The Westlawn Partnership for a Healthier Environment: Promoting Environmental Justice and Building Community Capacity

Introduction

Discussion

Formed in 2008, a locally driven coalition of Westlawn stakeholders was developed to engage the community in the identification, education, and understanding of environmental problems in the community and their ideas of what should be prioritized concerns. Stages in the coalition-building process were based on guidelines set forth in the CARE Resource Guide, which are aligned with the CARE Program's Roadmap, and include:

• Stage 1: The community, in partnership with EPA, creates a collaborative problem solving stakeholder group comprised of various stakeholders in the community.

The Westlawn coalition considered three major questions within this process: 1) Where are we now? (e.g., assessing the neighborhood's assets and environmental risks, and compiling a Community Profile); 2) Where are we going? (e.g., looking at trends in the neighborhood and predicting the community's environmental future based on trends, creating a trends statement and vision statement through consensus building); and 3) Where do we want to be? (e.g., development of an action plan based on the vision statement and needs, see Table 1).

Located in Milwaukee, Wisconsin, Westlawn is the largest, low-income, public housing development in the state and home to 708 families and 1,786 residents. The community includes the Westlawn public housing project, and the surrounding neighborhood within the 53218 zip code, which has 43,494 residents.6 Ninety-seven percent of Westlawn's residents are persons of color, of whom 92% are African American.7 Fifty-one percent of Westlawn's residents are children, ages 17 and under. Ninety-three percent of heads of households in Westlawn are female. The current average household income in the development is just $15,142 per year compared to $40,875 for the City of Milwaukee.8

The Westlawn neighborhood is an economically disadvantaged community, with a wide range of environmental risks including: poor air quality (person-days exceeding national air quality standard for ozone (8-hour)) resulting from power plant emissions, diesel emissions, and particulate matter from buses and trucks that can trigger asthma; above national average for chemical releases, the number of superfund sites, and lead exposure hazards; and poor water quality affecting the watershed, drinking water, and the beaches surrounding Lake Michigan. The Toxic Release Inventory (TRI), ranked by Potential Human Health Risks, indicate that Milwaukee County, where the Westlawn neighborhood is located, is ranked between the 90–100% dirtiest to worst counties in the U.S. for the following health risks: a) added cancer risk from hazardous air pollutants, b) noncancer risks from hazardous air pollutants, c) noncancer risk score, and d) air releases of recognized carcinogens; and in the 80–90% dirtiest to worst counties in the U.S. for the following indicators: a) cancer risk score, b) noncancer risk score, and c) air releases of developmental and reproductive toxicants.9

The high number of people living in poverty in the Westlawn community (over 20%) exacerbates the situation when considering health effects associated with a variety of environmental exposures and environmental justice issues surrounding the distribution of burdens by income. Westlawn has a high prevalence of asthma, especially among children. Estimated and self-reported asthma prevalence, annual pollen score, and poverty rates are worse than the national average. According to Fight Asthma Milwaukee Allies, over 30,000 children in Milwaukee County are diagnosed with asthma, and two-thirds of these children live in poverty. Furthermore, two-thirds of these children are also under five years old.

Specific to the 53218 zip code, which includes the Westlawn community, the Wisconsin Department of Health Services reported a rate of 151.31 (per 10,000) hospitalizations for asthma in 2008, compared to a crude rate of 17.58 for Milwaukee County and 9.42 for the state of Wisconsin. Children living in the Westlawn neighborhood are four times more likely to visit an emergency room for asthma attacks compared to the rest of the state; and more than three times more likely to be hospitalized for asthma compared to the rest of the state. Thus environmental health concerns, especially related to asthma triggers, are disproportionately affecting the Westlawn community.

