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6 Community Past, Present, and Futures Pittsburgh' s economy has lately been benefiting from a great deal of brown- field redevelopment. One can travel up and down the river and see new signs of life where old steel mills once stood. A paradigm shift among regulators from focusing on contamination to remediation to redevelopment has been proceed- ing at such a rapid pace that the public might well ask if the quality of the environment for the long term is at times being compromised for the sake of the economy in the near term. In some cases, however, environmental contamination has turned out to be relatively modest, even though opponents of the development project fought it on environmental grounds. This suggests a certain degree of chronic tension between the public and developers that needs to be respected, and tapped, for the common good. Education and knowledge sharing avenues for communication are essen- tial for trust and acceptance. This applies in both directions all stakeholders have not always been represented at the table, yet they've been expected to live with the consequences of the decisions. A related concern is that decision-making groups not lose sight of old communities while building new communities it's best to find ways to achieve integration and continuity between the two as brown- fields are put back into productive use. In addition to satisfying economic, environmental, and social concerns, it's important that communities be conducive to individuals' good-health practices. Redevelopment plans and land-use strategies must consciously incorporate fea- tures for "active living" for example, by providing numerous opportunities for exercise and an environment that's attractive for that purpose. The layout of * This chapter was prepared from the transcript of the meeting by Steven J. Marcus as the rappor- teur. The discussions were edited and organized around major themes to provide a more readable summary and to eliminate duplication of topics. 36

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COMMUNITYPAST, PRESENT, AND FUTURE 37 communities, especially created communities, should allow for a healthier population. A panel of speakers discussed strategies to secure active-living communities; redevelop brownfields with quality environment, quality of life, sound engineer- ing, and economic viability (and affordability) in mind; inspire regulators' efforts to balance redevelopment and environmental-safety objectives; obtain environ- mental justice (in essence, "ensure that the people who are most affected by a problem are at the table"; and ensure people's comfort and safety in their own homes. "ACTIVE LIVING" IN WALKABLE COMMUNITIES A strong relationship exists between physical activity (or the lack of it) and the prevention (or development) of disease, according to Andrea Kriska, an asso- ciate professor at the University of Pittsburgh's Graduate School of Public Health. Indeed, the 1996 Surgeon General's Report on Physical Activity and Health concluded that "Regular physical activity that is performed on most days of the week reduces the risk of developing or dying from some of the leading causes of illness and death in the United States" for example, cardiovascular disease, type II diabetes, osteoporosis, osteoarthritis, and cancer. Thirty minutes a day of moderately intensive exercise such as walking- can greatly impact on both physical and mental health. But the challenge, Kriska noted, is how to get people to actually do those 30 minutes, how to put activity into their day on a regular basis. The solution, she said, is "to take it to the community to go into the environment, remove the barriers, and create the opportunities for a person to be more active." Specifically, the public health literature suggests things like "purposeful walking" "many individuals are not going to get out there and just walk for the sake of walking. They want a reason to get there," Kriska said. There need to be attractive places they wish to go to. The actual number of places within walking distance of people's homes is strongly related to how much walking they do. Likewise, the safety of the neigh- borhood. One major reason why some parents keep their children in the home is safety. If they're sitting in front of the TV, at least they're not out on the street, vulnerable to crime, traffic, and infrastructure such as sidewalks in deterio- rated and hazardous condition. "The thing that put my field back 30 years," Kriska noted, "was [that mis- guided notion of] 'no pain, no gain.' People don't do things if they're unpleasant. Whether the sidewalks, the architecture, the green spaces are pleasant is very important to walking and physical activity." She cited the work of her doctoral student Wendy King, who investigated walking habits of a cohort of postmenopausal women as functions of their neigh- borhood environments. The results, some of which are shown in Figure 6-1, indicate that the number of locations within walking distance from the home had

