Abstract
Background:
Low-income urban communities of color, specifically African American and Hispanic populations living in industrial areas, are disproportionately affected by environmental health hazards, including exposure to air pollution and noise. In Southwest Detroit, a densely populated area with extensive industry and traffic, many residents are chronically exposed to air and noise pollution, contributing to a high prevalence of chronic illnesses such as asthma and cardiovascular disease.
Materials and Methods:
To better understand environmental health concerns and perceptions of environmental hazards, we conducted phone interviews with 22 residents in Southwest Detroit. During the interviews, participants were asked to reflect on reports of air and noise pollution based on monitoring inside and outside of their home, how their health might be affected, and to identify their main environmental health concerns.
Results:
Through qualitative analysis of phone interview notes, we identified truck traffic and inadequate mitigation efforts as concerns for Southwest Detroit residents. Our results suggested that study participants are aware of their disproportionate exposures to air and noise pollution and that while some residents are actively involved in environmental justice efforts, additional structural preventive measures including reduced pollutant emissions, are necessary to preserve public health.
Conclusion:
This study demonstrates that residents of Southwest Detroit are aware of high levels of both air pollutants and noise and perceive environmental exposures as critical components affecting health, both key aspects of environmental health literacy. This awareness, along with policy change, can facilitate community involvement in evaluating, understanding, and potentially abating air and noise pollution among minority populations.
Keywords: community benefits, environmental justice, air pollution, noise exposure
INTRODUCTION
Exposure to air pollutants and noise is a public health concern owing to linkages with asthma, cardiovascular disease, lung disease, hypertension, sleep disturbance, speech disruption, psychological health, cognitive performance, and other adverse health effects.1 Chronic exposure to air and noise pollution disproportionately affects communities of color.2 Given the presence of environmental hazards in these communities, it is important that residents have a high level of environmental health literacy (EHL), which is the understanding that environmental factors affect health.3 The need to address EHL and the perception of environmental hazards among racial and ethnic minority populations is critical to advancing environmental justice (EJ) because a person with a high level of EHL would be able to comprehend and use environmental health information to reduce hazards and health risks and ultimately would attain a better quality of life, the key principles of EJ.4
Southwest Detroit, the focus of this study, is home to ∼45,000 residents, of whom 57% are Hispanic/Latino, 24% are Black, and 73% have an income <$50,000. Residential areas are juxtaposed among a wide range of industrial and commercial facilities that include power plants, steel and coke facilities, a large refinery, the regional waste water treatment plant, motor vehicle assembly plants, and logistics and intermodal facilities, all of which contribute to air and noise pollution.5 In addition, the area has considerable truck traffic traveling across the Ambassador Bridge to Canada, on Interstate 75 (I-75), a 6–10 lane highway that bisects the community and leads to the bridge, and on many truck routes that pass through residential neighborhoods. I-75 has an average annual daily traffic volume of 110,000 vehicles, which includes 12,000 commercial vehicles,6 and the bridge is crossed daily by ∼12,000 vehicles and 8000 commercial vehicles.7 A new international crossing, the Gordie Howe International Bridge, is under construction and scheduled for completion in 2024, and is expected to bring additional traffic, noise, and air pollution to this area.8 Truck traffic has been a long-standing environmental health and safety concern in this community.9
Residents are exposed to high levels of particulate matter (PM), sulfur dioxide (SO2), black carbon (BC), noise, and other pollutants,10 and industry and pollution have been long-standing and prominent EJ issues, in addition to truck traffic.11 These exposures contribute to stark differences in health. For example, asthma prevalence in Detroit is 17% among adults and 15% among children, twice the national average,12 and asthma is the leading cause of preventable hospitalizations for Detroit children.13
Study objectives
This study was designed to identify and understand perceptions of air and noise pollution among urban, low-income community members in Southwest Detroit, Michigan, and to provide community members with environmental health literacy resources. Phone interviews with community members who participated in air and noise monitoring events at their home and who had received tailored exposure reports in a larger environmental health study allowed the collection of information on their environmental health concerns. The larger community-based participatory research study was designed to investigate both indoor and outdoor air and noise pollution (see Section A of Supplementary Data). In this study we report on several themes around air and noise pollution that were identified as major concerns by community members who received educational material, which was provided as a written, detailed, and tailored exposure report that described and explained common pollutants and their sources. The study is intended to inform future community-based studies examining environmental exposures, particularly in urban, low-income, and predominately nonwhite communities.
