Making It Count: How to Achieve Structural Change with Community-Based Participatory Research Projects.

Low-income communities of color are inequitably burdened with pollution and its related health effects.1 Environmental health researchers sometimes conduct community-based participatory research projects in which residents help design research questions, collect data, and interpret results.2 Such collaboration often improves the academic rigor of these studies3 and helps inform residents of health risks.4 But does it actually bring about systemic change to economic, social, and political structures? The authors of a review in Environmental Health Perspectives sought to answer that question.5

The authors of the new review discussed examples of community-based participatory research projects that successfully effected change. In one, members of the Crow Environmental Health Steering Committee at Little Big Horn College partnered with Montana State University to study contaminants in well water on the Apsaálooke (Crow) Reservation. Crow members of the team (including graduate student Emery Three Irons, shown sampling tap water) used culturally appropriate methods to collect samples and educate fellow Tribal members about the risks of drinking contaminated water. Ultimately, says investigator Margaret Eggers, the best intervention has been to provide free home water coolers that dispense safe drinking water from 5-gallon refillable jugs. Image: Courtesy John Doyle (Apsaálooke)/Little Big Horn College.

“I was interviewing community members, and some of their stories just kind of got to me,” says Leona Davis, the lead author of the review. A graduate student in environmental education, Davis was helping Mónica Ramírez-Andreotta, an environmental health science professor and one of her advisors at the University of Arizona, evaluate learning and outcomes of a cocreated citizen science program with disadvantaged communities in Arizona. One of these was Hayden, Arizona, a majority Latino town that is home to a copper smelter and piles of mine tailings.6 Although Davis recognized the residents’ environmental science literacy, she was struck by the glaring injustice of their situation. “I just remember … reflecting that this is a bigger issue than a lack of understanding of science,” says Davis.

Davis and Ramírez-Andreotta reviewed the literature to investigate which specific study design elements prompt structural change to benefit overburdened communities. They found that 26 of the 154 case studies they examined resulted in structural change, which they defined as “affecting macro- or meso-level determinants of health, such as zoning policy, economic policy, political power, built environment, public service provision, or environmental policy enforcement.”

Within those successful case studies, they found policy change was rarely a clear win, Davis says. For instance, in one case study,7 residents were unable to prevent a new waste facility from being built in their neighborhood. Still, they were able to negotiate a reduction in how much waste the facility handled and the removal of a diesel fueling station from the project. They also obtained guarantees that fleet vehicles would run on alternative fuels.

The investigators also found that successful projects shared certain characteristics. During initial planning, these projects examined the structures already in place. They were community-directed, and they adopted governance models where community members held formal leadership roles. Hiring community members to serve as project leaders whenever possible is critical, says Ramírez-Andreotta. She explains that by providing a salary and funding for expenses, financial support for grassroots leadership makes it easier for residents—who are often grappling with poverty, illness, and other stressors—to work toward the changes they want to see.

In projects that managed to bring about structural change, investigators had also valued the local knowledge and the lived experience of the community residents. They carefully translated the resulting data into a form that was understandable and useful for community members and other stakeholders. They also set policy change as a goal from the outset. Another key characteristic was commitment to a long-term presence in the community, which the authors defined as longer than 4 years. One case study8 examined the Detroit Community–Academic Urban Research Center, which has existed for more than 25 years and engaged in partnerships to address asthma, air quality, heart health, and other environmental health issues.9

Those long-term commitments help build trust, something that can be sorely lacking between community members and academics, says Yanna Lambrinidou, co-organizer of the Engineering Ethics and Community Rights Collaborative, a national initiative to institute community rights in participatory research. “I think [the review] holds a mirror up to academics, asking us to reflect on our trustworthiness—on whether our educational, research, and funding structures are adequately designed to support community-led, systemic solutions or if they may at times even stand in the way,” says Lambrinidou, who was not involved with the review. “Environmental justice communities have been voicing concerns for a long time about academics who show up to help,” she continues. “Yet to this day, academia provides no space for these communities to report problems and no mechanism for protecting them from harm.”

Davis and Ramírez-Andreotta hope their work will inform a new generation of investigators while acknowledging the steep systemic barriers to structural change. They point to one case study that involved the Aamjiwnaang First Nation community in Canada. For years, the group has collected data and filed numerous complaints about the dozens of surrounding petrochemical and polymer industrial facilities.10 Yet “despite years of formal complaints supported by empirical evidence,” the authors wrote, “the Canadian Ministry of the Environment continues to approve permits for local polluting industries.”

Looking at such cases, the two researchers say, raises a deeply troubling reality: “[Injustice] isn’t because [these communities] lack understanding or education or resources,” says Davis. “It’s the belief that … some people deserve to be the dumping grounds of others. And so even the most robust data set or the snazziest data communication campaign is not going to shake that. You need additional tools.” The authors conclude that project designs that include decision makers and policy goals, as well as increased hiring of faculty of color who can potentially serve as “cultural knowledge brokers,” may be just such tools.