Building Healthy Communities in Environmental Justice Areas:Communities of Concern in Pennsylvania

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Title: Building Healthy Communities in Environmental Justice Areas:Communities of Concern in Pennsylvania

1
Building Healthy Communities in Environmental
Justice AreasCommunities of Concern in
Pennsylvania

By Janine M. Legg, MBA
Environmental Justice Consultants
APHA Conference 2006

2
Building Healthy Communities in Environmental
Justice Areas, ( BHCEJA).
Risk Assessment/ Screening from Environmental
Burden
Identify Community of Concern
Disease Assessment Biomarker Testing
Community Health Assessment
Recommendations
Implementation
Reduce Environmental Burden
Mental Health Programs
Medical Care
Health Programs
Health Promotion
Health Risk Communication
Health Education
3
Risk Screening Environmental Indicators Model
offers

Risk related perspective of air and water
releases of TRI chemicals, (EPA, 2005, RSEI Ver.
2.1.2, Slide 4).
Hazard-based and pounds-based perspectives of
Releases to air, water and land, (EPA, 2005,
RSEI Ver. 2.1.2, Slide 7).
Chronic human health risk related results for
more than 400 chemicals/and chemical categories
and approximately 40,000 reporting facilities
(all 15 years), (EPA, 2005, RSEI Ver. 2.1.2,
Slide 7).
Databases of information (chemical, facility,
census, etc.) are fully accessible, (EPA, 2005,
RSEI Ver. 2.1.2, Slide 7).
Program generates outputs GIS mapping, graphs,
tables, etc. (EPA, 2005, RSEI Ver. 2.1.2, Slide
7).

4
The Model Building Healthy Communities in
Environmental Justice Areas, (BHCEJA).

Goals
Is risk related score within the top 80 of risk
and the rates of health indicators are above the
state averages.
Are the disease rates significantly above the
state average?
Compare RSEI risk related scores in relationship
to the state.
Determine health and mental health needs of the
community based upon disease burden review
existing community healthcare system determine
deficiencies in healthcare programs determine if
a ATSDR registry program is needed determine
barriers to healthcare programs determine if
improvements are needed in community healthcare
system, determine implementation plans.

5
Case Study-Counties of Concern in Pennsylvania

A study was performed, using the model, Building
Healthy Communities in Environmental Justice
Areas, (the BHCEJA model) to determine which
county communities in Pennsylvania, qualified as
environmental justice areas or were potential
counties of concern and/or were at higher risk
for environmental burden and health risk, (based
upon EPA RSEI scores (ver. 2.1.2), economics,
demographics and health indicators), (Legg,
(2006), p. 116).
The health indicators mortality- (all causes of
death) infant mortality cancer incidence Low
infant birth weight (LBW) and lead poisonings
were tabulated for the twenty county communities
that had the top risk related scores totaling
80.

6
Definitions

BHCEJA defines a Community of Concern as a
community with high environmental burden (at
least 5-10 of risk to state, disease statistics
significantly of health indicators, higher than
state average for percent living in poverty, and
identification of minority populations and
dominant populations).
BHCEJA defines an Environmental Justice Community
is a community that contains an expected 20
minority population (and identification of
dominant population) with high environmental
burden (at least 5-10 of risk to state), disease
statistics significantly higher than the state
average for selected health indicators, higher
than state average for percent living in poverty.

7
Methodology

Query using RSEI, Ver.2.1.2-Calculate Risk Scores
and identify areas of high risk related scores.
Identify the TRI chemicals of risk related scores
(80-95 risk to state).
Identify risk due to Registry chemicals (80-95
risk to state).
Identify the facilities of risk (Comprising
50-66.66 risk to state).
Calculate Health Indicators for areas of high
risk related scores.
Calculate Health Indicators above state average.
Calculate Area based measures for areas of high
risk related scores.
Compile statistics for areas above state poverty
level that have high risk related scores,
calculated health indicators, health indicators
above state for cancer incidence and calculated
area based measures.

