A EPA
United States
Environmental Protection
Agencv
EPA/600/R-17/309 | August 2017 | www.epa.gov/research
Valuing Community Benefits of
Final Ecosystem Goods and
Services: Human Health and
Ethnographic Approaches as
Complements to Economic
Valuation
SHC PROJECT 2.61
-------
EPA/600/R-17/309
August 2017
Valuing Community Benefits of Final
Ecosystem Goods and Services:
Human Health and Ethnographic Approaches
as Complements to Economic Valuation
SHC Project 2.61
by
John M. Johnston1, Rebeca de Jesus Crespo1, Matt Harwell1, Chloe
Jackson1, Mark Myer2, Nadia Seeteram2, Kathleen Williams2, Susan
Yee1, Joel Hoffman1
1U.S. Environmental Protection Agency
2Oak Ridge Institute for Science and Education
Washington, DC
Project Officer John M. Johnston
Computational Exposure Division
National Exposure Research Laboratory
Athens, GA 30605
11
-------
Notice/Disclaimer Statement
The research described in this document was funded by the U.S. Environmental Protection Agency
through the Office of Research and Development. The research described herein was conducted at the
Computational Exposure Division (Athens, Georgia) of the National Exposure Research Laboratory, and
at the Mid-Continent Ecology Division (Duluth, Minnesota) and Gulf Ecology Division (Gulf Breeze,
Florida) of the National Health and Environmental Effects Research Laboratory.
This document has been subjected to the Agency's peer and administrative review and has been
approved for publication as an EPA document. Opinions are those of the authors and do not represent
Agency policy. Any mention of trade names, products, or services does not imply an endorsement or
recommendation for use.
This is a contribution to the EPA ORD Sustainable and Healthy Communities Research Program.
The citation for this report is:
Johnston, J.M., R. de Jesus Crespo, M.C. Harwell, C. Jackson, M. Myer, N. Seeteram, K. Williams, S.
Yee, and J. Hoffman. (2017). Valuing Community Benefits of Final Ecosystem Goods and Services:
Human Health and Ethnographic Approaches as Complements to Economic Valuation. U.S.
Environmental Protection Agency, Athens, GA, EPA/600/R-17/309.
111
-------
Abstract
As part of the Sustainable and Healthy Communities Research Program, the National and Community
Benefits of Final Ecosystem Goods and Services Task is focused on translating the provisioning of final
ecosystem goods and services (FEGS) into community health and well-being. As stated by the EPA
Science Advisory Board, "The science of sustainability must emphasize the interrelated aspects of
human actions and [human] well-being and the functions of human altered and natural supporting
ecosystems". While other tasks in the SHC Research Program are centered on assessing the economic
valuation of FEGS, the Benefits task will create a complementary link to indicators of human health and
well-being, providing a more comprehensive accounting of the benefits that ecosystems provide.
Task objectives are being met through literature synthesis and case studies across the country. This
report provides a summary of three of our research projects: 1) an evaluation of the quality of scientific
evidence associating green spaces with health benefits, along with ensuing research in San Juan, Puerto
Rico; 2) a Health Impact Assessment of a Long Island sewering pilot program in Suffolk County, NY
that revealed health benefits associated with control of sewage- and effluent-related ecosystem goods
and services; and 3) a Great Lakes community case study that used ethnographic methods to
characterize how a community values FEGS affected by aquatic ecosystem remediation and restoration.
Each chapter is written as a standalone section with a narrative synthesis. Each study represents the
experiences of social, public health, and environmental scientists recruited to ongoing interdisciplinary
research projects at the Agency.
This report covers a period from October 2016 to May 2017 and work was completed as of June 2017.
IV
-------
Foreword
The U.S. Environmental Protection Agency (EPA) is charged by Congress with protecting the Nation's
land, air, and water resources. Under a mandate of national environmental laws, the Agency strives to
formulate and implement actions leading to a compatible balance between human activities and the
ability of natural systems to support and nurture life. To meet this mandate, EP A's research program is
providing data and technical support for solving environmental problems today and building a science
knowledge base necessary to manage our ecological resources wisely, understand how pollutants affect
our health, and prevent or reduce environmental risks in the future.
The National Exposure Research Laboratory (NERL) within the Office of Research and Development
(ORD) supports EPA's mission to protect human health and the environment by developing and
applying innovations in exposure science. Exposure science sets the context for understanding and
solving real-world problems and is used to help answer three fundamental questions:
Is there a risk?
If so, how do we reduce/mitigate/prevent the risk?
Have our actions been successful in reducing risk?
NERL collaborates with both public and private sector partners and is internationally recognized as the
leader in environmental exposure science. Our multidisciplinary expertise enables the laboratory to
bring cutting-edge research and technology to the field of exposure science to address the Agency's
priority environmental problems.
This report is a product provided by the Community and National Benefits of Final Ecosystem Goods
and Services Task 2.61.4 of the Sustainable and Healthy Communities National Research Program.
Dr. Andrew Gillespie, interim Director
Computational Exposure Division
v
-------
Table of Contents
Acronyms and Abbreviations ix
Acknowledgments x
Executive Summary xi
1. Introduction 1
1.1. Background 1
1.2. Approaches for Studying Non-Monetary Benefits of Ecosystem Services 1
1.3. Conceptual Modeling for Developing Analytical Frameworks 3
1.4. Case Studies 4
1.5. Report Structure 5
2. Human Health Approaches - Causal Inference 6
2.1. Causal Criteria Analysis 6
2.2. Application of Causal Criteria Analysis to Evaluate the Role of Green Space EGS on
Human Health 6
2.3. Empirical Approaches for Eco-Health Research 8
2.4. Upcoming Application of Empirical Approaches for Eco-Health Research in the San
Juan Bay Estuary, PR 11
2.5. Conclusions and Future Research Needs 14
3. Health Impact Assessment Approaches 15
3.1. Application in Long Island Sound 16
3.1.1. Approach (EGS/FEGS Involved) 18
3.1.2. Outcome 19
3.1.3. Lessons Learned 20
3.2. Conclusions and Future Research Needs 21
4. Ethnographic Approaches 23
4.1. Application in Great Lakes 24
4.1.1. Approach (EGS/FEGS Involved) 25
4.1.2. Outcome 28
4.1.3. Lessons Learned 31
4.2. Conclusions and Future Research Needs 33
5. Synthesis 34
6. References 36
7. Glossary 45
8. Appendices 47
vi
-------
Appendix 1. Total Economic Valuation Overview 47
Appendix 2. Simulating Eco-Health Benefits Using Data-Derived Models 50
Appendix 3. Causal Criteria Analysis of Direct and Indirect Linkages Between Green
Spaces and Human Health Endpoints 51
Appendix 4. Issues of Data Accessibility and Granularity in Mapping Human Health
Outcomes as Part of Eco-Health Studies 56
Appendix 5. Limitations to Current Social Science Research at ORD 59
Appendix 6. Innovative/Alternative OSDS Under Consideration 61
Appendix 7: Contaminated Site Remediation to Habitat Restoration to Community
Revitalization (R2R2R) in the Great Lakes' Areas of Concern (AOC) 62
Appendix 8: Neighborhood Model Tool: Mapping the Human Ecosystem for a Place 64
Appendix 9: Additional Suffolk County HIA Lessons Learned 73
Figures
Figure 1.1 Examining the benefits from EGS to human health and well-being among
ecosystem, societal, and human health elements 2
Figure 2.1 Eco-health pathways connecting the ecosystem attribute, green spaces, to human
health endpoints through indirect ("A"; buffering EGS) and direct ("B"; human health)
pathways 7
Figure 2.2 Conceptual Model for measuring Final Ecosystem Goods and Services 9
Figure 2.3 Schematic of the complex relationships between altered environmental conditions
and human health 10
Figure 2.4 The gradient of modeling complexity shows different types of analysis used to
generate the functional relations that estimate benefits of ecosystem goods and services
management 11
Figure 2.5 Dengue cases per person by zip code in the SJBE 13
Figure 2.6 Preliminary findings of our study linking Dengue cases to wetland ecosystem
services in the San Juan Bay Estuary 13
Figure 3.1 The six steps of the Health Impact Assessment process 15
Figure 3.2 Health Impact Assessment Impact Pathway diagram 16
Figure 3.3 Density of un-sewered parcels in Suffolk County 17
Figure 4.1 The interests of the City of Duluth, citizens, and state natural resource managers
converge at the St. Louis River 24
Figure 4.2 Map of City of Duluth St. Louis River Corridor community revitalization projects ... 26
Figure 4.3 Neighborhood diagram 28
Figure 4.4 Analysis of Irving Sustainable Neighborhood Action Plan. Parks, trails,
infrastructure, and aesthetics are among the most important elements to in the
vii
-------
neighborhood 32
Figure 8.1 Ecosystem goods and services values typology within a TEV framework 47
Figure 8.2 Illustrating the challenge of identifying where (ecosystem type) and when (different
life stages denoted by letters A-G) to value an ecosystem goods and services component
(fish) in complex ecosystems 48
Figure 8.3 Screenshot of the Eco Evidence Analysis Software overview page 51
Figure 8.4 Neighborhood diagram 65
Tables
Table 2.1 Results of causal criteria analysis of eco-health linkages 8
Table 2.2 Variables within the FEGS framework to evaluate Eco-Health linkages for the SJBE
between green spaces or coastal wetlands and heat morbidities, Gl disease, and Dengue
fever 12
Table 3.1 Decision impacts on policies for Suffolk County Department of Health Services
(SCDHS) regarding onsite sewage disposal systems 17
Table 3.2 Example data sources at national, state, and county levels 19
Table 4.1 Comparing the differences in priorities between City of Duluth officials and the public
regarding the Cross City Trail 27
Table 4.2 Elements of a place that contribute to well-being 29
Table 8.1 Available computer based modeling tools for estimating health consequences of
Ecosystem Services 50
Table 8.2 Factors considered and weight of evidence scores for causal criteria analysis 52
Table 8.3 Considerations for developing a research agenda addressing the direct link between
green spaces and gastrointestinal (Gl) disease, an area of limited empirical evidence but
strong background support and important management implications 53
Table 8.4 Priority questions for a research agenda to evaluate the role of ecosystem goods
and services provided by green spaces on human health 54
Table 8.5 Examples of available human health datasets 56
Vlll
-------
Acronyms and Abbreviations
AOC
Area of Concern
BACI
Before After Control Impact
BUI
Beneficial Use Impairment
CAV
Citizen Advisory Council
CCS
Coordinated Case Study
CDC
Center for Disease Control
CICES
Common International Classification of Ecosystem Services
CVD
Cardiovascular Disease
DSRP
Distinctions-Systems-Relationships-Perspectives Model
EGS
Ecosystem Goods and Services
EPA
U.S. Environmental Protection Agency
ES
Ecosystem Services
FEGS
Final Ecosystem Goods and Services
FEGS-CS
FEGS Classification System
FEMA
Federal Emergency Management Agency
GI
Gastrointestinal
GIS
Geographic Information System
GLNPO
Great Lakes National Program Office
GLWQA
Great Lakes Water Quality Agreement
HIA
Health Impact Assessment
HSRRO
Human Subject Research Review Official
ICR
Information Collection Request
IRB
Institutional Review Board
NEP
National Estuary Program
OMB
Office of Management and Budget
ORD
Office of Research and Development
OSDS
Onsite Sewage Disposal System
PAC
Public Advisory Council
PII
Personally Identifiable Information
PRA
Paperwork Reduction Act
RAP
Remedial Action Plan
R2R2R
Remediation to Restoration to Revitalization
SAB
Science Advisory Board
SHC
Sustainable and Healthy Communities National Research Program
SJBE
San Juan Bay Estuary
SSC
Student Services Contractor
TEV
Total Economic Value
WTP
Willingness to Pay
IX
-------
Acknowledgments
We acknowledge the support of Project Leads Matt Harwell and Ted DeWitt and thank the EPA internal
and external academic peer reviewers. Rebeca de Jesus Crespo and Susan Yee authored the section on
human health benefits of ecosystem services including the San Juan, PR, case study. Mark Myer
authored the Suffolk County, Long Island Health Impact Assessment, and Katie Williams authored the
Great Lakes Area of Concern community case study in Duluth, MN. Nadia Seeteram authored the
Introduction with contributions from Matt Harwell. Charles Rhodes and Justin Bousquin are thanked for
conversations relating to the challenges in approaching total economic valuations. We thank Kate
Mulvaney and Florence Fulk for internal review comments that improved the report. We acknowledge
external review comments of Robert Brinkmann and Anders Poulsen. Joel Hoffman, John Johnston,
Matt Harwell, and Chloe Jackson edited the report.
Cover photos courtesy of U.S. EPA.
x
-------
Executive Summary
As part of the Sustainable and Healthy Communities Research Program, the National and Community
Benefits of Final Ecosystem Goods and Services Task is focused on translating the provisioning of final
ecosystem goods and services (FEGS) into community health and well-being. This report provides a
summary of three research projects: 1) an evaluation of the quality of scientific evidence associating
green spaces with health benefits, along with ensuing research in San Juan, Puerto Rico; 2) a Health
Impact Assessment of a Long Island sewering pilot program in Suffolk County, NY that revealed health
benefits associated with control of sewage- and effluent-related EGS; and 3) a Great Lakes community
case study that used ethnographic methods to characterize how a community values FEGS affected by
aquatic ecosystem remediation and restoration. Whereas there is broad scientific consensus that
ecosystems provide a wide diversity of benefits to the public, there is not broad consensus among
researchers regarding the best way to determine the value of these benefits. In each of these studies,
multidisciplinary approaches to non-monetary FEGS valuation are explored, successful aspects of these
approaches are considered, areas where the approach can be improved are identified, and important
future research areas are discussed.
In the first study, the quality of scientific evidence regarding the associations between green space and
human health are considered, making the important connection between ecosystem services and well-
being. For communities to be successful managing green space for public benefit, stakeholders should
be informed of the underlying processes linking green spaces to health, as well as the methods available
both for estimating future health outcomes and for post-restoration monitoring effectiveness. Broadly, it
was found that the evidence linking EGS to human health mainly supports intermediate steps, and very
few published studies address the entire pathway from ecosystem quality to disease. Specifically,
multiple research needs were identified regarding ecosystem-health linkages between green space and
health. These needs include evaluating the association between green spaces and either gastrointestinal
disease or asthma, defining the predominant mechanism linking green spaces and cardiovascular
benefits (in particular, physical activity versus air pollution removal), and improving our understanding
of the factors that determine if green spaces promote or prevent respiratory illness. Studies evaluating
ecosystem-health linkages should take into consideration other aspects closely tied to human health and
captured in conceptual models such as the FEGS framework (e.g., socio-economic factors), the
interdisciplinary nature of eco-health research, and the importance of aligning research objectives with
the decision context. An example is provided demonstrating how a multidisciplinary team of scientists
collaborated with local stakeholders in the San Juan Bay Estuary, PR to better inform non-monetary
valuation of FEGS in this case study community.
In the second study, a Health Impact Assessment (HIA) was used to evaluate how proposed municipal
code changes regarding onsite sewage disposal systems (OSDS) in Suffolk County, New York might
affect human health. By connecting elements of a decision or project that affect local ecosystems to
potential impacts on human health and well-being, HIA can provide a linkage between FEGS and
community-level benefits. Suffolk County is considering changes to their Sanitary Code regarding
OSDS to address the growing environmental issues they face related to nitrogen loading from old,
failing, and densely packed systems. It was found that OSDS and cesspool systems are a major
contributor to nitrogen pollution in Suffolk County's surface and groundwater. Numerous benefits
associated with upgrading OSDS to innovative or alternative systems were further identified, including
reduction of the number of harmful algal blooms in local estuaries, reduction of the risk of illness from
sewage contamination to private drinking water wells, and improvement in community economics as a
result of cleaner surface waters. It is concluded that while HIA is not a research tool, it was possible to
XI
-------
use HIA to identify FEGS and health impacts that were of interest and concern to the community.
Further, this experience confirmed that of others, namely, that a HIA can be used by researchers
conducting community-level EGS studies as a tool for building mutual trust and understanding with the
community.
Finally, a community case study is presented in which the researchers sought to understand how
citizens, community groups, and a municipality (City of Duluth, Minnesota) value FEGS. Of particular
interest were the FEGS affected by improved ecosystem services and neighborhood revitalization
associated with ongoing sediment remediation and habitat restoration. This concept is called remediation
to restoration to revitalization, or R2R2R. Because the benefits of restoration are context-dependent and
based on personal and professional experiences, it is paramount to find methods that relate the values of
ecosystem services to the values of other actors or organizations. Ethnographic methods were used to
create a conceptual map of a neighborhood to identify and characterize the different values placed on an
ecosystem and its services. This community model includes and defines many of the components that
individuals, organizations, and local governments may discuss or make decisions about in the context of
their neighborhood or community. FEGS are embedded throughout the framework. It is concluded that
stakeholders and decision makers recognize and appreciate nature based on their relationships with it
and usually in context. Accordingly, how citizens, local governments, and natural resource managers
value the benefits of FEGS varies among these groups. The community model is a tool to facilitate
translation of goals and values between resource agencies and communities.
Collectively, the three approaches yield insight into how to conduct studies that address the link between
FEGS and their value to communities. First, FEGS valuation requires a multidisciplinary team.
However, researchers need to be aware that perspectives and language grounded in specific disciplines
can impede communication and lead to related challenges managing and analyzing multidisciplinary
data. As such, researchers should be aware of differing lexicons and the application of conceptual
models. Second, each study demonstrated promise in its own right. Researchers identified a variety of
community benefits related to human health and well-being associated with changes in FEGS. Where
these benefits were identified in concert with environmental decisions, the valuation of these benefits
had the potential to inform community decision making. Nevertheless, because these studies must be
interdisciplinary and require practitioners of social, economic, human health and ecological sciences,
integration must be designed into the research and development process.
Xll
-------
1. Introduction
1.1. Background
The EPA Scientific Advisory Board (SAB) stated that using a wide range of valuation methods could
allow EPA to "capture the full range of contributions stemming from ecosystem protection and multiple
sources of value derived from ecosystem sources" (U.S. EPA 2009: 23). Similarly, Costanza et al.
(2016) called for alternative measures of ecosystem and human well-being that incorporate ideas from
ecology and psychology to describe how the natural, social, human, and built dimensions of the
environment contribute to well-being. The greatest challenges in the ability to both value ecosystem
goods and services (EGS) and include them in the decision-making process are the effectiveness of
valuation approaches, and strong (direct and indirect) evidence connecting EGS to human health and
well-being.
Whereas there is broad scientific consensus that ecosystems provide many diverse benefits to the public,
researchers still face challenges in determining appropriate methods to assess the value of these benefits.
Generally, valuation methods are used to convey the importance of ecosystems in a manner that can be
readily understood by the general public and decision makers. To address these challenges, the EPA
Office of Research and Development (ORD) has developed or implemented tools and strategies to
identify more comprehensive approaches to characterize the contribution EGS to human health and
well-being. This report outlines a number of non-monetary approaches, frameworks, and tools that can
be used to make better decisions that include consideration of ecosystem services and connections to
human health and well-being.
1.2. Approaches for Studying Non-Monetary Benefits of Ecosystem Services
In addition to monetary valuation approaches, researchers at ORD have been employing alternative
ways of assessing benefits from EGS and values associated with EGS. Non-monetary valuations rank
and evaluate preferences based on socio-cultural values using qualitative methodologies that provide
social context and other salient details that may not be captured within a monetary valuation. Non-
monetary valuations capture greater detail on the type and range of community preferences and values
than monetary valuations, including relative weighting and potential tradeoffs, and therefore are not able
to perform with the same methodological consistency (i.e., not as straightforward) than the use of a
monetary valuation may provide (Kelemen et al. 2016). However, a focus on dollar values can have
unintended consequences because it overemphasizes the value of market goods, oversimplifies the full
complement of benefits and values associated with EGS, and largely excludes those benefits that are not
easily monetized (i.e., those for which publicly traded markets do not exist). Although dollars are an
accepted, universal standard of comparison, valuable information regarding what matters to
communities is lost when reducing value to a purely economic endpoint. As an example, omission of
cultural and spiritual values of EGS and their manifold benefits to human health and well-being in a
benefit/cost analysis can lead to natural resource depletion in the near term. This report examines three
types of non-monetary approaches to addressing benefits from EGS looking at ecosystem, societal, and
human health elements: causal criteria analyses, impact assessments, and ethnographic assessments
(Figure 1.1).
1
-------
Eco-Health Analyses
(Causal Criteria)
Tool: Eco-Evidence
Health Impact Analyses
(Impact Assessments)
Tool: HIA Pathway Diagramming
Societal
Elements
Neighborhood-Scale Analyses
(Ethnographic)
Tool: Community Modeling Framework
Figure 1.1 Examining the benefits from EGS to human health and well-being among ecosystem, societal,
and human health elements. Three different analytical approaches, and the tools examined in this report, are
described in the text boxes.
Causal criteria approaches examine the lines of evidence connecting direct and indirect linkages
between two or more items in a hypothesized relationship. The current knowledge base linking EGS to
human health (termed eco-health linkages) has been compiled by the U.S. EPA's Eco-Health browser1
(Eco-Health Relationship browser: accessed 20, July 2017). The browser describes the cause and effect
mechanisms linking ecosystems to health and disease through "health promotional" EGS (e.g., physical
activity, engagement with nature) and "buffering" EGS (e.g., clean air, clean water, weather hazard
mitigation; Jackson et al. 2013). It not only provides a comprehensive inventory of the best available
science, but also a visualization interface that allows users to better understand the complex
relationships between different ecosystems and aspects of human well-being. While certain eco-health
linkages have been studied by hundreds of research articles, others just have one or two supporting
studies, raising questions about which linkages have enough evidence to be used as a basis for
management decisions and which should be regarded as working hypotheses in need of further research.
Recently, ORD researchers have conducted a causal criteria analysis of the available scientific base
supporting eco-health linkages (de Jesus Crespo and Fulford 2017). This approach consists of evaluating
the weight of evidence towards causality in terms of: 1) probabilistic evidence (i.e., consistent cause-
1 Examples of other data-derived models to examine health consequences from ecosystem services are presented in
Appendix 2.
2
-------
effect association); and 2) mechanistic evidence (i.e., logical explanation of how the causal association
occurs) (Russo and Williamson 2007).
Impact assessment approaches examine the potential effects of a decision on the recipients of a
decision. Heath Impact Assessments (HIA) is "a means of assessing the health impacts of policies,
plans, and projects in diverse economic sectors using quantitative, qualitative, and participatory
techniques" (World Health Organization 2017) and can be used to examine linkages between EGS and
community-level benefits. HIAs examine the potential effects of a management decision on community
and human health by connecting elements of a decision or project that affect nature and local ecosystems
to potential impacts on human health and well-being using a tool called pathway diagramming. Health
Impact Assessments are an iterative stakeholder engagement process giving researchers insight into the
relative values that the community places on ecosystem goods and services and the health benefits they
provide.