MATERIALS AND METHODS
In two seasons, the summer and fall of 2019, we conducted up to two 1-week long air and noise monitoring events in 36 homes in Southwest Detroit. The monitoring events assessed indoor and outdoor levels of noise, carbon dioxide (CO2), PM was under 2.5 and 10 μm aerodynamic diameter (PM2.5, PM10) and BC (see Section B of Supplementary Data). These parameters were selected because of the industry and truck traffic in Southwest Detroit, which are sources of these pollutants (PM2.5 and BC are components of diesel exhaust), and because of their potential to cause adverse health outcomes. CO2 indoors was monitored to determine air change rates in homes, an important indoor air quality parameter. Of the 36 homes with monitoring events, 22 households elected to receive exposure reports and completed phone interviews. The interviews were originally envisioned as a face-to-face dialog, but we transitioned to phone interviews because of the COVID-19 pandemic.
Participants
In addition to assisting with the monitoring events, our long-standing community-based study partner, the Southwest Community Benefits Coalition (SWCBC) enlisted participants using flyers, presentations at community meetings, and word-of-mouth. Eligible participants lived in Southwest Detroit, were willing to participate in week-long air and noise pollution monitoring events, receive a tailored exposure report containing air and noise pollution information, and were head of household. No demographic information for the participants was collected to maintain anonymity. Enrolled participants who completed at least one monitoring event received $25 for each monitoring event (maximum total of $300 if all seasonal deployments over 3 years were completed). Recruitment and all other study aspects included written informed consent and complied with the University of Michigan Institutional Review Board requirements (HUM00148745).
Procedure
After consenting, participants received a tailored exposure report, created via Canva14 and Free Vector,15 that contained detailed information from the environmental assessments conducted at their homes in 2019 (Figs. 1–3). Spanish-speaking households received both English and Spanish versions of the report. The exposure report, developed with input and revisions by SWCBC members, included the following: levels of target pollutants measured in the home; ranking of the levels (i.e., good, moderate, unhealthy for sensitive groups, etc.); health effects associated with pollutant exposures; description of possible pollution sources; and ways to reduce their exposure to the pollutants. The reports were intended to give comprehensive information on environmental health hazards and were designed to be an EHL tool. Given the importance of readability for EHL,16 reports were run through a readability program and received a Flesch–Kincaid Grade Level of ninth grade. Although a lower reading grade level would have been ideal (at or below the average American reading level of seventh to eighth grade17), the difficulty of the vocabulary (CO2, PM, etc.) needed in the infographic raised the grade level score. (Section C of the Supplementary Data details the materials in the exposure reports.)
FIG. 1.
Example of an indoor environment infographic.
FIG. 2.
Example of an outdoor environment infographic.
FIG. 3.
Example of indoor exposure report. Note: The outdoor report mirrors the indoor.
Upon receiving the reports, phone appointments were scheduled, and interviews were conducted to answer questions about the report and obtain participants' perceptions of air and noise pollution. For Spanish-speaking residents, a live translator was on all the calls. Written scripts, developed in conjunction with SWCBC, were used to guide the calls and ensure uniformity between appointments. These included a series of open-ended questions involving the reports, for example: “What did you think of the report?” and “Did you know about ways you could reduce your exposure?” Important quotes, phrases, and indications of understanding from the residents, that is, “I understand mitigation efforts better now,” and the responses from the open-ended questions were documented using handwritten notes.