8
Methodology-RSEI Query

A query was done using the EPA RSEI Ver. 2.1.2.,
to determine the risk related scores derived from
fugitive air, stack air, direct water, POTW
Transfer and other incineration sources, released
in the State of Pennsylvania from 1988-2002.
The RSEI risk-related scores were calculated for
all counties in Pennsylvania by chemical,
facility, county, industry, and for all releases.
OSHA carcinogens released were then calculated
for all counties.
The most meaningful statistics that illustrated
risk, (and in keeping with the methodology of the
BHCEJA model), were the chemicals that
contributed the top risk and illustrated the top
risk related scores (adding up to the top risks
to the state between 50-80).

9
Methodology-Identify Highest RSEI Risk Related
Scores

Counties that had the highest RSEI risk related
scores that totaled 80 percent were tabulated for
the years 1988-2002.
The twenty counties that had the highest risk
related scores totaling 80 percent were reviewed
as potential counties of concern. The RSEI risk
related scores were also analyzed by chemical and
risk.
RSEI risk scores were also calculated by industry
(according to Standard Industrial Classification)
for all industries operating in Pennsylvania.
The industries classified by Standard Industrial
Classifications, which accounted for the highest
80 percent of the risk to the State of
Pennsylvania, were tabulated.
A listing of facilities by county was tabulated
by risk-related score, percent and cumulative
percentage. A listing of facilities that had the
highest RSEI scores and comprised the top 50
percent of cumulative risk to the State of
Pennsylvania was also tabulated.

10
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12
Methodology-Disease Assessment-Calculate Health
Indicators

Health indicators were calculated (for all races
where data is available) for 1) Low Baby Birth
Weight rate, (LBW)-Infants born under 2500
grams/(per 1000 live births
2) Infant Mortality/(per 1000 live births) (where
statistics are comparable and available)
3) Infant-4 year old mortality (age specified
rate per 100,000) 4) all cause mortality (per
100,000 based on 200 std. Million population)
5) Cancer incidence rate (per 100,000) and
6) Cancer incidence rates significantly above the
state average, (per 100,000) were calculated on
two-three year rates, (totaled rates for 5
years).

13
Methodology-Calculate Area Based Measures

Percentage of those in poverty was calculated for
each of the twenty counties that ranked as the
top risk-related scores totaling 80 and the
state rates.
Area based measures were calculated for counties
that scored above the state percentage of those
in poverty and had ranked as the top risk-related
scores totaling 80.
Area based measures calculated included
Demographics of population, housing, mean travel
time to work, median value of owner house, income
of household, persons per household, median
household income, per capita income, persons
below poverty percent.

14
State of Pennsylvania (Reprinted with permission
Source United States Department of
Census-TIGER/Line files).
Twenty Counties Highest Risk-Allegheny, Beaver.
Berks, Bucks, Cambria, Chester,Delaware, Erie,
Lackawanna, Lancaster, Lehigh, Mercer,
Montgomery, Northampton, Philadelphia,
Schuylkill, Venango, Washington, Westmoreland and
York Counties.
15
State of Pennsylvania (Reprinted with permission
Source United States Department of
Census-TIGER/Line files).

Ten County Communities of Concern- Allegheny,
Beaver, Cambria, Erie, Lackawanna, Mercer,
Philadelphia, Schuylkill, Venango, and Washington
Counties.

16
Communities of Risk

The twenty counties in Pennsylvania, (from
1988-2002), that scored the top 80 percent
risk-related scores and released the top scoring
TRI and OSHA carcinogens, (for any year between
1988-2002) included
Allegheny, Beaver. Berks, Bucks, Cambria,
Chester,Delaware, Erie, Lackawanna, Lancaster,
Lehigh, Mercer, Montgomery, Northampton,
Philadelphia, Schuylkill, Venango, Washington,
Westmoreland and York Counties.
Childhood lead poisonings (EBLLs) were tabulated
but data was of limited comparison, based upon
number of children tested. Philadelphia County
has the highest number of cases of EBLLs for
2003, 1650 cases confirmed of EBLLs out of
statewide confirmed cases of 1,873.