Ethnographic approaches. Qualitative researchers use a variety of methods to collect and analyze data.
In this study, an exploratory case study (Yin 2013) was utilized because of the contextual nature of
ecosystem services. In qualitative research, case studies are used to answer how and why questions (i.e.,
how do communities value ecosystem services) when the researcher lacks control over events, and it is
difficult to separate the object of study from its context (Creswell 2013, Yin 2013). Ethnographic data
collection methods, like participant observation and document analysis, facilitate the identification of
lived experiences, or day-to-day practices that might be taken for granted, through the participation in
events or collection of materials that were created for a purpose important to the organizers or authors
(de Volo and Schatz 2004). Ethnographic approaches to research are an alternative to the dominant
approaches to ecosystem service valuation (i.e., stated or revealed preference approaches), which rely on
discrete choice experiments or other survey instruments. Ethnographic research enables the
identification and characterization of the different values placed on an ecosystem and its services - and
is useful because those services may be different than what the researcher expects. This report presents a
tool that was created as a result of an ethnographic study of ecosystem services in R2R2R.
1.3. Conceptual Modeling for Developing Analytical Frameworks
Conceptual model building is a valuable approach to develop analytical frameworks to describe a
system, problem, or decision under consideration. Conceptual models are a communication vehicle that
presents a clear picture of what is understood about a system, problem, or decision and often connect the
knowledge and expertise of the relevant stakeholders for a given system, problem, or decision (ASTM
2009, Fulford et al. 2016a, U.S. EPA 1998, Yee et al. 2011). There are many approaches to building
conceptual models, including influence diagrams, concept mapping, and pathway diagrams (Fulford et
al. 2016b). The underlying premise involves analytical frameworks that diagram (i.e., capture, visualize,
and organize) cause and effect relationships that are important to the system, problem, or decision under
consideration (Fulford et al. 2016a, Joffe and Mindell 2006, Knol et al. 2010, Yee et al. 2011). This
report presents several conceptual models used in developing analytical frameworks such as the Eco-
Health Pathways Model (Figure 2.1), the Health Impact Assessment Pathway (Figure 3.2), and the
Neighborhood Model (Figure 4.1).
The Final Ecosystem Goods and Services (FEGS) Framework. This report uses a Final Ecosystem
Good and Services (FEGS) framework (model in Figure 2.2) to identify key factors that may influence
health outcomes (Fulford et al. 2016a). Final ecosystem goods and services are defined as the
components of nature directly enjoyed, consumed, or used to yield human well-being. The FEGS is a
biophysical quality or feature and needs minimal translation for relevance to human well-being (Boyd
and Banzhaf 2007), while benefits provided by ecosystems are defined as a good, service, or attribute of
3
-------
a good or service that promotes or enhances the well-being of an individual, an organization, or natural
system such as more food, better hiking, less flooding (Fisher and Turner 2008, Harwell et al. 2017). For
example, coral reef ecosystems provide a habitat for a variety of species, which is considered a FEGS.
However, the benefits to humans are the raw materials that can be consumed or extracted from a reef
such as fish harvest, or the recreational benefits from snorkeling or boating along the reef
The elements of the FEGS conceptual framework (e.g., stakeholder engagement/decision context,
intermediate and final ecosystem goods and services, ecological production functions, and measures of
benefit) represent efforts to support community-level decision making that incorporates quantitative
information on the production and delivery of ecosystem goods and services for the benefits of human
health and well-being (Fulford et al. 2016a, Harwell et al. 2017, Yee et al. 2011). The human benefits
perspective of the FEGS model includes four key components: ecosystem state metrics, EGS indicators,
health benefit indicators, and socio-economic factors (highlighted in Figure 2.2). Place-based studies
provide an opportunity to explore the application of this conceptual model.
1.4. Case Studies
A case study is typically defined as a place-based study that is connected to unique aspects of the
location of the work, most often associated with a target community, components of a watershed, or
other physical feature of the place (Fulford et al. 2016a). Case studies allow for examining the causes
and effects of human stress on the environment, and the reciprocal, namely how changes to the
environment (here, the production and delivery of ecosystem services) may affect human health and
well-being. A classic EPA application of the case-study approach is one that approaches a practical
problem. This report provides a summary of research from three selected case studies in the Sustainable
and Healthy Communities (SHC) National Research Program, relating ecosystem services to human
health benefits as a narrative synthesis. These case studies include ORD research in San Juan, Puerto
Rico, Suffolk County, Long Island, and the St. Louis River Area of Concern in Minnesota.
The San Juan Bay Estuary (SJBE) watershed, Puerto Rico, is part of the U.S. National Estuary
Program (NEP) and the U.S. EPA's Coordinated Case Study (CCS) communities of the Sustainable and
Healthy Communities program. Within the SJBE, a number of priority health outcomes have been
identified as key concerns of the local community, including vector borne diseases, gastrointestinal
diseases, heat morbidities, and respiratory conditions like asthma (Sheffield et al 2014, Mendez-Lazaro
et al. 2015). These diseases have been associated with environmental stressors such as the deterioration
of clean air and water, and the magnitude and frequency of weather hazard events. Green spaces within
cities can help mitigate these environmental hazards through buffering ecosystem services. To inform
management decisions, including creation, restoration, and preservation of green spaces, a key research
need is to understand the regional influence of green space cover on health outcomes associated with
environmental hazards in the SJBE and potentially other areas of Puerto Rico.
Suffolk County, Long Island, NY, was greatly impacted by Tropical Storm Sandy in October of 2012.
In the wake of this storm, a collaborative effort was initiated to examine how to increase community
resilience to coastal storms in the future. This work involves modeling, community engagement, and is a
collaboration between the state of NY, EPA Region 2, and EPA ORD (Fulford et al. 2016a). Suffolk
County has an estimated 360,000 residences that use on-site sewage disposal systems (OSDS),
representing 74 percent of residential buildings (Figure 3.3) (Suffolk County Government 2014a).
Almost 60 percent (approximately 209,000) of those are located in areas designated by the county as
environmentally sensitive. Approximately 252,000 of the un-sewered residences were built before 1973,
when new sewer code changes mandated the addition of septic tanks. These residences are served by
cesspool systems (Figure 3.3). Septic systems and cesspools provide little to no nitrogen removal and
4
-------
are a significant source of nitrogen in the local groundwater (Hansen and Schoonen 1999). Excess
nitrogen is a severe problem with Suffolk County surface waters, leading to harmful algal blooms
(Hattenrath et al. 2010, Nuzzi and Waters 2004), hypoxia and anoxia in embayments (Anderson and
Taylor 2001), and loss of aquatic life (LaRoche et al. 1997). Suffolk County is exploring options to
change to their Sanitary Code regarding OSDS to address the growing environmental issues they face
related to nitrogen loading from old, failing OSDS and areas with high concentrations of OSDS (Suffolk
County Government 2014b).
The St. Louis River Area of Concern2 (AOC), is one of 43 geographic areas that was designated by
the U.S. and Canada where "significant impairment of beneficial uses has occurred as a result of human
activities at the local level" (Governments of Canada and United States 2012). Historically, the AOC
program has been focused on remediating and restoring beneficial uses in the aquatic and riparian areas
of the Great Lakes. ORD and the Great Lakes National Program Office (GLNPO) are interested in the
steps between contaminated sediment remediation, habitat restoration, and community revitalization, or
R2R2R. The City of Duluth, Minnesota provides an illustrative case study to understand the dynamics of
R2R2R, because the City's revitalization strategy is focused on the neighborhoods adjacent to AOC
remediation and restoration projects. Furthermore, the City of Duluth's revitalization of the St. Louis
Corridor is based on environmental restoration, improving neighborhood quality of life, and attracting
new homeowners, while also creating a new visitor destination and stimulating development (City of
Duluth 2017). The focus of this study is how to relate the views of citizens to the objectives of city
officials and natural resource managers, which appear to diverge. Restoring beneficial uses of the
ecosystem in the AOC and in the City of Duluth will provide final ecosystem goods and services that
contribute to human well-being, like fish for sustenance and recreation, wild rice for habitat and spiritual
connection, scenic views, and increased access to natural areas.
1.5. Report Structure
The following chapters in this report present the application of each approach (Human Health - Causal
Inference Approaches; Human Health - Health Impact Assessment Approaches; Ethnographic
Approaches) to understand community level benefits related to health and human well-being derived
from EGS. Development of the tools for each of these approaches are presented, along with an
application (testing) in place-based case studies. Recognizing that decisions at the local level can impact
ecosystem services, and in turn human health and well-being, each section on the application of the case
studies presents the methods approach that incorporated ESS and FEGS, the outcome yielded by the
case study results, and lessons-learned and research design considerations as part of a discussion on how
to apply these frameworks and tools elsewhere. Each Chapter is summed up with a section on
conclusions and future research needs. More details on the approaches and case applications are
presented in the Appendices.
2 Area of Concern were designated in the 1987 Protocol to the 1978 Great Lakes Water Quality Agreement as "geographic
areas that fail to meet the general or specific objectives of the Agreement" (International Joint Commission 1987).
5
-------
2. Human Health Approaches - Causal
Inference
2.1. Causal Criteria Analysis
In epidemiology, observed associations between human health and environmental, social, or behavioral
variables are applied to inform causal inference about potential drivers of disease (Merrill et al. 2008).
The principles of causal inference, consistency, strength of association, temporality, biological
plausibility, and specificity3 (Merrill et al. 2008), need to be met in order for cause-effect relationships
to be supported. Causal criteria analysis applies these principles to determine the weight of evidence
towards causal connections in terms of: 1) probabilistic evidence (i.e., consistent cause-effect
association); and 2) mechanistic evidence (i.e., logical explanation of how the causal association occurs)
(Russo and Williamson 2007). A classic example of the application of this approach is the Surgeon
General's 1964 report on smoking and health, which has become a landmark of how science can be
effectively applied in decision making for the benefit of human health (Parascandola et al. 2006).
Regarding ecosystem services, U.S. EPA's Eco-Health browser provides a comprehensive inventory of
the best available science supporting the complex relationships between different ecosystems, human
health and well-being. This tool provides a starting point to construct a causal criteria analysis on this
context and better understand which linkages have enough evidence to be used as a basis for
management applications and which should be regarded as working hypotheses in need of more
research.
2.2. Application of Causal Criteria Analysis to Evaluate the Role of Green Space EGS on
Human Health
Building on U.S. EPA's Eco-Health browser, a causal criteria analysis was conducted using Eco
Evidence an open source software tool that incorporates causal inference principles CEco-Evidence tool:
accessed 20, July 2017) (Norris et al. 2011). The focus of this analysis were linkages between diseases
and the buffering EGS provided by green spaces (de Jesus Crespo and Fulford 2017; Figure 2.1).
Buffering EGS refers to the ecosystem's capacity to buffer against health impacts by removing
pollutants from air and water, and mitigating heat and water hazards (Jackson et al. 2013). The term
green space refers to any vegetation within a human dominated environment (Kabisch and Haase 2013).
This includes urban trees, green roofs, and natural or constructed wetlands, all of which provide EGS
that influence health (GI - gastrointestinal, CVD - cardiovascular disease). Green spaces intercept water,
3 Consistency: the association has been replicated by different research projects; Strength of association: the association is
not due to bias or confounding factors, and is statistically significant; Temporality: exposure to a suspected cause precedes
the disease; Biological plausibility: a logical biological mechanism for the association exists; Specificity: the exposure and
disease are specific to one another (this condition is not always needed in order to support causality) (Merrill et al. 2008).
6
-------
promote infiltration, and serve as barriers to stoim surges, leading to water hazard mitigation (Brody and
Highfield 2013, Costanza et al. 2008). Mitigation of water hazards reduces exposure risk to polluted
flood waters and GI disease (Wade et al. 2004). It also reduces the risk of post-flood household
dampness, which could lead to mold growth and asthma (Chew et al. 2006). Green spaces also promote
clean water by immobilizing and absorbing infectious and toxic pollutants (Karim et al. 2004, Silva et
al. 1990) and reducing the risk of GI disease from contact or consumption (Araya et al. 2004, Katukiza
et al. 2014). In addition, green spaces filter air pollutants (Rasanen et al. 2013) that cause respiratory
illness and cardiovascular disease (Brook et al. 2004, Peters et al. 1997). They also provide shade and
evapotranspiration, lowering the risk of heat wave induced morbidities (Bouchama and Knochel 2002).
EGS Health
Green Space ~ EGS
CVD
GI Disease
Heat Morbidity
Human Health
Respiratory
Illness
Buffering EGS
Ecosystem
Water Hazard
Mitigation
Clean Water
Heat Hazard
Mitigation
Clean Air
Q_
in
Green Space~ Health
Figure 2.1 Eco-health pathways connecting the ecosystem attribute, green spaces, to human health
endpoints through indirect ("A"; buffering EGS) and direct ("B"; human health) pathways. Figure from de
Jesus Crespo and Fulford (2017).
While all these linkages are mechanistically plausible, our results showed that the weight of evidence
supporting each of them varies as shown in Table 2.1. Notably, most of the current eco-health literature
supports findings of intermediate steps (e.g., ecosystem to buffering EGS and buffering EGS to human
health), but there is limited support for direct linkages from ecosystem (green spaces) to human health
(disease endpoints) (Table 2.1). For example, while there is sufficient evidence supporting water
pollution removal by vegetation, and sufficient evidence supporting a connection between certain water
pollutants and GI disease, there is insufficient evidence supporting a direct connection between
vegetation and GI disease (Table 8.3). Studies including all the components of the causal relationships
are much needed as they would help provide clear management recommendations, such as the
effectiveness of different plant species, relationships to the built environment and expected effect sizes
of restoration initiatives. For more details of these results and the methods used see Appendix 3, and de
7
-------
Jesus Crespo and Fulford (2017).
Table 2.1 Results of causal criteria analysis of eco-health linkages. (For more details, see Appendix 3; adapted
from de Jesus Crespo and Fulford 2017).
Linkage
Total
Studies
Found
Total
Studies
Reviewed
Weight of
Evidence in
Favor
Weight of
Evidence not
in Favor
Conclusion
Green Spaces and
Buffering EGS
Green Spaces-Clean Water
60
44
166
16
Support for Hypothesis
Green Spaces-Water
Hazard Mitigation
28
19
106
16
Support for Hypothesis
Green Spaces-Clean Air
44
22
105
16
Support for Hypothesis
Green Spaces-Heat Hazard
Mitigation
31
19
117
3
Support for Hypothesis
Buffering EGS and
Human Health
Clean Water-GI Disease
11
6
35
0
Support for Hypothesis
Water Hazard Mitigation-
GI Disease
9
7
41
7
Support for Hypothesis
Water Hazard Mitigation-
Respiratoiy Illness
4
4
16
5
Insufficient Evidence
Clean Air-Respiratoiy
Illness
37
28
247
178
Inconsistent Evidence*
Clean Air-Cardiovascular
Disease (CVD)
27
23
206
143
Inconsistent Evidence*
Heat Hazard Mitigation-
Heat Morbidities
22
18
114
2
Support for Hypothesis
Green Spaces and
Human Health-Direct
Green Spaces-GI Disease
0
0
0
0
Insufficient Evidence
Green Spaces-Respiratoiy
Illness
9
7
28
27
Inconsistent Evidence*
Green Spaces-CVD
9
3
27
0
Support for Hypothesis
Green Spaces-Heat
Morbidities
10
4
35
0
Support for Hypothesis
* Note: the finding of "inconsistent evidence" may indicate potential confounding factors that play a mediating role, or
highlight the role that context and the types of indicators used could play in detecting a given cause and effect relationship.
See Nichols et al. (2011) for more details on interpreting this and other conclusions derived using this approach.
2.3. Empirical Approaches for Eco-Health Research
Causal criteria analysis allowed identifying a research agenda (Appendix 3) to advance our
8
-------
understanding of eco-health linkages. Conceptual models, such as the Final Ecosystem Goods and
Services framework (Figure 2.2), have been developed to guide research on this topic, and may be
applied to address research needs. The FEGS framework includes four key components: Ecosystem state
metrics, EGS indicators, Health benefit indicators, and Socio-economic factors, which are essential to
fully characterize eco-health relationship pathways.
Ecol. Prod.
Functions
Benefit
Functions
Impact
Functions
Decision
Alternatives
A Final EGS
A Human
Well-being
Social & Economic
Services
A Ecosystem State
(& Intermediate EGS)
Information for Decision Support
Figure 2.2 Conceptual Model for measuring Final Ecosystem Goods and Services. Areas measured through
studies linking ecosystem services to health and well-being outcomes are highlighted in red.
Conducting spatially explicit correlation analyses is a logical first step towards testing eco-health
conceptual models such as FEGS. Mapping platforms provide a way to test the spatial relationship
between EGS and disease, contingent on the existence of suitable datasets to characterize the extent and
quality of ecosystem services, to understand the socio-economic context, and to locate disease hotspots.
Appendix 4 explores issues of data accessibility and granularity in mapping human health outcomes for
spatially explicit correlation analyses approaches in eco-health studies.
For indicators that help map EGS, useful approaches include (but are not limited to) habitat suitability
assessments, locations of trails or other recreational facilities, and modeling natural viewscapes. Angradi
et al. (2016) mapped EGS in the Great Lakes region; the study provides a useful example of how to use
existing datasets for EGS mapping, incorporating factors such as data uncertainty and tradeoffs into the
analysis. Available sources for mapping EGS include the U.S. Geological Survey's National Gap
Analysis Program, which helps estimate the distribution of species and ecosystems of interest, and the
U.S. EPA EnviroAtlas (EnviroAtlas: accessed 20, July 2017) (Jackson et al. 2013), which helps
visualize the extent of ecosystem services, among others.
Defining the spatial distribution of EGS is only the first step to modeling eco-health linkages. Socio-
economic factors may exacerbate or decrease vulnerability to EGS loss and certain communities may be
protected from the impacts of degrading EGS due to behavioral adaptations, technological adaptations,
or access to EGS from other regions (Figure 2.3). These factors have been termed insulating layers
(Myers et al. 2013), and are generally associated with wealth and access to information. Incorporating
socio-economic indicators that reflect the potential for certain communities to benefit more than others
from EGS provision (e.g., U.S. Census datasets) should be an essential part of studies assessing eco-
health linkages.
9
-------
CHANGES IN LAND USE AND COVER
Deforestation, dams arid irrigation,agricultural
extension and intensification, livestock
. management, urbanization, ,
v. road construction
JCVV THRESHOLD f0r ~
lEARNED
NEGATIVE
HEALTH
OUTCOMES
CLIMATE CHANGE
Warming temperatures, elevated
carbon dioxide, more extreme
storms, hydrologic extremes,
sea-level rise
RESOURCE SCARCITY
Land degradation,
water scarcity, deforestation,
wildlife population declines
DETERIORATION OF
ECOSYSTEM SERVICES
Provision of nutrition, safe
water, clean air, protection
from natural hazards,
regulation of infectious
diseases,and maintenance
of stable climate
insulating layers
Figure 2.3 Schematic of the complex relationships between altered environmental conditions and human
health. The impact of ecosystem goods and services loss is modified by socio-economic factors, termed
insulating layers, which can ameliorate potential negative outcomes. Adapted from Myers et al. (2013).
Aside from health benefits, there are other human benefits associated with ecosystem services, such as
safety, culture, and living standards. EPA's Human Well-Being Index (HWBI) provides a conceptual
framework for mapping well-being at multiple scales in the United States (Smith et al. 2012, Smith et al.
2014), as well as forecasting changes due to loss of EGS (Summers et al. 2016). The HWBI is a tool that
can be used to complement Eco-Health studies for a more general understanding of EGS benefits at the
county and state levels.
Similar to economic benefit valuation (Figure 2.4; Wainger and Mazzotta 2011), research approaches
for assessing health benefits could fall within a gradient of complexity, from the empirical analysis of
conceptual models, as we propose here, to the use of simulation tools that predict loss of benefit from
changes in EGS. Most conceptual models that describe eco-health linkages need more empirical
evidence to develop quantitative relationships. Therefore, the use of simulation models is limited in this
context to the few associations that have been studied extensively. A discussion of the use of data-
derived models for simulating eco-health benefits is presented in Appendix 2.
10
-------
Conceptual Models
Data-Derived Models
Land Use
Classification
Generalized
Functions
C
Weighted
Indicators
Fitted
Empirical
Models
P = f.3xj+J3x?+£
Simulation
Models
O
-fl-
oe
foe
SL
SL
0
n-3
Increasing complexity of analysis
Figure 2.4 The gradient of modeling complexity shows different types of analysis used to generate the
functional relations that estimate benefits of ecosystem goods and services management. From Wainger and
Mazzotta (2011).
2.4. Upcoming Application of Empirical Approaches for Eco-Health Research in the San
Juan Bay Estuary, PR
The communities in the SJBE, have identified many key health concerns associated with environmental
stressors (Sheffield et al. 2014, Mendez-Lazaro et al. 2015). To help mitigate these stressors, the
restoration of green spaces has been suggested a potential management strategy to improve health and
well-being for SJBE residents (SJEB Management Plan 2017: accessed 26, July 2017). However, more
studies are need to address the expected effectiveness of these practices. This case study seeks to
quantify health outcomes associated with green space cover and buffering EGS using the FEGS
framework (Figure 2.2) as a conceptual model. Using this approach entails identifying key ecosystems,
ecosystem services, and socio-economic variables that are likely to influence health outcomes in the
SJBE (Table 2.2), and then using statistical approaches to establish whether there is quantitative
evidence for relationships between these key variables. Existing publicly available data sources could
serve as indicators for each of these elements, in order to address the complex relationships in a cost-
effective manner.
Some challenges to consider include disparate spatial scales of datasets to be included in the model, and
restrictions on the availability of fine-scale human health information due to privacy considerations.
Mechanisms to access detailed health data include establishing collaborations with health organizations,
purchasing licenses to insurance claims or hospital data, or collecting information directly through
surveys. All of these processes require consideration of PII and IRB restrictions. Appendix 5 presents a
discussion on the challenges of collecting these types of data. To address limitations on the use of
restricted health data, the SJBE case study will leverage collaborations with laboratories that have a
health focus and the expertise in epidemiological research. This would not only allow access to data, but
also foster cross-disciplinary dialogue to better inform the design and interpretation of a
multidisciplinary topic such as eco-health linkages.
11
-------
Table 2.2 Variables within the FEGS framework to evaluate Eco-Health linkages for the SJBE between
green spaces or coastal wetlands and heat morbidities, GI disease, and Dengue fever.
