GGeeoorrggiiaa SSttaattee UUnniivveerrssiittyy SScchhoollaarrWWoorrkkss @@ GGeeoorrggiiaa SSttaattee UUnniivveerrssiittyy Public Health Theses School of Public Health Spring 4-28-2012 GGeeoorrggiiaa EEnnvviirroonnmmeennttaall AAddvvooccaaccyy GGrroouuppss HHeeaalltthh EEdduuccaattiioonn NNeeeeddss AAsssseessssmmeenntt Laura N. Frame Institute of Public Health Follow this and additional works at: https://scholarworks.gsu.edu/iph_theses RReeccoommmmeennddeedd CCiittaattiioonn Frame, Laura N., "Georgia Environmental Advocacy Groups Health Education Needs Assessment." Thesis, Georgia State University, 2012. doi: https://doi.org/10.57709/2806413 This Thesis is brought to you for free and open access by the School of Public Health at ScholarWorks @ Georgia State University. It has been accepted for inclusion in Public Health Theses by an authorized administrator of ScholarWorks @ Georgia State University. For more information, please contact [email protected]. GEORGIA ENVIRONMENTAL ADVOCACY GROUPS HEALTH EDUCATION NEEDS ASSESSMENT By Laura N. Frame M.S., GEORGIA STATE UNIVERSITY B.S., University of Georgia A Capstone Project Submitted to the Graduate Faculty Of Georgia State University in Partial Fulfillment Of the Requirements for the Degree MASTER OF PUBLIC HEALTH ATLANTA, GEORGIA 30303 i GEORGIA ENVIRONMENTAL ADVOCACY GROUPS HEALTH EDUCATION NEEDS ASSESSMENT By Laura N. Frame Approved: __________________________________________ Committee Chair __________________________________________ Committee Member __________________________________________ Date i ACKNOWLEDGEMENTS I would like to thank John Steward for the countless hours he spent helping me on this project and his support throughout this process and during my time at Georgia State University. I would also like to thank Jane Perry for her constant encouragement, optimism and enthusiasm as well as the rest of the staff of Chemical Hazards Program for providing additional insight and guidance. I would like to thank my family for their support the past two years. I am truly blessed to have such a supportive and loving family that has encouraged me every step of the way. Lastly, I would like to thank my amazing fiancé, Evan. Words can’t express how lucky I feel for having you in my life. Your constant encouragement, optimism, contagious laugh, and ability to make me smile were essential to my happiness and success as a student. I couldn’t have done this without you. ii ABSTRACT Georgia State University’s Institute of Public Health along with the Georgia Department of Public Health’s Chemical Hazards Program conducted a needs assessment survey to learn more about the concerns of environmental advocates and other community leaders in Georgia regarding exposure to toxic chemicals. The purpose of the Georgia Environmental Advocacy Groups Health Education Needs Assessment was to better understand community concerns, to identify hazardous waste sites that might warrant some degree of public health evaluation, to find community leaders and personnel interested in assisting the Chemical Hazards Program in implementing public health interventions, to inform the community about the services offered to the public by the Georgia Department of Public Health and to better understand the best methods for distributing health education material. This is the first time the Chemical Hazards Program has conducted an environmental advocacy group leader needs assessment. The results of this pilot study will help the development of future needs assessments conducted by the CHP. Survey development began in August of 2011 and Georgia State University Institutional Review Board approval was granted January 2012. Participants were selected due to their current leadership role of a Georgia environmental advocacy group/organization. Contact information was found for 137 environmental group leaders. Depending on available contact information, potential participants either received the survey through the mail or electronically via email. Surveys were distributed on January 13, 2012 and had to be returned by February 20, 2012. Twenty-one Georgia environmental advocacy group leaders participated in the survey. A majority of participants cited protect/restore natural habitats as the main purpose of their organization, but the survey did reveal 10 environmental groups that focused on protecting human health. Seven of participants that were dedicated to protecting human health expressed interest in working further with the GDPH to develop or implement public health interventions. The survey was also successful in informing participants about the Chemical Hazards Program. Prior to the needs assessment, more than 80% of participants were not aware of the program. Many pertinent suggestions were also made to aid in the development of the brochure aimed at educating community members about the services offered by the CHP. Although a variety of environmental health concerns were cited by the participants, water quality was most often mentioned. More participants reported they were very concerned about