Methods

Following the EPA Roadmap and the CARE Resource Guide, the Westlawn coalition began meeting on a monthly basis in fall 2008 at the Silver Spring Neighborhood Center (SSNC), a private, nonprofit human services agency, which is located in the heart of Westlawn and which has served the community for over 50 years. Located within SSNC, the University of Wisconsin-Milwaukee (UWM) Silver Spring Community Nursing Center (SSCNC) has provided health care to uninsured and underinsured residents of Westlawn for more than 25 years. The UWM College of Nursing Institute for Urban Health Partnerships, which oversees SSCNC, received and administered the funding from the U.S. EPA to develop the Westlawn coalition, and provided staff to facilitate and coordinate the partnership. Thus, the Westlawn coalition began with three key trusted partners: community residents, SSNC and SSCNC.

Other partners were invited to join the Westlawn coalition, including schools, government organizations, private businesses, health agencies, not-for-profit organizations, Westlawn residents, elected officials, and others, resulting in 28 organizational members, in addition to UWM faculty, staff, students, and Westlawn residents.

In 2009, the Westlawn coalition developed its own definition of environmental health: “environmental health is the promotion of wellness and reduction of health disparities through increased knowledge of and reduced exposure to toxics, both inside and outside of the home;” and named itself the Westlawn Partnership for a Healthier Environment. Partnership members identified 60 environmental health concerns in the Westlawn community. Individual partnership members then volunteered to do research on 1–3 environmental health risks and developed community profiles for the environmental health concerns identified and shared that information with the partnership in order to educate the group about the specific risk, and what its prevalence and impact was in the Westlawn neighborhood. The list of 60 environmental health concerns was then narrowed down to nine, through a series of votes by Westlawn Partnership members. The Westlawn Partnership ranked their top environmental health concerns as follows:

1. indoor air pollution

Not surprisingly, four out of the top five environmental health risks were related to asthma triggers, given the high prevalence of asthma in the community, especially for children.

Results

During Level I funding, the Westlawn Partnership improved the environmental health of neighborhood residents through a series of large and small initiatives. To build group identity and awareness in the community, a local artist worked with Westlawn children to develop a logo for the Westlawn Partnership (see Figures 1 and 2). The logo is used on all Westlawn Partnership correspondence. T-shirts with the logo are also sold and proudly worn throughout the community.

OPEN IN VIEWER

FIG. 1.

Student, Shania Bonds, helps design the Westlawn Partnership for a Healthier Environment logo.

OPEN IN VIEWER

FIG. 2.

Westlawn Partnership for a Healthier Environment logo.

Other early results addressed the coalition's concerns about indoor and outdoor air quality (see Table 2). The Westlawn Partnership worked with SSNC and Milwaukee Public Schools to install “No Smoking” signs at the building entrances to SSNC and the adjacent public elementary school. Residents were also concerned about safety and the built environment, especially speeding in the area, and safely walking in the neighborhood. The Westlawn Partnership worked with local law enforcement to have a new “Stop” sign erected near the local elementary school.

The Westlawn Partnership also worked with local law enforcement and community aldermen to shut down a local business that had been selling single cigarettes to underage kids. In addition, the UWM College of Nursing received funding from the State of Wisconsin to support the coalition's work, and implemented a small-scale Healthy Homes project in Westlawn residences.

Large initiatives included receipt of an environmental justice grant from the U.S. EPA in 2010 to develop a Bed Bugs awareness educational campaign, which was disseminated on local buses, television and radio stations, and on social media.10 Also in 2010, the Housing Authority of the City of Milwaukee (HACM), which manages the Westlawn public housing development and is a key member of the Westlawn Partnership, received funding from the Department of Housing and Urban Development (HUD) to redevelop the east side of Westlawn.11

In response to concerns raised during Westlawn Partnership meetings, HACM included bio swales in the new development, to eliminate water and mold in basements.12 Fourteen asthma-friendly housing units were included in the new construction, which are carpet-free, smoke-free, and have upgraded ventilation systems.13 Community gardens were also included in the new housing development, so residents would have access to fresh, organic, and locally grown produce.14

Conclusions

In building the Westlawn Partnership, several key findings emerged regarding the process of building a successful community partnership. The Westlawn Partnership found that the CARE Roadmap was an effective process that works well for engaging the community to attain expected outcomes. Following the CARE Roadmap steps in the exact order, however, was not as important as the group process. On several occasions, the Westlawn Partnership adjusted the suggested order of steps in order to better suit group needs.

