Building Healthy Communities in
Environmental Justice Areas:Communities of
Concern in Pennsylvania
By Janine M. Legg, MBA
Environmental Justice Consultants
APHA Conference 2006
Building Healthy Communities in Environmental
Justice Areas, ( BHCEJA).
Disease
Assessment
Biomarker
Testing
Identify Community of
Concern
Community Health
Assessment
Risk Assessment/
Screening from
Environmental
Burden
Recommendations
Implementation
Reduce
Medical Mental
Health
Health
Health Risk
Health
Environmental Care
Health
Programs Promotion Communication Education
Burden
Programs
Risk Screening Environmental Indicators Model
offers:
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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).
The Model: Building Healthy Communities in
Environmental Justice Areas, (BHCEJA).
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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.
Case Study-Counties of Concern in Pennsylvania
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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%.
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.
Methodology:
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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.
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.
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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.
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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%).
Methodology-Identify Highest RSEI Risk Related
Scores
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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.
Methodology-Disease Assessment-Calculate
Health Indicators
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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).
Methodology-Calculate Area Based Measures
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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.
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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%.
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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.
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.
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.
Communities of Risk
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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.
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
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 Source:RSEI Version 2.1.2, 2004).
All Years-Risk Related Scores
by Chemical and Company
Rank
Chemical
Name
Value
Percent
Cumulative
Value
1. Chester19381
Westchester
Phosphorus
Metallurgical
Products
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 CambriaJohnstown
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
24852863.55
Cumulative
Percent
24.67
Registry Chemicals-Ranking by County-1988,
1995
Reproduced with permission from the U.S. Environmental Protection Agency Source:RSEI Version 2.1.2.
Registry Chemicals-Ranking by County-2000,
2002
Reproduced with permission from the U.S. Environmental Protection Agency Source:RSEI Version 2.1.2.
Registry Chemicals-Ranking by Facility-1988,
1995
Reproduced with permission from the U.S. Environmental Protection Agency Source:RSEI Version 2.1.2.
Registry Chemicals-Ranking by Facility-2000,
2002
Reproduced with permission from the U.S. Environmental Protection Agency Source:RSEI Version 2.1.2.
Health Indicators Calculations
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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.
Health Indicators Calculations
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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.
Pennsylvania-All Causes Death-19982000, 2000-2002For All Cause Death, for 1998-2000, rate for Venango,
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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.
Source:Reproduced 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."
Pennsylvania-Percent Low Birth
Weight-1998-2000, and 2000-2002
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.
Source:Reproduced 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."
Pennsylvania-All causes of deathChildren aged 0-4-1998-2000, 20002002.
For All Cause Death, age 0-4, for 1998-2000, rate
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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.
Source:Reproduced 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."
Pennsylvania-Cancer Incidence-All Types and
Ages 1998-2000, and 2000-2002.
For
Cancer Incidence significantly above the
state rate for all years, 1998-2000 and 20002002, (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
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.
Source:Reproduced 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."
Persons with income below poverty and above
State rates-1998-2005
PA
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
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
11.0
10.2
9.8
10.2
Lackawanna
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
Washington
13.4
12.2
12.2
11.7
11.2
12.6
12.3
13.0
Pennsylvania Communities of Concern
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Ten counties were identified that had high risk from
environmental burden (based on risk-related scores from 19882002), and were also above the state percentage of those that
live in poverty.
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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.
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The ten counties identified also demonstrated disease
significantly above the state average on several levels.
Identified Environmental Justice County
Community
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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.
Demographics
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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.
Demographics
2000 Census
PA
Allegheny
Beaver
Cambria
Erie
Lackawanna
Mercer
Philadelphia
Schuylkill
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.
Conclusions
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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.
References:
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Bureau of Health Statistics and Research, Pennsylvania
Department of Health.
Legg, J.M. (2006). Building Healthy Communities in
Environmental Justice Areas. Charleston, South Carolina:Book
Surge, LLC.
United States Environmental Protection Agency. (2005). EPA’s
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.