17
PA Ranking Releases-All years-County, Chemical,
OSHA Carcinogen, Risk Related Score and percentage
Rank Chemical OSHA Carcinogen County Value Percent Cumulative Percent
1 Phosphorus False Chester 24852863.55 24.67 24.67
2 Diisocyanates False Lehigh 6167206.35 6.12 30.79
3 Asbestos True Erie 39688.22 3.94 34.73
4 Lead Compounds True Montgomery 3126505.32 3.10 37.84
5 Chromium Compounds True Allegheny 2669445.35 2.65 40.49
6 Nickel True Cambria 2334207.23 2.31 42.80
7 Chromium True Berks 2289260.30 2.27 45.08
8 Manganese Compounds False Allegheny 1890042.58 1.87 46.95
9 Lead True Berks 1705156.65 1.69 48.65
18
Highest Assigned Risk-related Scores by SIC code,
State of Pennsylvania-1988-2002

SIC Code-Percentage of Risk to State-Highest Risk
Related Scores
336-Non Ferrous Foundries 25.31
331-Finishing Mills 22.65
359-Machinery and Equipment 6.17
266-Paperboard 3.94
334-Ferrous Metals 3.16
325-Structural Clay Products 1.79
291-Petroleum Refining 1.44
327-Concrete, plastics and gypsum 1.22
226-Narrow Fabric .274
Total-66.95 of Risk to State of Pennsylvania-All
years
(Reproduced with permission from the U.S.
Environmental Protection Agency SourceRSEI
Version 2.1.2, 2004).

19
All Years-Risk Related Scores by Chemical and
Company
Rank Chemical Name Value Percent Cumulative Value Cumulative Percent
1. Chester-19381 Westchester Phosphorus Metallurgical Products 24852863.55 24.67 24852863.55 24.67
2. Lehigh-18017 Bethlehem Diisocyanates Bosch Rexroth Corp. 6125107.56 6.08 30977971.11 30.75
3. Erie-16512 Erie Asbestos Quin-T Corp. 3968822.42 3.94 34946793.53 34.69
4 Cambria- Johnstown Nickel Johnstown Corp. 2327144.25 2.31 37273937.78 37.01
5 Washington 15342 Houston Chromium Compounds Allegheny Ludlum Corp. 2211430.14 2.19 39485367.92 39.20
6 Bucks-19446 Landsdale Lead Compounds DA-Tile Corp. 1701064.86 1.69 41186432.78 40.89
7 Berks-19612 Reading Chromium Carpenter Tech. Corp. 1566576.76 1.56 42753009.55 42.45
8 Berks-19612 Reading Chromium Compounds Carpenter Tech. Corp. 1452839.71 1.44 44205849.26 43.89
9. Berks-19605 Reading Lead Compounds Exide Corp. Reading Smelter Div. 1346150.96 1.34 45552000.23 45.22
20
Registry Chemicals-Ranking by County-1988, 1995
Reproduced with permission from the U.S.
Environmental Protection Agency SourceRSEI
Version 2.1.2.
21
Registry Chemicals-Ranking by County-2000, 2002
Reproduced with permission from the U.S.
Environmental Protection Agency SourceRSEI
Version 2.1.2.
22
Registry Chemicals-Ranking by Facility-1988, 1995
Reproduced with permission from the U.S.
Environmental Protection Agency SourceRSEI
Version 2.1.2.
23
Registry Chemicals-Ranking by Facility-2000, 2002
Reproduced with permission from the U.S.
Environmental Protection Agency SourceRSEI
Version 2.1.2.
24
Health Indicators Calculations

