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Health Promotion and Disease Prevention
Project Description
Delta Project's Architecture
Collaborative Projects
Funding and Adjusted Timelines

Appendix A: Delta Commission Report Goals on the Environment
Appendix B: 5 Year Plan for the Office of the Associate Director for Minority Health (CDC)
Appendix C: Presidential Document (Executive Order 12898)
Appendix D: Historically Black Colleges and Universities in the Lower Delta Region
Appendix E: Presidential Document (Executive Order 12876)

DHHS Office of Minority Health
ATSDR Home Page

ATSDR - Mississippi Delta Project

Mississippi Delta "Economic development of the Delta cannot be separated from the and ethnic realities and cannot be planned apart from careful management of its resources and protection of its environment. This report envisions a coming time when ecological mindfulness and economic development are no longer seen as incompatible but as indivisible".

(Lower Mississippi Delta Development Commission, 1990)


The preceding quotation was taken from the report Realizing the Dream...Fulfilling the Potential, which was prepared by the Lower Mississippi Delta Development Commission (1). The words reflect a vision for the Lower Mississippi Delta Region wherein ecological concerns co-exist with economic development and social advancements. The Commission concluded its work and disbanded in 1990. The Commission's final report is a key document that combines concerns for improving the health of ethnic and racial minority populations in the United States and for achieving environmental justice. The work of the Commission provides compelling support for a demonstration project that forms partnerships in pursuit of regional excellence in public health and environment protection. The Mississippi Delta Project_Health and Environment is an attempt by government, academia, private sector organizations, and community residents to implement, within a key geographic region, a program that demonstrates how partnerships can be formed to identify and reduce the impact of environmental hazards. This document outlines the background of the Delta Project, its goal and objectives, its partners, and how the project is organized.

The Mississippi Delta Region was defined by the Lower Mississippi Delta Commission as a 219-county strip along the Mississippi River in Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee. The counties and parishes in the Delta Project are listed on the inside of the back cover page of this brochure. The Region is populated by approximately 8.3 million people, including a large number of persons of low income, African Americans, and growing numbers of other people of color.

No comprehensive database currently exists on the environmental hazards in the Delta Region. However, from databases in several federal and state health and environmental agencies, it is known that the Region's environmental hazards include the spectrum of non-point environmental problems such as mercury contamination in some states' surface waters, pesticides runoff in agricultural areas, seasonal degradation of ambient air quality, vector control, and the environmental and health consequences of natural disasters. Point-source environmental problems include releases of toxic substances from waste sites, lead-based paint in older housing, hazardous materials handling, chemical spills and explosions, and inadequate municipal waste treatment capacity. As one example, within the 219 counties, at least 40 uncontrolled hazardous waste sites are on the Environmental Protection Agency's (EPA) National Priorities List (NPL). The NPL is a listing of the most hazardous waste sites nationwide. In addition, states in the Region are responsible for managing the health and environmental risks posed by waste management, including non-federal abandoned waste sites.

Because of the diversity of environmental hazards and the high concern of the public over environmental and health impacts, government and private sector organizations are challenged to make an impact on reducing the risks posed by individual environmental hazards. While some communities and government agencies have worked closely on ameliorating specific environmental problems, a comprehensive regional plan to mobilize partnerships toward the goal of reducing environmental impacts and enhancing development is lacking. By focusing on a region with historic and demonstrated minority health disparities and identified environmental hazards, it is possible to develop the data and experience that will be necessary to shape public health, environmental, and educational interventions within the Region. Federal and state agencies, academic institutions, and community residents in the Region propose that a concentrated effort of sustainable partnerships be undertaken in the Lower Mississippi Delta Region.


The need for a regional demonstration project that proposes to establish regional excellence in public health and environmental protection, through partnerships, stems from the confluence of three concerns: 1) the need for further economic development of the Lower Mississippi Delta, 2) the importance of improving the health of persons of color and underserved populations, and 3) the need to ensure that environmental justice is achieved as a matter of social justice. Each concern has contributed to the genesis of the Delta Project. Details of each concern are described in the following paragraphs.

The Lower Mississippi Delta Development Commission

The Lower Mississippi Delta Development Commission was established in October 1988 to study and make recommendations on economic needs, problems, and opportunities in the Region and to develop a 10-year economic development plan for it. Two reports have been prepared by the Commission. They are Body of the Nation: The Interim Report of the Lower Mississippi Delta Development Commission and The Delta Initiatives: Realizing the Dream...Fulfilling the Potential. The latter report, which was the Commission's final report, notes "This final report is a trumpeting call by the Delta's own people to begin the tasks that will create a new and better tomorrow for this, the body of the nation, and therefore a brighter future for the nation as a whole." The same report concludes that the problems found in the Delta are common to all seven states_Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee_that have counties or parishes in the Region. The Commission makes a clear and compelling call for regional cooperation and cohesiveness in order to reach better solutions to the Region's problems.

