources and pollution levels than White and affluent populations with access to more resources. We have obtained latitude/longitude coordinates for EPA permitted air emitters, chemical plants, coal-fired plants, landfills, incinerators, toxic release inventory (TRI) facilities, Superfund sites, and other local environmental hazards from EPA databases including Envirofacts and Maryland Department of Environment (MDE) and Department of Natural Resources (DNR) GIS websites. Demographic data on race, income, and education for each census tract and county in the state of Maryland will be obtained from the 2000 and 2010 US Census. We are using GIS to construct choropleth maps for % African-American, % non-white, % poverty, and % less than HS education.
We have employed the spatial coincidence method and proximity analysis specifically utilizing buffer zones to assess the spatial distribution of the industrial sources of pollution in relation to the demographic composition of populations at the census tract level including the use of cumulative distance functions. We are using GIS to map CAPs, HAPs, and TRI levels in the project area and assess differences in spatial distribution of these pollutants based on demographic composition at the county and census tract levels.
Project CAESARR (Community-Based Assessment of Exposure to Substances in the Anacostia River Region)
Subsistence fishers are often low-income individuals or persons of color who fish for personal consumption. Previous studies have shown that vulnerable populations with unique exposures (low income, people of color, Indian tribes and other indigenous populations) are often most susceptible to adverse health effects because of their differential exposure to multiple environmental contaminants, psychosocial stressors, socioeconomic disadvantage and lack of access to quality health care. Subsistence fishers have uniquely high fish consumption rates; the U.S. Environmental Protection Agency (EPA) assumes default fish consumption rates among subsistence fishers of 142.4 grams per day, 8 times the default assumption of 17.5 grams per day for the general population. But, even this higher default may underestimate consumption by some fishing groups. There are approximately 1.5 million saltwater fishers, including many subsistence fishers, among the 17 million people living in the Chesapeake Bay region. Many of these fishers live in urban communities impacted by disproportionately high levels of environmental hazards that have led to contamination of local rivers and food sources from those rivers. Thus, the human health consequences of high fish consumption by vulnerable populations in the Chesapeake Bay region, a highly contaminated estuary on the Atlantic Coast, are an important public health issue. It is imperative to arm urban fishers and their neighborhoods with knowledge and tools to reduce their exposure to harmful pollution sources.
Project CAESARR is a project recently funded by the Smithsonian and University of Maryland Seed Grant Program. Dr. Sacoby Wilson is collaborating with Dr. Vikki Chanse, School of Agriculture, Mr. Tony Thomas, Anacostia Community Museum, and the Anacostia Watershed Society on the project. This study will be the first to comprehensively evaluate cumulative risk among subsistence, cultural, and recreational fishers and local residents incorporating biomarker based measure of exposure, and both individual and neighborhood level stressors. Our aims will be to: 1) Quantify key determinants (demographic, geographic, behavioral factors) of seafood consumption among urban fishers compared with residential populations in the Anacostia Watershed; 2) Assess underlying social and geographic vulnerability of fishers through Photovoice and interviews; 3) Enroll sport and subsistence saltwater fishers and controls in a study of fish consumption and biomarkers of exposure to assess spatial and temporal variability of exposure to mercury and PCBs; and 4) Perform cumulative risk assessment among sport and subsistence fishers and determine how these cumulative risks are distributed among demographic, geographic, and behavioral factors identified under Aim 1. Our use of community based participatory research (CBPR) approach will enable fishers to enhance stewardship of the Anacostia Watershed, reduce exposures, improve public health, and use data for better risk management strategies.
The Environmental Justice (EJ) Radar is a Public Participation Geographic Information Systems (PPGIS) website designed for South Carolina residents to know and share environmental information about the burden of physical and social environmental hazards with linkage to health disparities. The use of PPGIS will help residents map environmental health data, build capacity, and empower residents to be more engaged in environmental decision-making. The idea behind PPGIS is empowerment and inclusion of marginalized populations, who have little voice in the public arena, through geographic technology education and participation. PPGIS uses and produces digital maps, satellite imagery, sketch maps, and many other spatial and visual tools, to change geographic involvement and awareness on a local level.
