From the 1950s to 1970s, Southeast Greensboro communities such as Cottage Grove bustled with shops and business professionals who had steady employment, and families were able to buy food from local curb markets and grocery stores. As time evolved, disinvestment ensued, locally owned businesses went away, and substandard housing increased. Greensboro is the third-largest city in Guilford County, North Carolina, with a population of 301,094 residents, and also has some environmental challenges that impact the well-being and health of its community members [1]. The Asthma and Allergy Foundation of America ranks Greensboro as the 20th most challenging place to live in America with asthma [2].
The New Hope Community Development Group, a non-profit that focuses on improving community and economic conditions, helps to sustain and build healthy neighborhoods by building social capital, facilitating community engagement and organizing, assisting in building the capacity of neighborhood associations, and helping neighbors find solutions that will lessen the impact of social justice disparities. Our work is a part of Collaborative Cottage Grove, a multisector partnership founded on resident leadership to promote community change within the Cottage Grove neighborhood. Cottage Grove is in census tract 111.01 [3], with a population that is 80% African American, 8.9% Hispanic/Latino, and 3.7% Asian [3]. The community is a racially diverse, resilient group of people. Although resilient, residents are not immune to environmental injustice. We work alongside efforts such as the remediation of Bingham Park, which sits on top of a former landfill. The incinerator used at this location in the 1920s is central to the area where residents of this neighborhood now live [4]. According to a December 2020 article in North Carolina Health News, “The State Department of Environmental Quality says it has plans to clean up the contamination and make the park safe and useful... Documents show dozens of studies and research work have already been done” [4]. Community members have long advocated for changes to increase healthy spaces for people to live, play, and work. Although social determinants of health have recently become commonly understood, living with the impact of these social drivers has always been an experience for me (P.R.M.) and my neighbors.
Poor housing conditions in the community exacerbate health issues such as asthma. The lack of housing improvements and poor housing conditions affect indoor air quality, which leads to respiratory illnesses [5]. This is particularly significant for vulnerable populations, such as our immigrant and refugee families.
As a Montagnard (indigenous minority group) refugee from Vietnam, I (S.B.M.) fled with my family to the United States due to political and religious persecution [6]. When my family first resettled in the United States, we were placed in affordable rental properties. However, “affordable” did not equate to “safe” housing. The indoor housing quality was substandard and had mold and pests. We ended up settling in neighborhoods like Cottage Grove, a community heavily impacted by redlining in the 1930s. The practice denied Black and Brown people the ability to obtain loans from banks to buy homes, thus setting them up for economic disinvestment for years to come [7]. As refugees fleeing to the United States in 2002, it took us 10 years to secure stable, safe, and affordable housing in Cottage Grove.
While working as a community health worker for Collaborative Cottage Grove, I (S.B.M.) realized health extends beyond the doctor’s office. I began to understand how the built environment can deteriorate one’s health. It had never occurred to me how environmental issues can make you sick. “Good enough” was normal for me. I didn’t know until working on community change projects, advocating with residents and community organizations, that “good enough” is not always adequate, safe, or healthy. I wanted to show others that this should not be the norm. I wanted to be a part of improving environmental and health conditions through collective power with the Greensboro Housing Coalition and Collaborative Cottage Grove partners.
Since 2017, Collaborative Cottage Grove has worked to improve housing quality for children with asthma through the BUILD Health Challenge [8]. Our project provides healthy home education and remediation to homes with children between ages 5 and 11 with a record of hospitalization for asthma. It provides the opportunity to observe how well a child’s asthma was managed after receiving home remediation and education. Cone Health, Guilford County Department of Health school health nurses, the University of North Carolina at Greensboro, and Collaborative Cottage Grove partners aim to reduce high rates of emergency department utilization in target ZIP codes. Our ongoing community-centered approach is to support residents’ concerns through advocacy for systems and environmental changes.
Acknowledgments
Disclosure of interests. The authors report no relevant conflicts of interest.
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