The Commission's final report, Realizing the Dream...Fulfilling the Potential, contains sections on education, health, housing, community development, agriculture, natural resources, public infrastructure, entrepreneurial development, technology development, business and industrial development, tourism, and the environment. Each section contains goals and attendant recommendations. The sections on environment, community development, health, and education are especially pertinent to the Delta Project. The Environment section states:

A growing awareness of the need to face environmental problems was expressed by Lower Mississippi Delta citizens in hearings in each state. Yet many people still argue that environmental protection and economic development are incompatible. In fact, the reverse is true.

In the 21st Century, the world cannot accommodate growth and economic development apart from environmental protection. This means that in the long run, protecting the Delta's environment will pay dividends by attracting more new businesses, tourism dollars, research grants for institutions of higher learning and job opportunities. This new economic development concept will foster a great sense of "pride of place" among the Region's residents. All people will have to think of themselves asenvironmentalists. This will build a new environmental ethic and will create policies that reconcile preserving the environment with aggressive pursuit of economic growth.

The Commission developed three goals for environmental protection in the Delta Region:

  • By the year 2001, the Delta will improve its overall environmental quality by meeting or surpassing national environmental standards, and by preparing for natural and man-made disasters.
  • By the year 2001, the Delta will be at the forefront of environmental research and will promote community environmental awareness and education throughout the Region.
  • By the year 2001, all states in the Delta will achieve methods to dispose of their hazardous and solid waste without threatening groundwater and surface water and air quality.
Specific recommendations in support of the environment goals were developed in support of each goal. The set of recommendations is listed in Appendix A of this document.

Goals for community development, health, and education in the Delta include the following:

  • Community Development _By the year 2001, all 219 Delta counties and parishes will be operating in accordance with local strategic plans, integrated with the plans of state, regional, and federal entities. These plans will reflect volunteer initiatives representing local population diversity
    Attending this goal are recommendations that encourage the development of training programs for local leaders, volunteers, and community action groups. In particular, institutions of higher learning are encouraged to develop and implement leadership exchange programs for individuals from various groups, including academic institutions, businesses, state and local governments, churches, and communities.

  • Health _By the year 2001, all residents of the Delta will have access to health education and promotion programs.
    Recommendations attending this goal include encouragement to health care providers to adopt strategies to enhance health prevention practices, for state departments of education and local school systems to examine K-12 health education curricula to ensure prevention material is presented, and for training programs to increase time spent on health prevention.

  • Education _Expand the role of Delta higher education institutions in community and economic activities by the year 2001.

    Recommendations in support of this goal include encouraging institutions of higher learning to establish interstate programs among private industry, state government, and community-based groups.

Other goals could have been cited that would be relevant to achieving regional excellence in public health and environmental protection, but it is apparent from these goals that the Lower Mississippi Delta Commission envisioned the need for the creation of partnerships as an essential step in developing the Region and for addressing the area's problems. A guiding principle for developing strategies for achieving quality of life and sustaining the natural resource base in the Region is what has come to be known as sustainable development.

Minority Health Programs

Preventing adverse health effects in disadvantaged communities and people of color exposed to environmental hazards is a priority for government health agencies at all levels. Minority populations, particularly African Americans, Hispanics, and Native Americans, suffer disproportionately from preventable morbidity and mortality. Regardless of income, education, or geographic locale, these populations are in poorer health than their white, non-Hispanic counterparts. However, the health impact of the environment on minority populations has not been adequately characterized.

Reducing the disparity in health and improving quality of life among disadvantaged groups and among ethnic and racial populations impacted by environmental hazards will require the collective commitment of health professionals and environmental health scientists. Federal agencies and state health departments in the Region all have health outcome data that characterize the health of the public. For example, mortality data and disease incidence data are generally available. However, resources have generally been lacking in terms of linking morbidity and mortality databases and environmental quality data.

As illustration of federal minority health programs, the Agency for Toxic Substances and Disease Registry (ATSDR) and the Centers for Disease Control and Prevention (CDC) have conducted a series of projects to assess the impact of the environment on health in minority communities. The agencies' efforts since 1987 have evolved into an important Minority Health Program at ATSDR. In 1988, with the appointment at CDC/ATSDR of the Associate Director for Minority Health, a 5-Year Strategic Plan for Minority Health was completed (See Appendix B). Over the past several years, four goals have been developed for ATSDR's Minority Health Program. All or parts of these goals are believed by ATSDR to be shared by other federal agencies and some state agencies that have undertaken minority health and environmental justice programs.

