Environmental Health Policy in Communities: Growing Sustainable Change

With its focus on equitably involving community and other stakeholders in the research process and balancing research with action, community-based participatory research (CBPR) is a promising strategy for linking place-based research with healthy public policies that can improve population health and reduce health disparities.  This presentation highlights core principles of CBPR and draws on findings from two recent multi-site case study analyses of sixteen CBPR partnerships in the United States, each of which appeared to substantially contribute to policy level change.  Three case studies from the research then are used to illustrate how involving communities and other stakeholders in studying locally-identified environmental health concerns can both contribute to credible research and help in the translation of findings into sustainable policy level changes to promote the health of children, their families and their communities. One of the case studies highlight efforts to document and address, though data-informed policy advocacy, high rates of childhood asthma linked in part to disproportionate exposure to exhaust from diesel busses and related sources in Harlem, New York.  But because environmental health also is related to what communities are not exposed to—for example, healthy foods and safe and accessible spaces for recreation—a second case study briefly is used to demonstrate the creation of a municipal food security policy based in part on the  results  of  multi-method, youth-involved  research documenting poor access to healthy food in an economically disadvantaged San Francisco neighborhood.  Finally, attention is drawn to a recent effort in Bakersfield, California, through which walkability inventories and other methods were used to document and then address problems in the built environment as these may impact on health-related behaviors. The key role of multi-sectoral partnerships in such work, and in creating and sustaining community-wide change, is underscored, and evidence provided in support of several recommendations offered by the Robert Wood Johnson Foundation Commission to Build a Healthier America.  The paper concludes that CBPR holds special relevance for helping the Foundation achieve its ambitious aims, in part because of this research tradition’s attention to building individual and community capacity and agency, while addressing the broad social factors  that help shape and determine the health and wellbeing of our children, families and communities.

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