drinking water than any other environment. Ninety percent also reported being either concerned or very concerned about contamination in oceans, lakes and streams. A section of the survey also addressed hazards found within the home, unclean drinking water was selected by far the most often as being of greatest concern compared to all other indoor hazards. Many participants listed specific waste or industrial sites that are of concern among members of their community as a source of contaminants. A few contaminated environments were also listed including specific rivers and lakes. Though many did not list specific sources, the majority of participants cited water contamination as being a chemical contamination issue that has the greatest impact on human health. The survey helped reveal specific community concerns regarding potential chemical contaminants and sites that may lead to the CHP conducting public health assessments/consultations and exposure investigations. The survey also revealed the need for general environmental health education and intervention activities based on concerns of the participants as well as the lack of concern by many. The survey was also successful in identifying individuals that may help the CHP gain future partnerships and identifying creative methods for distributing health education material. The CHP plans to follow-up with many of the participants and the survey will be further developed and used to survey other leaders, community members, and public health workers etc. to further investigate the needs and concerns of communities across Georgia. iii AUTHOR’S STATEMENT In presenting this thesis as a partial fulfillment of the requirements for an advanced degree from Georgia State University, I agree that the Library of the University shall make it available for inspection and circulation in accordance with its regulations governing materials of this type. I agree that permission to quote from, to copy from, or to publish this thesis may be granted by the author or, in his/her absence, by the professor under whose direction it was written, or in his/her absence, by the Associate Dean, College of Health and Human Sciences. Such quoting, copying, or publishing must be solely for scholarly purposes and will not involve potential financial gain. It is understood that any copying from or publication of this dissertation which involves potential financial gain will not be allowed without written permission of the author. ________________________ Signature of Author iv All theses deposited in the Georgia State University Library must be used in accordance with the stipulations prescribed by the author in the preceding statement. The author of this thesis is: Laura Nicole Frame 508 Main St Apt 3424 Atlanta, GA 30324 [email protected] The Chair of the committee for this thesis is: John Steward, MPH Institute of Public Health Georgia State University P.O. Box 3995 Atlanta, Georgia 30302-3995 Users of this thesis who not regularly enrolled as students at Georgia State University are required to attest acceptance of the preceding stipulation by signing below. Libraries borrowing this thesis for the use of their patrons are required to see that each user records here the information requested. NAME OF USER ADDRESS DATE TYPE OF USE (EXAMINATION ONLY FOR COPYING) v Table of Contents ACKNOWLEDGEMENTS.............................................................................................................iii ABSTRACT.....................................................................................................................................iv Chapter I INTRODUCTION ..........................................................................................................................1 1.1 Purpose of Study ..........................................................................................................1 1.2 Project Goals….............................................................................................................2 Chapter II REVIEW OF THE LITERATURE .................................................................................................3 2.1 Environmental Protection Agency and ATSDR............................................................3 2.2 CERCLA, Superfund Sites and the National Priority List............................................4 2.3 The Agency for Toxic Substances and Disease Registry..............................................5 2.4 Bio-monitoring and NHANES Data..............................................................................7 2.5 Exposure Pathways…………………………………………………………...……….7 2.6 Industrial Emissions Impact on Health……………………………………………......9 2.7 Home Health Hazards………………………………………………………………..12 2.8 Social Justice and Environmental Health Disparities .................................................15 2.9 Benefit of Community Partnerships………………………………………………….19 Chapter III METHODS AND PROCEDURES.................................................................................................22 3.1 Survey Development………………………………………..