Racism as a public health issue in environmental health disparities and environmental justice: working toward solutions.

BACKGROUND: Environmental health research in the US has shown that racial and ethnic minorities and members of low-socioeconomic groups, are disproportionately burdened by harmful environmental exposures, in their homes, workplace, and neighborhood environments that impact their overall health and well-being. Systemic racism is a fundamental cause of these disproportionate exposures and associated health effects. To invigorate and inform current efforts on environmental justice and to raise awareness of environmental racism, the National Institute of Environmental Health Sciences (NIEHS) hosted a workshop where community leaders, academic researchers, and NIEHS staff shared perspectives and discussed ways to inform future work to address health disparities. OBJECTIVES: To share best practices learned and experienced in partnerships between academic researchers and communities that are addressing environmental racism across the US; and to outline critical needs and future actions for NIEHS, other federal agencies, and anyone who is interested in conducting or funding research that addresses environmental racism and advances health equity for all communities. DISCUSSION: Through this workshop with community leaders and researchers funded by NIEHS, we learned that partnerships between academics and communities hold great promise for addressing environmental racism; however, there are still profound obstacles. To overcome these barriers, translation of research into plain language and health-protective interventions is needed. Structural changes are also needed in current funding mechanisms and training programs across federal agencies. We also learned the importance of leveraging advances in technology to develop creative solutions that can protect public health.

Expanding the Concept of Translational Research: Making a Place for Environmental Health Sciences.

SUMMARY: The National Institute of Environmental Health Sciences (NIEHS) introduces a new translational research framework that builds upon previous biomedical models to create a more comprehensive and integrated environmental health paradigm. The framework was developed as a graphical construct that illustrates the complexity of designing, implementing, and tracking translational research in environmental health. We conceptualize translational research as a series of concentric rings and nodes, defining "translation" as movement either from one ring to another or between nodes on a ring. A "Fundamental Questions" ring expands upon the research described in other frameworks as "basic" to include three interrelated concepts critical to basic science research: research questions, experimental settings, and organisms. This feature enables us to capture more granularity and thus facilitates an approach for categorizing translational research and its growth over time. We anticipate that the framework will help researchers develop compelling long-term translational research stories and accelerate public health impacts by clearly mapping out opportunities for collaborations. By using this paradigm, researchers everywhere will be better positioned to design research programs, identify research partners based on cross-disciplinary research needs, identify stakeholders who are likely to use the research for environmental decision-making and intervention, and track progress toward common goals. https://doi.org/10.1289/EHP3657.

The Emergence of Environmental Health Literacy-From Its Roots to Its Future Potential.

BACKGROUND: Environmental health literacy (EHL) is coalescing into a new subdiscipline that combines key principles and procedural elements from the fields of risk communication, health literacy, environmental health sciences (EHS), communications research, and safety culture. These disciplines have contributed unique expertise and perspectives to the development of EHL. Since 1992, the National Institute of Environmental Health Sciences (NIEHS) has contributed to the evolution of EHL and now seeks to stimulate its scientific advancement and rigor. OBJECTIVES: The principal objective of this article is to stimulate a conversation on, and advance research in, EHL. DISCUSSION: In this article, we propose a definition of and conceptual framework for EHL, describe EHL in its social and historical context, identify the complementary fields and domains where EHL is being defined and implemented, and outline a research agenda. Extensive reviews of web and literature searches indicate that the concept of EHL is evolving rapidly, as are the definitions of its scope and inquiry. Although several authors have outlined different frameworks, we believe that a more nuanced model based on Bloom's taxonomy is better suited to EHL and to future research in this area. CONCLUSIONS: We posit that EHL can potentially benefit the conduct and outcomes of community-engaged and health disparities EHS research and can ensure that the translation of research findings will lead to greater understanding of specific risks, reduction of exposures, and improvement of health outcomes for individuals and communities. We provide four recommendations to advance work in EHL.

Integrating Health Research into Disaster Response: The New NIH Disaster Research Response Program.

