Northern Manhattan CARES: Participatory methods to address urban environmental injustices

Environmental injustices within the urban context manifest in communities of color and low income as a result of poor land use decisions and inequities in public participation processes. Northern Manhattan, with a minority population of nearly 90%, hosts 6 out of 7 of the Metropolitan Transportation Authority's bus depots, a sewage treatment plant, numerous diesel truck routes and some of the highest rates of obesity and chronic disease in New York City. While many of these hazards are identified, monitored and often regulated by public agencies, community members are left feeling disenfranchised and unrepresented by these same public agencies that are tasked with protecting them. West Harlem Environmental Action, Inc. received a grant from the United States Environmental Protection Agency to conduct a community-based environmental health assessment through the Community Action for a Renewed Environment (CARE) program. We formed the CARE Collaborative with the goal of identifying environmental health issues of concern in Northern Manhattan. Our community-based participatory research (CBPR) study consisted of 4 phases that included 4 community meetings conducted over an 18 month period (which provided insight into the major environmental health issues of concern), a environmental health survey that reached approximately 500 residents, a risk assessment process (that included input from 100 residents) of priority issues, and 2 community meetings to prioritize the identified issues of concern. The process identified 10 environmental health issues: land use, the built environment, environmental health service delivery, solid waste, lead poisoning, outdoor air quality, indoor air quality, pest and pesticide toxicity, stress, and access to healthy food. After training sessions designed to educate participants about environmental health, community residents participated in a facilitated, consensus-driven decision making process that prioritized: solid waste, pest and pesticides, indoor air quality and outdoor air quality that issues that need to be addressed. We will use this list to build community capacity and develop a comprehensive community-based strategy to limit exposures and engage public agencies in a discussion of harm reduction strategies.