Toward Environmental Justice Research, Education, and Health Policy Needs (1999) / Chapter Skim
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3 Research
3 Research
Pages 23-44
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From page 23... ...
The committee recognizes that the diagnosis, treatment, and prevention of adverse health outcomes caused by environmental health hazards require a good understanding of the biological and physiologic mechanisms by which such hazards cause disease and that these mechanisms act separately as well as in combination. However, the larger community- and population-based issues of environmental justice require a public health perspective.
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From page 24... ...
RESEARCH METHODOLOGIES Public health research on environmental justice issues incorporates two tasks: (1) assessment of the health status of the community and (2)
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From page 25... ...
. The TRI database is particularly useful for community organizations in assessing local environmental hazards
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From page 26... ...
Although substantial data are being collected, there are problems due to the lack of standardized definitions and methods and to the lack of standardized methods of data collection and retrieval, as well as significant gaps in the types of data that are needed to evaluate the effects that exposures to environmental hazards may have on the health of exposed populations. These shortcomings underscore the need, when undertaking an assessment of a potential environmental justice problem, to involve the affected community integrally in the process, particularly for the purpose of supplementing other sources of data with specific information pertinent to local conditions.
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From page 27... ...
Additional factors that Rios and colleagues concluded may differentially affect minority populations include compromised health status (e.g., people with diabetes may be less able to detoxify organic solvents) , social inequality of access to health care (e.g., poor control of asthma by primary care providers may increase susceptibility to particulate air pollution)
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From page 28... ...
Two of the biggest challenges to an epidemiologic analysis of health effects are the existence of multiple exposures in the community of interest and the possibility that an adverse health outcome may have multiple determinants. Multiplicity of Hazards A community of concern may be exposed to multiple environmental hazards, which may act cumulatively or which may even interact in complex ways to magnify their risks to human health.
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From page 29... ...
Biomarkers In the 1980s, the inability to link exposures to health outcomes by population studies and traditional methods for the classification of exposures led to the study of biological markers, or biomarkers, as possible tools for exploration of the effects of environmental exposures (sullen and Redlich, 1995~. As initially described by the National Research Council (NRC, 1989a,b)
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From page 30... ...
To be able to relate events to a specific health effect, however, one needs to lmow which events are associated win which disease outcomes and He degree of Hat association. The application of biomarkers to environmental health research requires extensive research on disease mechanisms, which is the linking of exposure to hazards at various doses to the preclinical signs of disease (Henderson, 1995~.
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From page 31... ...
The variation in individual responses to environmental exposures is wide, even within racial or ethnic classifications (see discussion in Addressing Race below)
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From page 32... ...
. A deeper understanding of susceptibility and the biomarkers that indicate heightened susceptibility would be a valuable tool in preventing avoidable adverse health effects due to environmental exposures to health hazards.
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From page 33... ...
Improved epidemiologic and clinical research methods that can better distinguish truly harmful from harmless environmental exposures in humans, that can detect lower doses, and that require smaller sample sizes need to be developed and validated. A challenge that faces researchers is the need to link biomarkers to the disease with which they are associated and to determine at what levels disease is induced.
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From page 34... ...
Some research deliberately excludes analysis of differential disease occurrences in minority workers because the small number of minority subjects would have provided an unacceptably low statistical power to test the primary hypotheses of the study. This is unfortunate because the small body of published occupational health literature that does explicitly include data from studies with these populations suggests that racial, ethnic, and economic disparities continue to influence the risk for adverse health effects due to environmental hazards in the workplace.
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From page 35... ...
Researchers need to design environmental health studies that will provide adequate measurement, classification, and reporting of data on race, ethnicity, and relevant socioeconomic variables and to develop improved methods of descriptive, analytic, clinical, and molecular epidemiology that are accurate and practical for investigating relationships between environmental exposures and disease in low-income and minority populations. One tool that can help epidemiologic studies is geographic information systems (GISs)
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From page 36... ...
The American Anthropological Association and the IOM Committee on Cancer Research Among Minorities and the Medically Underserved note that this reporting requirement may handicap health researchers, who are often unable to draw meaningful inferences regarding the source of group differences because "racial" groups do not vary systematically with regard to biological or genetic makeup, socioeconomic status, culture, or other relevant variables. The use of"race" in health research will be further complicated in the future because the U.S.
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From page 37... ...
In addition to allowing researchers to capitalize on local knowledge, the involvement of the affected community ensures that the research addresses the issues that are important to the community and reinforces the social validity of "the goals, procedures, and effects" of the research that is, participatory research ensures that the community truly benefits from the research being done (Fawcett, 1991, p.
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From page 38... ...
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ : ~ ~ ~:~:~::~:leath~er: ~epid~emio~log{:: (B:rown,:: ::1: 993,:~: Natio:nal :~::Research Go:~:n~c:il :~:~ ~:-1::991 a~:b~: :~:~:~These~:~ad~ had:~th:e~effe~:of:~ creatir~g ~intense:~ ~community~: concems ~about~: :~ ~diisease~ ~and~ a~d~esire:~:ld:r~:inform~ation ~health~ stucl~ies~:~and~environ:me:nta~l~ ~: ~ ~ ~ : ~ , ~ ~ · ~ ~ ~ ~ ~cleanu~p.~-~ Desp~i~their:: sci:entifi~c:~shortco~m:ing;s,~::both stu~d~ie~s~ had~::the ~::~effect~::of :~:: : : ::: : : : :: : : : ::: : : :: :::: : : :: ~ ::~:: : : ::: : : : ::: : :: :: ~ ~ra~ising~the:~pu~blic's~co~ncem:~about a~: potential link:of::TG:E to~::adverse~:he~al:th::~ ::: .
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From page 39... ...
The committee's site visit to the Hanford Nuclear Reservation served as an example of the need to consider cultural differences among populations that might not only affect the extent of environmental exposure to toxic compounds but also influence policies toward public health research and policy (see Box 3-3~. :: :: : : A: : : : ~i: i:::: i::: I:::: :BOX 3-3 :::::::: Han~fo~rd::N~u~cl~ear: Reservation: ~:~:~:~:~:~:~ If:: ~-~:~:-~-~ -~:~:~ ~:~ :l~n:~19431;~ theft federal: gove~mment:~acq~uired~::~:1:,450~sq:ua~re ~k~ilom - : :~:~60 : ::~ ::sq:uare::~ miles)
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From page 40... ...
the development of community expertise and capacity. The committee believes that public health research on environmental justice issues would be substantially improved by the development of one or more standard models of how best to undertake participatory research.
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From page 41... ...
· Strategy 1.4 Include members of minority groups in research to better describe specific susceptibilities and health effects. · Strategy 1.5 Connect environmental exposure databases and up-to-date demographic data, including data on age, gender, race, ethnic background, employment, housing, educational attainment, and income.
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From page 42... ...
· Strategy 2.5 Give high priority to participatory research when addressing the research needs of communities with environmental justice concerns. · Strategy 2.6 Involve the affected community in designing the protocol, collecting data, and disseminating the results of research on environmental justice issues.
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From page 43... ...
~ ~ : :~ ~ : :: : : :: ~:~:~:~:~ 2.~: :~lavolve: the: affected populations. Citizens from: the affected popula:~:~tion~s~i:n:::co:m~munities of concem:shou:ld be actively recruited:~to::pa:rticipate~in~:th~e:~ :d:esig~n:~:and~:execution of research.
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