  • Demographics_Develop a comprehensive demographic profile of communities living near hazardous waste sites and other sources of hazardous substances.

  • Health Studies and Applied Research_Determine associations between identified adverse human health outcomes in disadvantaged communities and people of color and hazardous substances, and implement health interventions based on significant findings from health studies and other applied research investigations.

  • Community Involvement and Risk Communication_Develop and execute environmental risk communication and community education programs to mitigate and prevent adverse health effects from environmental toxicants in minority communities.

  • Training and Education_Increase the numbers and racial and ethnic diversity of persons in the professional disciplines that constitute environmental public health. This includes assisting with curriculum development in academic institutions, supporting faculty through research projects, convening seminars and workshops in toxicology and related disciplines, and conducting short-term training for professionals in disciplines relevant to identifying and preventing environmental hazards.

Since 1987, ATSDR has investigated the public health impact of hazardous waste sites and other sources of exposure to environmental toxicants on persons in disadvantaged communities. ATSDR's efforts in minority health have not been concentrated on any one geographic area of the country. Rather, the Agency has pursued the four goals of its Minority Health Program in disadvantaged communities around individual waste sites across the nation. This approach has provided ATSDR with valuable data and insight into environmental hazards faced by minority groups. However, the goal of reducing the disparity in health and improving quality of life among disadvantaged groups and among ethnic and racial populations requires a more concentrated effort by the public and private sectors than what can possibly be accomplished by using a site-by-site approach and by any one agency acting alone.

Environmental Justice Emergence

The emergence of environmental justice as a significant social concern has contributed to identifying the need for the Mississippi Delta project. Although much of the evidence is anecdotal and circumstantial, there are mounting concerns that environmental health risks are borne disproportionately by members of the population who are poor and nonwhite. Concerns that possible disparities in environmentally induced illness are related to socioeconomic class and ethnicity or race have made this issue a top priority on the environmental health agenda of the United States.

Most of the studies cited as evidence of environmental inequities are observational. In other words, these studies document disparities by relying on statistical associations between demographic characteristics of populations, primarily race and income, and indirect surrogates for exposure to hazardous substances, such as residential proximity to pollution sources. According to a variety of sources (2) these investigations have been consistent in finding that members of disadvantaged groups are more likely than affluent whites to 1) live near sources of environmental pollution, such as hazardous waste sites; 2) reside in urban areas where ambient levels of certain pollutants, such as lead and carbon monoxide, are elevated; 3) eat significantly greater amounts of contaminated fish; and 4) be employed in potentially dangerous occupations, such as migrant farm work.

Inequitable distribution of the costs and benefits associated with environmental regulations has been the topic of discussion and study for more than 20 years. During the 1980s, hundreds of grassroots and community action groups brought attention to the environmental problems facing disadvantaged communities. In 1982, demonstrations by members of a low-income, predominantly African-American community against the proposed site for a polychlorinated biphenyl (PCB) landfill in Warren County, North Carolina, garnered national media coverage. The following year, a General Accounting Office (GAO) study found that three of the four largest operating hazardous waste sites in the southern United States were located in primarily African-American communities (3). In 1985, the first national African-American environmental organization, the Center for Environment, Commerce, and Energy, was established. That same year, the National Council of Churches' Eco-Justice Working Group began to address environmental issues.

The United Church of Christ's (UCC's) Commission for Racial Justice released a nationwide study in 1987 on the demographics of populations living near hazardous waste sites (4). The report found that in communities with one or more commercial hazardous waste facilities, the proportion of racial minorities was significantly greater than in communities without such facilities. Similarly, researchers found that African Americans were disproportionately represented in areas around operating (i.e., controlled) hazardous waste facilities around Detroit, Michigan. However, a study by University of Massachusetts investigators did not find any disparities according to racial or cultural groups residing near operating hazardous waste facilities. ATSDR has completed a study of the demographics of communities located near uncontrolled waste facilities. By its analysis, African Americans are represented in disproportionate numbers in communities located near Superfund priority waste sites.