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38 ENSURING ENVIRONMENTAL HEALTH IN POSTINDUSTRIAL CITIES [:::1 Pedometer (1 O*steps/day) PI Walking (kcal/week) ~ Activity (kcal/week) 1 600 1 400 1 200 1 000 800 600 400 200 0 1 2+ # Locations within Walking Distance FIGURE 6-1 People who have more locations to walk to, walk more each week than those who don't have locations within walking distance. SOURCE: King, et al. In press. Reprinted with permission. a significant impact on physical activity levels. "The more locations there are for you to walk to," Kriska observed, "the more you will walk." Likewise the neigh- borhood rating, as shown in Figure 6-2 "the better you rate your neighbor- hood, the more you are going to be getting out there and walking." In other words, she concluded, "the convenience of locations and quality of the neighbor- hood surroundings will impact physical activity." This relationship has not been lost on community leaders, and many are now actively trying to make their neighborhoods, towns, and cities more walkable. REDEVELOPING BROWNFIELDS: DEVELOPER Because many home buyers now demand planned, pedestrian-oriented com- munities with a great deal of open space, they're receptive to redeveloped brown- field sites that offer these attributes, according to Mark C. Schneider, president of the Rubinoff Company. On this issue, "the market is out in front of us devel- opers and public health officials. Some 35 percent of the new-housing market would live in communities like this, which makes these sites worth pursuing." Schneider is managing general partner of Summerset at Frick Park a redeveloped slag site in Pittsburgh previously called Nine Mile Run and he noted the irony that such former industrial locations, perennially thought to present serious environmental problems, can actually offer healthful, high-quality living for their residents or users. For one thing, a 230-acre parcel like Nine Mile Run, not often found in most cities, presents intriguing possibilities. For another, the problems for the developer at that specific site "were not environmental,"

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COMMUNITYPAST, PRESENT, AND FUTURE P=.0008 P=.0077 P=.001 6 Pedometer 200 We ing ( Cal eek) Boo Activity (kcal/week) 400 poor fair good excellent Neighborhood Rating 39 FIGURE 6-2 Individuals who rate their neighborhood good or excellent walk more than those who rate their neighborhood as poor. SOURCE: King et al. In press. Reprinted with . . permlsslon. Schneider maintained. "They were engineering, and continue to be engineering." Because slag was dumped at a steep slope, the company has had to regrade to ensure stable hillsides, vegetation growth, and sustainability. Nevertheless, "when you are working on a brownfield," he emphasized, "the environmental issue can become 'a wedge issue and a scare tactic' for people attempting to stop the project." Ultimately, they couldn't stop it, though they did substantially increase the amount of money that had to be spent and the time it took to get the site entitled. "We spent half a million dollars doing air monitoring, basically demonstrating that there was no problem with the grading of the slag or the moving of the slag," Schneider said. Environmental quality, fundamentally, is a legitimate concern, and develop- ers and public regulators must of course be careful that a project is safe. But to succeed, whether financially or environmentally, developers also need certainty and predictability. Schneider cited multiple levels of uncoordinated, redundant review for Summerset at Frick Park that he alleged made the project far more complex than it needed to be: "We had our own environmental experts. Our lenders had their own environmental experts. We had DEP (the Pennsylvania Department of Environmental Protection) opining on this for Act II of the con- sent order. URA (the Urban Redevelopment Authority of Pittsburgh), which was the landowner, had its own consultants. The Allegheny County Health Depart- ment reviewed this. The state health department was brought in by ATSDR (the U.S. Agency for Toxic Substances and Disease Registries) because EPA (the U.S. Environmental Protection Agency) got a complaint from somebody who wanted to stop the project. We had seven ATSDR public health advisories, and

