Prepared for the Robert Wood Johnson Foundation
Editor: Iddo K. Wernick, Program for the Human Environment, The Rockefeller University
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This report presents the results of a one-year exploratory study on the "Environment and Community Health: Historical Evolution and Emerging Needs" sponsored by the Robert Wood Johnson Foundation. The Program for the Human Environment at The Rockefeller University conducted the study. The subject of the study was the analytical, informational, and service delivery framework for meeting needs in health care and environmental protection using the community as the focal point or, by medical analogy, the "community as the patient."
To broaden the base of knowledge and professional contacts available to the project, we formed a Steering Group including members experienced in public health and environment, government, community organization, and information technologies and services (Appendix A). Prior to the first meeting of the Steering Group, we devised a framework to raise relevant issues, better define the most fruitful lines of inquiry, and map out the future course of the project. The Steering Group met on April 19, 1994 at The Rockefeller University. The members resolved to examine three basic questions and commission case studies to explore them in the context of specific communities in the United States.
The three questions were
-- What is the current status of deliberative processes for risk assessment at the level of the community?
-- How can governments, independent and private sector groups, and researchers better use information technologies to access, integrate, and disseminate information about health and environment and related concerns at the local level?
-- What policy levers can government use to ensure that communities better address remediating local environmental hazards and improve the efficacy of local health care delivery?
To conclude the definitional phase of the project, Iddo Wernick drafted a discussion paper with the assistance of the Steering Group articulating the problems so far uncovered and providing the orientation for further work (pages 25-34). Planning for a larger Forum began, and two case studies were formally commissioned to be presented at the Forum. Theodore Glickman, a Senior Fellow at the Center for Risk Management of Resources for the Future (RFF), prepared a report on environmental equity in Allegheny County, Pennsylvania, using a Geographical Information System (GIS) as the framework. Lenny Siegel, Director of the Pacific Studies Center in Mountain View, California, reviewed the recent history of community efforts in addressing environmental problems in Silicon Valley, California, and described a process for developing community risk profiles based on his experience working as a community activist with federal, state, and local governments.
The two case studies, "Evaluating Environmental Equity in Allegheny County" (pages 35-62) and "Comparing Apples and Supercomputers: Evaluating Environmental Risk in Silicon Valley" (pages 63-79) formed the core of the agenda for the Forum on Environment and Community Health, held on September 20, 1994 at The Rockefeller University. The Forum included professionals from the public and private sectors with expertise in public health, environment, and community services (list of participants, Appendix A). Background reading, sent prior to the Forum, oriented participants to the purposes of the project (see Bibliography and Suggested Reading).
This report presents the main findings of the exploratory study. We stop short of costing out its main recommendation, an obvious next step.
Drafted initially by Iddo Wernick, this report synthesizes the informed contributions offered by the many people who have been a part of the study. Reflecting our backgrounds in environment, we tend to offer more detail on environment than health. The Forum participants have reviewed this report, and the Steering Group members have reviewed and approved it.
We thank Doris Manville for her assistance in organizing and administering the project. We wish to thank other people with whom we consulted during the project including Mark Schaefer, Assistant Director for Environment, White House Office of Science and Technology Policy; Margaret Hamburg, M.D., Commissioner, New York City Department of Health; Debora Martin, U.S. Environmental Protection Agency; and Kenneth Jones and colleagues at the Northeast Center for Comparative Risk.
Jesse H. Ausubel
Director, Program for the Human Environment
Iddo K. Wernick
Research Associate, Program for the Human Environment