An Essential Role for Graduate Students in Environmental Public Health Community Engagement

Environmental health science is a core discipline of public health.¹ As a scientific discipline, over the years environmental health has expanded from one focused primarily on toxic chemicals to include issues such as the built environment, the food environment , environmental justice and climate change and health. The significance of environmental health was further emphasized in goal number 8 of the United States government document Healthy People 2020 (U.S. Department of Health and Human Services) that aims to "Promote health for all through a healthy environment."² The 6 major objectives with regard to the environment and human health focus on the following broad categories: (1) outdoor air quality, (2) water quality, (3) toxics and waste, (4) healthy homes and communities, (5) infrastructure and surveillance, and (6) global environmental health. Healthy People 2020 recognized that both our physical and social environments play critical roles in the health of both individuals and communities. It also recognized that an individual's biology (genetics and differences in susceptibility) is also important in how our health is influenced by our physical and social environments.

Many of the diseases that the public is concerned about include chronic diseases such as asthma, cancer, cardiovascular disease, and cognitive decline associated with environmental exposures. Many of these chronic diseases exhibit significant disparities between population groups with a heavy burden of disease in minority and/or socio-economically distressed populations.^3,4 Communities with the highest incidence of disease are often found in those neighborhoods with contaminated brownfields and/or old industrial sites, or waste disposal sites. Clearly an issue of environmental injustice. Environmental Public Health has been defined as the science of conducting and translating research into action to address environmental exposures and health risks of concern to the public.⁵ For such translational efforts to be effective, the principles of Community-Based Participatory Research (CBPR) need to be followed⁶ and effective partnerships need to be developed and nurtured.⁷ In order for residents to fully participate in environmental public health efforts, they need easy access to culturally appropriate health education materials to connect the environment to their health and to understand the impact of environmental hazards. In this issue, Close et al. describe a Community-Based Internship Program involving students from various programs at Florida A & M University, an environmental law firm (Wildlaw), and 5 community-based organizations (CBOs) in Florida. The mission statements of the CBOs involved in this project had an emphasis on protecting the health of communities and addressing environmental injustice issues. This internship program involved 22 students participating and assisting with the CBO for 20 hours/week for a period of 16 weeks. The article does a very nice job of describing the achievements of the program and the benefits to each of the partners. This Program is truly an example of how CBPR should work. Like many community-based efforts, there were also significant challenges that needed to be addressed. Many of the challenges involved funding. In this case, funding was through a Cooperative Agreement between the Association of Minority Health Professions School and the Agency for Toxic Substances and Disease Registry. Sustainability is another issue.

Over the years, many federal agencies have supported CBPR in environmental health, including the National Institute of Environmental Health Sciences, the Environmental Protection Agency and the Centers for Disease Control and Prevention. What is unique about the Close et al. article was the primary focus on incorporating graduate student internships into this effort. In order for Environmental Public Health to be successful at conducting and translating research into action to address environmental exposures and health risks of concern to the public, it is imperative that CBPR be a part of the training of the next generation of environmental health scientists. Although it is encouraging that graduate students are doing CBPR dissertations,⁸ we need to be creative about giving more trainees the opportunity to learn about the value of CBPR. As an Associate Editor for Progress in Community Health Partnerships, I have seen how postdoctoral fellows...