Low Income Families People Environmental Health

ENVIRONMENTAL HEALTH: LOW INCOME FAMILIES/PEOPLE

Environmental Health: Low Income Families/People

My health promotion program involved environmental health among low income families. Environmental health happens to be a critical issue among low income families owing to poor conditions the said population live in. For instance, low-income families tend to be more susceptible to environmental conditions owing to poor housing conditions. According to Kriegler and Higgins (2002), housing happens to be a major predictor of health. Some of the health conditions that low-income families face are inclusive of, but they are not limited to; mental health, injuries, stress pollution, lead poisoning, respiratory risks, and asthma (Kriegler and Higgins, 2002). The said risks are as a result of various hazards and exposures from the environment. In addition, low-income families are exposed to use of pesticides, pest allergens, second hand smoke, and other byproducts of combustion (Adamkiewicz et al, 2014). Various studies have in the past been conducted in an attempt to explore the environmental health conditions in low-income families. One such study was carried out in the Boston area whereby 211 participants from 20 low-income households were involved between 2005 and 2009 (Adamkiewicz et al, 2014). The study involved household exposures inclusive of inadequate ventilation, pests, chemicals, secondhand smoke, combustion byproducts, and molds. From the studied population, the said exposures were related to poor health conditions in low-income families.

The mission of the health promotion program is to educate families with low-incomes on various ways of avoiding and preventing exposures in their households. To promote health among low-income families, outcome goals and objectives which included health and quality of life goals were set. The health goal was to reduce indoor exposures from pests and molds that were the leading causes of cancer and asthma in low-income families (Adamkiewicz et al, 2014). To achieve the set goal, the following measurable steps and actions were set. They included:

· Providing low-income families with integrated pest management supplies, cleaning kits, doormats, vacuum cleaners, and bedding covers within a year.

· Repair all minor holes and leaks in low income households within one year.

To improve the quality of life among low-income families, the program aimed at improving their housing conditions. The following activities were to be carried out to ensure that the said goal would be achieved.

· Deal with all concerns related to households which have been identified by Kriegler and Higgins (2002) to be inclusive of; occupation, sanitation, and plumbing in 20% of low-income households within one year.

· Remedy seventy homes of low-income families at an average cost of $8000 within three years.

To determine whether the interventions put in place were providing the desired effect on behavior and environment, impact goals which included sample goals, behavioral goals, predisposing goals, and reinforcing goals were set. The sample goal for the program was to reduce indoor exposures in low-income households. The skill for achieving the said goal was to educate low-income families about safe and quality houses. Resources from public health were to be used to improve safety. The said resources were to educate low-income families on indoor quality of air, infant and toddler safety issues, and how to address fall hazards within one year.

The behavioral goal involved the process of identifying and reducing secondhand smoke exposure. First, smoke detectors would be distributed in low income households. Second, educational materials in print and web would be distributed to low-income families. With the said interventions, any secondhand exposure to smoke in children below 5 years would be reduced within a year. In addition, all tobacco users in low-income families would have been educated on behavioral change within one year. Centers for Disease Control and Prevention (2006) indicates that education is critical in scenarios such as these. The predisposing goal involved the provision of better housing conditions by involving management levels and tenants. The skills for achieving the said goal was to support individuals and communities who were seeking better housing conditions. Assisting tenants relocate or work with their landlords was also part of the activity aimed at achieving better housing conditions. After conducting the said activities, the program aimed at relocating low income families to newly constructed houses within 8 years. The authors further suggest that sanctions would have been imposed on all substandard houses within 8 years. With regard to the reinforcing goal, the program aimed at encouraging landlords to make repairs in their substandard houses by supporting community organizations efforts and advocating for affordable and healthy households.

Implementation process involved certain goals and objectives. The first process goal was to mitigate exposures from the environment among low-income families. The said process involved the following activities:

i. Making visits in low-income households after every one year to assess their exposure to toxic substances.

ii. Educating low-income families on various ways of avoiding poor ventilation and filthy housing.

iii. Reducing exposure from pesticides and allergens by adapting an integrated pest management method.