For low percent birth weight for 1998-2000
-Allegheny, Lehigh, Northampton and Philadelphia
Counties are significantly above the state rate.
For low percent birth weight for
2000-2002-Allegheny, Lehigh, Northampton and
Philadelphia Counties are significantly above the
state rate.
For All Cause Death, age 0-4, for 1998-2000-rate
for Philadelphia County is significantly above
the state rate.
For All Cause Death, age 0-4, for 2000-2002-rate
for Philadelphia County is significantly above
the state rate.
For All Cause Death, for 1998-2000-rate for
Venango, Lackawanna, Schuylkill, and Philadelphia
Counties are significantly above the state rate.
For All Cause Death for 2000-2002-rate for
Allegheny, Lackawanna, Schuylkill, Washington and
Philadelphia Counties are above the state rate.

25
Health Indicators Calculations

For Cancer Incidence for 1998-2000-Cambria,
Delaware, Lackawanna, Northampton and
Philadelphia Counties are significantly above the
state rate.
For Cancer Incidence for 2000-2002-Allegheny,
Bucks, Cambria and Delaware, Northampton and
Philadelphia Counties are significantly above the
state rate.
For Cancer Incidence significantly above the
state rate for all years, 1998-2000 and
2000-2002, (three year rates)-Allegheny, Beaver,
Cambria, Lackawanna, Mercer, Philadelphia,
Schuylkill, Venango and Washington Counties had
rates in at least one cancer significantly above
the state rate.
For all health indicators, Philadelphia County
demonstrated disease rates significantly above
the state average, and other cancers
significantly above the state average.

26
Pennsylvania-All Causes Death-1998-2000, 2000-2002

For All Cause Death, for 1998-2000, rate for
Venango, Lackawanna, Schuylkill, and Philadelphia
Counties are significantly above the state rate.
For All Cause Death for 2000-2002, rate for
Allegheny, Lackawanna, Schuylkill, Washington and
Philadelphia Counties are above the state rate.

For Low percent birth weight for 1998-2000
Allegheny, Lehigh, Northampton and Philadelphia
Counties are significantly above the state rate.
For Low percent birth weight for 2000-2002
Allegheny, Lehigh, Northampton and Philadelphia
Counties are significantly above the state rate.

For All Cause Death, age 0-4, for 1998-2000, rate
for Philadelphia County is significantly above
the state rate.
For All Cause Death, age 0-4, for 2000-2002, rate
for Philadelphia County is significantly above
the state rate.

For Cancer Incidence for 1998-2000, Cambria,
Delaware, Lackawanna, Northampton and
Philadelphia Counties are significantly above the
state rate.
For Cancer Incidence for 2000-2002, Allegheny,
Bucks, Cambria and Delaware, Northampton and
Philadelphia Counties are significantly above the
state rate.

For Cancer Incidence significantly above the
state rate for all years, 1998-2000 and
2000-2002, (three year rates), Allegheny, Beaver,
Cambria, Lackawanna, Mercer, Philadelphia,
Schuylkill, Venango and Washington Counties had
rates in at least one cancer significantly above
the state rate.