ECOSYSTEM STATE ECOSYSTEM GOODS AND A HUMAN HEALTH SOCIO-ECONOMIC FACTORS
SERVICES BENEFITS
NAME
Indicator
Name
Indicator
Name
Indicator
Name
Indicator
GREEN
SPACES
% Green
Space
Cover
Heat Hazard
mitigation
Surface temperature
derived from
satellite images
(Landsat 8); Heat
Wave Event time
period
Heat
Morbidities
Medicare
Claims for heat
related
morbidities:
Wealth (influences
air conditioning
use, housing
quality)
Median
Income
COASTAL
WETLANDS
% Wetland
cover
Water Hazard
Mitigation
FEMA1 Flood
Claims, Rainfall,
Extreme flood event
time period
Gastro-
intestinal
Disease
Medicare
Claims data for
gastro-
intestinal
diseases
Infrastructure
(influences storm
water management
effectiveness)
Sewage density
COASTAL
WETLANDS
% Wetland
cover
Habitat for
Species (i.e.,
Biological
Control)
Vertebrate Species
Richness (Gould et
al. 2008)
Dengue
fever
Dengue
prevalence
(CDC2)
Wealth (influences
air conditioning
use, housing
quality)
Median
Income
Clean Water
Nitrogen
Concentration
(SJBE 2015)
Demographics
(influences
susceptibility to
disease)
%Teenagers
Heat Hazard
mitigation
Surface temperature
derived from
satellite images
(Landsat 8)
Infrastructure
(influences vector
habitat
availability)
Sewage and
road density
'FEMA: Federal Emergency Management Agency
2CDC: Center for Disease Control
As an example, ongoing studies in the SJBE are evaluating the role of wetland ecosystem services (e.g.,
biological control, clean water, and heat hazard mitigation) on Dengue fever (Figure 2.5). Heat hazard
mitigation EGS may help reduce mosquito biting, ovi-position rate, and viral load; clean surface water
provides habitat for wildlife and healthier ecosystems, favoring bio-control of mosquitoes (Araujo et al.
2015, Ibarra et al. 2013, Cox et al. 2007, Morin et al. 2015). Preliminary findings suggest that wetlands
are negatively associated to Dengue cases even after controlling for potentially confounding variables
(Table 2.2). They were also found to help reduce temperature (Figure 2.6), which is an environmental
driver of Dengue transmission (Morin et al. 2015). These findings help support a connection between an
important ecosystem in the SJBE, and an ecosystem service that directly influences human health. In the
future, this and other eco-health research may help inform predictive models to estimate changes in
health benefits under different decision scenarios.
12
-------
50 Kilometers
Dengue Cases per Person by Zip Code (2000-2015)
¦¦ 0 000540- 0 004705
0 004706 - 0 009085
0 009086 - 0 010936
0 010937 - 0 013432
0 013433 - 0 017361
| SJBE Outline
Puerto Rico Outline
I i i i I i i i I
Florida
Mexico
Caribbean Sea Puerto Rico
Figure 2.5 Dengue cases per person by zip code in the SJBE. Dengue data was provided by the CDC Dengue
branch; Puerto Rico outline (United States Postal Service); Caribbean Map (DeLorme, Mapmylndia, ©
OpenStreetMap contributors, and the GIS community).
20 40 60
% Mangroves
s 002
Q-
£ 0.015
in
a
a o.oi
D
&D
£ 0.005
Land Surface Temperature (°Celsius)
49
0.03
0.025
0.02
0.015
0.01
0.005
0
%
%
10 20 30 40 50
% Mangroves
60
70
ECOSYSTEM
ECOSYSTEM GOODS
A HUMAN HEALTH
STATE
AND SERVICES
BENEFITS
Dengue Cases
Mangrove
Cover
Temperature
C. p = 0.03
Figure 2.6 Preliminary findings of our study linking Dengue cases to wetland ecosystem services in
the San Juan Bay Estuary (de Jesus Crespo et al. 2017). The p values for the linkages described in panel
A and C were derived from Beta-binomial regressions including socio-economic confounding factors
(Table 2.7). The p values from the link between mangroves and temperature were derived from simple
linear regressions.
13
-------
Work in the SJBE case study will link eco-health research to a decision context, which is the monitoring
and management scenarios already proposed by the National Estuary Program (NEP). Aligning research
objectives with those of the NEP will facilitate working with volunteers to collect data efficiently,
promote educational opportunities, and improve the likelihood that the accumulating body of eco-health
evidence (Table 2.2) is relevant and useful for decision makers.
2.5. Conclusions and Future Research Needs
Causal inference approaches allow researchers to use the best available science to inform evidence base
decisions making. The principles of causal inference were applied to evaluate the weight of evidence
linking green space EGS to human health and identify research needs. Results revealed that the evidence
linking EGS to human health mainly supports intermediate steps, and very few published studies link the
full pathways from ecosystem to disease. Establishing these linkages would be necessary to provide
accurate non-monetary valuation of FEGS for community-based decision making. Specific research
needs identified for the context of green space ecosystem services are summarized in Appendix 4 and
include:
Evaluating the association between green spaces on diseases such as GI disease and asthma
by means of water hazard mitigation and clean water EGS;
Defining the predominant mechanism driving the link between green spaces and
cardiovascular benefits (i.e., physical activity or recreation versus air pollution removal);
Better understanding the factors that determine if green spaces promote or prevent respiratory
illness considering factors such as plant allergens, and re-circulation of pollutants trapped by
foliage, among others.
For additional information on eco-health research needs involving ecosystems and health outcomes not
discussed here, see Lee and Maheswaran (2011), Myers et al. (2013), Hartig et al. (2014), Hough
(2014), and Sandifer and Sutton Grier (2014).
Addressing identified research needs could be facilitated by the application of conceptual models and
using spatially explicit methods to empirically test these conceptual models. Studies evaluating eco-
health linkages should take into consideration: 1) other aspects closely tied to human health and
captured in conceptual models such as the FEGS framework; 2) the multidisciplinary nature of eco-
health research; and 3) the importance of aligning research objectives to a decision context. In addition,
issues of data accessibility and granularity in mapping human health outcomes as part of eco-health
studies should also be considered (Appendix 4).
Examples were provided of the approach to incorporate these insights as part of ongoing research in the
San Juan Bay Estuary, PR. Collaborating with local stakeholders and researchers across disciplines has
facilitated progress in terms of identifying secondary data sources and defining priority questions to
better inform non-monetary valuation of FEGS in this case study community.
14
-------
3. Health Impact Assessment Approaches
Health Impact Assessments (HIAs) can provide a linkage between EGS and community-level benefits,
which connects elements of a decision or project that affect nature and local ecosystems to potential
impacts on human health and well-being. Regular meetings with stakeholders, decision makers, and
researchers conducting the assessment are the cornerstone of HIAs (World Health Organization 2017). It
is intended as a democratic process that solicits meaningful input from community members at all steps,
to make sure the concerns of affected people are at the forefront of discussion and to foster a sense of
ownership in the assessment results. The HIA approach is a recursive six-step process (Figure 3.1), and
participants are encouraged to revisit earlier steps at any point in the HIA process as the project
progresses. This typically occurs during stakeholder meetings. For example, when recommendations are
delivered, it is often a good idea to revisit the Scoping and Assessment steps as a group to identify health
impacts that may have been overlooked originally. Soliciting stakeholder input throughout the process
gives researchers insight into the relative values that the community places on ecosystem goods and
services and the health benefits they provide. While the focus of an HIA is to provide decision support,
HIAs can also be used to highlight the sendees that the local environment provides for the community.
Screening
Is HIA needed?
Health Impact
Assessment
Process
Recommendations:
What actions can be
taken to Improve health
or manage health
effects?
Figure 3.1 The six steps of the Health Impact Assessment process (Source: Mecklenburg County, North
Carolina Health Department).
15
-------
Pathway diagramming is a valuable tool used in the HI A process. The typical output of assessment HIA
is a report subdivided into Impact Pathways that illustrate the flow of impact from decisions to affected
systems, and ultimately well-being (Figure 3.2). In the case of pathways that affect natural systems, the
flow of impact goes from decisions, to ecosystem characteristics, to (in some cases) intermediate EGS,
and subsequently impacts community and human health.
Ecosystem ¦ Ecosystem Service ¦ Community Health ¦ Human Health
Changes in
community
health and
well-being
Status Quo
Changes in
ecosystem
characteristics
Alternative#!
Alternative #2
Figure 3.2 Health Impact Assessment Impact Pathway diagram.
3.1. Application in Long Island Sound
An HIA of a proposed municipal sewer code change in Suffolk County, New York, USA was conducted
to determine the decision's potential effects on community and human health. The HIA process was to
evaluate how a proposed municipal code changes regarding onsite sewage disposal systems (OSDS) in
Suffolk County, New York might affect human health. Figure 3.3 shows the density of un-sewered
parcels near recreational beaches in Suffolk County.
The County is considering changes to their Sanitary Code regarding OSDS to address the growing
environmental issues they face related to nitrogen loading from old, failing OSDS and areas with high
concentrations of OSDS (Suffolk County Government 2014b). The decision alternatives considered
(Table 3.1) included no change, an upgrade to conform all OSDS to current standards, a mandate to
upgrade old-style cesspool OSDS to a modern design in two proposed zones, and a mandate to upgrade
all OSDS to one of several innovative/alternative designs that minimize nitrogen and pathogen pollution
(Appendix 6).
16
-------
I
10
20 mi
Beaches
/
%
Unsewered Parcels
Magnitude/Square Kilometer
0
800
Base Man: Esri, DeLorme, GEBCO, NOAA NGDC, and other contributors
Beach Data:Adapted from Geographic Names Informatin System (GNIS), USGS and US Board of Geographic Names, 2015.
Map: CSS-Dynamac for US EPA.
Figure 3.3 Density of un-sewered parcels in Suffolk County. There is a high density of un-sewered parcels near
recreational beaches in the County.
Table 3.1 Decision impacts on policies for Suffolk County Department of Health Services (SCDHS)
regarding onsite sewage disposal systems. From Suffolk County Health Impact Assessment Report, unpublished.
Decision Scenarios
Potential Change(s) in Policies
Baseline
SCDHS operates under existing policies and procedures (i.e., "business as usual").
Homeowners have autonomy with the management of their individual sewerage
system.
Alternative I
AH existing OSDS must
be upgraded to conform
to current County
Sanitary Code and
standards.
All existing individual sewerage system upgrade waivers will be rendered defunct.
Cesspool/septic system service professionals will be required to report systems needing
upgraded to SCDHS.
SCDHS will assign a fixed schedule for each region in which property owners must
upgrade the sewerage system.
In the event of a property sale, the seller will be required to obtain a certificate from
SCDHS verifying the existing OSDS conforms to current codes and standards.
17
-------
Decision Scenarios
Potential Change(s) in Policies
Alternative II
All existing OSDS in the
high priority areas must
be upgraded to conform
to current County
Sanitary Code and
standards.
Those residences in high priority areas holding waivers under Memo #12 will rendered
defunct. (Homeowners outside the high priority areas will maintain autonomy with the
management of their individual sewerage system.)
Cesspool/septic system service professionals will be required to report systems needing
upgraded to SCDHS.
SCDHS will assign a fixed schedule in which property owners must upgrade the
sewerage system.
In the event of a property sale, the seller will be required to obtain a certificate from
SCDHS verifying the existing OSDS conforms to current codes and standards.
Alternative III
All existing OSDS and
C-OWTS in the high
priority areas must be
upgraded to an
innovative / alternative
system design.
Suffolk County Standards for Approval of Plans and Construction of Sewage Disposal
Systems for Single-family Residences must be amended to permit alternative system
designs approved by SCDHS for sites that meet requisite conditions (code change
proposed in 2016).
Those residences in high priority areas holding waivers under Memo #12 will rendered
defunct. (Homeowners outside the high priority areas will maintain autonomy with the
management of their individual sewerage system.)
Cesspool/septic system service professionals will be required to report systems needing
upgraded to SCDHS.
SCDHS will assign a fixed schedule in which property owners must upgrade the
sewerage system.
In the event of a property sale, the seller will be required to obtain a certificate from
SCDHS verifying the existing OSDS conforms to current codes and standards.
3.1.1. Approach (EGS/FEGS Involved)
HIA Impact Pathways initially were developed based on literature review and expert opinion. They were
further refined by rounds of stakeholder input on priorities, resulting in a finalized subset of five Impact
Pathways and benefits: Individual Sewerage System Performance/Failure; Water Quality; Community
and Household Economics; Vector Control; and Resiliency to Natural Disaster. Resiliency to Natural
Disaster was of interest in this area because of the 2012 Superstorm Sandy in Long Island. There was
widespread damage to local infrastructure and the county received significant funding for projects
increasing disaster resilience (Suffolk County Executive 2016).
Stakeholder engagement scoping workshops that asked attendees what health impacts concerned them
provided a window into identifying ecosystem value (and EGS), by connecting health benefits to the
ecosystems that provide them. For example, because of discussions regarding the particular concern
placed on coastal resilience to flooding and storm surge, wave energy attenuation by coastal wetlands
and vegetation were identified as an ecosystem service of value to stakeholders.
Because time and funding constraints limited the collection of new data, it was important to collect
existing data to inform predictions of how the proposed decision alternatives would impact the chosen
pathways (Table 3.2). Obtaining county-level data not available in national or state datasets, such as the
density of OSDS and statistics about harmful algal blooms in the area, was particularly important, and
involved collaboration with the Suffolk County government and the State University of New York. In
general, HIAs usually do not involve a quantitative measurement of impact, instead employing expert
opinion and literature review to come to an informed conclusion regarding decision impacts. This
enabled researchers to work around deficiencies in data sources more easily than if conducting a
18
-------
quantitative empirical model-based assessment. In Suffolk County, because of absent information on
changes in groundwater nitrogen from replacing OSDS, estimations of a specific reduction in nitrogen
from the adoption of alternative OSDS options we were not available. The HI A noted that a reduction in
nitrogen was probable based on other evidence for the OSDS technology being tested (New York State
Center for Clean Water Technology 2016) and the hydrography of Suffolk County.
Table 3.2 Example data sources at national, state, and county levels.
Dataset Extent
Examples of Data Sources
National
National Land Cover Database
U.S. Census
National Wetlands Inventory
State
New York State GIS Clearinghouse (New York State GIS Program Office 2017)
New York State Department of Health
Local
Suffolk County Government GIS Repository (Suffolk County Government 2014c)
Suffolk County Division of Planning and Environm ent
Suffolk County Arthropod-Borne Disease Laboratory
Data collection began with evaluation of national-level datasets. Several sets, including the MRLC
National Land Cover Database, the U.S. Census, and the U.S. FWS National Wetlands Inventory,
represented the highest-resolution data available. Often, high-resolution data are not collected on a state
or local level, or if collected, they are unavailable publicly. For those datasets collected at a state scale,
the New York Geographic Information System (GIS) Clearinghouse (New York State GIS Program
Office 2017), a collection of state-created and aggregated spatial files, provided an invaluable source. At
the county level, Suffolk County maintains a GIS repository and cartography website (Suffolk County
Government 2014c) with districting maps, census data, information from the County Division of
Planning and Environment, and more. Publicly-available data were found from a wide variety of internet
sources including the Peconic Estuary Program, Centers for Disease Control, New York State
Department of Health, and the U.S. Geological Survey.
Solicitation of data from local sources was performed in batches, to avoid alienating sources with
repetitive and excessive data requests. Lists of data needed were aggregated from each researcher to
complete their pathway analysis, and results then brought to local contacts in planning meetings.
Stakeholders were then able to direct researchers to needed data sources. In the case of data from a
known source, such as a county government agency or a local university, a single point of contact
helped establish a consistent "face" for project data tasks. A designated liaison for contacting local
researchers and data custodians helped avoid confusion and double-requesting.
3.1.2. Outcome
Onsite Sewage Disposal Systems and cesspool systems are a major contributor to nitrogen pollution in
Suffolk County's surface and groundwater. The HI A identified that changing the sanitary code to
mandate improvements in OSDS would reduce nitrogen discharge and mitigate the impact of nitrogen
pollution in the county. Estimates on specific reductions in nitrogen to groundwater from decision
alternatives were unable to be provided because onsite testing of OSDS technology is still underway.
Over 50 percent of the total nitrogen loading in the Great South Bay area, the largest estuary on the
Long Island south shore, stems from wastewater (Kinney and Valiela 2011). Resilience to natural
disaster was a major focus of the report, with the 2012 impact of Superstorm Sandy increasing local
concern. The natural hazards that most threaten Suffolk County are severe storms, hurricanes, and
Nor'easters, along with the coastal erosion and flooding that they cause (Suffolk County Department of
Fire, Rescue, and Emergency Services 2014). Coastal wetlands increase resiliency to storms, and risks to
19
-------
wetlands are considered under the purview of New York State programs to increase coastal resiliency
(NYS 2100 Commission 2013). Wave height can be reduced by up to 80 percent by traveling through a
50-meter wetland buffer (Ysebaert et al. 2011), and wave energy is reduced by over 50 percent in the
first three meters (Knutson et al. 1982). Suffolk County's wetlands have been in decline, however, with
18-36% reductions in cover in the Great South Bay from 1974-2001 because of factors including excess
nitrogen entering the watershed (NYSDEC 2014). Other factors leading to a loss of wetlands, including
sea level rise and ocean warming (Wigand et al. 2014), likely had a larger effect on wetland loss than the
input of nitrogen in Suffolk County. With that in mind, the HI A assessment concluded that changing
OSDS sanitary codes would likely not have a major effect on increasing the county's resilience to
storms.
Suffolk County draws its water from a sole-source aquifer, meaning that most drinking water is drawn
from a single aquifer and no reasonable alternative sources exist. The water table is very high, and all
drinking water in the county is drawn from precipitation-derived groundwater from shallow aquifers.
The protection of water quality is of paramount importance to maintain the provisioning of safe potable
water. Nitrogen contamination can cause harmful algal blooms (Paerl et al. 2001), and OSDS can spread
enteric pathogens to surrounding waters, causing illness in swimmers and consumers of shellfish
(Cahoon et al. 2006). The presence of organic nitrogen in groundwater can affect water quality by
increasing acidity, reducing dissolved oxygen, and inducing residual chloramines from the water
disinfection process (U.S. EPA 2002). Nitrogen levels in Suffolk County groundwater are well below
both EPA and New York State standards for drinking water quality, but the concentration of nitrate has
steadily increased in monitored wells since 1987 (Suffolk County Department of Environmental Quality
2015). The HIA analysis found that upgrading OSDS to innovative/alternative systems (Table 3.1,
Option III) would likely reduce the input of nitrogen to surface waters, and consequently reduce the
number of harmful algal blooms in Suffolk County estuaries. Links between OSDS improvement and
increases in public drinking water quality were not found, as the drinking water already meets standards.
However, private drinking water wells are unmonitored by the county and do not necessarily meet the
same standards. For this reason, the HIA analysis concluded that upgrading OSDS to
innovative/alternative systems would likely reduce the risk of illness from sewage contamination to
private drinking water wells.
Changing municipal codes influences household and community economics. The plans put forward by
Suffolk County include providing tax waivers or grants to ease the cost of upgrading OSDS, but
ultimately some cost would be borne by property owners. Suffolk County is relatively wealthy, with a
median household income of $88,663 per year (U.S. Census Bureau 2015). For comparison, the median
household income in the state of New York as a whole is $60,850. A living wage for a household with
two adults and one child in Suffolk County is estimated at $56,554 (Massachusetts Institute of
Technology 2017). The HIA analysis found that costs to homeowners would increase if OSDS upgrades
were mandated, and that the cost would be especially burdensome to lower-income households; 7.6
percent of the county has earnings below the national poverty line, and 27.3 percent earn below $50,000
per year. Community economics would benefit as a result of cleaner surface waters from reductions in
OSDS effluent, particularly through tourism. Tourism's total economic impact in Suffolk County was
estimated at nearly $2.5 billion in 2010 (Tourism Economics 2010), with beaches and water recreation
playing a major role.
3.1.3. Lessons Learned
The Suffolk County HIA identified several lessons that are applicable to any community-based scientific
20
-------
project 4. First, although HIA is not commonly considered a research tool, its democratic,
communication-driven process was successfully used to identify EGS and health impacts that were of
interest and concern to the community. The HIA process helped researchers learn that EGS that are of
initial interest to researchers are not necessarily the same as those valued by the community, and
furthermore the reasons that EGS are valued may not be initially apparent to ecologically-minded
researchers. Overall, HIAs can be used by researchers conducting community-level EGS studies as a
tool for building mutual trust and understanding with the community by taking, considering, and acting
upon input at multiple steps and showing that the study is focused on the well-being of community
members.
The Suffolk County case study demonstrated the importance of identifying data needs and other
requirements from local collaborators early in the process of conducting a place-based study to avoid
overburdening data custodians and creating "request fatigue." This helped expedite the study, avoiding a
loss of momentum or, worse, a loss of stakeholder and community interest. Designating a data liaison at
the beginning of a project creates a single assigned point-of-contact for local data custodians and may
reduce project delays and thus help with retaining community involvement.
Third, HIAs are a powerful tool for scientific communication when applied to an amenable problem: one
that has a clear impact on health and the environment, involves evaluating several well-defined
alternative choices, and one in which the community is invested both emotionally and intellectually. For
the Suffolk County case study, the decision between several explicit choices of OSDS upgrades had
clear implications in terms of nitrogen release to groundwater, the ecological and health impacts of
which are thoroughly documented in the scientific literature. A decision that involved more social or less
easily quantified changes, or one that would not conceivably affect the environment or health, would be
better served with a different assessment of its choices. Finally, the interests, biases, and motivations of
stakeholders need to be balanced carefully when conducting a community level study. Maintaining
interest and engagement with the project is paramount to the ability of a study to impact local decision
making.
3.2. Conclusions and Future Research Needs
Though the HIA step of revisiting Suffolk County's decision to evaluate the impact of the HIA
process/recommendations has not yet occurred, initial conclusions about the utility of the method and
how it was applied can be drawn. By using the HIA method, community planners and stakeholders were
drawn into the decision-making process where a science-based perspective on each of the OSDS
alternatives considered was presented. One of the major benefits of HIA is drawing decision makers and
stakeholders into the process of how decisions are made, and in case studies participants frequently
comment on 4tthe importance of being involved rather than being just [a] report recipient" (Elliott and
Francis 2005). Thus, the HIA approach provided participants with a window into the health and
4 Refer to Appendix 9 for more information.
21
-------
environmental considerations that are made for a county planning decision.
The immediate future research need is to complete the final monitoring and evaluation step of the HIA.
In this step, researchers return to the community after the decision is made and evaluate how the
recommendations of the HIA were used, what impact the process had on the decision, and what might
be changed for future HIAs to make them more effective. For the Suffolk County HIA, this evaluation
will look at whether citizen and stakeholder involvement in the decision process for the OSDS
alternatives increased ecosystem services literacy, and if it provoked any conversations within county
planning or community groups on how future decisions may impact ecosystem services and human
health. This information will come from revisiting the county and interviewing the decision makers,
stakeholders, and community members that participated in the earlier process, as well as independently
evaluating the results of the HIA's recommendations.