Analysis
Notes from the phone interviews were entered into Dedoose, a qualitative data analysis software program,18 to identify the most prominent and common concerns among participants. Using a grounded approach, an open coding process identified emergent themes across the interviews by labeling data from the interviews into discrete codes (representing truck traffic, prevention, noise, etc.). After this, axial coding was used to structure the open-coded labels into broader categories and to draw connections between codes (e.g., noise and BC both corresponded with concerns with truck traffic).
RESULTS
A total of 16 English and 6 Spanish-speaking interviews were completed (total N = 22). On average, the phone conversations lasted 21 minutes (ranging from 6 to 42 minutes). Typically, interviews were longer when participants had more questions involving the report, or where participants more avidly expressed concerns with results or health implications of the reports. Truck traffic and inadequate mitigation were two major themes that emerged from the interviews as areas of concern. These themes and additional subthemes are given in Figure 4.
FIG. 4.
Theme bubble of major themes from phone interviews. Note: The size of the bubble corresponds with the frequency of the mentioned theme.
Truck traffic
Concerns with truck traffic were expressed by 12 (54%) participants and focused on the number of trucks and how frequent they are in their neighborhood or on their street. Quotes from participants include:
“Early in the morning and late at night the trucks go by.”
“At 3 am I am waking out of my bed because the trucks are very loud coming down the street.”
“All the semi-trucks going by…it's unbelievable, there is no reason for them.”
These quotes suggest participants' annoyance with the constant flow of trucks, occurring at all hours of the day. In addition, participants (n = 13, 59%) expressed concerns about BC levels and/or attributed the high levels of BC inside and outside their homes to the heavy truck presence.
“The black soot is outside because of the vehicles”
“The trucks are constantly around us so we could have had the windows open and that's why our black carbon levels are high”
Such statements demonstrate not only that participants are aware of the high levels of BC, but also that they have identified the likely source of this pollutant. Participants also vocalized grievances with the construction of the international (Gordie Howe) bridge (n = 8, 36%), and several participants (n = 7, 32%) complained that trucks were being rerouted down the residential streets:
“The trucks are such a problem, and they are being re-routed all along with the neighborhood.”
“Truck traffic is changing because of the construction of the bridge”
These quotes show that participants pay particular attention to truck traffic and that they attribute traffic shifts to activities related to bridge construction. In addition, some residents (n = 6, 27%) had further grievances associated with bridge construction. Participants expressed that the completion of the bridge will aggravate environmental health concerns in Southwest Detroit:
“With it [the bridge] coming, we will only get more pollution.”
“Because of the bridge being built, dust is kicking up, there are constant piles of dirt and sand that the city isn't doing anything about it.”
“The second bridge is already being built so what do you think is gonna happen when it's done…even more semi-trucks.”
In addition to awareness of both pollution levels and pollutant sources, participants often referred to personal or familial experience with health problems attributed to air pollution and truck pollution (n = 10, 46%). Here, participants observed health trends in their neighborhood and daily lives:
“I have asthma and I have lost a lot of people to cancers and such, both of my parents and sister had cancer.”
“I have asthma, my children have asthma, and my grandchildren have asthma.”
“I want to show the report [exposure report] to the doctor, to show him exactly what I have going on and why I have COPD.”
“I have tinnitus from all the noise and my ENT doctor told me it was because of the constant truck traffic noise; I can't even listen to music or TV at a loud decibel”
These statements demonstrate the fundamental understanding of EHL—that the environment can affect your health. Not all participants attributed health concerns to truck traffic. Several participants (n = 6, 27%) complained about persistent smells, scrap metal shards, and the inhalation of dirt. Nevertheless, the extent of truck traffic, BC levels, and adverse health outcomes associated with truck traffic were commonly identified, demonstrating the participants' understanding that environmental hazards can have significant impacts.