SourceReproduced with permission EPIQMS System,
PA Department of Health Statistics. These data
were provided by the Bureau of Health Statistics
and Research, Pennsylvania Department of Health.
The Department specifically disclaims
responsibility for any analyses, interpretations
or conclusions."
S
30
Persons with income below poverty and above State
rates-1998-2005
Persons with income below Poverty Year 1998 Persons with income below Poverty Year 1999 Persons with income below Poverty Year 2000 Persons with income below Poverty Year 2001 Persons with income below Poverty Year 2002 Persons with income below Poverty Year 2003 Persons with income below Poverty Year 2004 Persons with income below Poverty Year 2005
PA 12.9 11.4 11.4 10.9 10.7 10.0 9.5 10.0
Allegheny 10.8
Beaver 13.7 11.9 11.9 11.4 11.0 9.8
Cambria 14.6 13.3 13.3 12.7 12.9 11.9 11.8 12.4
Eerie 13.9 13.1 13.1 12.7 12.4 11.7 11.1 12.2
Lackawanna 11.0 10.2 9.8 10.2
Mercer 14.8 13.4 13.4 13.2 13.0 11.8 11.5 12.3
Philadelphia 26.5 23.8 23.8 21.7 21.1 19.2 18.5 19.5
Schuylkill 10.2
Venango 15.8 14.5 14.5 13.9 13.5 12.6 12.3 13.0
Washington 13.4 12.2 12.2 11.7 11.2
31
Pennsylvania Communities of Concern

Ten counties were identified that had high risk
from environmental burden (based on risk-related
scores from 1988-2002), and were also above the
state percentage of those that live in poverty.
Those ten counties that qualified for both
conditions, (of risk and poverty) for any year
(1988-2002) are Allegheny, Beaver, Cambria,
Erie, Lackawanna, Mercer, Philadelphia,
Schuylkill, Venango, and Washington Counties.
The ten counties identified also demonstrated
disease significantly above the state average on
several levels.

32
Identified Environmental Justice County Community

Philadelphia County met all the criteria of the
BHCEJA model (for high environmental burden,
poverty and health indicators) for an
environmental justice area and demonstrated
disease (for all years) for all four health
indicators significantly above the state average
and various cancers significantly above the state
average.

33
Demographics

Those ten counties that qualified for both
conditions, (of risk and poverty) for any year
(1988-2002) are Allegheny, Beaver, Cambria,
Erie, Lackawanna, Mercer, Philadelphia,
Schuylkill, Venango, and Washington Counties.

34
Demographics
2000 Census PA Allegheny Beaver Cambria Erie Lacka-wanna Mercer Philadel- phia Schuyl-kill Venango Washing-ton
White 85.4 84.3 92.5 95.8 90.9 96.7 93.1 45.0 96.6 97.6 95.3
Black 10.0 12.4 6.0 2.8 6.1 1.3 5.3 43.2 2.1 1.1 3.3
American Indian/ Alaska Native .1 .1 .1 .1 .2 .1 .1 .3 .1 .2 .1
Asian 1.8 .4 .7 .4 4.5 .4 .2 .4
Native Hawaiian Z Z Z Z Z Z Z Z Z Z Z
Hispanic 3.2 .9 .7 .9 2.2 1.4 0.7 8.5 1.1 .5 0.6
Statistics based upon Bureau of Health
Statistics, Pennsylvania Department of Health,
Population estimate of 12,281,054 for Year 2000.
35
Conclusions

BHCEJA is a workable biopsychosocial model with
an environmental health component to perform risk
screening/risk assessment and health assessment.
Results are verifiable and reproducible.
Ten separate future studies to be conducted in
Counties of Concern using BHCEJA model.
Recommendation of Permit reviews by PA DEP in 10
Counties of Concern and Philadelphia.
Address Policy issues of Environmental Justice on
State level.
Address and discuss appropriateness of
Environmental Justice policies on a Race Neutral
basis to implement solutions.
Need for effective Medical, Health, Mental Health
and Economic programs in identified 10 Counties
of Concern.
Need to establish Registries for Benzene, TCE,
and TCA exposure.

36
References

Bureau of Health Statistics and Research,
Pennsylvania Department of Health.
Legg, J.M. (2006). Building Healthy Communities
in Environmental Justice Areas. Charleston, South
CarolinaBook Surge, LLC.
United States Environmental Protection Agency.
(2005). EPAs Risk Screening Environmental
Indicators. Slide Presentation, Philadelphia, PA.
U.S. Environmental Protection Agency. (2004).
RSEI Version 2.1.2.
United States Department of Census-TIGER/Line
files.