摘要：The environmental justice movement has stimulated community-driven research about the living and working conditions of people of color and low-income communities. We describe an epidemiological study designed to link research with community education and organizing for social justice. In eastern North Carolina, high-density industrial swine production occurs in communities of low-income people and people of color. We investigated relationships between the resulting pollution and the health and quality of life of the hog operations’ neighbors. A repeat-measures longitudinal design, community involvement in data collection, and integration of qualitative and quantitative research methods helped promote data quality while providing opportunities for community education and organizing. Research could affect policy through its findings and its mobilization of communities. There is growing interest in public health research that addresses the concerns of communities exposed to environmental hazards through research partnerships between scientists and community-based organizations. 1 – 10 This interest is generated in part by public demands for accountability from scientific institutions that are increasingly dependent on funding from industries and research grants. 11 , 12 Interest in community-driven research has also been stimulated by the environmental justice movement, which developed from grassroots efforts to oppose disproportionate placement of waste sites and polluting industries in communities that lack political power. 13 – 15 Low-income communities and those composed predominantly of people of color not only have little influence on land-use decisions that bring pollution and disin-centives for safe and sustainable development, they also lack resources for conducting research into relationships between land use, pollution, race, and class, or for investigating the impacts of land use and pollution on the health and quality of life. Such research could help to increase understanding of the scope, magnitude, and effects of environmental injustice, raise community awareness, educate policymakers, inform legal disputes, and contribute to the knowledge base for improving public health. 1 , 2 , 16 – 18 Several barriers limit community-driven environmental health research. First, its small share of environmental and health research funding is disproportionate to its needs. Second, people of color and low-income people often distrust researchers who visit their communities only when their research interests are piqued, come from institutions that foster and benefit from economic and racial inequalities, or are from professions with a history of discriminatory practices. 19 – 21 This distrust creates further disincentives for researchers because, in the context of funding shortages, they must take the time and effort to build trust, learn about community situations and perspectives, and learn how to communicate with nonresearchers about technical topics. 22 Third, researchers and community members may fear harassment, litigation, or loss of funding if they find evidence of discrimination or harm caused by industry practices and choose to bring them into the public arena. 23 These challenges highlight the need for refinement of study designs and methods for community-driven public health research. We describe the design and methods of an epidemiological investigation of the impact of air pollution from industrial swine production facilities on the health and quality of life of neighboring communities as an example of (1) how community-driven environmental health research can connect research, education, and organizing for change and (2) how community participation in research can improve the validity of the data collected. Community Health Effects of Industrial Hog Operations (CHEIHO) grew out of a collaboration between academic researchers and the Concerned Citizens of Tillery (CCT), 24 a community-based organization that promotes social justice and self-determination for rural African American communities. Our hypotheses and methods were based on community experiences and previous research. The study enrolled 102 people in 16 communities who collected data twice a day for 2 weeks. It was designed to integrate ethnographic and epidemiological research 25 , 26 on acute exposures and their relationships to both health-related outcomes and quality-of-life concerns, while providing environmental health education and promoting community participation in environmental and social justice movements.