22
-------
4. Ethnographic Approaches
The EPA Scientific Advisory Board (SAB) stated that using a wide range of valuation methods could
allow EPA to "capture the full range contributions stemming from ecosystem protection and multiple
sources of value derived from ecosystem sources" (U.S. EPA 2009: 23). One of the challenges of
utilizing a wide range of valuation methods is the differences in language, approaches and methods
between disciplines (Lele and Norgaard 2005). Generally, the dominant approach to ecosystem service
valuation is stated or revealed preference, which relies on discrete choice experiments or other survey
instruments. Economic approaches based on utility and individual rational choice may limit valuation to
a narrow range of the human experience and may exclude consideration of services that are intrinsically
or collectively valued (Wegner and Pascual 2011). Psychological contributions to well-being (including
endogenous preference), altruism, and motivational pluralism all present challenges for conventional
approaches to valuation (Paavola and Adger 2005, Wegner and Pascual 2011). Recognizing the need to
identify and characterize the different values placed on an ecosystem and its services, a study was
designed to capture ecosystem knowledge across disciplines and spheres of responsibility. Specifically,
ethnographic approaches were used to collect data, like participant observation and document analysis,
which are intended to identify and characterize lived experiences (de Volo and Schatz 2004). As a result,
ORD scientists developed a neighborhood-scale community conceptual model to identify and describe
how ecosystem and environmental elements contribute to well-being.
An exploratory case study was done on the process of contaminated sediment remediation to habitat
restoration to community revitalization (R2R2R) in the St. Louis River Area of Concern (AOC).
Participant observation was utilized and document analysis to identify how the public, community
groups, and the City of Duluth officials value ecosystem goods and services (EGS) (Baum et al. 2006,
Hoggart et al. 2002, Laurier 2006). This was done through a study of the revitalization of the western
neighborhoods in Duluth, Minnesota.
The City of Duluth was interested in revitalizing the neighborhood through enhanced access to
environmental resources. Citizens, however, felt the City of Duluth was ignoring their concerns about
their neighborhoods, like housing conditions and neighborhood traffic. At the same time, natural
resource managers were interested in what citizens care about, but focused on their individual projects.
It became evident that additional effort was needed to translate across diverging spheres of experience
and responsibility that shape perspectives about a resource (Figure 4.1) or lived personal and
professional experience of city officials, natural resource managers, and local residents. Thus, a
neighborhood-scale community model intended to relate different perspectives to each other through the
application of framework was developed.
23
-------
City of
Duluth
Citizens
Natural
resource
managers
Figure 4.1 The interests of the City of Duluth, citizens, and state natural resource managers converge at the
St. Louis River (center of the diagram). The interests diverge where city staff make decisions about the
provision of city services including trail creation and maintenance; where natural resource managers make
decisions about restoring aquatic habitat, including creating islands or reefs; and citizens make decisions about
advocacy and engagement, including participation in city planning processes.
4.1. Application in Great Lakes
ORD scientists undertook an exploratory case study (Yin 2013) of the process of contaminated sediment
remediation to habitat restoration to community revitalization, (R2R2R; see Appendix 7) in the St. Louis
River AOC. Data were collected through ethnographic methods (i.e., participant observation and
document analysis) and were utilized to identify and characterize the elements of different decision
contexts where ecosystem sen/ices or human well-being might be discussed in relation to the AOC
(Baum et al. 2006, Hoggart et al. 2002, Laurier 2006) including in technical or scientific, governmental,
and community settings.5 Through a study of the revitalization of the western neighborhoods in Duluth,
Minnesota, it became apparent that perspectives and relationships were complicating discussions
regarding EGS value, like the benefits that a trail alignment would provide (i.e., access to amenities
versus scenic view of the river). For example, the City of Duluth was interested in revitalizing the
5 The results of this section reflect the results of a multi-faceted study to identify the factors that shape different decisions,
where data were collected in different contexts over an extended period of time. Themes that emerged in the study as
forces that shape decisions include disconnected and isolated decision contexts, variable opportunities for citizen input,
educational approaches to reducing conceptual barriers, and importance of boundary (i.e., the boundaries between science
and policy) spanning. Because both tools and people are important for boundary spanning, the method presented here is a
primary result of the study.
24
-------
neighborhood through enhanced access to environmental resources. Citizens, however, felt the City of
Duluth was ignoring their concerns about their neighborhoods, like housing conditions and
neighborhood traffic. At the same time, natural resource managers were interested in what citizens cared
about, but focused on their individual projects. It became evident that additional effort was needed to
translate across diverging spheres of experience and responsibility that shape perspectives about a
resource (Figure 4.1) or lived personal and professional experience of city officials, natural resource
managers, and local residents.
The research team's goal was to identify the relative valuation of ecosystem services, meaning that it
was important to identify which services were important relative to each other. More specifically, the
research biologists were interested in determining what people cared about, as well as the physical
elements of place. Because place attachment is emotional or affective (Brown 2015, Williams et al.
1992), the study goals became to identify what services were important. Thus, the social scientist chose
a methodology based on observing behavior as expressed through participation and policy actions or
documents to determine important goals and values. Following collection and analysis of background
data and observation, a neighborhood-scale community model was developed to relate different
perspectives to each other through the application of framework. The City of Duluth provides an
illustrative case study application of the neighborhood-scale community model because the City's
revitalization strategy is focused on the neighborhoods adjacent to AOC remediation and restoration
projects. Further, the City of Duluth's revitalization of the St. Louis Corridor is based on environmental
restoration, improving neighborhood quality of life, and attracting new homeowners, while also creating
a new visitor destination and stimulating development (City of Duluth 2017). The purpose of the
neighborhood-scale community model was to relate the views of citizens and objectives of city officials
or natural resource managers.
4.1.1. Approach (EGS/FEGS Involved)
In the course of data collection and analysis, it became evident there was a disconnect between city
officials and citizen visions for the St. Louis River Corridor. To better understand the nature of the
differences between the City and citizen perspectives, perceptions related to a contentious trail were
examined. The City was conducting planning processes for parks and trails throughout the western
neighborhoods, including a trail connection that would complete the Cross City Trail, a city-wide trail
that was to run parallel to the river (and AOC) and connect numerous western neighborhoods (Figure
4.2). The following section outlines an initial analysis and a proposed framework for analysis.
In January 2016, the City of Duluth held a public meeting to outline the project and their priorities,
followed by a survey to inform their decisions about a connecting trail segment. The City's stated
project purpose was to provide a "One of a kind, off-road trail for non-motorized trail users of all ages
and abilities. The trail will provide a connection to the Munger State Trail to the Duluth Lakewalk, offer
safe access to distinctive natural areas in West Duluth, present exceptional views of the St. Louis River
Corridor and estuary, and fill a gap in a significant state trail route from central Minnesota to the North
Shore of Lake Superior." Additional considerations for the City of Duluth are connecting community,
ensuring a safe user experience, encourage economic development, and economically and technically
feasible (City of Duluth 2017).
25
-------
Tallam |
Riverfront Indian Point
Park n K'"9sbur»
1 Bay L
Figure 4.2 Map of City of Duluth St. Louis River Corridor community revitalization projects (Source: City of
Duluth).
As part of the survey, the City of Duluth asked an open-ended question, "Do you have any comments on
the project's vision?" An analysis was conducted of the submitted answers to determine what citizens
believe that the trail should provide (Hsieh and Shannon 2005). There were 173 responses (Figure 4.3).
An analysis of the comments revealed that the respondents were most concerned about a dedicated off-
road trail with the fewest road crossings (safety), felt the trail should connect to existing resources
(Munger State Trail), and provide a unique and scenic experience (experience). Furthermore, several of
the emergent themes reflected an attachment to multiple benefits or ecosystem services, especially
aesthetics or "viewscapes" or "sounds and scents" but other comments indicate citizens appreciate that
the trail connects communities, connects people to nature, and provides economic benefits. In other
words, both the city and the survey respondents valued the trail alignment based on what the trail
provided, and they valued different alignments based on their priorities.
The initial analysis provided an opportunity for critical examination. While citizen input was collected,
and reflected in the plan's recommendations, it was included with hints at the difficulty of
implementation. The City's explanation starts "the riverside portion of Segment II requires purchase of
two railroad properties, an easement along the periphery of an industrial site, and coordination with an
MPCA -led environmental restoration site" (Minnesota Pollution Control Agency; City of Duluth 2017,
p. 22). The plan further described the challenges implementing the citizen-desired alignment owing to
constraints facing the City, including complicated real estate negotiations, the need to create a route
underneath an interstate, and perplexing engineering to avoid existing infrastructure (Table 4.1). This
finding implies that citizen articulation of ecosystem benefits may not match the values, purpose, or
realities of park or economic developers, and it may be difficult to incorporate citizen values into
project-specific planning efforts.
-------
Project Vision Comments
O
Figure 4.3 Safety, connections to existing resources, and experience were some of the most important
components identified in open-ended responses to the question "Do you have any comments on the
project's vision?" from a survey by the City of Duluth.
Table 4.1 Comparing the differences in priorities between City of Duluth officials and the public regarding
the Cross City Trail.
City of Duluth priorities
Priorities from public input
Respond to demographic trends
Safety: fewest intersection crossings
Connect visitor resources and regional
trail assets
Munger: connect to regional trail through
neighborhood
Faces constraints in securing real estate
for trail placement
Unique experience: embraces industrial nature
of neighborhood
27
-------
In this example, the benefits of environmental restoration were recognized by both citizens and city
officials, but different definitions of benefits that related specifically to their organizational
responsibilities or lived experiences resulted in disagreement that can be difficult to resolve.
4.1.2. Outcome
The results of the community group observation and analysis of the Cross City Trail survey results
prompted a question: If the desires regarding a trail is a reflection of neighborhood and personal
experiences for one group, but a resource and connection to amenities for another - how can the
difference in perspective resolved? Both the emotional attachment to a place, as well as the professional
obligation to create amenities that serve many purposes are valid, true and express different ideas about
well-being. Recognizing how resources may provide variable contributions to well-being depending on
an individual's or organization's relationship to it, a review was undertaken of the dimensions of
community planning and human well-being that emerged in the entirety of the R2R2R study. The result
is a conceptual model of a neighborhood or place, that can be used to translate values across
perspectives and create opportunities to examine the relationships between actors (i.e., city officials and
citizens) and the landscape (Figure 4.3).
These categories reflect the
relationship people have with the
environment.
Sustainability
or resilience
Aesthetics
These categories
reflect the
neighborhood
attributes with
which people most
engage.
Trails or
connections
Housing
Schools or
education
Parks or
public spaces
Neighborhood
or spatial unit of analysis
Infrastructure
Economy
Governance
or rules
Demographics
Natural features
Local businesses
Anchor
institutions
Crime
Safety
Social cohesion
Identity or place
attachment
Participation
These categories
reflect the personal
attachments to self,
community, and
identity that might
motivate action.
The structural dimensions of the community
that shape how people and organizations
navigate their neighborhood.
Physical environment is in this category
Figure 4.3 Neighborhood diagram. The colors represent how individuals might interact with individual
attributes. Blue attributes are representative of the built environment, the reasons that individuals might choose
their neighborhoods, or what cities plan to change. Black attributes are structural dimensions, or the important
elements that are fixed, part of larger process, or expressed in statistics. Orange characteristics reflect personal
attachments, values, or motivations of individuals. Green attributes represent human-environment relationships
(Refer to Appendix 8 for more information).
28
-------
The framework utilizes approaches from conflict resolution theory and systems thinking. The DSRP or
Distinctions-Systems-Relationships-Perspectives heuristic (Cabrera et al. 2015) guided the development
of the framework. The DSRP model explains how people think, more specifically that individuals each
have their own perspectives, make distinctions, and identify part-whole relationships. Thus, a tool was
created that could capture different perspectives, as well as identify and explain relationships. The model
is specifically designed to capture the difficult to quantify elements in the environment that contribute to
personal identity or organizational mission, safety and connection to place or professional ethic, thereby
enabling researchers to compare perspectives and identify sources of disagreement.
The model is a tool that can be used as a coding strategy to sort and classify text-based or other
qualitative data. Cheng et al. (2003) argued that the physical environment is "not an inert, physical entity
'out there'... but a dynamic system of interconnected, meaning-laden places." Examination of R2R2R
provided an opportunity to examine how environments and communities are related. There were three
distinct communities in this investigation: agencies, local governments and the public. While this study
was based in Duluth, state agency, local government, and advocacy groups operate similarly in their
own unique settings. Thus, the elements of the environment and community identified in this study (i.e.,
environment to be restored, rules that govern the process, emotional impulse to protect home) were
treated as an addition problem and integrated into a mental map of a community, similar to other
communities. The map (Figure 4.3) was refined through a literature review of the relationships between
elements of the natural, structural, or built environments in order to be codified into a system as
summarized in Table 4.2.
The community model identifies many of the components that individuals, organizations, and local
governments may discuss or make decisions about in the context of their neighborhood or community.
The characteristics in the model are a mix of built environment types, structural dimensions, personal
experiences, and human-environment relationships. The assemblage of attributes functions like a
framework. Definitions for each type of attribute is listed below. The model can be applied to a
community or neighborhood of any size.
Table 4.2 Elements of a place that contribute to well-being. The descriptions below describe dimensions of the
physical, built, and social environment.
Component
Explanation
Parks
People visit parks to relax, commune with nature, find peace, be with friends, play sports,
or experience other recreation (Chiesura 2004). Parks are an integral part of a sustainable
city. Access to quality parks and greenspace is often cited as a positive contributor to
health, well-being, and quality of life.
Trails
Trails can connect neighborhoods to each other, as well as amenities and other
destinations. Trails can be considered both linear parks and infrastructure for
transportation. "The cities that are deemed most vibrant and alive are the ones where
large numbers of people move around outside their cars in the public realm (Erickson
2006)."
Housing
Community advocates argue that overburdened neighborhoods are impacted by multiple
environmental stressors (Morello-Forsch et al. 2011). Community leaders further contend
that social factors including housing quality and neighborhood composition may impact
long-term well-being.
Schools -
Education
Schools are a critical community resource for learning, community cohesion and
sometimes other basic needs. Schools are the place where children spend a lot of time -
in class and in after-school activities. Additionally, schools can be important to the
identity of the neighborhood, especially through sports. Scholars argue that the quality of
schools is often linked to the quality of the neighborhood.
Infrastructure
Infrastructure shapes and facilitates how people move around their neighborhood.
Examples of infrastructure include roads, sidewalks, utilities, street lights, interstate
29
-------
Component
Explanation
highways, ports, pipelines, which can enhance or detract from connectivity or quality of
life in the neighborhood.
Natural features
The dominant natural features shape neighborhood layout, experience, and affect (or
disaffect). Parks are often the access points to natural features like hills, grasslands, rivers
and streams. Natural features include topography, water, vegetation, and climate. In
Sustainable and Healthy Communities research, natural features may be an ecosystem
service or an indicator of an ecosystem service.
Government or
rules
Government might be local, state, tribal, or federal governments. These governmental
entities might be impacting the neighborhood in positive and/or negative ways.
Government may be repairing something in the landscape (road, park, water/sewer line,
interstate highway), or creating plans (land use, site, neighborhood) for the
neighborhoods or whole city.
Economy
Economy in the context of document analysis might include discussion of the macro-
economy (national economy and how it impacts the neighborhood - such as the loss of
large industrial manufacturers), local economy and local businesses; the purchasing
behavior of residents; development of industrial sectors (like tourism, retail, agriculture,
or manufacturing); and property values.
Anchor
institutions (i.e.,
health care)
The presence of health care facilities and pharmacies in a neighborhood is an important
indicator of access to care for families and the elderly (less mobile). At the same time, the
presences of such facilities are considered assets. Place-based enterprises like
universities, hospitals and cultural institutions are important foci of community
redevelopment efforts.
Safety-
In a neighborhood, there are any number of conditions that could cause harm, such as
environmental conditions that promote the growth or movement of disease vectors;
exposure to risk (e.g., air or water pollution); inadequate lighting; poorly maintained
infrastructure; or hazardous traffic conditions. In many ways, "safety" questions are the
conditions that cause residents or other stakeholders to contact governmental entities.
Participation or
self-
determination
Participation or participatory democracy is a method for improving environmental
decisions that impact the public by giving residents a voice in the process. In short, often
(not always) citizens want a voice in their own neighborhood's development. In fact, the
outcome may not matter - a seat at the table and knowing they were heard is sometimes
enough.
Identity and
place
attachment
Identity is a complex and can include the personal, political, social, or organizational.
Identity is a function psychological processes, but might manifest themselves in a
number of ways in neighborhoods or communities. Identity with a neighborhood or place
can be affective, reactionary, and protective based on the type of connection to the place.
Identity and place are also contested terms and reflect the conflicts that might exist in a
space. For this investigation, identity will refer to how a group (neighborhood or
otherwise) describes itself or origin; how the place is rooted in history; and how the
group identifies the space they claim.
Local groups,
organizations,
churches
Local organizations, including service and advocacy groups, are important resources in a
community. They are potential community assets, knowledge brokers, gatekeepers and
collaborators. Religious communities, libraries, block groups, park organizations, cultural
or neighborhood groups might all be reflections of collective action in the area.
Sustainability
or resilience
Sustainability can be interpreted in the intergenerational equity sense, or might mean how
the neighborhood can be sustained and less vulnerable to elements such as pollution,
flooding, loss of jobs, or food insecurity. Sustainability in this model can refer to how a
neighborhood enhances its own sustainability or builds resilience including neighborhood
beautification, other placemaking activities, community gardens, or green infrastructure.
Scholars debate sustainability, but many are beginning to recognize that sustainability is
a process that is or should be inclusive, interdisciplinary, and intentional. Sustainability
might be reflected in any strategy that attempts to improve well-being of both humans
and the environment simultaneously.
30
-------
Component
Explanation
Aesthetics
One definition of aesthetics is the governing principles that define an idea of beauty at a
particular time or place (Aesthetics 2017). Furthermore, landscape ecologists have argued
that what makes a landscape pleasing is context dependent and limited to the "human
perceptual realm" (Gobster 2007).
Final ecosystem goods and services (FEGS-CS) (i.e., specific elements that contribute to human well-
being) are embedded throughout the framework. For example, parks are an important pathway through
which people experience nature or ecosystem services (Buchel and Frantzeskaki 2015, Landers and
Nahlik 2013). Some of the FEGS experienced in parks include sights and sounds, fishing, learning, and
existence. Similarly, aesthetics may be dependent on the physical components of the environment and
social context. In Duluth, the scenic views of the river are not limited to the aquatic vegetation or the
water, but include the ore docks that provide a sense of history and identity. Identity, place attachment,
and social cohesion are important elements of human well-being, and are a function of the spaces
available to experience them. (Smith et al. 2013). Thus, this framework helps organize articulations of
value and relates them to specific domains of the ecosystem and well-being. Using FEGS-CS as a key
facilitates the identification of the EGS (i.e., the fish, view, wild rice, or existence), the key beneficiaries
(i.e., boaters, anglers, experiencers). At the same time, the HWBI provides means for describing other
dimensions of environmental benefit - namely the connection to place and culture. Together, the tools
woven together provide a means to analyze both the environmental and cultural dimensions of human
well-being.
4.1.3. Lessons Learned
Throughout the study, it became evident that the "what" individuals and organizations cared about was
attached to a "why," which was difficult for them to articulate, but was expressed as resistance to the
City of Duluth's planning efforts. We found that the "what" people organized around or advocated for
was attached to neighborhood identity, current use of parks and resources, or ideas of how they thought
their neighborhoods should look. In other words, people advocated not for an object or resource, but for
participation in the process, protection of the landscape features they use and appreciate, and a say over
what happens in their neighborhood. In other words, the hopes and values of citizens could not be met
with the normal procedures that many agencies follow to gather input - because that input was not
necessarily relevant to the project at the risk of being discounted. Similarly, ecosystem goods and
services and physical or social determinants of health are embedded in city planning documents and
planning processes, but not necessarily in ways that are obvious to researchers investigating ecosystem
services.
The envisioned steps to utilize the model are: 1) collect data6 (text-based or other qualitative data); 2)
6 There is no preconceived amount of data needed to apply the model. Data sets could be as small as a written note or
photograph, or as large as a set of written comments from multiple audiences. The data could be collected at a single site,
or many sites over time. The tool is meant to be flexible and transferable.
31
-------
initially code the data according to the categories; 3) conduct content analysis on the data in each
category. The model should reveal what is valued about each element. More details about how to apply
the strategy can be found in Appendix 8.
T o test the framework, an analysis of a neighborhood development plan developed by community
organizations was analyzed through the framework. The results of the analysis demonstrate that the most
important elements of the neighborhood as determined by the number of words coded in the document
are parks, trails, infrastructure, and aesthetics (Figure 4.4). The categories are important, but an analysis
of the contents of each category reveal important details that explains how each element contributes to
the neighborhood's well-being. For example, parks are important to the Irving Neighborhood because
they provide gathering spaces, year-round recreation, and an identifying feature. The plan states that the
neighborhood groups and City of Duluth should, "undertake steps that improve Irving as a walkable
residential neighborhood and highlights Irving Park as the key identifying feature." Understanding
valued resources, like parks, in context is critical because it has the potential to shift the conversation
from the abstract object, in this case, the park, to being able to describe what the park contributes to the
well-being of the neighborhood. In this case, it is a gathering place and a signature feature - or elements
that contribute to the social cohesion and identity.
Irving Neighborhood Plan Analysis
3000
2700
2400
2100
Community Dimensions
Figure 4.4 Analysis of Irving Sustainable Neighborhood Action Plan. Parks, trails, infrastructure, and
aesthetics are among the most important elements to in the neighborhood.
32
-------
4.2. Conclusions and Future Research Needs
Communities and individuals recognize and appreciate nature based on their relationships with it and
usually in ways that challenge typical approaches to ecosystem service valuation (Wegner and Pascual
2011). The context for experiences with nature include the built environment, the physical environment
(including infrastructure and natural features), and personal experiences. Childers et al. (2015: 3778)
argued that "cities are habitat for people, so the urban design process should include city residents and
integrate a social component into design objectives and actions." It was found that such an endeavor is
easier stated than implemented, because the values of benefits vary between stakeholder groups
including citizens, local government, and natural resource managers.
This study utilized an exploratory case study approach to develop a method to characterize the roles of
different actors, how ecosystem service values influence decision-making practices, and how citizens
value environmental resources. While elements have been identified that influence R2R2R in Duluth
and the St. Louis River AOC, comparisons of the revitalization process in other AOCs will provide
opportunities to test and refine the findings. Furthermore, the programmatic relationship, wherein EPA,
state agencies, and local governments must collaborate to implement environmental programs, is not
unique. Comparing the AOC program to other types of EPA programs including Superfund, National
Estuary Program, or other geographic programs will provide further insights about how different
agencies and individuals who participate in the programs value ecosystem services.