Inadequate mitigation and prevention efforts
Inadequate mitigation of environmental exposures was the second most common theme emerging from phone interviews. For many participants (n = 13, 59%), these concerns began with them explaining their awareness and activity in community betterment efforts and the importance of community involvement:
“I am very knowledgeable on issues and am a board member for the community.”
“It is super important that we are involved in our community, and join research studies, and collaborate with community groups. This is how we prove that we are being poisoned and how we can advocate to stop poisoning us.”
“I get ticked off because I can't even breathe in my own house, so of course I am involved in any way that I can be.”
Such statements demonstrate an understanding that community involvement can lead to actions that can decrease environmental risks. In addition to community involvement, participants (n = 11, 50%) referred to cleaning practices and individual mitigation efforts used to reduce their exposure. Here, participants reported several strategies that they use to clean their house, regardless of how helpful they believe these practices to be:
“I just bought two air purifiers so hopefully that will help.”
“It doesn't matter what I'm doing because everything around me is making it the opposite.”
“I am tired of always cleaning, I sweep and dust every day, and I don't have the money for someone to come in a clean the ducts well.”
“I vacuum every day.”
Participants understood that environmental hazards can be harmful, and therefore implore individual and community practices that can reduce exposure and potential adverse health impacts. Still, despite involvement in community coalitions (n = 6, 27%) and taking mitigation and cleaning practices into their own hands, many participants reported frustration with the responses of state and city governments. Participants (n = 8, 36%) felt that the city/state did not care or put forth their best efforts into protecting them:
“I don't know why no one cares about us, the trees are dying, the sidewalk is messed up and it's the cities job to fix it, just like everything else, we have to do it [clean up] or no one else will.”
“The state doesn't even care.”
“The city isn't doing anything about it [truck traffic and rerouting from the bridge].”
“They want us to pay our taxes and if we don't, we can be in trouble or lose our houses, but what do we get in return? What do our taxes pay for? Poison.”
Regardless of support or lack thereof from the government, mitigation strategies used by industries were perceived to be insufficient, resulting in frustrations expressed by participants. As an example, several study homes were located near the Marathon Petroleum Refinery in Southwest Detroit, which aims to expand its property. Marathon is currently promoting home buyouts as a beneficial initiative that allows people to relocate to potentially less polluted areas. However, several participants voiced annoyance with home buyouts, specifically low offers from Marathon. In addition to attributing blame for high levels of pollution, Marathon's buyouts were a top complaint by participants (n = 8, 36%):
“We were bought out by Marathon, but we would have never moved if we weren't forced to because the house is paid off.”
“They [Marathon] offered us $50,000 we can't buy a new home for that, and yet I want to sell the house and move because I am tired of being sick.”
“If they really care about us, they shouldn't offer money for the house, they should reduce [their emissions] but no, they just want to expand.”
DISCUSSION
The interviews highlighted the participants' environmental awareness, concerns with truck traffic, and the inadequacy of prevention measures. These themes appeared to be grounded in personal experiences and observations in Southwest Detroit. Many participants demonstrated significant knowledge on these topics, and overall, the community appears knowledgeable of EJ issues. Given the extent of truck traffic in Southwest Detroit resulting from imports, exports, logistics, and manufacturing activities, it is unsurprising that concerns with truck traffic emerged as a dominant theme from the interviews. Similarly, because truck traffic is an established public health issue,19 the concern with BC emitted by diesel trucks is also understandable.
