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Combining Community-Based Research and Local Knowledge to Confront Asthma and Subsistence-Fishing Hazards in Greenpoint/Williamsburg, Brooklyn, New York - A Quick Reference Guide

Authors

Jason Corburn

 

Summary

The Greenpoint/Williamsburg (G/W) neighborhood in Brooklyn, New York has approximately 160,000 residents living in an area less than 5 square miles.  These residents are also some of the poorest in New York City. 

This article highlights the work of El Puente and The Watchperson Project - two community-based organizations in the G/W neighborhood.  These two organizations have engaged in community-based participatory research (CBPR) to address asthma and risks from subsistence-fish diets.  The CBPR process attempted to engage community members as equal partners with scientists in defining the problems, collecting information, and analysing data for locally relevant action for social change.

 

Type of Data/Science

A series of community health surveys were designed, administered, and interpreted by community residents with the assistence of both Community Information and Epidemiological Technologies (CIET) and the U.S. Environmental Protection Agency (EPA).

 

Type of Community Action

An asthma mastery program was develped to enable local organizers to train community members in developing individual and family asthma management plans.

Cultural competency program to train local healthcare providers in Latino folk medicinal practices.

Enrollment of community members in the free insurance program.

"Fish-in" days were developed to educate anglers about the potential toxic contamination in the fish they were eating and cleaning up the riverbank.

Ongoing community partnerships to identify alternative food sources for subsistence anglers, including community gardens.

 

Lessons Learned

Community health educators are NECESSARY for the success of CBPR partnerships.  Community health educators with long-term ties to the community, knoweldge of the neighborhood and local services were the direct link between the researchers and the community.  Additionally,  community health educators with direct experience with the health issue (asthma or subsistence fishing) were more successful in connecting with and maintaining long-term relationships with community members.  The community health educators had credibility that lead to widespread community participation in the ongoing research, including surveys and focus groups.

Focus groups were an important information-gathering tool that gave depth to the survey findings.  The meetings often gave context and narratives to the survey numbers that did not make sense to researchers.  For example, one survey found high rates of asthma in older women, which is counter to traditional asthma findings.  In the focus groups, the researchers learned that many of the women worked in places with high workplace exposures to chemicals, such as dry cleaners, nail salons, and textile factories.   

Solutions must take into account the cultural practices of the communities that are impacted by the health issue.  The project was more successful in asking community members to change various behaviors when they did not go directly against the cultural practices in a community.  Often, community members relied on herbal and home remedies to deal with asthma.  There was a general distrust of physicians that completely disregarded and denigrated these cultural practices.  Projects must somehow strive for middle ground in acknowledging cultural practices, while asking communities to adopt new practices.

Listen to local communities.  EPA chose G/W as a neighborhood with suspected high levels of exposure and the need for interventions.  However, it wasn't until the EPA met with the community regarding dietary assessments that the issue of risks from susbsistence fishing arose.  EPA had no idea that this was an issue in this neighborhood already beset with many environmental exposures.  EPA responded by working with local community organizations to develop an angler survey.

Community members can be experts, too.  Regardless of the level of education or fluency in English, community members can be equally expert if not moreso than conventional scientists in gathering information about hazards and disease in their own communities.  Community health educators and surveyors had credible and already existing lines of communication with community members to gather this information, as well as provide expertise on analysis based on local context and knowledge.

Community should be understood as both a geographic place and an identity group.  The G/W neighborhood is extremely diverse.  El Puente knew they could not possibly administer a survey to all of the residents in G/W.  Instead, they focused on the Latino community, within which their organization had some familiarity and credibility.  Often, common language, heritage, norms, and life experiences can define a community more than geography. 

Work with already established community groups and organizations.  Building credibility and relationships will go faster with an organization or group that has established ties with the community.  Working with these groups saves time and avoiding reinventing the wheel. 

Community residents must be seen as full partners in all aspects of the research process.  It cannot be stressed enough that local ownership of the research leads to trust in the process and results, as well as locally-driven action.  

CBPR must be a long-term process.  Achieving environmental justice in communities with multiple exposures will take a significant amount of time.  The best CBPR projects are long-term and repeats itself over time to take into account the changing nature of environmental problems in a community. 

 

For More Information:

El Puente Website

Mapping and CBPR (Corburn and Swanston, 2005) 

 

 

 

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