Engaging community and academic partners in efforts to refine definitions of vulnerable populations: Detroit Reproductive Environmental Advocacy Matters (DREAM) Team

Background:

Definitions of vulnerable populations do not adequately consider relevant sociodemographic data (e.g., poverty), underlying health conditions, or the cumulative impact of exposure to multiple pollutants (e.g., highway proximity, lead paint) that contribute to excess vulnerability for residents of low to moderate income communities and communities of color.   There is a need for public health and community members to develop effective strategies for working with the United States Environmental Protection Agency (EPA) to assure adequate protections for vulnerable populations, to promote environmental justice and reduce health inequities.

 

Methods:

The Detroit Reproductive Environmental Advocacy Matters (DREAM) Team, including Detroit residents, health care providers, environmental activists, and public health researchers, participated in the Reach the Decision Makers Program designed to build skills in working effectively with the EPA regarding science-based health standards and policies.  We applied John Kingdon’s policy analysis framework to guide efforts to encourage revision of the Clean Air Act National Ambient Air Quality Standards (NAAQS) to include an expanded definition of vulnerable populations.   

 

Results:

Kingdon’s policy analysis framework includes: problem definition, proposed policy solutions, building political receptivity, and identification of predictable policy windows. Following definition of the goal (above), the ozone rulemaking process was selected as a policy window toward broader change in NAAQS.  We describe proposed policy solutions (e.g., work with biomedical societies to better define vulnerability), efforts to build political will for the proposed solution (e.g., building alliances with public health, environmental, medical, and other public interest groups with common interests), and results of these efforts. 

Conclusion/Discussion:

There is a critical need for public health professionals, environmental groups, and community residents to work effectively together to encourage implementation of environmental regulations that promote environmental justice and health equity.  We offer one example of a framework that can help to guide such efforts.