In 1990, ATSDR sponsored the "Minority Health Conference: Focus on Environmental Contamination," which was the first federally sponsored conference of this kind. Media coverage accelerated in 1991 and a number of conferences and symposia were held to examine the issue. In 1993, Congressman Louis Stokes convened the U.S. Congressional Black Caucus Brain Trust Meeting on Environmental Racism. In February 1994, six government agencies with the support of community and academic leaders convened the first federal symposium on environmental justice entitled "The Symposium on Health Research and Needs to Ensure Environmental Justice." This symposium was attended by approximately 1,200 grassroots, academic, government, labor, business, and community leaders. During the symposium, President Clinton signed Executive Order #12898, which states "...each Federal agency shall make achieving environmental justice part of its mission by identifying and addressing, as appropriate, disproportionately high and adverse human health or environmental effects of its programs, policies, and activities on minority populations and low-income populations...." (See Appendix C.)

In response to the Executive Order, federal agencies are developing and implementing strategies to establish a framework to ensure that they design and conduct research, educational, regulatory, service, and support programs in full partnership with stakeholders in a manner that considers, and addresses as appropriate, disproportionate and adverse environmental and minority populations. Of particular relevance to the Delta Project are the environmental justice strategies developed by the Department of Health and Human Services (DHHS) and the EPA in response to the Executive Order. These strategies include several that will be incorporated into the Mississippi Delta Project. Both set of strategies are consistent with the following two working definitions developed by EPA's Office of Environmental Justice :

  • Environmental Justice - means the fair treatment and meaningful involvement of all people, regardless of race, ethnicity, culture, income, or education level with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.

  • Fair Treatment - means that no population, due to political or economic disempowerment, is forced to shoulder the negative human health and environmental impacts of pollution or other environmental hazards.

The DHHS strategy for environmental justice covers a range of responsibilities and activities, largely current, some planned. The activity areas addressed in the strategy are public education, training, services, data collection and analysis, and health research. These activity areas are complemented by three cross-cutting efforts that cover DHHS program policies, interagency coordination, and public partnerships.

The goal of EPA's strategy is to ensure that 1) no segment of the population, regardless of race, color, national origin, or income, as a result of EPA's policies, programs, or activities, suffers disproportionately from adverse human health or environmental effects, and all people live in clean and sustainable communities; and 2) those who must live with environmental decisions_community residents; environmental groups; state, tribal and local governments; businesses_must have every opportunity for public participation in the making of those decisions. An informed and involved local community is a necessary and integral part of protecting the environment.

The EPA strategy outlines cross-cutting mission areas in health and environmental research; data collection and analysis; stakeholder access to information; enforcement and compliance assurance; partnerships, outreach, and communication with stakeholders; Native American, indigenous, and tribal programs; and integration of environmental justice into all EPA activities.

Both DHHS and EPA have listed the Mississippi Delta Project as a model interagency environmental justice project. Strategies outlined in both institutions' environmental justice programs will be incorporated into the Mississippi Delta Project (where appropriate for conditions in the Region).

Health Promotion and Disease Prevention

Recommendations in the Lower Mississippi Delta Development Commission's final report advocate actions that would enhance environmental protection and the health and well-being of the Region's people. Similar concerns are evident in government agencies' minority health programs and in the emergence of environmental justice concerns. From experience accrued in many areas of public policy and service, it is now recognized that the most beneficial approach to solving many health and environmental problems is through health promotion and disease prevention measures. That is, prevention of factors that cause excess morbidity and premature mortality is well known by public health officials to be the most cost effective and healthful approach. Similarly, prevention of environmental hazards is to be preferred to remediating hazards after they have occurred. For these reasons, the Delta Project adopts the prevention model as its core concept. Moreover, education strategies to promote and maintain a healthful environment must be undertaken to institute the ATSDR vision of "Healthy People in a Healthy Environment."

The public health prevention model contains the following elements:

  • Identify instances of excess morbidity, premature mortality, or unsuspected health risk. This is often achieved through health surveillance systems, clinical observations, laboratory findings, or outcomes of research investigations.

  • Assess the causal factors that account for the excess morbidity, premature mortality, or identified health risk factor. This is pursued through epidemiologic investigations, laboratory studies, clinical studies, or other kinds of investigations.

  • Intervene with actions that interdict or mitigate the causal factors that account for the identified health risks. Because many adverse health problems are multifactorial in terms of risk factors, intervention strategies are developed and applied on a small scale to determine their efficacy. Intervention strategies are then refined and the revised strategies are applied to the population at risk.

  • Promote the interventions that prevent or mitigate the adverse health event. This occurs through dissemination of actions and materials to health care providers, health officials, and public and private sector agencies that describe the occurrences, causes, and prevention actions specific to the identified health risk.

  • Evaluate the effectiveness of the implemented interventions and adjust them where needed to improve reduction of human health risk.

