Using community-based participatory research as a mechanism to identify and assess the social and physical features that may contribute to poor health outcomes in North Charleston, South Carolina

Purpose: A considerable body of environmental justice (EJ) research finds that neighborhoods with lower environmental quality may be overrepresented by ethnic minorities and economically disadvantaged populations.  The quality of the physical environment is one of the factors that contribute to high levels of community stress and leads to disparities in health.   We assessed the physical and social features that contribute to poor health.

Methods: We trained 10 community leaders and stakeholders to conduct community block assessments (CBA) identifying physical and social features and categorizing and mapping non-residential characteristics in their neighborhoods.  A structured assessment tool was adapted from the Johns Hopkins Neighborhood Inventory for Environmental Typology (NiFeTy) and modified to best suit the rural nature of North Charleston.  A total of 62 blocks in four target communities were assessed and compared to each other on salutogenic and pathogenic features. 

Results: Community participants felt empowered by the experienced and were more confident in recognizing features in their communities that contribute to health.  The results of the CBA indicated that targeted communities had high levels of pathogenic (e.g., liquor stores, fast food restaurants, loitering, etc.) features and exposure to environmental hazards including landfills, incinerators, sewer and water treatment plants, Superfund sites and Toxic Release Inventory facilities.  

Conclusion:  Next steps include creating overlay maps with aggregated health conditions of interest (e.g., cancer, asthma, birth defects, etc.) and advocating for more resources to mitigate the effects of the pathogenic features.