………………….…….22 3.2 Participant Selection…………………………………………………………………25 3.3 Distribution and Data Collection……………………………….……………………26 3.4 Analytical Methods……………………………………………….………………….28 Chapter IV SURVEY RESULTS......................................................................................................................29 4.1 Completed Surveys…………………………………………………………………..29 4.2 Group/Organization Characteristics……………………………………………..…...29 4.3 Chemical Hazard Program Knowledge and Brochure Evaluation…..........................32 4.4 Environment Contamination Concerns………………………………….……….…..32 4.5 Impact on Human Health………………………………………………...…………..33 4.6 Indoor Health Hazards…………………………………………………...…………..38 4.7 Distributing Health Education Material………………..…………………………….40 Chapter V DISCUSSION AND CONCLUSION.............................................................................................42 5.1 Study Implications………………………………..………………………………….42 5.2 Follow-up and Future Survey Development................................................................48 5.3 Study Challenges.…………………………………………..………………………..48 5.4 Conclusion...................................................................................................................50 REFERENCES…………………………………………………………………...………………52 LIST OF TABLES 1. Georgia Hazardous Wastes Sites on the National Priority List……………………………….5 2. Common Air Pollutants and Sources……………………………….…………………………9 3. Adjusted Purpose/Goals of Environmental Groups…………………...……………………..30 4. Chemical Contamination Issues and Sources……………………………..………………….34 LIST OF FIGURES 1. Human Exposure Pathways………………...…………………………….…………………...8 vi 2. Distribution of National Total Emissions Estimates by Source Category for Specific Pollutants……………………………………………………….……………………….……11 3. Framework for Understanding Racial/Ethnic Disparities in Environmental Health………....16 4. Proportion of Population Living in Counties that Exceed Particulate Matter Standard by Race/Ethnicity……………………………………………………….…………………….…17 5. Blood Mercury Concentration by Race/Ethnicity………………………….……………...…18 6. Purpose of Environmental Groups………………………………………………….………..29 7. Revised Purposes of Environmental Groups…………………………………………………31 8. Participants Level of Concern for Specific Environment Contamination……….………….. 33 9. Participants Belief Regarding Chemical Contaminants as Health Concerns in Their Community……………………………………………………….…………………..………37 10. Participant’s Belief on Whose Health has been Affected by Environmental Exposures to Chemicals……………………………………………………….……………………………37 11. Level of Concern for Indoor Health Hazards………………………………………….……..39 12. Indoor Health Hazards Perceived Likelihood………………………………………………..40 13. Best Methods for Providing Health Information……………………………………………..40 APPENDICES……………………………………………………….…………………..……….54 A. Cover Letter……………………………………………………………………..…….………54 B. Chemical Hazards Program Brochure.………….……………………………..……...….……55 C. Consent Form ………………………………………………………………………….…...…56 D. Survey……………………………………………………………………………………...….58 E. Cover Letter Adapted for Email………………………………………………………..….…..63 F. Reminder Postcard……………………………………………………………………..…..…..64 vii Chapter I Introduction 1.1 Purpose The mission of the Georgia Department of Public Health’s Chemical Hazards Program is “to prevent illness and promote quality of life through the reduction and elimination of exposures to hazardous chemicals in the environment” (Chemical Hazards Program, 2012). Their specific goals are to “identify people at risk for health problems as a result of exposure to hazardous substances in the environment, determine relationships between exposure to hazardous substances in the environment and human diseases and eliminate exposures of health concern and prevent negative human health outcomes related to hazardous substances in the environment.” In order to accomplish these goals, the program conducts public health assessments, provides technical assistance, creates and distributes health education material, fosters community involvement, assists with health Studies and with the training of professional in public health disciplines (Chemical Hazards Program, 2012). Georgia State University’s Institute of Public Health and the Georgia Department of Public Health conducted a pilot needs assessment to primarily learn more about the concerns of environmental advocates and other community leaders in Georgia regarding exposure to toxic chemicals. The purpose of the Georgia Environmental Advocacy Groups Health Education Needs Assessment was to also inform the Georgia Department of Public Health about community public health concerns so they can help communities by conducting public health assessments and consultations, exposure investigation, community involvement/health education and other site-specific activities. The purpose of the needs assessment was to also identify new potential hazardous substances concerns among community members so the GDPH can conduct investigations into potential sources of chemical exposures. In addition to identifying community 1