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40 ENSURING ENVIRONMENTAL HEALTH IN POSTINDUSTRIAL CITIES also the URA ended up paying for a separate consultant to work with the com- munity group to overview all this work." In place of such an ad hoc, seemingly open-ended procedure, he suggested, should be leadership, partnership, and clear policies with agreed-upon and un- ambiguous rules by which developer, regulator, and the public can make their respective contributions thoroughly, yet fairly to livable, health-promoting communities. REDEVELOPING BROWNFIELDS: REGULATOR The terms "Superfund site" and "brownfield" may sometimes appear synony- mous, but the ATSDR makes an important operational distinction. According to Henry Falk, assistant administrator of ATSDR, the Superfund program focuses on hazardous-waste contamination and how sites can be remediated, while the brownfields program deals largely with moving sites toward redevelopment, or redeveloping sites that were contaminated in one way or another but not to a degree that they'd be considered Superfund sites. The Superfund program created by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980, generally referred to as the "Superfund law" was prompted by the events at Love Canal. Putting first things first, the law addressed environmental issues such as criteria for prioritizing sites, looking especially at populations at risk. Next, it addressed the potential for contamination of drinking water, for direct human contact, and for destruc- tion of sensitive ecosystems. Thus, ATSDR, an agency that also was created by the Superfund law, does environmental public health evaluations, exposure assessments, health investiga- tions, and toxicology profiles to evaluate the health aspects of Superfund sites in a very systematic way. It also issues public health advisories when substances from the site are present at levels that may threaten human health. Occasionally, these threats prove highly significant. In Libby, Montana, which used to host the country's largest vermiculite mine, the agency examined 7,300 people, almost 20 percent of whom had chest X rays showing pleural abnormalities related to asbestos (the mined vermiculite had contained a certain amount of tremolite asbestos). Of the former W.R. Grace workers who ran the mine in its final decades and participated in the examinations, 51 percent showed pleural abnormalities. Moreover, even the people who didn't have abnormalities are at risk of developing them in years to come. Such sites are under prolonged remediation, of course. But some Superfund sites do get redeveloped. The Rocky Mountain Arsenal is now a very enchanting nature preserve, Falk observed. The Presidio of San Francisco has been the site of a "Star Wars" movie studio, and the Memphis Defense Depot is multiuse commercial region. So it does happen, but it takes a very long time, and in any case redevelopment has not been the focus of the Superfund program.

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COMMUNITYPAST, PRESENT, AND FUTURE 41 By contrast, numerous brownfield sites do get redeveloped, often with ATSDR's assistance. In 2002, some 428 of them (former industrial, military, or public-facility sites, for the most part) were cited in business journals and news- papers as redevelopments completed or in progress. The most common type is called "mixed use" combining office, retail, and residential. Other redevelop- ments are cultural, recreational, or even industrial, though roughly 80 percent or more of these sites do not go back into any type of industrial use. The legislation that relates to brownfields is quite different from that of Superfund, Falk observed. The EPA Brownfields Program, very heavily focused on redevelopment, provides states and local areas with help in assessing specific sites and evaluating the viability of proposed uses there. Summary descriptions of the program in fact convey the number of property assessments, how much redevelopment they have leveraged, and how many jobs they've created. Spe- cifically, EPA maintains a revolving loan fund and provides "smart growth" grants, "blighted community" grants, and job-training grants, among other things. A prominent local example of a redeveloped brownfield site is the above- mentioned Nine Mile Run slag site, the subject of numerous health consultations by the Pennsylvania Department of Health over the years, with assistance from ATSDR (see Figure 6-3~. A variety of health problems had to be dealt with at this former site of steel- related slag, Falk said. They included potential for exposure to manganese and other metals in soil; grading, sloping, and physical hazards; CO2 venting; and the suppression of airborne particulates and dust during construction. But the result of redeveloping this very large site was a community of hundreds of homes of different scales and types. Not all brownfield redevelopments have happy endings. After condominiums were built on the Grant Street site in Hoboken, New Jersey a building once used for the production of electric vapor lamps residents started seeing drops of mercury on their oven ranges and tabletops. Subsequent medical investiga- tions found high levels of mercury in their bodies, which led to a public health advisory and medical intervention for residents provided by Robert Wood Johnson Medical School. They had to be permanently relocated, as the building was declared uncleanable and therefore unfit for habitation. Practices for brownfield environmental evaluation, including sensitive ana- lytic methods, more and better sampling (including all contaminants of concern), and thorough consideration of the historical uses of the property, have improved since the Grant Street episode. Nevertheless, "as we work with redeveloping brownfields," Falk said, "one needs to retain a healthy measure of inquiry to focus on what these properties have been used for and on what can be done for them in the future."

