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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

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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

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(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. 