The second process goal was to improve that quality of houses in low income families. This was to be achieved by:

i. Replacing windows, removing water-damaged carpets, wallboard, and installation of ventilation systems within three years.

ii. Supporting low-income families by providing them with resources within one year.

iii. Make minor repairs on leaks and holes within one year.

The third process goal was to provide low income families living in substandard houses with better houses. The process involved:

i. Provision of resources to owners of substandard houses to help them make repairs.

ii. Build standard houses within 8 years.

iii. Train landlords and builders on effective ways of dealing with concerns raised by low-income families.

The fourth process goal was to advocate for affordable and quality houses. This would be achieved by:

i. Ensuring that power, assets, and incomes are equally distributed

ii. Making demonstrations of comparing individuals who moved from substandard houses to those who did not move.

iii. Provide housing subsidies

The fifth process goal was to ensure healthy housing by collaborating with housing agencies. The process entailed:

i. Development of guidelines and revision of housing codes within one year.

ii. Offering consultation services to developers and housing agencies while taking part in local planning.

iii. Support community building activities.

To develop my model of planning-the generalized model of planning whose main aim was to educate families from low incomes on methods of avoiding and preventing exposures, the program utilized the social cognitive theory. The said theory happens to be useful while dealing with environmental conditions and individuals. Essentially, human behavior is determined by personal and environmental factors (Bandura, 1998). Therefore, it would be possible to determine whether individuals from low-income families would change their behavior by utilizing self-efficacy, outcomes and goals. For the health promotion to be effective, low-income families must first believe that they are capable of changing their environment through their actions. For this reason, it would be prudent that they take the necessary actions towards change so as to achieve the expected outcomes given that the said outcomes are likely to benefit them in terms of health and quality of life. Bandura (1998) suggests that the said individuals will achieve the set goals and objectives through reinforcements and controls aimed at reducing exposures. The author further suggest that individual behaviors are influenced by various factors. For instance, a person’s behavior can be influenced by learning, observing, and/or imitating other peoples’ behavior.

It would be prudent to ensure that families from low-incomes learn of healthy environmental conditions and ways of reducing exposures. For this reason, the generalized model of planning comes in handy in this step. This happens to be the case given that the generalized model educates people on simpler ways of executing a program (Carlson and Saadati, n. d). In addition, individuals from low-income families could learn by observing the activities that public health agencies conduct that are aimed reducing exposures.

The purpose of this program was to improve the lives of low-income families by reducing exposures. Therefore, it would be imperative that a needs assessment is conducted in the said target group to assess their most crucial needs. The first step in community assessment would be to identify the size of the population. The total number of population studied was 211 participants from 20 low-income households. The number of households was an indication that there were numerous persons living in one household. One participant from every household was interviewed. The said participants were individuals aged 18 years and above. Participants were both men and women. On average, the studied population’s incomes were below the poverty line in reference to the federal poverty level. The study included Hispanics, Non-Hispanic Whites, and African Americans. The studied population spoke English, Spanish, and Haitian Creole. The population studied had low levels of education. The households studied had children below 5 years and adults aged 65 years and above. The condition under which the houses of the target group were in revealed that the participants had lived in the said conditions for a long time. Chemical problems observed were inclusive of, but they were not limited to; inadequate ventilation, combustion byproducts, pests, secondhand smoke, mold owing to inadequate bathroom ventilation, and chemical pesticides from daily use of sprays.

The program aims at using various strategies at various levels to help promote health among low-income families. For instance, the program aims at advocating for affordable and healthy houses. This would be done by public health workers who assist participants and encourage landlords to make repairs and correct conditions that are not conducive. Community organizations that seek to improve housing conditions would also be roped in. Public health advocates would also advocate for better outcomes in health by demonstrating the effect of moving from substandard houses to standard houses. The next intervention, as has been alluded to above, would be collaboration with various entities. For instance, it would be prudent to collaborate with housing agencies and other relevant stakeholders to develop guidelines and revise housing codes. Housing agencies and relevant stakeholders to collaborate with will be inclusive of, but they are not limited to; urban planners, architects, landlords, home owners, builders, community development corporations, nonprofit housing organizations, community housing advocacy groups, tenants, and government agencies that regulate construction of houses (Kriegler and Higgins, 2002). Social marketing would also form part of the strategic intervention for this program. Essentially, this would incorporate the ‘4Ps’ of marketing which include price, place, product, and promotion. This strategy involves the process of providing products for reducing indoor exposures to low income families and ensuring that the said group would be able to afford the said products. In addition the program on health promotion would be advanced through information dissemination whereby community health workers would educate the community on safe and healthy homes. To ensure that the said project would be ideal for residents, houses would be subsidized, as well as and products for reducing exposures. The said products could be inclusive of, but they are not limited to; integrated pest management supplies, cleaning kits, doormats, vacuum cleaners, and bedding covers (Kriegler and Higgins, 2002).

