October 2020 Volume 5 Issue 1 1 Katrina Smith Korfmacher, PhD BOOK REVIEW: BRIDGING SILOS: COLLABORATING FOR ENVIRONMENTAL HEALTH AND JUSTICE IN URBAN COMMUNITIES Introduction Environmental health practitioners dedicated to creating healthy places are often looking for replicable policies, processes, and programs to bring to their communities. This can include model policy language or an implementation toolkit to easily be able to execute systems-level change. However, as this book outlines, there is rarely a one size fits all. This book outlines three case studies, including 1.) a community coalition-based lead poisoning prevention effort in Rochester, New York; 2.) a wide range of efforts to create an equitable and healthy built environment in Duluth, Minnesota; and 3.) comprehensive environmental justice efforts near the port freight corridors in Los Angeles and Long Beach, California. From these cases, the book extracts concepts, processes, and lessons learned that all communities can utilize. The author (Korfmacher) mentions that this book was sparked by a late night conversation after a National Institute of Environmental Health Science Core Centers meeting, where she and three other scholars at the forefront of urban environmental health, reflected on their local collaborative systems-level work in communities across the country. The group realized that their diverse work had several common elements and key lessons learned that any community could apply to their own issues. Out of that conversation, came this book, which breaks down how and why local environmental health collaborations can successfully impact systems change. Title: Bridging Silos: Collaborating for Environmental Health and Justice in Urban Communities Publishing: 2019 copyright Massachusetts Institute of Technology, Westchester Publishing Services U.S. isbn: 978-0-262-53756-8 Reviewed by: Alison Redenz, MURP, AICP Book Review: Bridging Silos Redenz 2 Bridging Silos as a Guide for Health Impact Practitioners and Beyond The title “Bridging Silos,” gets to core content of this book, as a wide variety of academics, government professionals, advocates, and others understand that often the barrier to successful collaboration is established management silos. This book will probably be most valuable to an interdisciplinary professional who is trying to move the needle on a new idea in their community, and wanting to utilize best practices from other communities. Often a professional from one discipline or an advocate will recognize an issue, but then realize the complexity of accomplishing any change within that issue due to silos, complex regulatory barriers, or lack of communication between disciplines. This book outlines step-by- step how these three communities were able to form successful community-based partnerships, and how progress can be measured many different ways. Health Impact Assessment practitioners will find this book useful for: best practices in engaging coalitions of community members, public health professionals, planners, researchers, and other key stakeholders to provide critical ideas and data, expand the definition of public health, and find key intervention points to mitigate any health disparities that are shown as part of the health impact assessment. Health Impact Assessments (HIAs) were used in two of the three cases studies to impact decision making. Coalition Building for Critical Ideas and Data In Duluth, three health impact assessments were used to assess the health impacts in the non-health decisions of potential neighborhood redevelopment. These three health impact assessments “allowed local stakeholders to develop greater familiarity with HIA, use health data to analyze how built environment decisions affect health disparities, and gather community input on improving health equity” (Korfmacher, 2019, p. 144). As Korfmacher mentions, each of the three HIAs performed in Duluth built “collaboration, capacity, and systems to improve health equity in Duluth’s built environment” (2019, p. 144). The core successes from the health impact assessments were the exchange of ideas between city and county health officials, and the community’s exposure to the idea of health impact assessment. The HIAs were scoped to influence plans for the City, not direct decision-making, but they set the City up for success by creating plans with health impact at the core. Expanding the Definition of Public Health Impacts through HIA in Los Angeles The Impact Project was an academic- community partnership aimed at increase the consideration of health in decisions related to transportation around the Ports of Los Angeles and Long Beach. The partnership interacted extensively with the planning process to redevelop a major highway to the ports, the I-710. As part of this process, THE Impact Project pushed for the environmental review process to include both a health risk assessment (HRA) and a health impact assessment (HIA). The HIA assessed a broader range of health impacts than the HRA including the “effects of air quality, jobs, noise, access to neighborhood resources, and mobility issues such as safety, travel time, physical activity, and stress involved in commuting for work (Human Impact Partners 2013)” (Korfmacher, 2019, p. 212). According to one of the key partners from East Yard Communities for Environmental Justice, “The HIA made people who were making recommendations to Caltrans realize that public health is much broader…Building a freeway is not just about happens on that freeway, it is about what happens in the community” Book Review: Bridging Silos Redenz 3 (Korfmacher, 2019, p. 213). This is a replicable example of how HIA can show the multiple pathways of health impacts of projects. Even if the final decision is not impacted by the HIA, the process was successful in broadening the definition of health impacts to include the social determinants of health. Finding key intervention points: “HIA- like” analysis in Rochester, NY Although the final case study in Bridging Silos did not include a formal health impact assessment, its process mirrored HIA’s use of public health data and community engagement to inform targeted intervention points and create action steps. The Coalition to Prevent Lead Poisoning in Rochester, New York was able to provide diverse health impact data and knowledge to inform the key intervention: a new local lead law. From health care providers summarizing medical literature, to health department staff providing elevated blood lead data, to lead professionals contributing knowledge from lead risk assessments, a wide variety of data-informed the Coalition’s initial step of communicating the problem to the community. These analyses helped the Coalition justify their recommendations from a cost-saving and health benefits perspective. Providing the cost of “not preventing the lead poisoning,” parallels the HIA process as it helps to show the health benefits of the lead law. By leveraging the types of resources and data in traditional health impact assessments, the Coalition in Rochester was able to show intervention points, and the costs of not implementing them. Evaluating the Impact of the Initiatives Korfmacher outlines the different types of impacts of the three case studies’ initiatives, as including outputs (products), social outcomes (capacity and relationships), and impacts of policies, systems, and environments (PSE). Korfmacher focuses on “upstream,” “systems- level” work which we know has the most long- lasting effort in creating change in communities. All three of the initiatives’ outputs were aimed at creating the conditions for change in systems in environmental health, whether that was conducting an assessment, or providing a training workshop on a topic. Social outcomes were another type of output of the initiatives, as when a coalition came together and built social capacity, trust, or relationships. Both types of outputs are the building blocks of policy, systems, and environmental changes and provide their own worth for creating awareness and creating the human capital to deliver the improvements. All three cases revealed ways in which the coalitions changed processes by which decisions were made. Other direct impacts of policy, systems, and environmental changes are more concrete such as the change in Rochester’s lead law, and the changes in processes by county health and human services departments. Summary Bridging Silos provides an excellent outline of the policy, systems, and environmental change impacts and nuanced ways of measuring success for three distinct environmental health efforts across the United States. Health impact assessment professionals will find ways to enhance their own work through the diverse range of case studies described. This book provides a great framework for a wide range of professionals looking to understand modern environmental health issues, how three communities addressed them, and how to learn from and apply their success to create healthier places in their own communities.