EJ and environmental health literacy
This appears to be one of the few studies to conduct qualitative interviews in an EJ community to assess perceptions of air and noise pollution. Research that emphasizes EJ among predominantly nonwhite populations, especially those of low socioeconomic status, is important because these communities often experience co-exposure to multiple stresses, such as deteriorated housing quality, inadequate schools, and limited access to health care. In addition, understanding environmental health inequities can help motivate and inform actions that can reduce such health disparities and social determinants of health simultaneously.20 Furthermore, preexisting health conditions like obesity, diabetes, and asthma may increase susceptibility to adverse health effects associated with air and noise pollution.21 The understanding of how communities perceive such environmental exposures is thus critical to minority health because residents must act to institute mitigation efforts and policies for these environmental hazards.22
Our findings support the importance of EJ and highlight the continuing need for mitigation efforts in Southwest Detroit. The narratives obtained provide important context for understanding how residents of this community perceive their environmental health risks. They suggest that although the presence of truck traffic and air pollution was generally understood, participants were uncertain whether mitigation activities were sufficient to adequately protect them from current and anticipated levels of air and noise pollution. Thus, the community is aware and trying to respond to environmental hazards, as evidenced by some residents who both demonstrated a high level of EHL and emphasized their involvement in community betterment organizations, as well by groups such as the SWCBC and community–university coalitions that are researching and advocating for cleaner air and lower exposure to environmental hazards.23
Our findings above indicate that the Southwest Detroit community does not feel adequately protected against air and noise pollution. This suggests that EHL alone is not enough to combat environmental health disparities, and that efforts to mobilize and achieve additional mitigation efforts are required. These ideas are supported by the two themes that emerged from interviews with residents, which highlight the need for more effective interventions to improve air quality and reduce noise exposure in Southwest Detroit, and the need to better address safety, vibration, and other issues associated with truck traffic.
Study strengths and limitations
Community-based work provides a great opportunity to assess community perceptions on environmental health and EJ issues. This study shows that many people are invested in their health, involved in community betterment organizations, and have real concerns about air and noise pollution. Community-based work also involves logistic and technical challenges, such as loss to follow-up. In the larger environmental health study, a total of 36 homes had monitoring events; however, we were only able to successfully contact 22 of those participants. This small sample size limits generalizability about opinions on air and noise pollution in Southwest Detroit, and the lack of a comparison group limits generalizability to other minority communities experiencing environmental injustices.
Demographic information was not collected to maintain anonymity; this information might have provided additional insights as to why particular trends from the phone interviews emerged. Similarly, as interviews were personal accounts, individual biases, and social contagion, that is, neighbors talking to each other about the effects of the construction on their neighborhoods, it may have influenced results. Obstacles related to the COVID-19 pandemic posed additional challenges to community-based work. Still, we were able to reach Spanish-speaking households, which represent a significant proportion of the population in Southwest Detroit. Overall, we gained valuable insights and identified emerging themes from our interviews and sampling events in Southwest Detroit.
Directions for future studies
Future directions include integrating community perceptions on air and noise pollution into community abatement or mitigation events and presenting findings to larger stakeholders and policymakers to improve environmental quality in Southwest Detroit. Additional research is needed to see if the concerns with truck traffic and inadequate mitigation and prevention, identified from the interviews, persist or change over time, potentially controlled by using buffers, enforced truck routes, and other strategies.
CONCLUSION
In Southwest Detroit, EJ concerns include exposure to ambient air contaminants and noise pollution. Although community organizations in Detroit have decades of organizing and mobilizing to advocate for reduced exposure to environmental hazards, these concerns remain unresolved. Our interviews with residents identified two key themes: concern with truck traffic, and inadequate mitigation and prevention efforts. Residents expressed additional environmental health concerns, including noise exposure, respiratory disease stemming from pollution, and disturbances from construction, and they felt that these also warranted future mitigation efforts. These themes suggest a preexisting understanding of environmental health risks among at-risk group as they recognize the nature and impacts of risks, the need for policies and actions to reduce risks, and the importance of community involvement in evaluating and understanding air and noise pollution among communities of color.
Understanding perceptions of environmental risks and possible preventative actions in Southwest Detroit and other impacted communities is only one step in combatting EJ. To solve EJ issues within these communities, resources, tools, and data are necessary to mitigate and prevent pollution impacts from motor vehicles, industry, construction, and other emission sources, and to address other factors that affect health and well-being.
Supplementary Material
ACKNOWLEDGMENTS
The authors thank the Southwest Detroit Community Benefits Coalition and all the study participants. Also, the authors thank our translator, Nelson Figueroa, Simone Charles, and Lauren Fink who helped advise this project, and Shannon Brownlee and the Detroit Health Department for their assistance.