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42 ENSURING ENVIRONMENTAL HEALTH IN POSTINDUSTRIAL CITIES FIGURE 6-3 Through active monitoring, numerous brownfield sites can be redeveloped. Often they are developed into mixed uses combining office, retail, and residential. SOURCE: ATSDR (brownfield site); Summerset Land Development Associates (devel- oped site). Reprinted with permission. ENVIRONMENTAL JUSTICE According to EPA, "Environmental justice is achieved when everyone, regardless of race, culture, or income, enjoys the same degree of protection from environmental and health hazards and equal access to the decision-making process to have a healthy environment in which to live, learn, and work."

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COMMUNITYPAST, PRESENT, AND FUTURE 43 While Leon Haynes, executive director of Hosanna House, endorsed this definition, he stressed an essential prerequisite. "Our success in addressing envi- ronmental justice depends on our ability to collaborate with all stakeholders," he said. "We have got to make sure that the people who are most affected by a problem are at the table. Anything less than that is not justice." Moreover, Haynes added, "we must acknowledge that there is no one answer in solving environmental- justice problems. We must consider a holistic approach that includes every sector." He cited the federal Interagency Working Group on Environmental Justice, and particularly its Revitalization Demonstration Projects in some 15 different communities. The goal of these projects is to improve the quality of life of minority and low-income people who suffer disproportionate environmental impacts and who traditionally have had limited access to environmental services. The program recognizes that many environmental issues cannot be adequately addressed without the combined resources of federal, state, and local govern- ment, along with capacity building at the community level, Haynes said. In that way, long-term solutions can be developed through a bottom-up approach that "involves community folks in making good decisions." An example of such a process, he suggested, is his own Hosanna House, a nonprofit that took over an abandoned 1916-vintage school building rife with environmental problems such as lead and asbestos. "We had to educate our- selves on what it means to remove or encapsulate. But we pressed on. We got information. We gathered people to work with us in order to do that. And today we have renovated 126,000 square feet of facility that is providing services to over 17,000 people. These are some of the things that I think the community can do if we give it a chance." Another example, pending in the East End of Pittsburgh, is toxic fumes from the buses that the residents of this high-density community depend on to go to work. These people need to be educated to look at bus transportation from an environmental viewpoint, Haynes said. And they should be empowered with information on alternatives to diesel-fueled buses e.g., natural-gas buses or electric buses. "My concerns," he said, "are with the things that affect what I think my community folks would see and pay more attention to if they had more informa- tion things like lead poisoning, asbestos, and even violence among young African-American males. These, along with undesirable land use, lack of green space, and toxins from automobiles, are environmental injustices" that are not dealt with properly, in large part because of inadequate information. We thus need "to take the time to make sure that they have the information necessary in front of them to make the best decisions for themselves and their families," Haynes said. "I don't think we've done a good enough job on that. We also need to understand that people don't care how much we know until they know how much we care."

