Building environmental health emergency capacity and resilience in urban communities of the Inland Empire of Southern California

As natural and man-made emergencies or disasters have negative repercussions on the environmental health and safety of those affected, it is imperative that the Environmental Health and Emergency Preparedness/Response (EHEPR) branches of local public health departments coordinate their efforts to engage with communities in discovering solutions to disparities in emergency preparedness. In this mixed methods, quasi-experimental study, we are comparing the conventional expert-driven approach to public health emergency preparedness by the San Bernardino County EHEPR workforce to an environmental health emergency preparedness (EHEP) community-based participatory approach by the Riverside County EHEPR workforce. These adjacent counties have the greatest land mass in the nation, but are two of the most resource poor. Almost half of their population is Latino, many being low English proficient. A great proportion of the urban residents of these two counties live adjacent to the largest railyards east of the Los Angeles port cities. In addition to the chronic earthquake threats endemic to all of California, their health and safety is endangered by environmental hazards including high levels of air pollution due to train and truck exhaust and potential hazardous materials spills resulting from train derailments. Formative research was conducted with EHEPR and community residents of both counties using key informant interviews, validation focus groups, windshield surveys, and GIS demographic mapping. The qualitative data set was transcribed, coded, and analyzed for emerging themes. Next, the EHEPR workforces were surveyed to examine personal and collective efficacy, capacity, and readiness to engage community organizations and members in environmental health emergency preparedness. Community capacity to deal with emergencies was captured in a household survey administered in both counties. Baseline assessment findings lead to the creation of a culturally-appropriate EHEP community program for Riverside County. Such alliances are essential for public health to effectively move forward in these challenging times.