There are various community agencies that I intent to partner with. For instance, collaboration with the local housing authorities would ensure that awareness on the impact of housing conditions on asthma is created. Further, the partnership between housing authorities and the New York City Department of Health would be encouraged as it could come in handy in efforts to reduce exposures from cockroach antigens and pesticides – i.e. by implementing an integrated pest management project. Further, Kriegler and Higgins (2002) suggest that the relationship between community development corporations and the Boston Healthy Homes Project would help organize grants to owners of low-income homes. Resources for my program would involve financial resources, human resources, educational resources, and physical resources. Financial resources would come from funds from the federal government which will be provided by local health departments and the state. Other resources would be inclusive of, but they would not be limited to; energy assistant grants, federal home loans programs, etc. Human resources would be provided by community health workers and public health nurses. Educational materials would include resources on websites and in print. Physical resources would include integrated pest management supplies, smoke detectors, subsidies, cleaning kits, doormats, vacuum cleaners, and bedding covers.

Environmental Health: Project Budget

FISCAL YEAR

2021

FY 2021

FY 2021

FY 2021

FY 2021

REVENUE

PROPOSED

ACTUAL

VARIANCE

+/- PRIOR YEAR

Fundraisers and events

450000.00

Foundation

250000.00

Donations

150000.00

Grants

250000.00

Miscellaneous

TOTALS

$1,100,000.00

$0.00

$0.00

$0.00

FY 2021

FY 2021

FY 2021

FY 2021

EXPENSES

PROPOSED

ACTUAL

VARIANCE

+/- PRIOR YEAR

Educational Campaign (Informational and Preventive)

112,000.00

Direct Intervention Efforts (to reduce exposure)

545,000.00

Efforts to Engage Key Stakeholders (i.e. Landlords)

153,000.00

Advocacy Efforts (Targeting Public Housing and Health Agencies)

81,000.00

Promotion of Partnership with Community Housing Advocates

199,000.00

Miscellaneous

10,000.00

TOTALS

$1,100,000.00

$0.00

$0.00

$0.00

Core Needs of the Program

1. Educational Campaign (Informational and Preventive)

There will be need to first sensitize the community and create awareness about the various hazards that they are exposed to and the impact these could have on their health and wellbeing.

2. Direct Intervention Efforts (to reduce exposure)

Actual strategies that will be deployed in efforts to ensure that affected families are immediately secured from the hazards they are exposed to, i.e. in relation to:

· Exposure to chloroform, acetaldehyde, 1, 4-dichlorobenzene, and formaldehyde owing to air fresheners

· Exposure to mold

· Exposure to pesticides

3. Efforts to Engage Key Stakeholders (i.e. Landlords)

There will be need to engage landlords and ensure that they are aware of (and motivated to undertake) the various modifications/adaptations to minimize their tenants’ exposure to hazards.

4. Advocacy Efforts (Targeting Public Housing and Health Agencies)

There will be need to ensure that the relevant housing and health agencies are notified about the problem and the need to put in place measures to reign in the concern.

5. Promotion of Partnership with Community Housing Advocates

There are a number of community housing advocates we could reach out to in efforts forge meaningful partnerships. These partnerships are essentially meant to supplement each other’s strengths.

6. Miscellaneous

These will be inclusive of expenses that do not fall under the broad categories highlighted above.

To determine whether the program is making a difference in the community by reducing indoor exposures, it would be prudent to indicate both short-term and long-term indicators. For instance, short-term indicators would include the following: