has noted that “Meaningful community engagement in urban health research is an aspirational goal that deserves the attention of the research community and the public at large.” As illustrated in this and other case studies,6–8,35–37
the form of engagement known as CBPR also merits, and is receiving, increased attention from policy makers. The EHC partnership is an example of a CBPR effort that appears to have both produced credible science and helped bring about environmental health policy change. EHC’s in-house research, including toxic release footprints of OTNC and adjacent areas, provided visually powerful data on the toll that disproportionate exposure was taking on this community. Similarly, both quantitative data from university-based colleagues and a promotora
-led survey of residents received good media coverage and frequently were cited in testimony before the City Council and other bodies to help capture the key concerns and priorities of residents and in turn help shape the Specific Plan.
From a policy perspective, passage of the amortization ordinance, the passing of a law to limit the operation a truck-driving school adjacent to the local elementary school, and the securing of funds for a feasibility study for an industrial park outside the city limits all were described by local media and relevant policy makers and other stakeholders as having been substantially related to the work of EHC and its partnership.23,28
These incremental changes, moreover, were important in helping achieve the longer term goal of putting into place a Specific Plan, whose content and passage were described as reflecting substantially the contributions of EHC and its allies.
Although the findings of the case study presented in this article are, by definition, not generalizable, they reinforce those of a number of other studies involving policy-focused CBPR in environmental justice. The Trade, Health and Environment (THE) Impact Project, for example, a regional coalition comprised of community-based organizations (CBOs) and academic partners in Los Angeles, Long Beach, and the Inland Valleys, trained community members to serve on neighborhood assessment teams and gather data through traffic counts and the measurement of particle concentration.37
Their collaboration, with academic partners at USC, contributed to the passing of the Clean Truck Plan and to a successful delay of the expansion of a major freeway to allow more public participation and consideration of its community and health impacts.37
In Northern Manhattan, NY, United States, impressive CBPR by a partnership between West Harlem Environmental Action (WE ACT) and epidemiologists at the Mailman School of Public Health at Columbia University38
was described by EPA policy makers as having played a key role in helping to secure tighter air-quality standards, as well as the placement, by the EPA, of permanent air monitors in Harlem and other “hot spots” around the country.10,35
Furthermore, several of these efforts have been credited with helping change the broader policy environment. THE Impact Project has been described as having helped “change the debate” on neighborhood contamination through increased community participation.37
Similarly, the Southern California Environmental Justice Collaborative was given substantial credit for the fact that the state EPA and other decision-making bodies increasingly think in terms of cumulative
rather than individual risk in their policy deliberations.7,10,39
Although National City represents a much smaller geographic area, the work of the EHC partnership likewise was described by policy makers and others interviewed as having helped change the policy environment, with the organization and its active community base identified as an important force influencing governmental planning efforts.
Several of the factors that appeared critical to the success of the EHC partnership also have been observed with respect to other environmental health CBPR partnerships. The need for strong alliances and a solid community base has been widely cited,6,7,10,30,39,40
as has the importance of credible science that can “stand up to careful scrutiny.”7,10,24,35,36,41
The powerful combination of research, community organizing and policy advocacy in this work also frequently has been emphasized. As Morello-Frosch and her colleagues7
[Strong CBPR partnerships] “promote not only good science, but science that is focused on important problems that affect the lives of real people, and they do so while enhancing community capacity and participation in research and advocacy—all of which can ultimately improve the regulatory and policymaking process”
The combining of several kinds of data collection, and of balancing “statistics and stories,” similarly has been highlighted as enhancing efforts to move policy.7,10,24,30,42,43
Indeed, EHC and each of the other abovementioned projects both undertook quantitative data collection and provided training for community members in public speaking and in other ways communicating their personal stories and messages as a key component of the work.
The importance of making the time to engage in substantial background work, including strategic planning, power mapping, and researching policy options and alternatives as a prelude to policy action, has been widely discussed in the literature6,24,30,35–37,40,43
and was well-demonstrated in the EHC partnership. Relatedly, effective use of the mass media has proven an important feature of policy-oriented CBPR in environmental justice and related areas.6,7,10,30,40
Although attention to and skills in the above areas served the EHC partnership well, a number of challenges and barriers were uncovered in this case study, many of which also have been reported in other policy-focused CBPR partnerships working to promote environmental justice in low income urban areas.
In both OTNC and West Oakland, CA, United States, for example, a policy win (OTNC’s amortization ordinance and West Oakland’s 2006 truck ordinance) proved difficult to enforce due to either zoning that precluded enforcement or inadequate staff for providing oversight.44
In New York City, the WE ACT partnership’s successful efforts to help close a bus depot in Northern Manhattan (which was home to seven of the City’s eight depots) similarly was described as involving a shell game, with the City soon opening another depot in a different part of this community.
Time and role constraints and complications, particularly for community partners, also have been widely reported10,34,42–47
and were a particular issue for EHC promotoras
in the early stages of the work. Resentment from husbands and children, and being labeled as “gossips” by some community women not involved in the work, were of particular concern and are a reminder of the need to address the fact that training and hiring community members as team members may make them “outsiders within” or as Freire48
remarks, “strangers in their own community.” Substantial time for trust building,34,45,47
special training, and mentoring of community partners with respect to these and other challenging aspects of their roles, and, in the case of communities like the heavily Latino OTNC, outreach to participants’ husbands, are an important part of individual and community capacity building. Provision of meals and childcare, as well as a modest stipend also can be important in helping to lessen some of the burdens that community partners often face in this work. Finally, training for academic and other outside partners is needed so that they can better understand, and where possible avoid or ameliorate, such problematic aspects of participation for their community partners.10,45–47
Interestingly, one widely cited limitation faced by many CBPR partnerships, namely, inadequate financial support, particularly for community partners,10,34,45–47
appeared not to have presented a major obstacle to the EHC partnership. EHC’s earlier noted ability to bring in substantial funding from The California Endowment and The James Irvine Foundation, as well as eight years of NIH funding in support of its work, was a major contributor to its fiscal viability and its consequent ability to foster sustainability. The EHC partnership’s experience, like that of WE ACT and the Southern California Environmental Justice Collaborative highlighted above, underscores the importance of foundation and federal funding that makes “long term investment in change,”7
including support for developing the internal capacity of CBO partners to bring in and administer large federal or foundation grants over a long time period. The value of having strong, in-house researchers who can both help design rigorous research and write competitive grant proposals also was pointed out.
Policy-focused CBPR is labor and time intensive and, as indicated above, may face numerous barriers and obstacles at each step of the process. At the same time, however, partnerships like that of the EHC in OTNC remain important examples of the potential of CBPR for producing sound research and at the same time helping to amplify community voice toward the end of helping to promote policies that can improve the prospects for environmental justice in urban communities.