The need for high quality and timely disaster research has been a topic of great discussion over the past several years. Recent high profile incidents have exposed gaps in knowledge about the health impacts of disasters or the benefits of specific interventions-such was the case with the 2010 Gulf Oil Spill and recent events associated with lead-contaminated drinking water in Flint, Michigan, and the evolving health crisis related to Zika virus disease. Our inability to perform timely research to inform the community about health and safety risks or address specific concerns further heightens anxiety and distrust. Since nearly all disasters, whether natural or man-made, have an environmental health component, it is critical that specialized research tools and trained researchers be readily available to evaluate complex exposures and health effects, especially for vulnerable sub-populations such as the elderly, children, pregnant women, and those with socioeconomic and environmental disparities. In response, the National Institute of Environmental Health Science has initiated a Disaster Research Response Program to create new tools, protocols, networks of researchers, training exercises, and outreach involving diverse groups of stakeholders to help overcome the challenges of disaster research and to improve our ability to collect vital information to reduce the adverse health impacts and improve future preparedness.

Partnerships for environmental and occupational justice: contributions to research, capacity and public health.

In 1994, the National Institute of Environmental Health Sciences (NIEHS) initiated a program to address communication gaps between community residents, researchers and health care providers in the context of disproportionate environmental exposures. Over 13 years, together with the Environmental Protection Agency and National Institute for Occupational Health and Safety, NIEHS funded 54 environmental justice projects. Here we examine the methods used and outcomes produced based on data gathered from summaries submitted for annual grantees' meetings. Data highlight how projects fulfilled program objectives of improving community awareness and capacity and the positive public health and public policy outcomes achieved. Our findings underscore the importance of community participation in developing effective, culturally sensitive interventions and emphasize the importance of systematic program planning and evaluation.

Strategies for setting a national research agenda that is responsive to community needs.

Setting a national environmental health research agenda requires broad public input, including that from leading scientists, health care professionals, and communities. Contributions from these diverse constituencies are essential to formulating a research and education strategy that both advances our understanding of the causes and mechanisms of environmentally related diseases and translates such findings into effective prevention and clinical applications to protect those most affected by adverse environmental exposures. Given the increasing number of individual researchers working with communities to address environmental health needs during the past decade, it is also essential for research institutions to foster relationships with communities to understand and respond to their unique public health needs, as well as to communicate research advances in a manner that is both understandable and culturally appropriate. To achieve broad public input and to foster community-university partnerships, the National Institute of Environmental Health Sciences (NIEHS) supports various workshops, roundtables, and advisory groups. In particular, the NIEHS finds Town Meetings to be a successful model for bringing academic researchers together with community residents, state and local departments of health, and community-based organizations to foster greater awareness of community needs, public health needs, and environmental health science research. Since 1998, the NIEHS has supported 16 Town Meetings across the country. In this article we highlight the major outcomes of these meetings to demonstrate the effectiveness of this mechanism for enhancing cooperation among researchers, community residents, and public health officials with the goal of improving public health and setting a national research agenda.

Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health.

Mounting evidence suggests physical and mental health problems relate to the built environment, including human-modified places such as homes, schools, workplaces, parks, industrial areas, farms, roads and highways. The public health relevance of the built environment requires examination. Preliminary research demonstrates the health benefits of sustainable communities. However, the impact of mediating and moderating factors within the built environment on health must be explored further. Given the complexity of the built environment, understanding its influence on human health requires a community-based, multilevel, interdisciplinary research approach. The authors offer recommendations, based upon a recent conference sponsored by the National Institute of Environmental Health Sciences (NIEHS), for research and policy approaches, and suggest interagency research alliances for greater public health impact.

Community-based participatory research as a tool to advance environmental health sciences.

The past two decades have witnessed a rapid proliferation of community-based participatory research (CBPR) projects. CBPR methodology presents an alternative to traditional population-based biomedical research practices by encouraging active and equal partnerships between community members and academic investigators. The National Institute of Environmental Health Sciences (NIEHS), the premier biomedical research facility for environmental health, is a leader in promoting the use of CBPR in instances where community-university partnerships serve to advance our understanding of environmentally related disease. In this article, the authors highlight six key principles of CBPR and describe how these principles are met within specific NIEHS-supported research investigations. These projects demonstrate that community-based participatory research can be an effective tool to enhance our knowledge of the causes and mechanisms of disorders having an environmental etiology, reduce adverse health outcomes through innovative intervention strategies and policy change, and address the environmental health concerns of community residents.