The CARE program and CARE Roadmap allowed time to build a partnership and establish goals. Over the course of two years, Level I funding was dedicated solely to building the Westlawn Partnership, and identifying environmental health concerns. The Westlawn Partnership also benefitted greatly from the 25-year history of trust and commitment to the community that the UWM Silver Spring Community Nursing Center has demonstrated by its presence and service in Westlawn.

In addition to trust, ongoing communication was key to building the coalition. Surveys were conducted to reach Westlawn residents who could not attend Westlawn Partnership meetings. HACM also included Westlawn Partnership information with monthly rent statements, to keep all members of the Westlawn neighborhood informed.

The Westlawn Partnership also found that all members of the partnership bring expertise in building community capacity. Partners had varying levels of participation that depended on the needs of the Westlawn Partnership and individual members. For example, some members were on the Westlawn Partnership e-mail listserv and attended meetings only occasionally, while other partners attended all meetings. While all community members did not become actively involved, behaviors of community members were reflected in and influenced by community leaders, many of whom were founding members of the Westlawn Partnership. Ongoing engagement is important for sustaining a community partnership.

Engaging business partners, however, has been a challenge. The EPA CARE program promotes the involvement of local businesses as key to a successful partnership, because local businesses can contribute money and in-kind donations, as well as time.15 Given the economically depressed area in which the Westlawn Partnership is located, this has been difficult. The Westlawn Partnership currently includes two business organizations, which are minimally involved, and the partnership continues to reach out to other potential business partners. New partners continue to join the Westlawn Partnership, which adds capacity to the community, and all partners are accepted.

The Westlawn Partnership greatly benefitted from the active involvement of the EPA. The Region 5 Project Officer attended most meetings, and gave a face to the EPA, with which most community residents were unfamiliar. The EPA was then perceived as a helpful participant in the identification and solution of problems. They listened to community concerns and could influence government decision-making from the bottom up. One of the Westlawn Partnership's highlights was when Lisa Jackson, former director of the EPA, visited the community in 2011.

The EPA was also an equal partner at the table. It was important for coalition members to share power and have equal voices, in order to build trust and respect, and form a strong community partnership. The Westlawn Partnership found that community members, including those in disadvantaged communities, can and strongly desire to take an active role in solving their community's problems.

Finally, the Westlawn Partnership found that an evaluation of process was helpful to make sure that the partnership was truly meeting the needs of the community. The Westlawn Partnership developed and continues to use a meeting evaluation tool every month, which has been helpful in moving the group forward and addressing individual concerns before they become problems. In addition, the function of the group was defined early on, with the stakeholders involved, which helped to clarify the vision and mission of the coalition.

In 2011, the Westlawn Partnership celebrated after learning that it was one of only three CARE communities in the U.S. to receive a second level of funding from the EPA. In order to address the priority environmental health risks identified by the community during the Level I funding period, three overarching goals were established for the Level II funding period: a) long-term sustainability of the Westlawn Partnership; b) Healthy Homes initiative; and c) Healthy Day Cares initiative. Three community environmental health workers were hired by the Westlawn Partnership to help implement these goals. Given the commitment of Westlawn Partnership members, sustainability of the partnership beyond the EPA funding cycle will be robust.

Plan EJ 2014 embodies the ideals of the CARE program, and the Westlawn Partnership is a successful example of what EPA's commitment to environmental justice can accomplish. The Westlawn Partnership for a Healthier Environment has worked to decrease toxic pollution in this overburdened community. Only by working together, and drawing on its collective strengths, can communities truly be healthy.