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44 ENSURING ENVIRONMENTAL HEALTH IN POSTINDUSTRIAL CITIES TOWARD HEALTHY HOMES "Our homes should be our safe places the places where our children are tucked in at night, but we know that this is not always the case," said Samantha Roth, executive director of Healthy Home Resources. "Our homes may be dan- gerous, mysterious places that can cause multiple problems, especially for young children who are unwittingly exposed to in-home environmental hazards." For example, residents can come into contact with lead via lead-paint dust and lead dust as well as pesticides, molds, and various solvents. Among the more vulnerable i.e., the youngest occupants some of these agents are known to cause physical and learning disabilities, developmental delays in fine and gross motor skills, and recent research by Dr. Herbert Needleman from the University of Pittsburgh suggests that with even low levels of lead exposure, our children may develop behavioral issues such as ADHD (attention-deficit/ hyperactivity disorder) and oppositional defiance disorder Living in a healthy home is obviously a desirable goal. But barriers often prevent its realization. General lack of knowledge. Shelter, safe neighborhoods, and home ownership are justly each resident's top priority. But fully understanding the structural issues of a home, the materials used within it, and a home's potential impact on our health has not yet risen to the top of our minds- even as a secondary priority. Research findings are starting to proliferate, but they must be put into language that can commonly be understood and supported by state and federal housing inspection regulations. Low home-ownership rates. People are empowered to make changes by their ability to control the environment around them as well as having good information. If they are renters, that ability is compromised because they can't readily contract services to have work done in their home. Oftentimes they find themselves in an adversarial relationship with their landlord if such requests are made. Inaccessibility to services and products. The cost of remediation is high. Even with the knowledge of potentially hazardous conditions in their homes, low-income homeowners find maintenance and remediation cost- prohibitive. Lead abatement as well as mold mitigation can exceed $10,000 per unit. Inadequate regulatory and enforcement policies and data collection sys- tems. This may be seen at the local, state, and federal departments of environment, public health, housing and urban development, and health and human services the very systems that we rely upon to provide the general public with accurate and timely information. For example, 90 percent of Pittsburgh's housing stock was built prior to 1978, the year in which lead paint was banned. Thus, lead paint may be present in 90 percent of our city's homes. Even though the State of Pennsylvania man-

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COMMUNITYPAST, PRESENT, AND FUTURE 45 dates that all Medicaid children be screened for lead poisoning at 12 and 24 months of age as part of the EPDST [Early and Periodic Screening, Diagnosis, and Treatment program], "the percentage of Medicaid children being screened in Allegheny County is abysmal," Roth said. According to the Allegheny County Health Department, only 6 percent of Medicaid children were screened in 1999 and screening rates continue to fall each year. "This is only one cross-section of our child population. How can we know the extent of the problem and aptly make choices about program- ming if the data are not readily available nor being collected?" "In the absence of good local data, we are gravely concerned that lead poisoning prevention resources will diminish. These barriers may be lower with the help of "community action models" that reflect creative program design and multiple approaches. Three program- matic models, two of them currently focused on lead and the third on multiple in-home environmental issues, are: . . Lead Safe Pittsburgh, recognized by the Alliance to End Childhood Lead Poisoning as an excellent example of community collaboration, is a coali- tion of more than 65 institutional and community-based stakeholders in southwestern Pennsylvania. It is addressing the systemic barriers in place policy and data systems as well as physician practice that allow lead exposure in the home to go undetected. CLEARCorps, The Community Lead Education and Reduction Corps is a national AmeriCorps program. It works within communities to educate residents, in part by nurturing local champions and neighborhood stew- ards, on the prevention of lead poisoning. "Our CLEARCorps program is currently focusing its educational efforts in partnership with local early childhood development centers and parents," said Roth, "in an effort to express a simple concept: with engaged educators and parents who under- stand the link between health and a child's ability to learn, and a home free of developmentally devastating hazards, our children have a better chance of success in life." The American Respiratory Alliance of southwestern Pennsylvania is part- nering for the first time ever with an environmental organization in an effort to answer the following questions: (1) What is the local prevalence of environmental irritants or poor indoor air quality in the homes of asth- matic children and does this prevalence align with national findings? (2) What would it cost, on average, to remediate affected homes and are there creative means to finance these costs? (3) Can varying degrees of remediation and in-home environmental education for parents of children with asthma reduce school absenteeism and health care expenditures (such as the cost of frequent emergency room visits)?

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46 ENSURING ENVIRONMENTAL HEALTH IN POSTINDUSTRIAL CITIES "This approach is exciting because it's expanding the traditional medical management approach of asthma into comprehensive approach that includes an environmental perspective of the home," Roth said. Still, she cited areas for further expansion, such as the advocacy of health standards both for the home itself and the products that enter it, and the mobiliza- tion of already-served families to help form parent-action groups and communi- cate the problem (and solutions) to the public. "Sustained change in this area," Roth emphasized, "really does mean work- ing along side the community and its residents to address these issues and help everyone understand that the healthiness of our homes does impact our health, especially that of our children."