33
-------
5. Synthesis
This report is intended for community decision makers and those who support and participate in
decision making at various levels of government. Within the report, three studies were presented that
explore multidisciplinary approaches to non-monetary valuation of FEGS, particularly the use and
application of non-monetary valuation in the context of community decision making. Although the
approach presented in each study is distinct, a number of common findings emerged. First, ecosystem
goods and services do factor into community decision making and are important to communities and
states. Second, ecosystem goods and services contribute to human health and well-being in manifold
ways, and characterizing the entire pathway between ecosystem state and health is important to aid
decision making. However, to improve the application of ecological-health relationships in decision
making, researchers need to address the whole pathway connecting FEGS to human health and well-
being outcomes (whether directly or indirectly). Third, the ability to include and value FEGS in decision
making can be improved by including approaches from the social and public health sciences. These
approaches complement monetary valuation of FEGS and can be used now to incorporate a wide range
of community values related to FEGS, as well as their connection to human health and well-being. The
three place-based studies presented in this report demonstrate how FEGS, benefits, and community
values were brought into the conversation successfully and practically - including what worked well and
what could be improved in the future.
Each study demonstrates distinct benefits related to health or well-being from changes in FEGS that
were in turn related to community-level environmental decisions (i.e., green space, onsite sewage
disposal, and developing trail networks). The value of these benefits was affected by the relative
certainty of the outcome, the policy alternative chosen, and who was assessing the benefits. In the first
study, where evidence for the health benefits of green spaces was insufficient, the quality of information
had a direct impact on the value of the green space. In the second study, whether the county chose an
innovative or an alternative system for sewage disposal affected the benefit with respect to both harmful
algae bloom reduction and risk of illness. And in the third study, how citizens, local governments, and
natural resource managers value the benefits of FEGS varied. These findings emphasize the need to
proceed with a decision-support framework built upon concepts of transparency and equity (such as the
Health Impact Assessment) and to use a tool such as the community model (presented in the third study)
that can facilitate translation of goals and values between the various stakeholders and decision makers.
It was concluded that a thorough documentation and understanding of the causal pathways between the
community decision, FEGS, and benefits, combined with an appropriate decision-support process, can
contribute to decisions that result in healthier, more resilient communities. Public health and
ethnographic methods and tools provide a variety of approaches to integrate human beings and their
collective values into ecosystems, including urban and other developed systems.
Based on these studies, specific recommendations are offered regarding how to conduct future research
that addresses the link between FEGS, their value, and their benefit to communities. First, FEGS
valuation should be conducted by an interdisciplinary team, including those with expertise in social
science, public health, and ecology. Notably, researchers need to be aware that perspectives and
language grounded in different disciplines can impede communication. The research team should plan
how to manage and analyze multidisciplinary data and establish a common terminology when working
with conceptual models. Moreover, integration must be designed into both the research and decision
support from the outset. Second, communities and states require access to and the active support of
practitioners of social, economic, human health, and ecological sciences to make this a reality. These
practitioners can build trust with stakeholders and decision makers by producing data with the
34
-------
community and using a decision-support process that is built upon concepts of transparency and equity.
Expertise can be recruited from amongst community staff, from universities and non-profit
organizations, from industry, and also from federal staff, but each discipline should be represented.
35
-------
6. References
Aesthetics. (2017). Dictionary.com. Accessed 15, August 2017 from
http://www.dictionary.com/browse/aesthetics.
Anderson, T.H. and G.T. Taylor. (2001). Nutrient pulses, plankton blooms, and seasonal hypoxia in
western Long Island Sound. Estuaries 24(2):228-243.
Angradi, T.R., J.J. Launspach, D.W. Bolgrien, B.J. Bellinger, M.A. Starry, J.C. Hoffman, A.S. Trebitz,
M.E. Sierszen, and T.P. Hollenhorst. (2016). Mapping ecosystem service indicators in a Great Lakes
Estuarine Area of Concern. Journal of Great Lakes Research 42(3):717-727.
Araujo, R.V., M.R. Albertini, A.L. Costa-da-Silva, L. Suesdek, N.C.S. Franceschi, N.M. Bastos, G.
Katz, V.A. Cardoso, B.C. Castro, M.L. Capurro, and V.L.A.C. Allegro. (2015). Sao Paulo urban heat
islands have a higher incidence of dengue than other urban areas. The Brazilian Journal of Infectious
Diseases 19(2): 146-155.
Araya, M., M. Olivares, F. Pizarro, A. Llanos, G. Figueroa, and R. Uauy. (2004). Community-based
randomized double-blind study of gastrointestinal effects and copper exposure in drinking water.
Environmental Health Perspectives pp. 1068-1073.
American Society for Testing and Materials (ASTM). (2009). E-1689 Standard Guide for Developing
Conceptual Site Models for Contaminated Sites. Annual Book of Standards. ASTM International,
Conshohocken, PA.
Baum, F., C. MacDougall, and D. Smith. (2006). Participatory action research. Journal of
Epidemiology and Community Health 60(10):854.
Bouchama, A. and J.P. Knochel. (2002). Heat stroke. New England Journal of Medicine 346(25): 1978-
1988.
Boyd, J.W. and S. Banzhaf. (2007). What are ecosystem services? The need for standardized
environmental accounting units. Ecological Economics 63(2-3):616-626.
Bracht, N., J.R. Finnegan Jr., C. Rissel, R. Weisbrod, J. Gleason, J. Corbett, and S. Veblen-Mortenson.
(1994). Community ownership and program continuation following a health demonstration project.
Health Education Research Theory & Practice 9(2):243-255.
Brody, S.D. and W.E. Highfield. (2013). Open space protection and flood mitigation: A national study.
Land Use Policy 32:89-95.
Brown, G., C.M. Raymond, and J. Corcoran. (2015). Mapping and measuring place attachment.
Applied Geography, 57, 42-53.
Buchel, S. and N. Frantzeskaki. (2015). Citizens' voice: A case study about perceived ecosystem
services by urban park users in Rotterdam, the Netherlands. Ecosystem Services 12:169-177.
Cabrera, D., L. Cabrera, and E. Powers. (2015). A unifying theory of systems thinking with
psychosocial applications. Systems Research and Behavioral Science 32(5):534-545.
36
-------
Cahoon, L.B., J.C. Hales, E.S. Carey, S. Loucaides, K.R. Rowland, and J.E. Nearhoof. (2006).
Shellfishing closures in southwest Brunswick County, North Carolina: Septic tanks versus stormwater
runoff as fecal coliform sources. Journal of Coastal Research 22(2):319-327.
Cheng, A.S., L.E. Kruger, and S.E. Daniels. (2003). " Place" as an integrating concept in natural
resource politics: Propositions for a social science research agenda. Society & Natural Resources
16(2):87-104.
Chew, G.L., J. Wilson, F.A. Rabito, F. Grimsley, S. Iqbal, T. Reponen, M.L. Muilenberg, P.S. Thorne,
D.G. Dearborn, and R.L. Morley. (2006). Mold and endotoxin levels in the aftermath of Hurricane
Katrina: A pilot project of homes in New Orleans undergoing renovation. Environmental Health
Perspectivespp. 1883-1889.
Chiesura, A. (2004). The role of urban parks for the sustainable city. Landscape and Urban Planning
68(1): 129-138.
Childers, D.L., M.L. Cadenasso, J.M. Grove, V. Marshall, B. McGrath, and S.T. Pickett. (2015). An
ecology for cities: A transformational nexus of design and ecology to advance climate change resilience
and urban sustainability. Sustainability 7(4):3774-3791.
City of Duluth. (2017). Cross City Trail Mini Master Plan. Accessed 4, April 2017 from
http://www.duluthmn.gov/media/542221/cross-citv-trail-mmp-final-high-res.pdf
Costanza, R., L. Fioramonti, and I. Kubiszewski. (2016). The UN sustainable development goals and
the dynamics of well-being. Frontiers inEcology and the Environment 14(2):59.
Costanza, R., O. Perez-Maqueo, M.L. Martinez, P. Sutton, S.J. Anderson, and K. Mulder. (2008). The
value of coastal wetlands for hurricane protection. AMBIO: A Journal of the Human Environment
37(4):241-248.
Cox, J., M.E. Grillet, O.M. Ramos, M. Amador, and R. Barrera. (2007). Habitat segregation of dengue
vectors along an urban environmental gradient. The American Journal of Tropical Medicine and
Hygiene 76(5):820-826.
Creswell, J.W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage
publications.
de Jesus Crespo, R. and R. Fulford. (2017). Eco-Health linkages: Assessing the role of ecosystem goods
and services on human health using causal criteria analysis. International Journal of Public Health, doi:
10.1007/s000 38-017-1020-3.
Delfino, R.J., N. Staimer, T. Tjoa, D.L. Gillen, J.J. Schauer, and M.M. Shafer. (2013). Airway
inflammation and oxidative potential of air pollutant particles in a pediatric asthma panel. Journal of
Exposure Science and Environmental Epidemiology 23(5):466-473.
de Volo, L.B. and E. Schatz. (2004). From the inside out: Ethnographic methods in political research.
Political Science and Politics 37(02):267-271.
Elliott, E. and S. Francis. (2005). Making effective links to decision-making: Key challenges for health
impact assessment. Environmental Impact Assessment Review 25(7-8):747-757.
37
-------
Erickson, D. (2006). MetroGreen: Connecting Open Space in North American Cities. Island Press.
Fisher, B. and R.K. Turner. (2008). Ecosystem services: Classification for valuation. Biological
Conservation 141(5): 1167-1169.
Fulford, R., R. Bruins, T. Canfield, J. Handy, J.M. Johnston, P. Ringold, M. Russell, N. Seeteram, K.
Winters, and S. Yee. (2016a). Lessons Learned in Applying Ecosystem Goods and Services to
Community Decision Making. U.S. Environmental Protection Agency, Gulf Breeze, FL, EPA/600/R-
16/136.
Fulford, R.S., M. Russell, J. Harvey, and M.C. Harwell. (2016b) Sustainability at the Community
Level: Searching for Common Ground as Part of a National Strategy for Decision Support. U.S.
Environmental Protection Agency, Gulf Breeze, FL, EPA/600/R-16/178.
Gobster, P.H., J.I. Nassauer, T.C. Daniel, and G. Fry. (2007). The shared landscape: What does
aesthetics have to do with ecology? Landscape Ecology 22(7):959-972.
Gould, W.A., C. Alarcon, B. Fevold, M.E. Jimenez, S. Martinuzzi, G. Potts, M. Quinones, M.
Solorzano, and E. Ventosa. (2008). The Puerto Rico Gap Analysis Project. Volume 1: Land Cover,
Vertebrate Species Distributions, and Land Stewardship. Gen. Tech. Rep. IITF-GTR-39. Rio Piedras,
PR: U.S. Department of Agriculture, Forest Service, International Institute of Tropical Forestry. 165 p.
Government of Canada and the Government of the United States of America. (2012). Great Lakes
Water Quality Agreement. Accessed 10, August 2017 from at https://binational.net//wp-
content/uploads/2014/05/1094 C anada-U S A- GL WO A- e.pdf.
Hansen, G.N. and M. Schoonen. (1999). A geochemical study of the effects of land use on nitrate
contamination in the Long Island Aquifer system. Stony Brook: Department of Geosciences, SUNY.
Hartig, T., R. Mitchell, S. De Vries, and H. Frumkin. (2014). Nature and health. Annual Review of
Public Health 35:207-228.
Harwell, M.C., C. Jackson, and J. Molleda. (2017). Managed Vocabulary for use of Ecosystem Goods
and Services in Decision-Making. U.S. Environmental Protection Agency, Gulf Breeze, FL,
EPA/600/X-17/168.
Hattenrath, T.K., D.M. Anderson, and C.J. Gobler. (2010). The influence of anthropogenic nitrogen
loading and meteorological conditions on the dynamics and toxicity of Alexandrium fundyense blooms
in a New York (USA) estuary. Harmful Algae 9(4):402-412.
Hoggart, K., L. Lees, A. Davies, and A. Davies. (2002). Researching Human Geography. Arnold,
Hodder Headline Group, London, UK.
Hough, R.L. (2014). Biodiversity and human health: Evidence for causality? Biodiversity and
Conservation 23(2):267-288.
Hsieh, H.F. and S.E. Shannon. (2005). Three approaches to qualitative content analysis. Qualitative
Health Research 15(9):1277-1288.
38
-------
Ibarra, A.M.S., S.J. Ryan, E. Beltran, R. Mejia, M. Silva, and A. Munoz. (2013). Dengue vector
dynamics (Aedes aegypti) influenced by climate and social factors in Ecuador: Implications for targeted
control. PloS one 8(1 l):e78263.
International Joint Commission. (1978, 1987). Great Lakes Water Quality Agreement of 1978.
Accessed 16, March 2015 from http://binational.net/glwqa-aqegl/.
Jackson, L.E., J. Daniel, B. McCorkle, A. Sears, and K.F. Bush. (2013). Linking ecosystem services
and human health: The Eco-Health Relationship Browser. International Journal of Public Health
58(5):747-755.
Joffe, M. and J. Mindell. (2006). Complex causal process diagrams for analyzing the health impacts of
policy interventions. American Journal of Public Health 96:473-479.
Kabisch, N. and D. Haase. (2013). Green spaces of European cities revisited for 1990-2006. Landscape
and Urban Planning 110:113-122.
Karim, M.R., F.D. Manshadi, M.M. Karpiscak, and C.P. Gerba. (2004). The persistence and removal of
enteric pathogens in constructed wetlands. Water Research 38(7): 1831-1837.
Katukiza, A.Y., M. Ronteltap, P. Steen, J.W.A. Foppen, and P.N.L. Lens. (2014). Quantification of
microbial risks to human health caused by waterborne viruses and bacteria in an urban slum. Journal of
Applied Microbiology 116(2):447-463.
Kelemen, E., M. Garcia-Llorente, G. Pataki, B. Martin-Lopez, E. and Gomez-Baggethun. (2016). Non-
monetary techniques for the valuation of ecosystem services. In: Potschin, M. and Jax, K. (eds):
OpenNESSEcosystem Services References Book. EC FP7 Grant Agreement no. 308428.
Kinney, E.L. and I. Valiela. (2011). Nitrogen loading to Great South Bay: Land use, sources, retention,
and transport from land to bay. Journal of Coastal Research 27(4):672-686.
Knol, A.B., D.J. Briggs, and E. Lebret. (2010). Assessment of complex environmental health problems:
Framing the structures and structuring the frameworks. Science of the Total Environment 408:2785-
2794.
Knutson, P.L., R.A. Brochu, W.N. Seelig, and M. Inskeep. (1982). Wave damping in Spartina
alterniflora marshes. Wetlands 2(1):87-104.
Krantzberg, G. (2012). First off the List: The Collingwood Harbour Story. In Grover, Velma I., and
Gail Krantzberg, eds. Great Lakes: Lessons in participatory governance. CRC Press, 2012.
Landers, D. and A. Nahlik. (2013). Final Ecosystem Goods and Services Classification System (FEGS-
CS). U.S. Environmental Protection Agency, Washington, DC, EPA/600/R-13/ORD-004914.
LaRoche, J.L., R. Nuzzi, R. Waters, K. Wyman, P.G. Falkowski, and D.W.R. Wallace. (1997). Brown
tide blooms in Long Island's coastal waters linked to interannual variability in groundwater flow.
Global Change Biology 3:397-410.
Laurier, E. (2006). Participant Observation. In: Clifford, N., Valentine, G. (eds) Key Methods in
Geography, First edition, Sage Publications Ltd. Thousand Oaks, London, UK. pp. 133-148.
39
-------
Lee, A.C. and R. Maheswaran. (2011). The health benefits of urban green spaces: A review of the
evidence. Journal of Public Health 33(2):212-222.
Lele, S. and R.B. Norgaard. (2005). Practicing interdisciplinary. Bioscience 55(ll):967-975.
Lim, S.S., T. Vos, A.D. Flaxman, G. Danaei, K. Shibuya, H. Adair-Rohani, M.A. AlMazroa, M.
Amann, H.R. Anderson, K.G. Andrews, and M. Aryee. (2013). A comparative risk assessment of
burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-
2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet 380(9859):2224-
2260.
Lovasi, G.S., J.P. O'Neil-Dunne, J.W. Lu, D. Sheehan, M.S. Perzanowski, S.W. MacFaden, K.L. King,
T. Matte, R.L. Miller, L.A. Hoepner, and F.P. Perera. (2013). Urban tree canopy and asthma, wheeze,
rhinitis, and allergic sensitization to tree pollen in a New York City birth cohort. Environmental Health
Perspectives 121(4):494.
MacMynowski, D. (2007). Pausing at the brink of interdisciplinary: Power and knowledge at the
meeting of social and biophysical science. Ecology and Society 12(1).
Massachusetts Institute of Technology. (2017). Living Wage Calculator. Accessed 7, July 2017 from
http: //livingwage. mit. edu/.
McDonough, K., S. Hutchinson, T. Moore, and J.M. Shawn Hutchinson. (2017). Analysis of
publication trends in ecosystem services research. Ecosystem Services 25:82-88.
Mendez-Lazaro, P., O. Martinez-Sanchez, R. Mendez-Tejeda, E. Rodriguez, E. Morales, and N.
Schmitt-Cortijo. (2015). Extreme heat events in San Juan Puerto Rico: Trends and variability of
unusual hot weather and its possible effects on ecology and society. Journal of Climatology & Weather
Forecasting 3:135.
Miller, J.R., M.G. Turner, E.A. Smithwick, C.L. Dent, and E.H. Stanley. (2004). Spatial extrapolation:
The science of predicting ecological patterns and processes. Bioscience 54(4):310-320.
Merrill, Ray M. (2008). Environmental Epidemiology: Principles and Methods. Jones & Bartlett
Learning.
Morello-Frosch, R., M. Zuk, M. Jerrett, B. Shamasunder, and A.D. Kyle. (2011). Understanding the
cumulative impacts of inequalities in environmental health: Implications for policy. Health Affairs
30(5):879-887.
Morin, C.W., A.J. Monaghan, M.H. Hayden, R. Barrera, and K. Ernst. (2015). Meteorologically driven
simulations of dengue epidemics in San Juan, PR. PLOSNeglected Tropical Diseases 9(8):e0004002.
Mumby, P.J., A.J. Edwards, J.E. Arias-Gonzalez, K.C. Lindeman, P.G. Blackwell, A. Gall, M.I.
Gorczynska, A.R. Harborne, C.L. Pescod, H. Renken, and C.C. Wabnitz. (2004). Mangroves enhance
the biomass of coral reef fish communities in the Caribbean. Nature 427(6974):533-536.
Munns, W.R., A.W. Rea, M.J. Mazzotta, L.A. Wainger, and K. Saterson. (2015). Toward a standard
lexicon for ecosystem services. Integrated Environmental Assessment and Management 11(4):666-673.
40
-------
Myers, S.S., L. Gaffikin, C.D. Golden, R.S. Ostfeld, K.H. Redford, T.H. Ricketts, W.R. Turner, and
S.A. Osofsky. (2013). Human health impacts of ecosystem alteration. Proceedings of the National
Academy of Sciences 110(47): 18753-18760.
New York State (NYS) 2100 Commission. (2013). Recommendations to Improve the Strength and
Resilience of the Empire State's Infrastructure. New York City, NY.
New York State Center for Clean Water Technology. (2016). Nitrogen Removing Biofilters for Onsite
Wastewater Treatment on Long Island: Current and Future Prospects. Stony Brook University, Stony
Brook, NY.
New York State GIS Program Office. (2017). NYS GIS Clearinghouse. Accessed 7, July 2017 from
http://gis.nv.gov.
Nichols, S., A. Webb, R. Norris, and M. Stewardson. (2011). Eco Evidence Analysis Methods Manual:
A Systematic Approach to Evaluate Causality in Environmental Science. eWater Cooperative Research
Centre, Canberra.
Norris, R.H., J.A. Webb, S.J. Nichols, M.J. Stewardson, and E.T. Harrison. (2011). Analyzing cause
and effect in environmental assessments: Using weighted evidence from the literature. Freshwater
Science 31(1):5-21.
Nuzzi, R. and R. A. Waters. (2004). Long-term perspective on the dynamics of brown tide blooms in
Long Island coastal bays. Harmful Algae 3(4):279-293.
New York State Department of Environmental Conservation (NYSDEC). (2014). Nitrogen Pollution
and Adverse Impacts on Resilient Tidal Marshlands: NYSDEC Technical Briefing Summary. New
York State Department of Environmental Conservation, Albany, NY.
Oosterbroek, B., J. de Kraker, M.M. Huynen, and P. Martens. (2016). Assessing ecosystem impacts on
health: A tool review. Ecosystem Services 17:237-254.
Paavola, J. and W.N. Adger. (2005). Institutional ecological economics. Ecological Economics
53(3):353-368.
Paerl, H.W., R.S. Fulton, P.H. Moisander, and J. Dyble. (2001). Harmful freshwater algal blooms, with
an emphasis on cyanobacteria. Scientific World Journal 1:76-113.
Parascandola, M., D.L. Weed, and A. Dasgupta. (2006). Two Surgeon General's reports on smoking
and cancer: A historical investigation of the practice of causal inference. Emerging Themes in
Epidemiology 3(1):1.
Pascual, U., R. Muradian, L. Brander, E. Gomez-Baggethun, B. Martin-Lopez, M. Verma, P.
Armsworth, M. Christie, H. Cornelissen, F. Eppink, and J. Farley. (2010). The Economics of Valuing
Ecosystem Services and Biodiversity. TEEB-Ecological and Economic Foundation.
Peters, A., A. Doring, H.E. Wichmann, and W. Koenig. (1997). Increased plasma viscosity during an
air pollution episode: A link to mortality? The Lancet 349(9065): 1582-1587.
41
-------
Rasanen, J.V., T. Holopainen, J. Joutsensaari, C. Ndam, P. Pasanen, A. Rinnan, and M. Kivimaenpaa.
(2013). Effects of species-specific leaf characteristics and reduced water availability on fine particle
capture efficiency of trees. Environmental pollution 183:64-70.
Reef Resilience Network. (2016). Resilient MPA Design: Connectivity. Accessed 26, May 2017 from
http://www.reefresilience.org/coral-reefs/resilient-mpa-design/connectivitv/.
Richardson, E.A., J. Pearce, R. Mitchell, and S. Kingham. (2013). Role of physical activity in the
relationship between urban green space and health. Public Health 127(4):318-324.
Russo, F. and J. Williamson. (2007). Interpreting causality in the health sciences. International Studies
in the Philosophy of Science 21(2):157-170.