Charleston Area Pollution Prevention Partnership (CAPs)
The Charleston Area Pollution Prevention Partnership (CAPs) was established as a community-university partnership between the Low-Country Alliance for Model Communities (LAMC), the University of South Carolina (USC), South Carolina Department of Health and Environmental Health (SC DHEC), and recently, the University of Maryland at College Park (UMD). Guided by the community-based participatory research (CBPR) framework and collaborative-problem solving model (CPSM) principles, CAPs has an overarching goal to address environmental injustice, public health, and revitalization issues in North Charleston, South Carolina (SC). In an effort to achieve the aforementioned goal, the CAPs project has the following aims: (1) assess the geographic distribution of pollution sources in North Charleston, SC, (2) quantify levels of particulate matter and heavy metals near industrial and non-point sources of pollution in economically disadvantaged neighborhoods in North Charleston, SC, and (3) increase community-capacity to reduce exposure, prevent pollution, and improve public health through community-based outreach, education, and training. Some of the research activities of CAPs include assessing spatial disparities in the distribution of Toxic Release Inventory (TRI) facilities, Superfund sites, and Leaking Underground Storage Tanks (LUSTs) facilities; monitoring of particulate matter levels at the neighborhood level near sensitive community locations and heavily trafficked roadways; determining cancer risk disparities; conducting soil assessment for heavy metals and trace elements including arsenic, mercury and lead; and providing environmental education and training opportunities to community members.
Mission: To promote environmental awareness, literacy, and empowerment in the African-American community.
Project Excellence activities include summer camps, summer enrichment programs, environmental health workshops, environmental justice and health modules for local schools, air monitoring training, soil assessment training, and an annual dissemination event and health fair known as the Day of Neighborly Needs.
Environmental Health Core (EHCORE)
The environmental health core was established as an extension of the Coordinating Center of Excellence in the Social Promotion of Health Equity in Research, Research Education and Training, and Community Engagement and Outreach (CCE-SPHERE), an NIMHD-funded Center of Excellence (CoE) housed in the Institute for Partnerships to Eliminate Health Disparities (IPEHD), at the University of South Carolina Arnold School of Public Health. In partnership with the University of Maryland, the environmental health core uses resident expertise in the areas of environmental, social, and behavioral science coupled with community-based participatory and translational research to achieve health equity. The environmental health core has a project aim that is threefold: (1) assess environmental health disparities and the spatial distribution of hazardous waste sites in the state through data collected by the South Carolina Department of Health and Environmental Control (SC DHEC) 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 health disparity populations in the use of the block assessment methodology to help stakeholders identify ecological stressors and intervene to address disparities in burden, exposure, and health. EHCORE team members have partnered with community groups in Orangeburg, South Carolina and Charleston, South Carolina to build community capacity to address environmental justice issues and environmental health disparities. CBPR activities have included the use of Photovoice to assess community perception about environmental health risks and cancer disparities.
The Graniteville Recovery and Chlorine and Epidemiology Study also known as the GRACE Study Center was established with the vision of developing a healthy Graniteville community sufficiently recovered from the chlorine spill disaster. On January 6, 2005, a train derailed in Graniteville South Carolina, causing a major chlorine gas spill. The residents of Graniteville were left to suffer great emotional, physical and economical loss. Nine people lost their lives as a result of the derailment, and hundreds of people visited hospital local emergency rooms with complaints of symptoms as it relates to the crash. More than fifty people were admitted to hospitals and many still suffer from the consequences of chlorine exposure. GRACE is exploring the long-term respiratory effects of human exposure to chlorine gas. General health screenings and simple lung function tests are provided through the center. In order to achieve their scientific goal, GRACE also measured the lung function among the Avondale millworkers to determine the long term effects of chlorine on lungs. CEEJH team members are assisting with community engagement efforts including working with GRACE Community Advisory Board (CAB).