Human subjects
This study did not involve human subjects data, however, an allied portion of the study obtained some information from participants and provided financial incentives, in accordance with the University of Michigan Institutional Review Board under for the project “The Gordie Howe International Bridge (GHIB) Air Monitoring” (HUM00148745).
AUTHOR DISCLOSURE STATEMENT
No competing financial interests exist.
FUNDING INFORMATION
Portions of this work were supported by the State of Michigan in a grant administered by the City of Detroit called “Air Monitoring for the Gordie Howe International Bridge.” S.B. also acknowledges support from grant P30ES017885 from the National Institute of Environmental Health Sciences, National Institutes of Health.
Supplementary Material
WHO. “Guidelines for Community Noise.” 1999. <https://www.who.int/docstore/peh/noise/Comnoise-1.pdf>. (Last accessed on February 25, 2022); Sheena E. Martenies, Chad W. Milando, Guy O. Williams, and Stuart A. Batterman. “Disease and Health Inequalities Attributable to Air Pollutant Exposure in Detroit, Michigan.” International Journal of Environmental Research and Public Health 14 (2017): 1–24; Marie Eve Héroux, Wolfgang Babisch, Goran Belojevic, Mark Brink, Sabine Janssen, Peter Lercher, Marco Paviotti, Göran Pershagen, Kerstin Persson Waye, Anna Preis, Stephen Stansfeld, Martin van den Berg, and Jos Verbeek. “WHO Environmental Noise Guidelines for the European Region.” Euronoise 2015 (2020): 2589–2593; Harris Héritier, Danielle Vienneau, Maria Foraster, Ikenna C Eze, Emmanuel Schaffner, Kees de Hoogh, Laurie Thiesse, Franziska Rudzik, Manuel Habermacher, Micha Köpfli, Reto Pieren, Mark Brink, Christian Cajochen, Jean Marc Wunderli, Nicole Probst-Hensch, and Martin Röösli. “A Systematic Analysis of Mutual Effects of Transportation Noise and Air Pollution Exposure on Myocardial Infarction Mortality: A Nationwide Cohort Study in Switzerland.” European Heart Journal 40 (2019): 598–603; Environmental Protection Agency (EPA). “The Links Between Air Pollution and Childhood Asthma.” 2018. <https://www.epa.gov/sciencematters/links-between-air-pollution-and-childhood-asthma#:~:text=Researchers have long linked asthma,with exposure to air pollution.&text = trigger asthma attacks.-,The estimated six million children in the United States with,espe>. (Last accessed on February 25, 2022); Environmental Protection Agency (EPA). “Research on Health Effects of Air Quality.” 2020. <https://www.epa.gov/air-research/research-health-effects-air-quality>. (Last accessed on February 25, 2022); Centers for Disease Control and Prevention (CDC). “Public Health Issues.” 2019. <https://www.cdc.gov/air/air_health.htm>. (Last accessed on February 25, 2022).
Environmental Protection Agency (EPA). “The Links Between Air Pollution and Childhood Asthma”; Michelle L. Hernandez, Radhika Dhingra, Allison J. Burbank, Robert B. Devlin, David B. Peden, and David Diaz-Sanchez. “Low-Level Ozone Has Both Respiratory and Systemic Effects in African American Adolescents with Asthma despite Asthma Controller Therapy.” Journal of Allergy and Clinical Immunology 142 (2018): 1974.e3–1977.e3; Centers for Disease Control and Prevention (CDC). “CDC Health Disparities & Inequikutues Report (CHDIR).” 2013. <https://www.cdc.gov/minorityhealth/CHDIReport.html>. (Last accessed on February 25, 2022); Joan A. Casey, Rachel Morello-Frosch, Daniel J. Mennitt, Kurt Fristrup, Elizabeth L. Ogburn, and Peter James. “Race/Ethnicity, Socioeconomic Status, Residential Segregation, and Spatial Variation in Noise Exposure in the Contiguous United States.” Environmental Health Perspectives 125 (2017): 1–10.
