Influences of Chemical and Nonchemical Stressors on Health and Quality of Life in Fenceline Communities: A Community-Based Participatory Research Survey in Southeastern Pennsylvania

Background: Community organizers in Southern Delaware County, PA, expressed a desire to collect comprehensive data on environmental, health, and social conditions in their neighborhoods to inform advocacy efforts to prompt public health action. Methods: Using a community-based participatory research (CBPR) approach, our team of academic and community coinvestigators developed an online community health survey to characterize residents' health concerns and the strengths, burdens, and needs of fenceline communities in Southern Delaware County. We included questions on chemical exposures, sources of pollution, financial stressors, health care, medical conditions, and priorities for policymakers. Results: Participants reported experiencing adverse effects of poor air quality, odors, and noise in their communities. Eighty-six percent of participants reported experiencing at least two nonchemical stressors, such as poor housing conditions, food insecurity, and experiences of racism and discrimination. We found high proportions of reported asthma diagnoses and symptoms in participants and the children living in their households. Symptoms of asthma, depression, and anxiety were more common than clinician diagnoses of these conditions. Participants also commonly reported decreased quality of life or functioning associated with physical and mental health issues. Discussion: Our findings highlight the importance of characterizing chemical and nonchemical stressors among residents in fenceline communities and expanding consideration of health to include acute symptoms, well-being, and quality of life. Our study was strengthened by our CBPR approach. Conclusion: Our work demonstrates the value of assessing cumulative impacts and employing CBPR approaches in fenceline communities.