In 2005, a train derailment and chlorine spill occurred in Graniteville, South Carolina, several people died with over 1,000 local residents impacted by the event. The community was medically underserved before the train disaster. There is a paucity of information on what the combined effects of a disaster and living in a medically underserved rural area have on a vulnerable community's health, access to health resources, and quality of life. An attempt to capture the recovery piece of an already vulnerable community in the aftermath of a disaster only further serves to elucidate the grim landscape behind a medically underserved community. Attention is rarely drawn to the behind-the-scenes reality of post-recovery efforts within a fragmented community disproportionately suffering from pre-existing medical service delivery issues. This aspect of vulnerability is further exacerbated in the event of a disaster, but to our knowledge there has been little research documenting the effects of a disaster, particularly the "secondary surge" (e.g., the sudden increase in need for long-term health services following a disaster), on an already stressed community's health status and health care needs.
NIH funded RISE (Restoration in Graniteville Through Supportive Engagment), a project to understand the long-term effects of the man-made disaster in Graniteville, South Carolina. Dr. Wilson is a Co-PI of the project with Dr. Lucy Annang, an assistant professor at the Arnold School of Public Health, University of South Carolina. The goal of this project is to use both qualitative and quantitative data collection and analysis, with community-based participatory research (CBPR), to document how the challenges presented by the post-disaster surge in health service delivery are further compounded within a medically underserved community in the rural South. To achieve this goal, we propose the following specific aims: 1) assess community members' perceptions about the long-term impacts of the disaster on public health, quality of life, and access to health services; 2) assess healthcare providers' perceptions about the long-term impacts of the disaster on public health, quality of life, and access to health services; 3) assess hospital discharge data (inpatient and emergency room) from area hospitals for utilization and severity and frequency of various diagnoses and procedures pre- and post-disaster. The project is novel because it will study the long-term health impacts of a chlorine spill in a small rural medically underserved area for the first time. The information will be used to help improve recovery and revitalization efforts in the community.
What has worked well, what hasn't and what work still needs to be done in Graniteville is being documented with the help of photos. Project RISE has given a small group of people digital cameras to carry with them for the next seven days so that they may capture different aspects of Midland Valley to develop a narrative of the area now that seven years have passed since the devastating train disaster. The method, combining photography with grassroots social action, is called PhotoVoice. The pictures, along with the input of those behind the cameras, will be an effective tool to show how Midland Valley was affected by the disaster and will be shared with other community members, agencies and policy makers like the Environmental Protection Agency and the Federal Emergency Management Agency.
West End Revitalization Association
The West End Revitalization Association (WERA) is a community organization located in Mebane, North Carolina. WERA has an innovative community-university partnership that has included students and faculty from the from the School of Public Health in the University of North Carolina, Chapel Hill, University of South Carolina, Elon University, North Carolina Central University, University of Maryland-College Park, among others. WERA focuses on addressing the lack of basic amenities and infrastructure in distressed African-American communities in Mebane and other areas in the Southeastern United States. WERA has fought for 20 years to stop the building of the 119-Bypass through historic African-American neighborhoods. Because of its community-owned and managed research, nearly 100 homes have received first time installation of sewer and water infrastructure and neighborhood roads were paved for the first time. Omega Wilson, President of WERA, has presented on this work at national and international conferences. He received a 2008 Environmental Justice Achievement Award from the USEPA and had a recent appointment to the National Environmental Justice Advisory Council.
The WERA Neighborhoods include West End, White Level, and Buckhorn/Perry Hill. These neighborhoods are primarily African-American, elderly, and low-income.
EPA 20th Anniversary Environmental Justice Video Series: Sacoby Wilson