National Institute of Environmental Health Sciences. “Environmental Health Literacy as a Tool to Promote Prevention and Improve Health.” 2017. <https://www.niehs.nih.gov/research/supported/translational/peph/currentissue/lists/5_17/environmental_health_literacy_as_a_tool_to_promote_prevention_and_improve_health.cfm>. (Last accessed on February 25, 2022); Doug Brugge, Migdalia Tracy, Katherine Thayer, Anne Thayer, Brianna Dayer, Nancy Figueroa, and Sabrina Kurtz-Rossih. “The Role of Environmental Health Literacy When Developing Traffic Pollution Fact Sheets for Puerto Rican Adults.” Environmental Justice 11 (2018): 40–46; Marie Wolff and Cheryl A. Maurana. “Building Effective Community—Academic Partnerships to Improve Health: A Qualitative Study of Perspectives from Communities.” Academic Medicine 76 (2001): 166–172.
Casey, et al. “Race/Ethnicity, Socioeconomic Status, Residential Segregation, and Spatial Variation in Noise Exposure in the Contiguous United States”; Kalahn Taylor-Clark, Howard Koh, and K. Viswanath. “Perceptions of Environmental Health Risks and Communication Barriers among Low-SEP and Racial/Ethnic Minority Communities.” Journal of Health Care for the Poor and Underserved 18, 4 Suppl (2007): 165–183.
Data Driven Detroit. “Southwest Detroit Neighborhoods Profile.” 2013: 1–11. <https://datadrivendetroit.org/files/SGN/SW_Detroit_Neighborhoods_Profile_2013_081913.pdf>. (Last accessed on February 25, 2022).
Bridge and Tunnel Operators Association (BTOA). “2019 Border Traffic Statistics Issued by the Bridge and Tunnel Operators Association (BTOA).” 2020; Michigan Department of Transportation. “Traffic Volumes Maps.” 2018. <https://lrs.state.mi.us/portal/apps/webappviewer/index.html?id=1a8bf6b2681d483ca9090ebec5d105ff>. (Last accessed on February 25, 2022).
Michigan Department of Transportation. “Traffic Volumes Maps.”
Natalie Sampson, Simone Sagovac, Amy Schulz, Lauren Fink, Graciela Mentz, Angela Reyes, Kristina Rice, Ricardo de Majo, Cindy Gamboa, and Bridget Vial. “Mobilizing for Community Benefits to Assess Health and Promote Environmental Justice near the Gordie Howe International Bridge.” International Journal of Environmental Research and Public Health 17 (2020): 4680.
Martenies et al. “Disease and Health Inequalities Attributable to Air Pollutant Exposure in Detroit, Michigan”; Stuart Batterman, Sydni C. Warner, Tian Xia, Simone Sagovac, Benjamin Roberts, Bridget Vial, and Chris Godwin. “A Community Noise Survey in Southwest Detroit.” Environmental Research 197 (2021):111064.
Batterman et al. “A Community Noise Survey in Southwest Detroit”; Environmental Protection Agency (EPA). “Inventory of U.S. Greenhouse Gas Emissions and Sinks.” 2020. <https://www.epa.gov/ghgemissions/inventory-us-greenhouse-gas-emissions-and-sinks>. (Last accessed on February 25, 2022); Climate and Clean Air Coalition. “Black Carbon.” 2018. <https://ccacoalition.org/en/slcps/black-carbon>. (Last accessed on February 25, 2022).
Martenies et al. “Disease and Health Inequalities Attributable to Air Pollutant Exposure in Detroit, Michigan”; Batterman et al. “A Community Noise Survey in Southwest Detroit”; Sampson et al. “Mobilizing for Community Benefits to Assess Health and Promote Environmental Justice near the Gordie Howe International Bridge”; Tae-Kyung Hong, Jeongin Lee, Giha Lee, Junhyung Lee, and Seongjun Park. “Correlation between Ambient Seismic Noises and Economic Growth.” 2020. <https://doi.org/10.1785/0220190369.Introduction>. (Last accessed on February 25, 2022).