Safety. (2017). Merriam-Webster Dictionary. Accessed 15, August 2017 from https://www.merriam-
webster.com/dictionarv/safetv.
San Juan Bay Estuary (SJBE). (2015). Area cientifica: Datos de monitoreo. Accessed 30, January 2017
from http://www.estuario.org/index.php/datos/ciencia?limitstart=Q.
Sandifer, P. A. and A.E. Sutton-Grier. (2014). Connecting stressors, ocean ecosystem services, and
human health. Natural Resources Forum 38(3): 157-167.
Sheffield PE, Agu DP, Rowe M, Fischer K, Perez AE, Rodriguez LN, Aviles KR. 2014. Health Impact
Assessment of the Proposed Environmental Restoration of Cano Martin Pena. San Juan, Puerto Rico.
Silva, C.A.R., L.D. Lacerda, and C.E. Rezende. (1990). Metals reservoir in a red mangrove forest.
Biotropica pp. 339-345.
Smith, L.M., J.L. Case, H.M. Smith, L.C. Harwell, and J.K. Summers. (2013). Relating ecoystem
services to domains of human well-being: Foundation for a U.S. index. Ecological Indicators 28:79-90.
Smith, L.M., H.M. Smith, J.L. Case, L.C. Harwell, J.K. Summers, C. Wade. (2012). Indicators mid
Methods for Constructing a U.S. Human Weil-Being Index (HWBI) for Ecosystem Services Research.
U.S. Environmental Protection Agency, Washington, DC, EPA/600/R-12/023
Smith, L.M., L. Harwell, J.K. Summers, H.M. Smith, C.M. Wade, K.R. Straub, and J.L. Case. (2014).
A U.S. Human Weil-Being Index (HWBI) for Multiple Scales: Linking Service Provisioning to Human
Weil-Being Endpoints (2000-2010). U.S. Environmental Protection Agency, Washington, DC,
EPA/600/R-14/223.
Suffolk County Department of Fire, Rescue, and Emergency Services. (2014). Multi-jurisdictional
Hazard Mitigation Plan Update. Suffolk County Government, Yaphank, NY.
Suffolk County Department of Health Services. (2000). General Guidance Memorandum #12:
Guidelines for Issuing Approval of Sewage Disposal Systems and Water Supplies for Existing
Residences. Division of Environmental Quality, Yaphank, NY.
Suffolk County Department of Environmental Quality. (2015). Comprehensive Water Resources
Management Plan. Suffolk County, Hauppage, NY.
42
-------
Suffolk County Executive. (2016). Coastal Resiliency Projects. Accessed 7, July 2017 from
http://sufFolkcountynv.gOv/Portals/0/countyexecutive/PDF/Resiliencv%20FAQs%20FINAL.pdf.
Suffolk County Government. (2014a). Suffolk County Water Quality and Coastal Resiliency Action
Plan. Municipal Officials Conference: Managing Cesspools and Septic Systems to Protest Long Island's
Waters, March 25, 2014 (p. PowerPoint). Suffolk County Department of Health Services.
Suffolk County Government. (2014b). Proposed Sanitary Code Policy Changes for Upgrading Existing
OSDSs, Rev. 2. Suffolk County Department of Health Services.
Suffolk County Government. (2014c). Suffolk County GIS Portal. Accessed 7, July 2017 from
https://gisportal.suffolkcountvnv.gov/gis/home/.
Summers, J.K. and L.M. Smith. (2014). The role of social and intergenerational equity in making
changes in human well-being sustainable. Ambio 43(6):718-728.
Summers, J.K., L.C. Harwell, and L.M. Smith. (2016). A model for change: An approach for
forecasting well-being from service-based decisions. Ecological Indicators 69:295-309.
Tourism Economics. (2010). The Economic Impact of Tourism in New York, Long Island Focus.
Oxford Economics, Philadelphia, PA.
U.S. Environmental Protection Agency (U.S. EPA). (1998). Guidelines for Ecological Risk
Assessment. U.S. Environmental Protection Agency, Washington, DC, EPA/630/R-95/002F.
U.S. EPA. (2002). Nitrification. U.S. Environmental Protection Agency, Office of Groundwater and
Drinking Water, Washington, DC.
U.S. EPA. (2009). Valuing the Protection of Ecological Systems and Services: A report of the EPA
Science Advisory Board. U.S. Environmental Protection Agency, Washington, DC, EPA-SAB-09-012.
U.S. EPA and Environment and Climate Change Canada. (2012). Great Lakes Water Quality
Agreement, Great Lakes Areas of Concern, Annex 1. Accessed 24, March 2017 from
https://binational.net/annexes/al/.
U.S. Census Bureau. (2015). Suffolk County, NY. Accessed 7, July 2017 from
https://www.census.gov/quickfacts/table/HCN010212/36103.
Wade, T.J., S.K. Sandhu, D. Levy, S. Lee, M.W. LeChevallier, L. Katz, and J.M. Colford. (2004). Did a
severe flood in the Midwest cause an increase in the incidence of gastrointestinal symptoms? American
Journal of Epidemiology 159(4):398-405.
Wainger, L. and M. Mazzotta. (2011). Realizing the potential of ecosystem services: A framework for
relating ecological changes to economic benefits. Environmental management 48(4):710
Wania, A., M. Bruse, N. Blond, and C. Weber. (2012). Analyzing the influence of different street
vegetation on traffic-induced particle dispersion using microscale simulations. Journal of
Environmental Management 94(1):91-101.
Wegner, G. and U. Pascual. (2011). Cost-benefit analysis in the context of ecosystem services for
human well-being: A multidisciplinary critique. Global Environmental Change 21(2):492-504.
43
-------
Wigand, C., C. Roman, R. Davey, M. Stolt, R. Johnson, A. Hanson, and P. Rafferty. (2014). Below the
disappearing marshes of an urban estuary: Historic nitrogen trends and soil structure. Ecological
Applications 24(4):952-963.
Williams, D. R., M.E. Patterson, and J.W. Roggenbuck. (1992). Beyond the commodity metaphor:
Examining emotional and symbolic attachment to place. Leisure Sciences, 14, 29-46.
Williams, K.C., J.C. Hoffman. 2017. Remediation to Restoration to Revitalization - A Path Forward for
AOCs? US Environmental Protection Agency. EPA/600/R-17/119.
World Health Organization. (2017). Health Impact Assessment (HIA). Accessed 7, July 2017 from
http: //www. who. int/hi a/ en/.
Yin, R.K. (2013). Case Study Research: Design and Methods. Sage publications.
Yee, S.H., J.E. Rogers, J. Harvey, W. Fisher, M. Russell, and P. Bradley. (2011). Concept Mapping
Ecosystem Goods and Services. In: Applied Concept Mapping: Capturing, Analyzing, and Organizing
Knowledge, Moon, B.M., R.R. Hoffman, J.D. Novak, and A.J. Canals (eds.). CRC Press, Boca Raton,
FL, pp. 193-214.
Ysebaert, T., S.L. Yang, L. Zhang, Q. He, T.J. Bourma, and P.M. Herman. (2011). Wave attenuation by
two contrasting ecosystem engineering salt marsh macrophytes in the intertidal pioneer zone. Wetlands
31(6):1043-1054.
44
-------
7. Glossary
Glossary definitions were obtained from:
Harwell, M.C., C. Jackson, and J. Molleda. (2017). Managed Vocabulary for use of Ecosystem Goods
and Services in Decision-Making. U.S. Environmental Protection Agency, Gulf Breeze, FL,
EPA/600/X-17/168.
Area of Concern: Geographic areas within the Great Lakes where significant impairment of beneficial
uses has occurred as a result of human activities at the local level.
Benefits: A good, service, or attribute of a good or service that promotes or enhances the well-being of
an individual, an organization, or a natural system.
Buffering ecosystem services: "Regulating" ecosystem services that buffer from pollution and
environmental hazards (e.g., water filtration or heat hazard mitigation).
Classification system: A method to group individual elements or features into collections similar in
type, function, affiliation, behavior, response, or ontogeny.
Conceptual model: A written description and/or visual representation of known or hypothesized
relationships among variables in a system (e.g., human or ecological entities), often representing causes
and effects, environmental stressors, and/or potential management strategies.
Decision context: The environment in which a decision is made, and the environment that will prevail
when the effects of the decision are brought to bear, including the set of values, preferences, constraints,
policies, and regulations that will affect both the decision makers and those identified as the ultimate
beneficiaries.
Decision maker: Individual(s) or groups of people responsible for making choices or determining
policies that impact the functions, processes, and conditions of ecological systems. Decisions may be
local, regional, or national in scale.
Eco-health: Linkages between human health and ecosystem services.
Ecosystem goods and services: Outputs of ecological processes that directly ("final ecosystem
service") or indirectly ("intermediate ecosystem service") contribute to social welfare. Some outputs
may be bought and sold, but most are not marketed. Often abbreviated as ecosystem services, a common
descriptor for non-technical audiences when describing ecosystem goods and services.
Final ecosystem goods and services: Components of nature, directly enjoyed, consumed, or used to
yield human well-being. The final ecosystem goods or services is a biophysical quality or feature and
needs minimal translation for relevance to human well-being. Furthermore, a final ecosystem good or
service is the last step in an ecological production function before the user interacts with the ecosystem,
either by enjoying, consuming, or using the good or service, or using it as an input in the human
economy.
Health impact assessment: A means of assessing the health impacts of policies, plans and projects in
diverse economic sectors using quantitative, qualitative, and participatory techniques.
45
-------
Human well-being: A multidimensional description of the state of people's lives, which encompasses
personal relationships, strong and inclusive communities, meeting basic human needs, good health,
financial and personal security, access to education, adequate free time, connectedness to the natural
environment, rewarding employment, and the ability to achieve personal goals.
Human well-being index: An index of well-being for the U. S. based on indicators and metrics derived
from existing measures of well-being.
Intermediate ecosystem goods and services: Attributes of ecological structure or processes (including
functions, characteristics, and interactions) that influence the quantity and/or quality of ecosystem
services but do not themselves quantify as final ecosystem goods and services (because they are not
directly enjoyed, consumed, or used by beneficiaries).
Nonuse value: The value people hold for an ecosystem attribute or service that they do not use in any
tangible way. Sometimes referred to as "passive use value."
Place-based study: A research project focused on a specific geographic location or geographic type.
Revealed preference: Preference revealed through buying behavior.
Stakeholder engagement: A process through which stakeholders influence and share control over
initiatives and the decision and resources which affect them.
Stated preference: Preferences revealed from surveys or otherwise asking people directly how much
they prefer or value something.
Total economic value: The concept of total economic value involves measuring the value of the sum of
all flows -present or future- of natural capital provisioned by an ecosystem, including both use and
nonuse values.
Use value: The value of a good or service derived from its direct or indirect use (as opposed to nonuse
value). This includes direct and indirect values.
Weight of evidence: The process for characterizing the extent to which the available data support a
hypothesis that an agent causes a particular effect.
46
-------
8. Appendices
Appendix 1. Total Economic Valuation Overview
Monetary valuations provide values for various components of ecosystems, or provide proxy values for
the value of an ecosystem, using dollar values as the common currency. Methods for monetary valuation
can be divided into revealed or stated preferences. Revealed preferences methods seek to "reveal" the
implied values through an individual's choice by examining how environmental quality factors into
housing values (hedonic pricing), and distance traveled and amount spent for a recreational experience
(travel cost method). Stated preferences methods, including contingent valuation and choice
experiments, ask respondents through surveys to directly indicate their willingness to pay (WTP) for
quantities of ecosystem goods and services. Regardless of the chosen valuation method, all economic
valuation methods disaggregate the totality of ecoservices provided by an ecosystem. As such, valuation
efforts do not capture the total economic value (TEV) of an ecosystem (Figure 8.1). The concept of TEV
involves measuring the value of the sum of all flows - present or future - of natural capital provisioned
by an ecosystem, including both use and non-use values (Figure 8.1). Use values refer to benefits gained
from ecosystems, in such a way that beneficiaries use them. Use values include both consumptive (raw
materials, fisheries, livestock, etc.) and non-consumptive goods (recreation, spiritual, etc.), as well as
indirect uses, which include regulating and supporting ecosystem services (water purification,
pollination, etc.). Non-use values include bequest or existence values, in which a person derives utility
from the knowledge that future generations will have access to the ecosystem or that the ecosystem will
continue to exist, respectively (Pascual et al. 2010).
Altruist value
Existence
value
Indirect use
Direct use
Bequest
value
Use value
Actual Value
Altruism to
biodiversity
Non-use
value
Philanthropic
value
Consumptive
Non
consumptive
Total Economic Value
Figure 8.1 Ecosystem goods and services values typology within a TEV framework. Adapted from Pascual et
al. (2010).
The TEV framework provides an approach for conceptualizing FEGS to encompass all possible values,
but also inherently poses a challenge to valuation efforts- specifically monetization efforts. Uncertainties
within TEV assessments stem from: (1) the inability to identify all beneficiaries for a given FEGS or to
correctly address attribution between ecosystems; (2) the previously described challenges to quantify
non-use values; and (3) uncertainties related to valuation methodologies based on human subjects and
47
-------
their ability (or lack thereof) to understand/assign value to FEGS. Further, siloed academic discipline-
based perspectives and methods present a challenge both for discussing ecosystem service valuation
within multidisciplinary research teams and, more broadly, producing valuation information with
stakeholders and decision makers.
Mapping the flow of EGS within an ecosystem is an important step to determine TEV. However,
ecoservices flow between both adjacent and distant ecosystems, and these flows are critical for
ecosystem heath and resilience. For example, coastal ecosystems such as mangroves, seagrass beds, and
coral reefs are interconnected in a myriad of ways (Figure 8.2). If one of the fish species depicted in
Figure 8.2 is a commercially harvested species fished from the coral reef, which ecosystem would the
provision of the raw material (food source) be attributed to if the species in question requires the
presence of all three ecosystems for various stages of its ontogenetic development? This question is
representative of just one of the problems in determining a boundary for the flow of ecoservices among
ecosystems, which is essential to determine the TEV of a single ecosystem. Ecosystem goods and
services classification systems, including EPA's Final Ecosystem Goods and Sendees (FEGS-CS;
accessed 20, July 2017) and the European Environment Agency's Common International Classification
of Ecosystem Sendees (CICES; accessed 20, July 2017), focus primarily on the FEGS that an ecosystem
provides, and do not address these attribution considerations. An assessment of TEV requires precise
boundary settings of the ecosystem under scrutiny to avoid double-counting, or errors in sen ice
attribution.
Figure 8.2 Illustrating the challenge of identifying where (ecosystem type) and when (different life stages
denoted by letters A-G) to value an ecosystem goods and services component (fish) in complex ecosystems.
Adapted from Mumby et al. (2004) and Reef Resilience Network (accessed 26, May 2017).
Non-use values also present a challenge for assessing the TEV of an ecosystem. Non-use values are
passive benefits that people ascribe to the environment; for example, a person might obtain
psychological well-being from knowing that an ecosystem exists (existence value). Current monetization
methods do not sufficiently account for these values; certain monetization methods aim to assess a
market value that can reveal values associated with a desired ecosystem good or service, while others
aim to estimate marginal values for specific ecological or social attributes. However, it is not possible to
assess whether an individual would be willing to pay for a marginal increase within an existence value
because the unit is undefined. Further, some stakeholders and decision makers believe the monetization
of non-use values is inappropriate because they believe that spiritual, cultural, and other abstract values
that contribute to well-being cannot, or should not, be converted into a currency value. Finally, assessing
the whole of the beneficiary landscape is difficult because beneficiaries may not necessarily live near an
ecosystem they value and derive utility from its existence. For example, the Everglades in Florida
provide many ES primarily to residents of Florida and visitors. However, parts of the Everglades are a
48
-------
U.S. National Park, a World Heritage Site, and a UNESCO/Ramsar Wetland of International
Importance. Accordingly, the Everglades have beneficiaries worldwide who value its existence despite
never visiting the ecosystem.
Given the challenges associated with TEV, it is important to bridge the gap between how different
disciplines define and assess goals surrounding TEV. That is, in a multidisciplinary context, it is
necessary to recognize that each member of the team will perceive, construct, and approach economic
valuation research questions grounded within their respective discipline, and this discipline-specific
view will determine how each team member understands the ultimate goals for a project. Further, it is
important for the research team, stakeholders, and decision makers to understand the different
approaches that project partners use to conceptualize the study goals and plans to approach valuation
research questions. Doing so in an intentional manner can help build consensus on appropriate study
goals, how to reach those goals, and the appropriate interpretation of the findings across disciplines.
From a systems-thinking perspective, TEV may be an appealing approach to value FEGS. A systems-
level perspective of economic valuation attempts to outline all the various ways humans may derive
value from an ecosystem; this perspective may resemble the TEV model shown in Figure 8.1. From an
economist's perspective, it is important to acknowledge the challenges inherent within monetizing all
values identified in a TEV framework. For example, discrete choice experiments remain the most state-
of-the-art method that economists use to estimate monetary values for various ecological and social
attributes associated with an ecosystem; however, as a marginal analysis, it cannot effectively measure
non-use values. From a decision maker's perspective, it is important to understand whether information
from different disciplines represented among members of an interdisciplinary valuation team create a
disparity in understanding that will cause scientists to talk past one another (Lele and Norgaard 2005).
This is important in an ecoservices context because valuing benefits will require natural scientists, health
scientists, and social scientists to effectively communicate among each other. To address this challenge,
when measuring and valuing ecoservices in a multidisciplinary team, an important starting point is
establishing a common lexicon among team members and disciplines (e.g., Harwell et al. 2017, Munns
et al. 2015, McDonough et al. 2017). Interdisciplinary teamwork models focusing on cooperation and
mutual identification of communication, models, and approaches can be used to improve the efficacy of
conducting integrated, interdisciplinary research (MacMynowski 2007). By increasing communication
among team members and emphasizing the importance of not regarding the knowledge from any one
team member's discipline as superior or proprietary, researchers can cultivate a space in which
researchers feel comfortable exchanging ideas to develop interdisciplinary research solutions.
49
-------
Appendix 2. Simulating Eco-Health Benefits Using Data-Derived Models
For eco-health linkages that have been studied extensively, it is possible to apply functions based on
land cover classifications to estimate the current and future health benefits associated to EGS. Reduction
of respiratory disease, water and heat hazard vulnerability, and overall mortality are examples of
benefits that may be estimated through existing modeling tools (Table 8.1). These modeling approaches
vary in level of complexity and generally require some level of calibration using locally-collected data.
There are, however, very few health outcomes that can currently be modeled using available tools,
which reflects the current state of knowledge regarding eco-health linkages. Being able to estimate the
changes in a wider range of health benefits from a loss of EGS would require more primary research
studies that quantify these associations in a variety of contexts and multiple spatial scales.
Table 8.1 Available computer based modeling tools for estimating health consequences of Ecosystem
Services. Qualitative assessment of relative technical difficulty is based on data input requirements, software
requirements, and the availability of user guides and training tools. Adapted from Oosterbroek et al. (2016).
Modeling Tool EGS-Health Linkage Technical Reference
Difficulty
Enviro-Atlas
Clean Air-Respiratoiy Disease
Low
EnviroAtlas Interactive Man ("Accessed 16. August
2017)
Green
Infrastructure
Engagement with Nature-Mortality
Moderate/Low
Green Infrastructure Valuation Toolkit ("Accessed 16.
August 2017)
Toolkit
i-tree Eco
Clean Air-Respiratoiy Illness
Moderate/High
i-Tree Eco (Accessed 16. August 2017)
InVEST
Water Hazard Mitigation-
Vulnerability to Coastal Storms
Moderate/High
Natural Capital Proiect - InVEST (Accessed 16.
August 2017)
MIMES
Heat Hazard Mitigation-Heat
Morbidity/Mortality
High
Affordable Futures - MIMES (Accessed 16. August
2017)
50
-------
Appendix 3. Causal Criteria Analysis of Direct and Indirect Linkages Between Green
Spaces and Human Health Endpoints
An empirical causality assessment of these pathways between green spaces and human health endpoints,
specifically diseases linked to buffering EGS provided by green spaces, was conducted using the Eco
Evidence Analysis Software tool (Nonis et al. 2011). A total of 2,756 publications were screened
regarding potential eco-health linkages following the systematic framework outlined in the Eco
Evidence Analysis Software (Figure 8.3). Selected papers providing empirical evidence on one or more
of the intermediate or direct linkages (or both) were classified using the weights described in Table 8.2.
(see de Jesus Crespo and Fulford 2017 for more details).
F
Overview
1. Formulate question
2. Define the context
3. Describe conceptual model
4. Identify cause-effect linkages
5. Conduct literature review
6. Consider revisions
7. Weight the evidence
8. Draw conclusions
Eco Evidence Analysis Software provides a systematic framework for the evaluation of evidence for
environmental cause-effect relationships. The various steps can be grouped into 3 broad tasks:
Formulate the problem
Describe the problem of interest and formulate the question to be assessed
Define the context of the question
¦ Develop a conceptual model of the potential causes and effects
¦ Identify the potential causes-effect linkages that will be investigated
Search and review the literature
Describe the search strategy you used for the literature review
Summarise each of the citations consulted
Analyse the evidence from each citation to assess its relevance
Weight the evidence and judge causation
Weight the evidence according to the study design and sampling units
¦ View the generated analysis report
Figure 8.3 Screens hot of the Eco Evidence Analysis Software overview page.
51
-------
Table 8.2 Factors considered and weight of evidence scores for causal criteria analysis (modified from Norris
et al. 2011). A score of 20 was the threshold value for rejecting or supporting the causal linkage. This threshold
means that at least three high quality studies are needed for evidence of causality (Norris et al. 2011).
Factors Considered Weight Applied
I. Study Design
Before After Control 4
Impact (BACI)
Gradient Response 3
Model
Before v. After 2
Control/Reference v. 2
Impact
After Impact Only 1
II. Number of Control Locations
0 0
1 2
1+ 3
III. Number of Independent Impact Locations
1 0
2 2
2+ 3
IV. Locations for Gradient Response Model
3 0
4 2
5 4
5+ 6
Possible Outcomes *
Score in Favor Score Not Conclusion
in Favor
> 20 <20 Sufficient
Evidence in
Favor
<20 > 20 Sufficient
Evidence
not in
Favor
<20 <20 Insufficient
Evidence
>20 >20 Inconsistent
Evidence
*The scores are a result of summing the weights for each category. Factors categorized here as II and III are applied to all
design types except "gradient response". Category IV is only applied to "gradient response" designs.
Sufficient evidence was found showing green spaces help promote clean water and provide water hazard
mitigation, and that these EGS are causally related to GI disease (Table 2.2; de Jesus Crespo and Fulford
52
-------
2017). However, no studies were found directly linking green spaces to GI disease. This may be an
important area for future research because of its potential significant management implications. Studies
linking green spaces to GI disease should include considerations of exposure mechanisms, primary
sources of pathogens and whether it is feasible to use green space EGS for pathogen removal or
exposure prevention (Table 8.3).
