Delaware, Ohio: Community Environmental Health Assessment

[Lenny Siegel <lsiegel@cpeo.org>]

The results are starting to come in from the National Association of
County and City Health Officials (NACCHO) Community Environmental Health
Assessment pilot project. Ten health departments across the country are
testing the "Protocol for Assessing Community Excellence in
Environmental Health" (PACE-EH).

The idea of the project is to ask members of the community, not just the
experts, about environmental health concerns. While it appears that the
health departments that are using this tool see it primarily as a way to
focus public resources better, a community-based assessment should also
prove valuable as a baseline for community-driven brownfields
revitalization.

The following report, from Delaware County, Ohio, appeared originally in
the April, 1999 edition of "Setting the PACE," published by NACCHO
(http://naccho.org) and the Green Mountain Institute for Environmental
Democracy (http://gmied.org), with support from the National Center for
Environmental Health (http://www.cdc.gov/nceh).

LS




COMMUNITY OUTREACH IN DELAWARE, OHIO
Jonathan Schwartz, Paul Rosile, and Hilton da Silva


        The Delaware County (Ohio) PACE EH pilot site has, from the
outset, focused its efforts on producing a community environmental
health assessment that incorporates a variety of opportunities for
collecting, analyzing and acting upon widespread community input. 
Taking a cue from the methodology proposed in PACE EH, the Delaware
assessment committee did not limit the process by coordinating issue
identification around either the existence of, or feasibility of
collecting, specific environmental health data.  Instead, they began the
issue identification process with the proverbial "blank slate."  Opting
to, temporarily, put aside the extensive local environmental health
knowledge held individually by the assessment committee members, the
PACE EH committee chose to concentrate on learning about the
environmental health of the community from the community.  To this end,
the assessment committee employed a number of specific community
outreach programs.  

Focus Groups
        Five focus groups were convened with the assistance of a
professional consulting firm to ensure the quality and accuracy of the
data collected.  The focus groups involved a total of 65 participants
randomly chosen from each of the five distinct geographic regions found
in the county.  The participants were convened such that each focus
group accurately represented the overall demographic make-up of each
region.

        The aim of the focus groups was to collect public input about
perceived environmental and environmental health issues in Delaware
County.  Staff from the consulting firm facilitated the discussions. 
Each facilitator had the focus group discuss the following:
* what is best about living in Delaware County, 
* what are the biggest county-wide problems, 
* what does the word "environment" mean,
* what are the main environmental concerns in the county, 
* what are the main environmental health concerns in the county, 
* how should these concerns be prioritized, and 
* what should be done to resolve these concerns.

The five focus group responses were then analyzed for both individual
content and broad similarities and differences.  The consulting firm
provided the PACE EH assessment committee with a report that both
detailed specific individualized responses and presented a broad
overview of public perception of local environmental health.  The report
also relayed suggestions for prioritization of, and action upon, a
number of environmental health issues identified by the general
population.  

Facilitated Discussions
        At the same time, the assessment committee also conducted
twenty-four facilitated discussions throughout the different townships,
villages and geographic regions of the county.  Hundreds of individuals,
representing every local township and numerous community organizations,
took part in the facilitated discussions.  The aim of the facilitated
discussions, like the focus group study, was to develop an understanding
of the community perspective of the environmental health issues and
priorities of Delaware County.  The facilitated discussions were led by
representatives of the PACE EH assessment committee and followed a
script similar to the one employed throughout the focus group
discussions.  The facilitated discussions, however, served an
educational function by introducing the participants to the PACE EH
project, the role of the assessment committee, and the use and value of
environmental health indicators in relation to the project.

        In this fashion, the assessment committee compiled a less
statistically random, but far more extensive, collection of data
representing local perspectives of environmental health than that
generated by the focus group study.  Furthermore, the assessment
committee had also begun constructing a framework for coalition-building
between themselves and the community.  In effect, the community outreach
achieved by the facilitated discussions was not limited to data
collection but also incorporated project promotion and the germination
of future coalition-building with community representatives.

Key Informant Interviews
        In addition the assessment committee organized twenty-six key
informant interviews.  The informants were chosen based on a
demonstrated expertise, or occupation, in environmental and/or
environmental health issues.  Open-ended questionnaires, asking about
perceived environmental health problems in the county and
recommendations for addressing them, were sent in advance to each of the
key informants, follow-up phone interviews were conducted to elicit
responses.  The informants were also given the option to supply written
comments.  The key informant interviews were valuable tools for
comparing the perspective of the general populous to that of local
environmental and environmental health "experts."  The key informant
interviews validated community opinion and provided more sophisticated
issue analysis that served to orient future project planning.

