Assessing chemical and non-chemical stressors to advance science and policy

Communities living on the US Gulf Coast face a range of chemical and non-chemical stressors producing a triple health threat: persistent risks associated with exposures to hazardous substances, a historic burden of health disparities, and the impact on their health of living in a disaster-prone area. The Transdisciplinary Research Consortium for Gulf Resilience on Women’s Health focuses on women of reproductive age living in vulnerable Gulf Coast parishes and aims to strengthen community resilience. Social support has been shown to play a role in mediating health during pregnancy. A community-based participatory research project equipped Community Health Workers (CHWs) with mobile health technology to promote education and access beyond the health care system. The cohort (N=141) was predominately <25 years old (65%), African American (69%), urban (73%), single (57%), high school educated (63%) and enrolled in Medicaid (61%). A survey used to quantify the strength and integrity of the relationship between the CHW and participant were significantly different between trimesters (p=0.003) with significantly increasing scores as the study progressed and highest scores following delivery (p=0.0011). A parallel mix-methods ethnographic study examining cultural attitudes about hurricane preparedness found a shared model, but significant differences in beliefs across education (p=0.001) income (p=.056) and previous hurricane experience (p=0.06). Cross-referencing all study findings with a state policy gap analysis uncovered critical areas to coordinate with policy makers.  A science-driven policy framework designed as a promising national model will detail a roadmap for future culturally-tailored health interventions targeting population exposed to complex chemical and non-chemical stressors.