Table 8.3 Considerations for developing a research agenda addressing the direct link between green spaces
and gastrointestinal (GI) disease, an area of limited empirical evidence but strong background support and
important management implications.
Sources of Pathogenic Microbes
Poor wastewater management
Leaky sewage
Combined sewage
Environmental Exposure Pathways
Consumption
Drinking water
Irrigated crops
Polluted fisheries
Recreation
Swimming
Wading
Fishing
Boating
Water Hazards
Contact with flood water
Contact with items affected by flood
Potential Role of Green Spaces
Constructed/Natural wetlands for wastewater management
Constructed/Natural wetlands for storm surge mitigation
Landscape level wetland/green space cover for runoff filtration
Landscape level wetland/green space cover for flood mitigation
Examples of hypotheses to be tested
The use of constructed wetlands should help reduce waste water pollution, improve irrigation water
quality and consequently lower GI disease prevalence in rural areas.
Landscape level green space cover should help mitigate flood exposure and consequently GI disease
prevalence in urban areas.
Fishing communities characterized by large extents of coastal wetlands and/or riparian buffers should
have healthier fisheries and consequently lower GI disease prevalence.
Estuaries with protected wetlands are likely associated to cleaner beach water, and consequently lower
GI disease prevalence among swimmers.
Potential Confounding Factors
Unknown waste water inputs
Impacted water flow (damming, clogging)
Unmapped sewage infrastructure
53
-------
There was sufficient evidence linking green spaces to clean air and green spaces directly to
cardiovascular disease (CVD) (Table 2.2; de Jesus Crespo and Fulford 2017). There was inconsistent
evidence found linking CVD to the EGS of clean air. This inconsistency may be due to the relatively
large number of studies evaluating this link (N=27), with a large variety of contexts and indicators (e.g.,
blood pressure, hospital admissions, blood clot formation, etc.) (Table 2.2). Identifying which
physiological responses associated to CVD are more sensitive to air pollution, and under which
circumstance this cause-effect relationship is observed could be the subject of future research (Table
8.4). Aside from clean air, alternative pathways linking green spaces to CVD include promotion of
physical activity and stress reduction. These factors were not assessed in this study, but they have been
shown to be key at moderating CVD risk (Lim et al. 2013) and have been associated to green space
cover (Richardson et al. 2013).
Table 8.4 Priority questions for a research agenda to evaluate the role of ecosystem goods and services
provided by green spaces on human health (GI - gastrointestinal, CVD - cardiovascular disease).
ECO-HEALTH PRIORITY QUESTIONS
LINKAGES
GREEN SPACES-CLEAN"
WATER/POLLUTED
WATER-GI DISEASE
Is GI disease prevalence related to green space measures (presence, % cover, etc.) in areas
exposed to water pollution? (see also Table 3)
GREEN SPACES-WATER
HAZARD
MITIGATION/WATER
HAZARDS-GI DISEASE
Is GI disease prevalence related to green space measures (presence, % cover, etc.) in flood prone
areas? (see also Table 3)
GREEN SPACES-WATER
HAZARD
MITIGATION/WATER
HAZARD S-RESPIRAT ORY
ILLNESS
Is mold more common in houses prone to natural flooding? Does household mold correlate to
asthma?
GREEN SPACES-CLEAN
AIR/POLLUTED AIR
RESPIRATORY ILLNESS
What are the best indicators to detect the impact of air quality on respiratory illnesses (e.g.,
oxidative potential vs pollutant mass)?
Are there consistent confounding factors (demographics, seasonality) determining the impact of
air pollutants?
Could we define transferable green space restoration guidelines to enhance pollution removal and
reduce allergen potential?
How can we incorporate flow dynamic principles into the design of green space restoration to
deal with the issue of re-circulation?
GREEN SPACES-CLEAN
AIR/POLLUTED AIR-CVD
What are the best indicators to detect the impact of air quality on CVD (e.g., inflammatory
response, coagulation, CVD prevalence)?
Are there consistent confounding factors (demographics, seasonality) determining the impact of
air pollutants on CVD?
What is the main mediator between green spaces and CVD-physical activity or clean air?
54
-------
There was inconsistent evidence linking green spaces to respiratory illness (de Jesus Crespo and Fulford
2017). This is in part because certain types of vegetation act as a source of allergens (e.g., pollen; Lovasi
et al. 2013), and because, depending on tree and building configuration, particles trapped by trees may
be re-circulated, exposing nearby communities (Wania et al. 2012). There were also inconsistencies
regarding the intermediate pathway linking clean air to respiratory illness. The types of clean air
indicators used may help explain this inconsistency. Traits such as oxidative potential, which strongly
influence inflammatory response (Delfino et al. 2013), may better correlate to respiratory illness than
mass of air pollutants, which is the most commonly-used indicator. Future studies may focus on
oxidative potential and the role of green spaces at mitigating this impact.
Insufficient evidence was found to support the link between water hazard mitigation and respiratory
illness (de Jesus Crespo and Fulford 2017). No study has looked at the direct connection between green
spaces and respiratory illness through this eco-health pathway so this potential linkage cannot be
validated.
The best supported linkage was between green spaces and prevention of heat morbidities. This eco-
health linkage may be prioritized for management action related to efforts to protect vulnerable
communities such as the elderly, especially within cities affected by urban heat islands.
Overall, most of the current eco-health literature supports findings of intermediate steps (e.g., ecosystem
to buffering EGS and buffering EGS to human health), but there is limited support for direct linkages
from ecosystem (green spaces) to human health (disease endpoints). Few studies have involved
measures for each step of the eco-health relationship pathway. Determining whether green space
management delivers human health benefits through buffering EGS is still an area of research in need of
development. Based on these results, priority questions are outlined in Table 8.4 to help guide future
research on this topic.
55
-------
Appendix 4. Issues of Data Accessibility and Granularity in Mapping Human Health
Outcomes as Part of Eco-Health Studies
In mapping human health outcomes as part of eco-health studies, there is a tradeoff between data
accessibility and granularity. At large scales (e.g., state, metropolitan area, and county level), data are
accessible generally without restrictions or the need to request approval from the organization/agency's
Institutional Review Board (IRB). In addition, behaviors that can pose health risks, access to healthcare
and certain self-reported health outcomes are estimated at the census-tract level for selected
metropolitan areas across the United States (e.g., Center for Disease Control's 500 Cities project). Some
examples of these available datasets are included in Table 8.5.
Table 8.5 Examples of available human health datasets.
Dataset Finest Scale EGS related health outcomes Source
CDC Wonder
(Mortality by
Cause, Cancer
Diagnoses, TB
cases, STD
morbidity)
County;
Metro Area
Causes of Death-ICD-10 codes
CDC Wonder - Mortalitvbv Cause
(Accessed 16, August 2017)
Morbidity and
Mortality Weekly
Report
(National
State
Notifiable diseases such as cholera,
malaria, yellow fever, vibriosis, among
others.
CDC Wonder - Morbidity and Mortality
Weekly Report (Accessed 16, August
2017)
Notifiable
Diseases)
Community
Health Status
Indicators
(health profiles,
risk behavior,
access to health
care)
County
Stroke, diabetes, cancer, heart disease,
chronic lower respiratory disease,
asthma, kidney disease, obesity, physical
inactivity, depression.
CDC Community Health Status Indicators
(Accessed 16, August 2017)
Health, USA
(disease, health
insurance, risk
factors, etc.)
National,
Geographic
Region
(North, South,
East West)
Mental health, cancer, infectious
diseases, obesity, hypertension, diabetes,
age adjusted death rates, physical
activity, notifiable diseases.
CDC - Health (Accessed 16, August 2017)
USGS Disease
Maps (zoonotic
diseases)
County
West Nile Virus, Dengue Fever,
Chikungunya, E astern/Western Equine
Encephalitis, La Crosse Encephalitis
USGS Disease Mans ("Accessed 16.
August 2017)
56
-------
Dataset Finest Sccde EGS related health outcomes
Source
500 cities project Census tract Asthma, blood pressure, cholesterol,
(riskfactors, (for select heart disease, chronic obstructive
health outcomes) cities) pulmonary disease, kidney disease,
mental health, stroke, diabetes, obesity,
mental health, physical activity
CDC - 500 Cities Project (Accessed 16,
August 2017)
These datasets however, have limited applicability for assessing the role of EGS on health. Most are
summarized at large spatial scales, which provides an incomplete understanding of the level of exposure
to environmental hazards and key EGS. The 500 Cities Project (500 Cities Project: accessed 20, July
2017) is useful in this sense, but it provides estimates on only a subset of health indicators, which may
not relate to the EGS of interest. Another limitation is that data are generally aggregated on an annual
basis or longer timespans making it difficult to establish associations to events of interests such as heat
waves and floods and hazard mitigation services. For gathering empirical evidence associating health
and environmental factors that vary in time and space, the level of detail offered by readily accessible
datasets is often not enough.
Acquiring finer-scale health data may require the collection of primary data through field work or
establishing collaborations with health providers or local health agencies that may have access to non-
public datasets. Often these datasets come with restrictions associated to personally identifiable
information (PII) and require IRB approval prior for their use in analysis. Certain datasets may be
acquired through the purchase of licenses for specific timeframes. An example of this is the use of
Medicare Claims data, which is common in research because it is standardized across the nation, and
allows associating disease occurrence with specific time intervals and therefore hazard events of interest.
Medicare Claims Data can be acquired through services such as University of Minnesota's Research
Data Assistance Center (Research Data Assistance Center; accessed 20, July 2017), among others.
The following is a list of considerations to help guide studies focusing on Eco-Health linkages:
Interdisciplinary aspects: Health and environmental scientists may have different analytical
perspectives and are trained to address common challenges such as confounding factors,
controls, and replicates using different methodologies and terminologies. Ideally, Eco-Health
studies should be developed as collaborative, multidisciplinary projects between, for
example, ecologists, epidemiologists, and social scientists to ensure rigorous design and
execution. This may not always be possible, in which case, researchers are advised to at least
become familiarized with these differences and acknowledge the potential limitations and
biases.
Temporal and spatial differences: Researchers may have high-quality, fine-grain health data
for a study, but only poorly-defined environmental and EGS datasets to establish
comparisons, or vice versa. This is a source of error and uncertainty that must also be
acknowledged. Researchers should adhere to principles of extrapolating data to different
scales (e.g., Miller et al. 2004) and report such approaches to promote consistency and
transparency. Medical coding: Acquiring health data requires gaining familiarity with the
International Statistical Classification of Diseases and Related Health Problems (ICD;
accessed 17 August, 2017) coding system, which has several versions, with specific codes for
each medical diagnosis. Different sources may use different versions of the classifications
(ICD-9, vs ICD-10), and codes vary based on the level of specificity (e.g. ICD 9 code,
Intestinal infection due to other organisms: 008; Intestinal infection due to entero-pathogenic
57
-------
E. coir. 008.01). This is especially relevant for accessing insurance claims data and hospital
admissions data.
Big data: Studies that include health benefits may use data from hospital records and
insurance claims, often available on a daily basis. These data are generally analyzed within
large timeframes to account for disease seasonality or lag times between exposure and
disease occurrence. The resulting datasets may therefore include thousands of entries that
may present storage and manipulation challenges especially when combined with similarly
large long term environmental information. Strategies for synthesizing, analyzing and storing
this information should be considered during the planning process.
58
-------
Appendix 5. Limitations to Current Social Science Research at ORD
In EPA's ORD, barriers to conducting social science research include the lack of an Institutional Review
Board (IRB) within ORD and challenges in obtaining an Information Collection Request (ICR) from the
Office of Management and Budget (OMB).
The IRB is an administrative body within a research institution that aims to protect human participants
within scientific studies. Researchers using human subjects within their studies design protocols to
safeguard confidentiality, collect informed consent, convey all the risks associated with the study, and
other measures designed to ensure the fair treatment of all subjects and protection of their rights. Social
science studies generally pose minimal risk to participants as they primarily include surveys and
interviews. However, an approval by the IRB is still needed to proceed with this type of research before
data collection begins. The lack of a transparent and predictable process surrounding how a social
science researcher within ORD who does not have a university-affiliated researcher on their team to
obtain an IRB approval may discourage researchers to pursue more rigorous social science methods in
favor of less generalizable methods that fall outside the purview of the IRB.
In addition to obtaining IRB approval, researchers within the federal government must also prepare an
ICR for OMB approval as part of the Paperwork Reduction Act (PRA; accessed 20, July 2017). The
OMB must approve an ICR before any federal agency begins information collection through surveys
or questionnaires from 10 or more members of the public. The process for ICR approval takes
approximately six to nine months and includes two periods for public comment and two separate review
periods. Studies that warrant an ICR include primary data collection methods within the social sciences
and create an additional burden on government and government-affiliated researchers in meeting this
requirement. As part of the ICR, draft materials, such as survey instruments and supporting
documentation, will need to have already been completed in the event that members of the public
request the materials as part of the public review/comment periods. Drafting a survey instrument can
take between six months to a year, and the survey might still need further refinement through focus
groups and expert consultation. Although the six to nine-month period could be used to further develop
a survey instrument, significant effort will have already been needed to design the survey, which further
elongates the timeline towards project completion. Finally, EPA researchers must also receive approval
from the Human Subject Research Review Official (HSRRO; accessed 20, July 2017), in addition to the
IRB and the ICR. The HSRRO is charged with ensuring that all human subject research conducted
within EPA are subject to EPA regulations. The HSRRO requires that an IRB approved research
protocol must be in place before their approval is granted.
Conducting research within EPA that aims to understand how human populations value or consume
benefits derived from the environment inherently results in social-science challenges. In addition to the
burdensome operational requirements in the form of obtaining three separate approvals (IRB, HSRRO,
and ICR), the lack of a clearly defined process that outlines how researchers should complete these
approval processes with the necessary documentation at each step further complicates how researchers
obtain these approvals. Developing a streamlined process that integrates the requirements for all
approvals, and a clearinghouse for information about these processes, would be beneficial to researchers
and provide more clarity on how to initiate these studies.
There are, however, many ways in which researchers interested in using social science methods can
pursue conducting ecosystem services valuation research. First, researchers can choose to limit their
investigations to nine people or less to avoid the need for an ICR. Second, for researchers who opt for 10
or more participants in their study, they can utilize a few generic OMB clearances, such as the Citizen
Science and Crowdsourcing Projects (accessed 20, July 2017) initiative or the Focus Groups as Used by
59
-------
EPA for Economics Projects (accessed 20, July 2017), to streamline a portion of the research approvals
process. However, researchers must carefully consider the limitations of each generic clearance and
design around these challenges, as they may limit data collection methods or statistical extrapolation.
Finally, researchers can try to utilize existing data to fill in data gaps. Public meetings and local
meetings held by relevant stakeholder groups can provide a wealth of knowledge on community
priorities and values, along with opportunities to speak to the public in an informal manner. Data and
information from public reports and social media also represent opportunities to understand how the
public is interacting with ecosystems, and which ecosystem goods and services are valued.
60
-------
Appendix 6. Innovative/Alternative OSDS Under Consideration
Suffolk County Chooses Four Vendors for Round One of Demonstration of Innovative Alternative
Onsite Wastewater Treatment Systems: 2-4-2015
Suffolk County has selected four firms with proprietary nitrogen removal technology- BUSSE Green
Technologies, Hydro-Action Industries, Norweco and Orenco Systems - to participate in Round One of
the Suffolk County's demonstration of innovative/alternative OSDS program.
The selection followed a thorough review conducted by the selection committee consisting of
representatives from the County Departments of Economic Development and Planning, Health Services,
and Public Works. As part of the evaluation, the selection team looked at the applicants' system
approvals on national and state level, financials, treatment process, effluent testing data, performance in
comparable climate conditions, as well as the costs of the installed system and annual maintenance. All
of the selected vendors previously demonstrated average effluent concentrations of total nitrogen equal
to or below 19 mg/1 (i.e., nitrogen reduction of 50% or more).
Three vendors (BUSSE, Hydro-Action, and Norweco) have been recommended for demonstration of
their systems on private residential properties. The fourth vendor (Orenco) was recommended for
demonstration of its systems on county municipal property. The self-reported costs of advanced
treatment systems proposed by three firms ranged from $5,000 to $16,500 installed; the cost of a system
proposed by the fourth firm was $23,000 installed. The annual maintenance cost for all systems ranged
from $200 to $600 per year. In addition, one non-proprietary treatment technology constructed
wetlands - has been added to the demonstration program and is expected to be tested on select county
parkland residencies and town park settings. Additional information about four selected vendors is
provided below.
BUSSE technology has been installed in Maine and Massachusetts. It was also approved in
Maryland and New Jersey. BUSSE MF. the system proposed for demonstration, utilizes
Membrane Bio Reactor (MBR) treatment process. MBR technology combines biological
treatment with a membrane filtration into one unit process and, as such, requires smaller
footprint.
Hydro-Action technology has been installed in Illinois and Ohio (n = 7,700 systems in IL and
5,600 systems in OH) and several other states, according to the firm. Hydro-Action AN
Series, the system proposed for demonstration, uses extended aeration activated sludge
process in which microorganisms that treat wastewater remain in the treatment process for a
longer period of time (more than 24 hrs.).
Norweco technology has been approved and installed in Massachusetts (n = 140 systems),
Maryland, Ohio, and Rhode Island. Norweco Singulair TNT and Hydro-Kinetic are two
systems proposed for demonstration project; both systems use extended aeration activated
sludge process.
Orenco technology has been approved and installed in Massachusetts (56 systems), Maryland, Rhode
Island, and several other states. According to the firm, more than 20,000 Orenco systems have been
installed in the U.S. and Canada. Two systems proposed for the demonstration, Orenco Advantex AX-
RT and Advantex AX. use attached growth packed bed reactor process where microorganisms
responsible for biological treatment are attached to textile media.
61
-------
Appendix 7: Contaminated Site Remediation to Habitat Restoration to Community
Revitalization (R2R2R) in the Great Lakes' Areas of Concern (AOC)
In many ways, the progression of community revitalization in Areas of Concerns (AOCs) represents the
next evolution of advancement in AOCs in environmental restoration. The City of Duluth, Minnesota is
located adjacent to the St. Louis River, one of the 42 AOCs in the United States and Canada identified in
the Great Lakes Water Quality Agreement (GLWQA). Areas of Concern are geographic areas
"designated by the Parties where significant impairment of beneficial uses has occurred as a result of
human activities at the local level (U.S. EPA and Environment and Climate Change Canada 2012)." In
other words, many of the beneficial uses of the ecosystem (in essence, ecosystem goods and services)
are impaired. Fish and wildlife populations, benthos health, water for drinking, beach-going, safe fish
consumption, and aesthetics are among the beneficial uses of the environment that could be impaired
because of the compromised water, sediment, and habitat quality. Restoring beneficial uses of the
ecosystem will provide final ecosystem goods and services that contribute to human well-being, like fish
for sustenance and recreation, wild rice for habitat and spiritual connection, and scenic views.
To restore the Beneficial Use Impairments (BUI), state agencies and Public or Citizen Advisory
Councils (P AC) have developed Remedial Action Plans (RAP) to identify the problems in each AOC, as
well as the actions needed to remove the BUIs. It is important to note that nearly all of the attention to
improving water quality in the Great Lakes through GLWQA-related actions have been focused on the
aquatic ecosystem. But, stakeholders throughout the region, the EPA Great Lakes National Program
Office, and EPA Office of Research and Development scientists are starting to recognize aspects of
development in the communities adjacent to AOCs and ask how contaminated sediment remediation and
aquatic habitat restoration are related to community revitalization (Angradi et al. 2016, Williams and
Hoffman 2017).
There are community examples where one of the mechanisms used to clean-up AOCs, the Great Lakes
Legacy Act, has been utilized to transform degraded waterfront by removing contaminated sediments
and restoring aquatic habitat. A new resort and marina facilities in Sheboygan, Wisconsin, and a
brewpub and adjacent business revitalization in Milwaukee, Wisconsin, demonstrate the potential for
reclaiming and utilizing formerly degraded waterways. The EPA Great Lakes National Program Office,
which is responsible for cleaning-up AOCs, uses the term "R2R2R" or "R3" to characterize this process
of remediating contaminated sediments and restoring aquatic habitat to help revitalize coastal
communities.
It is not yet clear exactly how sediment remediation and habitat restoration can help spur community
revitalization, especially in the context of AOC delisting. One of the complications is that the AOC
delisting process involves multiple layers of program and funding interactions. For example, sediment
remediation and habitat restoration activities are often the responsibility of state agencies who solicit and
manage federal funding from the EPA and other agencies, but also must coordinate efforts of
cooperating federal, state, and local organizations. Furthermore, another complicating factor in R2R2R
implementation is the difficulty in communicating and aligning remediation, restoration and
revitalization goals among federal and state agencies, tribal governments, local government entities,
nonprofit organizations, and citizens. Another complicating factor is that because the AOC program is
an aquatic program, AOC boundaries are most often at the shoreline. On the other hand, community
redevelopment or revitalization, including brownfields reclamation, often unfolds simultaneously in the
communities next to the AOC. More often than not, these processes occur in parallel to each other -
separate and not intersecting.
62
-------
Because the benefits of restoration are defined for organizations and individuals based on their personal
and professional experiences and responsibilities, it is paramount to find methods to relate the values
articulated by actors to each other. Early successes from the AOC program demonstrate that federal and
state remediation and restoration projects to remove impairments and restore EGS can achieve stated
goals if the activities engage citizens, leverage ongoing community redevelopment (revitalization)
objectives, and aligned with community values (Krantzberg 2012). Given the importance of aligning
AOC goals for the aquatic ecosystem with the community vision for waterfront neighborhoods, it is
likely that both the change in EGS related to a R2R2R project and the R2R2R process that restores EGS
are equally important to improving community well-being.
63
-------
Appendix 8: Neighborhood Model Tool: Mapping the Human Ecosystem for a Place
Overview
The neighborhood model is an interpretive or
translational tool designed to help identify
how elements of the environment (built,
social, or natural) contribute to well-being. In
this case, the environment may consist of
more than the biophysical elements.
The neighborhood model is an organizational
tool to sort and classify data collected
through inductive research methods like
document or archive analysis or participant
observation (Figure 8.4). Inductive methods
facilitate the identification of lived experiences, or day-to-day practices that might be taken for granted,
through the participation in events or collection of materials that were created for a purpose important to
the organizers or authors. Cheng et al. (2003, p. 96) argued that the physical environment is "not an
inert, physical entity 'out there'.. .but a dynamic system of interconnected, meaning-laden places." The
tool is meant to disentangle and classify some of the place meanings in order to better understand how
the environment influences (positively or negatively) community life and how environmental attributes
might be valued.