Assessment Committee Opinion
        In order to both coordinate future activities and utilize the
environmental health expertise demonstrated by individual members of the
Delaware County PACE EH assessment committee, each member was asked to
present his or her opinions regarding local environmental health to the
overall committee.  This procedure was designed to both develop
additional data for analysis, as well as familiarize the assessment
committee with the kinds of data they would soon be analyzing.  However,
this step also produced an unexpected benefit.  It graphically
demonstrated that, for the most part, the environmental health concerns
and priorities expressed by the community mirrored those suggested by
the assessment committee members.  Thus, it served to remind the
committee that they in fact are representatives of the community, and
that there does exist potential for widespread community consensus in
addressing local environmental health issues. 

Data Management
        Two months were spent compiling the information from the focus
groups, facilitated discussions, key informant interviews, and PACE EH
assessment committee statements of opinion.  Through analysis of the
data, 465 distinct "concerns" pertaining to the environmental health of
the community were identified.  The concerns ranged from global warming
and unchecked population growth to local water quality and solid waste
management. 

        This list of 465 concerns was aggregated and grouped into 19
distinct environmental health categories.  Thirteen of these categories
were considered by the assessment committee "traditional" environmental
health distinctions.  The assessment committee developed six additional
categories.  

13 Traditional Environmental Health Categories:
1.) Water Supply, Water Quality and Water Pollution
2.) Sewage Disposal
3.) Indoor and Outdoor Air Pollution
4.) Solid Waste Management
5.) Food Safety and Protection
6.) Animal Control (insect, rodent, parasite and other pests)
7.) Housing Safety and Sanitation (incl. Residential Environmental
Control)
8.) Radiation Safety
9.) Noise Control
10.) Pesticide and Toxic Substances Control
11.) Occupational Environmental Control
12.) Recreational Environmental Control
13.) Injury Prevention, Control and Public Safety

6 Additional Environmental Health Categories:
1.) Recycling
2.) Environmental Education and Funding
3.) Environmental Enforcement, Regulation, Law, and Zoning
4.) Quality of Life
5.) Development
6.) Parking Lot (General Issues not directly related to Environmental
Health)

        A series of graphs were developed to visually represent the
findings of the committee.  A subcommittee derived from the assessment
team was tasked with developing "frequency" criteria, and a frequency
analysis was conducted in order to determine which issues were mentioned
most often, and in which geographic regions specific issues were deemed
significant.  This analysis allowed for further organization of the list
and facilitated the grouping of some issues.  Next the issues were
reviewed by the assessment committee for similarities and redundancies. 
Finally, overarching issues and those unrelated to the environment were
isolated and removed from the developing issue list.

        The grouping of issues and elimination of redundancies reduced
the initial 465 environmental health concerns to 194 issues.  Further
refinement of specific issues, and a broadening of the categories,
reduced the list to 66 issues.  Next the assessment committee combined
the results of a frequency analysis and a set of modified criteria
originally presented in the City of Columbus Priorities '95 Project that
focused on data availability, potential risk, feasibility of public
comprehension, and potential for action.  In this fashion the remaining
66 issues were screened and twenty local environmental concerns were
identified.  All the issues in the list were approved by consensus of
the assessment committee, and they represented a 95% correlation with
the most frequently mentioned issues gathered from the Delaware
community at large.  The identification of the top 20 issues concluded
Phase I of the Delaware (OH) PACE EH project.


        The experiences of the Delaware (OH) PACE EH assessment
committee indicate that the effort put toward widespread community
outreach as a form of data collection was valuable in a variety of
ways.  It both produced a great deal of relevant environmental health
data for analysis, and provided a conduit between the assessment
committee and the community that set the stage for project promotion and
coalition building.  Community outreach, combined with research,
provided the assessment committee not only with insight into the
environmental health values and perceptions of the community, but also
the recognition that their task was both valuable and appreciated. 
Community outreach efforts informed the assessment committee that not
only are they representatives of the community, but members as
well.       


-- 


Lenny Siegel
Director, Center for Public Environmental Oversight
c/o PSC, 222B View St., Mountain View, CA 94041
Voice: 650/961-8918 or 650/969-1545
Fax: 650/968-1126
lsiegel@cpeo.org
(PLEASE NOTE THAT WE ARE PHASING OUT
MY OLD E-MAIL ADDRESS: lsiegel@igc.org)
http://www.cpeo.org