NIEHS Supports Partnerships in Environmental Public Health

I would like to start by thanking the journal for inviting me to write an editorial to accompany Dr. Juliana van Olphen and her colleagues’ thoughtful evaluation that focuses on the important topic of community health partnerships.¹ As the new director of the National Institute of Environmental Health Sciences (NIEHS) and the National Toxicology Program, I am pleased to take on this role during a time when both the environment and health are top priorities for our country. I am a big supporter of community-based participatory research (CBPR) that ensures community members have an active role in planning, implementing, translating and disseminating research that addresses local environmental health concerns.

NIEHS has been a long-standing leader in fostering partnerships between community groups and researchers to better understand environmental causes of disease. Our commitment is demonstrated in a number of ways. For example, NIEHS, in cooperation with the National Cancer Institute, requires that a Community Outreach and Translation Core (COTC) is established in each of our four Breast Cancer and the Environment Research Centers—one of which was the subject of Dr. van Olphen’s independent analysis published in this issue. COTCs conduct essential work to ensure that the views and concerns of the breast cancer advocacy community are heard and that the research findings are disseminated to the public. Developing educational materials for children and adults about breast cancer and the environment, holding public awareness forums and town meetings, and exploring areas of concern or interest to the community are all essential activities led by the COTC to create community participation in environmental health issues such as breast cancer. What van Olphen’s article demonstrates is that COTCs can further advance and promote CBPR principles within research-intensive Centers.

NIEHS grantees employing CBPR approaches are contributing to our understanding about breast cancer and the environment. There is a growing body of literature showing that early-life exposures to endocrine disruptors—particularly during gestation and childhood, but also continuing through puberty, first childbirth, and breastfeeding—are critical to later-life breast cancer risk. As researchers learn more about what causes and how to prevent breast cancer, grantees such as those we support through our environmental justice program are spreading the word and empowering communities to take action. Breast cancer advocates in two communities that differ in racial/ethnic and economic character are working in partnership with researchers to assess household exposures to endocrine disrupting compounds, and to develop communication tools for reporting results to affected individuals and communities.² These research findings are being used by community groups and advocates to affect public health and lead to policy changes.

Congress recently recognized the contributions of NIEHS and the National Institutes of Health as a whole for their outstanding work in the breast cancer and environment area, when it passed the “Breast Cancer and Environment Research Act of 2008.”³ The Act looks to NIH to take a lead role in defining the future research agenda for collaborative research efforts related to breast cancer and the environment.

NIEHS’ leadership role in translating research on breast cancer and the environment is the outgrowth of the Institute’s commitment to CBPR approaches that promote having the community actively involved in shaping and conducting research and intervention strategies. Since 1995, through its CBPR activities, the Institute has supported principles that have been developed and shared by leaders in the field such as those developed by Barbara Israel et al. ⁴ and Lawrence Green et al.⁵ Principles that call for building on the strengths and resources within the community; focusing on the local relevance of public health problems; and disseminating results to all partners are endorsed by NIEHS and are evident in work supported by NIEHS. Recognizing the continuum of CBPR, the Institute promotes these principles throughout a variety of programs from traditional outreach and education efforts to more complex biomedical, hypothesis-driven research questions that address environmental justice and health disparities issues.

To build upon our past accomplishments and to progress our research agenda in this area, we recently sought input from research grantees and members of advocacy...