Attribute definitions
The neighborhood model tool identifies many neighborhood components that individuals, organizations,
local governments may discuss in the context of their community. The characteristics are a mix of built
environment types, structural dimensions, personal experiences, and human-environment relationships.
The assemblage of attributes functions like a framework and can be broken into four broad categories.
Definitions for each type of attribute are listed in the Methodology section.
Role of critical questions
Critical questions are guiding questions meant to direct the analyst's attention toward the reasons that a
particular item might have been included in a document (i.e., they have particular meaning for the
neighborhood, organization, document author or other entity in question). Recognition and
documentation of such details in environmental research might be a way to integrate local knowledge
into inquiry. The application of the framework is meant to shift the discussion away from residents want
"x," to why "x" is important for residents. Changing the direction of the conversation is important
because "x" is often context dependent - as in the context of the neighborhood or geographic area. The
item in question is attached to something else that is an essential element to how "x" is perceived to be
important for residents. A set of critical questions for each attribute are listed in the Methodology
section.
"Furthermore, engaging in environmental restoration
work may provide benefits to workers beyond simple
employment, including exposure to and interactions
with nature, which is a limited "commodity" in many
urban locations. In short, cities are habitat for people,
so the urban design process should include city
residents and integrate a social component into design
objectives and actions."
(Childers et al. 2015: 3778; emphasis added)
64
-------
These categories reflect the
relationship people have with the
environment.
Sustainability
or resilience
Aesthetics
These categories
reflect the
neighborhood
attributes with
which people most
engage.
Trails or
connections
Housing
Schools or
education
Parks or
public spaces
Neighborhood
orspatial unit of analysis
Infrastructure
Economy
Governance
or rules
Demographics
Natural features
Local businesses
Anchor
institutions
Crime
Participation
Identity or place
attachment
Social cohesion
Safety
These categories
reflect the personal
attachments to self,
community, and
identity that might
motivate action.
The structural dimensions of the community
that shape how people and organizations
navigate their neighborhood.
Physical environment is in this category
Figure 8.4 Neighborhood diagram. The different colors of text represent how individuals might interact with
individual attributes. Blue text attributes are representative of the built environment, the reasons that individuals
might choose their neighborhoods, or what cities plan to change. Black text attributes are structural dimensions,
or the important elements that are fixed, part of larger process, or expressed in statistics. Orange text
characteristics reflect personal attachments, values, or motivations of individuals. Finally, the green text
attributes represent human-environment relationships.
Methodology
A two-step process can be used to guide in the coding of text-based data:
1. Decide to which broad category, and the subsequent attributes, a piece of text data belongs: (1)
engaging attributes (parks, trails, housing, schools); (2) physical environment attributes
(infrastructure, economy, anchor institutions, governance (or rules, politics, program
requirements), natural features, demographics, crime); (3) personal attachment attributes (safety,
identity, self-determination or participation, identity or character, or social cohesion); or (4)
relationship with the environment attributes (sustainability, aesthetics).
2. Conduct a content analysis on the answers to the critical questions for each category. The pattern
that emerges reflects what the identified element contributes to well-being as defined by the
source of the text data.
65
-------
ENGAGING ATTRIBUTES
Parks
People visit parks to relax, commune with nature, find peace, be with friends, play sports, or experience
other recreation (Chiesura 2004). Parks are an integral part of a sustainable city. Access to quality parks
and greenspace is often cited as a positive contributor to health and well-being.
Critical questions:
What do residents the authors document say about the parks?
o Are they a place to gather?
o A place to avoid?
o A place for events?
What do people do in the parks?
o Both positive and negative
Trails or Connections
Trails can connect neighborhoods to each other, as well as amenities and other destinations. Trails can
be considered both linear parks and infrastructure for transportation. "The cities that are deemed most
vibrant and alive are the ones where large numbers of people move around outside their cars in the
public realm (Erickson 2006, p. 139)."
Critical questions:
What do residents/the authors/document say about the trails?
o Are they for transportation?
o Do they link the neighborhood to important things?
¦ Businesses
¦ Features or points of interest
¦ Important resources (water, scenic places)
¦ Cultural resources
o Something to avoid?
¦ Go by dangerous undesirable sites
¦ Not enough lights
¦ Trash, debris, industry (smells bad)
¦ No
Important for visitors
o Both positive and negative
o From the suburbs or somewhere else nearby
o From far away (tourist destination)
Housing
Community advocates argue that overburdened neighborhoods are impacted by multiple environmental
stressors (Morello-Forsch et al. 2011). Community leaders further contend that social factors including
housing quality and neighborhood composition may impact long-term well-being. "We conclude that
current environmental policy.. .should be broadened to take into account the cumulative impact of
exposures and vulnerabilities encounter by people who live in neighborhoods consisting of largely racial
or ethnic minorities or people of low socio-economic status (Morello-Forsch et al. 2011, 879 abstract)."
66
-------
Critical questions:
What do residents/the authors/document say about housing?
o Is the housing adequate?
o Does the document refer to the demographics of the residents?
o Talk about foreclosures tear-downs?
Does the document mention vacant lots?
Opportunities for building?
Substantial repair?
What is the voice of the document?
o Protective of the neighborhood?
o A need to change or improve the neighborhood?
Schools/Education
Schools are a critical community resource for learning, community cohesion and sometimes other basic
needs. Schools are the place where children spend a lot of time - in class and in after-school activities.
Additionally, schools can be important to the identity of the neighborhood, especially through sports.
Scholars argue that the quality of schools is often linked to the quality of the neighborhood.
Critical questions:
What do residents the authors document say about the schools?
o Are they a place to gather?
o A place to avoid?
o A place for events?
o A place to learn?
o A place to access services?
What do people do in the schools?
o Both positive and negative
Do they (the source of the documents or notes) mention intergenerational programming?
Are the schools a source of pride?
Is there a neighborhood school or is the school somewhere else?
PHYSICAL ENVIRONMENT ATTRIBUTES
Infrastructure
Infrastructure shapes and facilitates how people move around their neighborhood. Roads, sidewalks,
water/sewer, street lights, interstates, ports, pipelines can enhance or detract from connectivity and/or
quality of life in the neighborhood - including public transportation.
Critical questions:
What do residents/the authors/document say about infrastructure?
o It is in good/bad repair?
o It works well/does not?
o It enhances/detracts from the neighborhood?
o Infrastructure serves.. .residents? Industry?
o It directs users to or away from the neighborhood?
67
-------
Natural Features
The dominant natural features shape neighborhood layout, experience, and affect (or disaffect). Parks
are often the access points to natural features like hills, grasslands, rivers and streams. Natural features
include topography, water, vegetation, and climate. In Sustainable and Healthy Communities research,
natural features may be an ecosystem service or an indicator of an ecosystem service.
Critical questions:
What do residents/the authors/document say about natural features?
o Water bodies, rivers/streams, rocks (including bedrock), mountains, soil
Do they mention natural features?
Does the neighborhood have access or do they want it?
Is the natural feature a positive feature?
Is it or has it been a hazard?
Why was it mentioned?
What do they want to do with it?
Government (any level) or Rules
Government might be local, state, or federal governments. These governmental entities might be
impacting the neighborhood in positive and/or negative ways. Government may be repairing something
in the landscape (e.g., road, park, water/sewer line, interstate highway), creating plans (e.g., land use,
site, neighborhood) for the neighborhoods or whole city. A short hand for knowing whether government
is the right category is if there is something wrong - is there an office that someone might call to get the
problem resolved?
Critical questions:
What do residents/the authors/document say about natural features?
o Water bodies, rivers/streams, rocks (including bedrock), mountains, soil
Do they mention natural features?
Does the neighborhood have access or do they want it?
Is the natural feature a positive feature?
Is it or has it been a hazard?
Why was it mentioned?
What do they want to do with it?
Demographics & Crime
Demographics and crime (i.e., statistics, numbers, or objective data) are generally large datasets that
summarize the characteristics that can be counted and aggregated for a geographic area. The most
common source of demographic data is the U.S. Census Bureau. The Pew Research Trust, the Centers
for Disease Control, and the National Oceanic and Atmospheric Administration, and local governmental
entities, have all analyzed the data to produce demographic-base products (i.e., the Social Vulnerability
Index).
Critical questions:
What do residents/the authors/document say about demographics or crime?
o It is in good/bad for the neighborhood or geographic area?
o It enhances/detracts from the neighborhood?
68
-------
o It directs visitors or residents to or away from the neighborhood?
Why was it mentioned?
Economy
Economy in the context of document analysis might include: discussion of the macro-economy (e.g.,
national economy and how it impacts the neighborhood - like the loss of large industrial manufacturers);
local economy and local businesses; the purchasing behavior of residents; development of industrial
sectors (e.g., tourism, retail, agriculture, or manufacturing); and/or property values.
Critical questions:
Do residents/the authors/document discuss any economic indicators?
o Discussed as a positive or negative for the neighborhood or geographic area?
o It enhances/detracts from the neighborhood?
o It directs visitors or residents to or away from the neighborhood?
Health Care and/or Facilities (Anchor Institutions)
The presence of health care facilities and pharmacies in a neighborhood is an important indicator of
access to care for families and the elderly (less mobile). At the same time, the presence of such facilities
is considered assets. Place-based enterprises like universities, hospitals and cultural institutions are
important foci of community redevelopment efforts.
Critical questions:
What do residents/the authors/document say about health care facilities?
o It is in good/bad for the neighborhood or geographic area?
o It enhances/detracts from the neighborhood?
o It directs visitors or residents to or away from the neighborhood?
Why was it mentioned?
PERSONAL ATTACHMENT ATTRIBUTES
Safety (lighting, traffic, etc.)
Safety, a rather large concept, is "the condition of being safe from undergoing or causing hurt, injury, or
loss (Safety 2017)" In a neighborhood, there are any number of conditions that could cause harm:
environmental conditions that promote the growth or movement of disease vectors; exposure to risk
(e.g., air or water pollution); inadequate lighting; poorly maintained infrastructure; hazardous traffic
conditions. In many ways, safety issues are the conditions that cause residents or other stakeholders to
contact governmental entities. If crime is mentioned and coded in this section, it means the
author/speaker feels that their personal safety is threatened by perceived crime.
Critical questions:
What do residents/the authors/document say about safety?
o It is in good/bad for the neighborhood or geographic area?
o It enhances/detracts from the neighborhood?
o It directs visitors or residents to or away from the neighborhood?
Why was it mentioned?
Participation (desire to/opportunity for/capacity to)
Participation or participatory democracy is often held up as a method for improving environmental
69
-------
decisions that impact the public by giving residents a voice in the process. In short, citizens often (not
always) want a voice in their own neighborhood's development. In fact, the outcome may not matter - a
seat at the table and knowing they were heard is sometimes enough.
Critical questions
Do residents/the authors/document mention a desire to participate?
If so, why?
Are they asking for any particular thing or are they asking to be part of the process?
Identity and Place Attachment/Character
Identity is complex and can include the personal, political, social, or organizational. Identity is a
function psychological processes, but might manifest themselves in a number of ways in neighborhoods
or communities. Identity with a neighborhood or place can be affective, reactionary, and protective
based on the type of connection to the place.
Identity and place are also contested terms and might result in competing definitions of the potential
value of a place. For the purpose of this guide, identity will refer to how a group (neighborhood or
otherwise) describes itself or origin; how the place is rooted in history; and/or how the group identifies
the space they claim.
Critical questions
How residents/the authors/document describe themselves?
o Do they articulate a claim for a particular place (e.g., this neighborhood is...)?
o How/do they describe history?
o What do the residents/authors/document want to protect?
Social Cohesion (Local Groups, Organizations, Churches)
Local organizations, including service and advocacy groups, are important resources in a community.
They are potential community assets, knowledge brokers, gatekeepers and collaborators. Religious
communities, libraries, block groups, park organizations, cultural or neighborhood groups might all be
reflections of collective action in the area.
Critical questions
Are local organizations mentioned by residents/authors/document?
Are these groups considered stakeholders?
How are they described? What are their roles?
RELATIONSHIP WITH THE ENVIRONMENT ATTRIBUTES
Sustainability
Sustainability could mean sustainability in the intergenerational equity sense (Summers and Smith
2014), or might mean how the neighborhood can be sustained and less vulnerable to elements like
pollution, flooding, loss of jobs or food insecurity. Sustainability can refer to how a neighborhood
enhances its own sustainability or builds resilience including neighborhood beautification, other
placemaking activities, community gardens, or green infrastructure.
Scholars debate sustainability, but many are beginning to recognize that sustainability is a process that is
or should be inclusive, interdisciplinary, and intentional. Sustainability might be reflected in any strategy
70
-------
that attempts to improve well-being of both humans and the environment simultaneously.
Critical potential indicators (not an exhaustive list):
Food security or community gardens
Green infrastructure
Floodplain enhancement
Trees/shade/temperature control
Targeted plantings
Improving ecological function for the human population
Aesthetics (i.e., how the neighborhood should look)
One definition of aesthetics is the governing principles that define an idea of beauty at a particular time
or place (Aesthetics 2017). Furthermore, landscape ecologists have argued that what makes a landscape
pleasing is context dependent and limited to the "human perceptual realm" (Gobster et al. 2007).
Critical questions
Do residents/the authors/document mention changing the landscape to change their experience
with some element in the neighborhood?
o It could be positive.. .want to enhance views of a feature
o It could be negative and framed as a buffer to some element that detracts from the
neighborhood experience, (e.g., a buffer for noise, sound, smells)
If so, do they describe why the enhancement would be important?
"The environment is not an inert, physical entity "out there" with trees, water, animals, and the like,
but a dynamic system of interconnected, meaning-laden places. Biophysical attributes may be the
most obvious features of places; however, those attributes are constantly altered by social and
political processes (e.gpersonal experiences, community uses, regional economic production,
national conservation policies) and vary greatly in their social and cultural significance."
(Cheng et al. 2003, 96; emphasis added)
Example
As an example, a set of comments from a neighborhood planning exercise were sorted according to the
model. All comments regarding how participants felt the neighborhood should look were coded as
"aesthetics", one attribute within the broader category of human-environment relationships. The source
of comments is provided at the end of each comment.
Aesthetics
Cohesion and design
Consult local organization/urban design student plans for reuse site. (Stakeholders)
Major arterial road lacks the presence of businesses that provide "cues" to the proximity
of the nearby trail system. (Technical advisors)
Major arterial road needs an "amenity plan" that extends from the business area down to
the recreational hubs further to the west. E.g., banners. (Technical advisors)
Entrance to arterial highway has blight and lots of scrub vegetation.... if this were cut
down and cleaned up, it would make a more inviting entrance to the regional recreation
71
-------
area. (Conservation organization)
Buffers, mitigation, and hazards
Neighbors have voiced desire for a buffer between railroad and back alley on truck route.
(Stakeholders)
Green-up the area along interstate/near the former school to mitigate air pollution
from the interstate and paper mill. Questions paper mill's odor monitoring; references
treatment plant's program that ties monitoring with permitting. (Technical advisors)
Jake Braking: still happens in spite of signage prohibiting such. (Businesses)
There should be clear aesthetic buffers between residential and industrial areas.
(Businesses)
Absentee landlords that don't ensure yards/homes are maintained hurts the neighborhood
(especially single family rentals). (Parents group)
Analyzing all of the comments coded as aesthetics reveals that there were two broad themes - desired
changes and mitigating less-desired features. Further analysis reveals that the Parents group identified a
unique hazard that diminishes the quality of life. This highlights the fact that yards are a source of green
space that contributes to well-being.
72
-------
Appendix 9: Additional Suffolk County HIA Lessons Learned
The HIA process is built upon iterative collaboration between the researchers conducting the
assessment, decision makers who have an impact on the choice being considered, and the stakeholders
who will be impacted by the decision. Because of the many rounds of feedback and revision, it is often
impossible to know in advance what aspects of the decision will end up being emphasized and which
ecosystem benefits will be of importance to stakeholders. Because of this uncertainty, the HIA team may
include members from a broad range of disciplines and knowledge bases as identified throughout the
process.
Multidisciplinary collaboration was necessary to provide thorough subject-area knowledge and expert
opinion on the Impact Pathways. Ecology, public health science, municipal planning, economics,
epidemiology, and hydrology provide a partial example of the expertise represented by the team behind
the HIA. The HIA team was geographically dispersed, and primarily communicated through planning
team meetings to guide the development of the report and technical team meetings for discussion of
scientific and technical matters. Small teams wrote each pathway chapter of the report separately with
frequent check-ins with the planning team to guide the work progress and provide advice on draft
products. It was particularly helpful to have a technical editor as part of the team, who helped to unite
the disparate elements of the five pathway documents and resulted in a report with a consistent tone,
flow, and voice despite its constituent parts being written by a large group. Researchers on the pathways
were able to send drafts to the technical editor throughout the process of writing, which allowed the
technical to serve as a central guiding influence for the paper's composition.
The separation of the technical group from planning was key in avoiding bog-down in meetings about
the broad direction of the report. The planning group was responsible for making decisions about report
formatting, which sections would ultimately be included in the final report, recruiting public input, and
speaking to stakeholders among other broad duties. This freed time in the technical calls for discussing
the details of how impacts should be estimated, the scope of the literature review, refinement of Impact
Pathways, and similar narrow concerns. As with any project involving decision making, timing is crucial
to the HIA process. While keeping everyone involved in the project informed and up-to-date is
important, it can be necessary to limit debate on details of analysis to those who are involved so that the
project sticks to schedule. The choice of organizational structure allowed each team to save time by
working in parallel.
HIA is meant to improve local decision making by allowing the researchers to act as a conduit for
democratic and equitable input from community members and stakeholders to decision makers. The
health impacts under evaluation are chosen by asking members of the community what they are
concerned about, and at each step of the evaluation process stakeholders are consulted. This allows the
final product, a report detailing potential health impacts of the decision alternatives at hand, to reflect the
concerns and wishes of the community. Local control of the decisions that affect people's lives is the
central aim of a HIA. The decision context of this study was particularly amenable to the HIA process.
The decision at hand, involving changes in requirements for OSDS wastewater treatment, had direct and
measurable impacts on environmental quality and human well-being. Since HIA involves forecasting the
effects of a decision on future community health, it is important that the mechanisms of impact are well-
understood and ample scientific literature is available to justify the researchers' conclusions. Decisions
involving less well-studied mechanisms can suffer from poor strength of evidence. The main mechanism
of effect, discharge of nitrogen to groundwater, is a well-publicized and widely shared concern in
Suffolk County. This allowed the difficult task of informing the public about the issue to be bypassed.
The decision context involved multiple tiers of intervention, with increased costs and benefits associated
73
-------
with higher tiers. The alternatives that mandated that more residents upgrade their OSDS or switch to
costlier innovative or alternative systems resulted in greater benefits to community health. This allowed
examination of the human and ecological health results of proposed decisions on a scale, comparing the
relative merits of the various choices. The decentralized nature of OSDS, in that most residents have one
on their property, encourages personal participation in the decision. When community members feel that
the decision will affect them directly, the HIA is bolstered by increased interest.
Obtaining data at the scale of individual towns was difficult, especially for the pathways that involved
economic information (monetary value). It was found in the study area, which is a high-net-worth, high-
population county east of New York City, that local data custodians were reluctant to share datasets that
reveal property characteristics or commercial value. Licenses to access cadastral data are often sold by
counties to various bodies in the real estate industry. The data that was needed were eventually obtained
to examine the economic impacts of the decision, but it was a time-consuming process that resulted in a
major delay. Communication between the researchers who needed the data, the project managers who
were authorized to sign documents on behalf of EPA and disburse payment for datasets, and the local
offices that license data were often complex. Requesting data from county or town-level departments
may be best done in-person whenever possible. If requests must be done via phone or email, it should be
conducted by one designated contact on the team who is vested with the necessary authorizations to
make payments or sign documents as needed. This avoids a time-consuming back and forth of obtaining
permissions, which may prove frustrating for stakeholders and local collaborators.
There was trouble engaging the local community in the study: while the initial meetings in 2014 and
2015 had a good level of participation, the final round of community participation meetings in 2016 had
no attendees. The 2014 meeting was a planning and kickoff meeting and many of the future planning
committee members were in attendance, along with the local stakeholders and decision makers. The
2015 community meeting attendees consisted of stakeholders representing local organizations including
The Nature Conservancy, Long Island Sound Study of the New York Department of Environmental
Conservation, Suffolk County Water Authority, and local county legislators, among others. While the
2015 meetings had over a dozen attendees, the 2016 meetings went unnoticed. There were several
differences between these meetings that may have contributed to the disparity.
The 2016 meetings, in contrast to 2015, had no invited attendees from representatives of stakeholder
organizations. They were meant to be information sessions for the general public. Since no members of
the project group reside in the study area, it was difficult to identify and engage a community leader to
act as a local champion for the study and increase awareness. Librarians were recruited to put up posters
in local libraries advertising the meetings, and sent around emails to citizen groups who may have been
interested. However, it seemed that without an ambassador that could act as a messenger trusted by local
people, there was little interest in the HIA meetings. The communities in Suffolk County seemed not to
suffer from low civic engagement; there were many meetings and community symposia advertised on
the bulletin boards where the flyers were posted. This may have contributed to the lack of participation
as well: the meetings were scheduled during the late 2016 Presidential election season and happened to
coincide with well-attended political meetings. The meeting would have been scheduled for another time
if a local representative or if one of the project's group members had been able to go in-person to scout
the area and put up flyers personally.
The decision in this study is a fairly polarizing one in Suffolk County; adoption of several of the
decision alternatives would lead to the imposition of costly OSDS repair for homeowners in the area.
These repairs would likely need to be done anyway, as the majority of OSDS in Suffolk were
constructed prior to 1973. However, a government mandate to perform even a badly-needed repair is
74
-------
less appealing to a homeowner than arriving at the decision to repair the system themselves.
Additionally, the project's stakeholders in local government had an interest in some decision alternatives
explored in the study achieving a certain result, and expressed some dissatisfaction with the final report
because sufficient evidence was not found to support that result.
These issues both serve to emphasize the importance of establishing stakeholder and community
ownership of the HIA process. When decision makers and stakeholders feel that the final product of a
community-based study is theirs, and they played a significant part in its creation, they are more likely
to accept its recommendations (Bracht et al. 1994). The stakeholder engagement included multiple well-
attended meetings and check-ins by phone throughout the project. One thing that could be improved was
community engagement, possibly by designating a team member for public relations to seek local
champions in community interest groups and acting as a liaison to distribute information. Creating a
series of easy-to-understand progress reports in the form of posters, flyers, or pamphlets and designating
a team member or local surrogate to present them in community meetings of existing area ecological and
environmental groups could have improved local awareness and engagement.
75
-------
5-EPA
United States
Environmental Protection
Agency
Office of Research and
Development (8101R)
Washington, DC 20460
Offal Business
Penalty for Private Use $300
76
------- |