Community-Oriented Research Programs: Disease Prevention

The quality of any community-based research depends - to an extent often underestimated - on the degree to which the community itself views the research as relevant and responsive to its needs.

Mount Sinai is unusual in the degree to which it achieves this precondition of success. Through grassroots and representative organizations, community residents are closely involved in defining research priorities, assisting in the design of investigative protocols, and implementing the resulting recommendations. Thanks to this collaborative relationship between academic scientists and those affected by their work, community residents see themselves not merely as subjects in a study, but as active participants and beneficiaries.

In July 1999, a new study on the underlying dynamics of the asthma epidemic was front page news throughout much of the New York metropolitan area and beyond. The study - involving an ecologic analysis of socioeconomic factors and asthma hospitalization rates in New York City by zip code - found a strong correlation between high asthma hospitalization rates and low median family income, percentage of minorities in the populations, and percentage of children under 18.

The data from this study was used by the regional office of the EPA to justify the placement of new air monitors for fine particulate matter in neighborhoods found to have high asthma hospitalization rates. This example demonstrates the ways in which research undertaken at our School yields tangible benefits for the neighboring populations, a key factor in the amount of support our scientific programs have earned in East Harlem and other communities. Our research also serves as a tool for regulatory and service agencies to design intervention strategies targeted to areas with the greatest need for resources. It can further be used to monitor the effectiveness of those strategies, and to facilitate the communication of results to the affected communities.

In 1998, Mount Sinai assumed a national leadership role in addressing the problem of environmentally-triggered childhood disease. Generous initial support from the New York Community Trust has resulted in a constellation of major new programs.

Center for Children's Environmental Health and Disease Prevention Research

The Center for Children's Environmental Health and Disease Prevention Research was created with dual funding from the National Institutes of Health and the Environmental Protection Agency. The Center will focus on environmental toxicants and neuro-developmental impairment in inner-city children, who suffer some of the heaviest exposures to pollutants in the United States and also exhibit a disproportionate incidence of learning disabilities, mental retardation, autism, delinquency and other behavioral impairments.

Center for Children's Health and the Environment

The goals of this Center are to identify the impact of pollutants on the developing brain and the mechanisms by which they cause dysfunction, with the ultimate aim of preventing such disorders in urban children. One of eight new national facilities established to promote children's health and wellbeing, it is one of only two to address children's neurodevelopment. At the heart of this program is a community-based prevention research trial that involves removing as many toxic substances as possible from homes and measuring the effects of that reduction, especially pesticides. The various research projects bring together a remarkable team of internal and external partners.

The Center for Children's Health and the Environment was created with a $2.5 million grant from the Pew Charitable Trusts as the nation's first academic research and policy center to examine the links between exposure to toxic pollutants and childhood illness. The Center will examine a range of diseases that includes asthma, cancer and neurodevelopmental disorders, and will also make scientifically-based policy recommendations for protecting children.

The Mount Sinai Clinical Specialty Unit in Environmental Pediatrics

Working with both these centers is an additional new program: The Mount Sinai Clinical Specialty Unit in Environmental Pediatrics. The Unit provides evaluation, diagnosis, treatment and prevention services to children who have been exposed to toxicants or have contracted diseases of toxic environmental origin. It also serves as a regional and national source of referral and consultation for pediatricians and other health providers. A further objective is to increase the knowledge of pediatricians at Mount Sinai about environmental threats to children, and at a later stage, to train pediatric environmental health fellows.