Vulnerability,Risk Perception,and Health Profile of Marginalized People Exposed to Multiple Built‐Environment Stressors in Worcester,Massachusetts: A Pilot Project

Millions of low‐income people of diverse ethnicities inhabit stressful old urban industrial neighborhoods. Yet we know little about the health impacts of built‐environment stressors and risk perceptions in such settings; we lack even basic health profiles. Difficult access is one reason (it took us 30 months to survey 80 households); the lack of multifaceted survey tools is another. We designed and implemented a pilot vulnerability assessment tool in Worcester, Massachusetts. We answer: (1) How can we assess vulnerability to multiple stressors? (2) What is the nature of complex vulnerability—including risk perceptions and health profiles? (3) How can findings be used by our wider community, and what lessons did we learn? (4) What implications arise for science and policy? We sought a holistic picture of neighborhood life. A reasonably representative sample of 80 respondents captured data for 254 people about: demographics, community concerns and resources, time‐activity patterns, health information, risk/stress perceptions, and resources/capacities for coping. Our key findings derive partly from the survey data and partly from our experience in obtaining those data. Data strongly suggest complex vulnerability dominated by psychosocial stress. Unexpected significant gender and ethnic disease disparities emerged: notably, females have twice the disease burden of males, and white females twice the burden of females of color (p < 0.01). Self‐reported depression differentiated by gender and age is illustrative. Community based participatory research (CBPR) approaches require active engagement with marginalized populations, including representatives as funded partners. Complex vulnerability necessitates holistic, participatory approaches to improve scientific understanding and societal responses.     

Public Support for Policies to Reduce Risk After Hurricane Sandy

A phone survey was conducted in New Jersey in 2013 four months after the second of two major devastating tropical storms (Sandy in 2012 and Irene in 2011). The objective was to estimate public support for restricting land uses in flood zones, requiring housing to be built to resist storm waters, and otherwise increasing mitigation and resilience. Respondents who supported these mitigation and resilience policies disproportionately were concerned about global climate change, trusted climate scientists and the federal government, and were willing to contribute to a redevelopment program through taxes, bonds, and fees. They also tended to have collectivist and egalitarian worldviews. Half of the respondents supported at least four of the seven risk‐reducing policies. How their support translates into public policy remains to be seen. Lack of willingness to personally fund these policies is an obstacle.