Centers for Disease Control and Prevention (CDC). “Asthma.” 2020. <https://www.cdc.gov/nchs/fastats/asthma.htm>. (Last accessed on February 25, 2022); Detroit Alliance for ASthma Awareness. “Detroit Asthma Statistics.” 2015. <https://getasthmahelp.org/detroit-alliance-for-asthma-awareness.aspx>. (Last accessed on February 25, 2022).
Detroit Alliance for ASthma Awareness. “Detroit Asthma Statistics”; Shi Li, Stuart Batterman, Elizabeth Wasilevich, Robert Wahl, Julie Wirth, Feng-Chiao Su, and Bhramar Mukherjee. “Association of Daily Asthma Emergency Department Visits and Hospital Admissions with Ambient Air Pollutants among the Pediatric Medicaid Population in Detroit: Time-Series and Time-Stratified Case-Crossover Analyses with Threshold Effects.” Environmental Research 111 (2011): 1137–1147.
Melanie Perkins, Cliff Obrecht, and Cameron Adams. “Canva.” (Sydney, Australia, 2012). <www.canva.com>. (Last accessed on February 25, 2022).
Free Vector. “Free Vector Art & Graphics.” 2004. <https://www.freevector.com/>. (Last accessed on February 25, 2022).
Lisa Marchand. “What Is Readability and Why Should Content Editors Care about It?” 2017. <https://centerforplainlanguage.org/what-is-readability/>. (Last accessed on February 25, 2022).
Marchand; U.S. Department of Education. “Literacy, Numeracy and Problem Solving in Technology-Rich Environments.” Literacy, Numeracy and Problem Solving in Technology-Rich Environments (2013). <https://doi.org/10.1787/9789264128859-en>. (Last accessed on February 25, 2022).
SocioCultural Research Consultants LLC. “Dedoose Version” (Los Angeles, CA, 2018). <www.dedoose.com>. (Last accessed on February 25, 2022).
Batterman et al. “A Community Noise Survey in Southwest Detroit”; Environmental Protection Agency (EPA). “Inventory of U.S. Greenhouse Gas Emissions and Sinks”; Climate and Clean Air Coalition. “Black Carbon.”
Harold Rickenbacker, Fred Brown, and Melissa Bilec. “Creating Environmental Consciousness in Underserved Communities: Implementation and Outcomes of Community-Based Environmental Justice and Air Pollution Research.” Sustainable Cities and Society 47 (2019): 101473.
Thomas Münzel, Mette Sørensen, Frank Schmidt, Erwin Schmidt, Sebastian Steven, Swenja Kröller-Schön, and Andreas Daiber. “The Adverse Effects of Environmental Noise Exposure on Oxidative Stress and Cardiovascular Risk.” Antioxidants and Redox Signaling 28 (2018): 873–908; Ioannis Manisalidis, Elisavet Stavropoulou, and Agathangelos Stavropoulos. “Environmental and Health Impacts of Air Pollution: A Review.” Frontiers in Public Health 8 (2020): 14.
Jill E. Johnston, Zully Juarez, Sandy Navarro, Ashley Hernandez, and Wendy Gutschow. “Youth Engaged Participatory Air Monitoring: A ‘Day in the Life’ in Urban Environmental Justice Communities.” International Journal of Environmental Research and Public Health 17 (2020). <https://doi.org/10.3390/ijerph17010093>. (Last accessed on February 25, 2022).
Sampson, et al. “Mobilizing for Community Benefits to Assess Health and Promote Environmental Justice Near the Gordie Howe International Bridge”; Batterman et al. “A Community Noise Survey in Southwest Detroit.”
Associated Data
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