Project Description

Given the concerns of the Lower Mississippi Delta Development Commission for improvements in the social and economic conditions of the Region, and recognizing the importance of using prevention methods to achieve improvements in the public health and environment of the Region in ways consistent with environmental justice, the Delta Project has evolved.

The overall goal of the Delta Project is to demonstrate that partnerships between government, academia, private sector organizations, and community residents can identify key environmental hazards (and barriers to this identification), promote environmental quality, and reduce and, where possible, prevent these hazards from impacting on health and the environment, with emphasis on persons in underserved communities. This goal will be pursued jointly by federal agencies, state and local health departments, local community groups, and institutions of higher education, particularly those that serve large minority populations.

The federal agencies cooperating in the Mississippi Delta Project are the Office of Solid Waste and Emergency Response (OSWER), Office of Environmental Justice/EPA, the National Institute of Environmental Health Sciences/National Institutes of Health (NIH), the National Library of Medicine/NIH, the National Institute for Occupational Safety and Health/CDC, the National Center for Environmental Health/CDC, the Office of the Associate Director for Minority Health/CDC, and ATSDR. Each federal agency brings to this project different statutory responsibilities and resources bearing on specific environmental hazards. Moreover, state and local agencies have specific health and environmental authorities for managing environmental hazards. By joining the interests, authorities, and resources of the relevant federal and state agencies, a more comprehensive and effective effort can be implemented to reduce and, where possible, prevent the health and environmental impacts of environmental hazards.

Because of the demographics and economic profiles inherent to the Mississippi Delta Region, this project will give special emphasis to identifying and reducing the disparities of environmental hazards experienced by disadvantaged communities and persons of color. The participation of communities in the conduct of the project will be essential for long-term success. Working closely with communities and Historically Black Colleges and Universities (HBCUs) in the Region will be an essential component of this project. (See Appendices D and E.)

Overall Objectives

Therefore, in association with state and local health agencies, regulatory agencies, and academic institutions in the Delta Region, and consistent with the principles of sustainable development and preventing adverse health impacts from environmental hazards, the objectives of the Delta Project are these:

  • Identify key environmental hazards and barriers to recognizing hazards that may affect the health and quality of life of people who live in communities believed to be at risk.

  • Assess the potentially harmful impact on high risk-populations of exposure to key environmental hazards.

  • Increase the awareness of health care providers practicing in the Delta Region of the adverse environmental health impact of key environmental hazards. Empower and educate the community about environmental hazards. Evaluate the impact of educational efforts to ensure that health care providers are familiar with the recognition and treatment of illness associated with exposure to environmental hazards.

  • Enhance capacity building in state and local health departments, environmental departments, academic institutions, and community non-profit groups to address environmental public health issues associated with minority health.

  • Increase the awareness of the importance of environmental public health among students at Head Start Centers, other preschools, and primary through college-level institutions in the Delta Region.

  • Provide pollution prevention and health promotion education regarding exposure to environmental hazards.

  • Ensure that efforts occur that lead to enhanced community empowerment and involvement in addressing environmental public health issues.

  • Identify and coordinate state and federal actions to address environmental health issues in the Delta Region.

  • Evaluate and disseminate the effectiveness of strategies to prevent health and environmental impacts of key environmental hazards.

These objectives are being pursued through a phased approach for the Delta Project. Bearing in mind that the Delta Project will attempt to achieve these objectives through formation of partnerships across and within government and private sector lines, it is fundamental to implement the Delta Project in steps that build consensus and cooperation and that draw upon existing resources. Three phases have therefore been identified for this project.

Delta Project's Phases

Phase 1 - Problem Definition and Needs Assessment

The first step is to determine the problems in the Region that are linked to environmental hazards. This is being accomplished through a needs assessment. In this context, a needs assessment is expected to ask what needs to be done, given conditions and circumstances in the Region. For the purposes of the Delta Project, the emphasis is on key environmental hazards that impact underserved communities and persons of color. The needs assessment is being conducted by Meharry Medical College, Nashville, Tennessee, in cooperation with the Minority Health Professions Foundation. The Steering Group for the Delta Project will advise Meharry on the overall conduct of the needs assessment, based on recommendations from the Assessment Workgroup (refer to the following section on architecture).

The needs assessment will be conducted using four profiles developed by Meharry:

  1. Profile the key environmental hazards believed to be of consequence to the public health of communities in the Region.

  2. Profile the demographics of the Region, health problems, and associated health status.

  3. Profile the providers of health and environmental services in the Region, including state and local health departments, local health care centers, environmental agencies, health providers, and non-government organizations that can serve as partners in achieving the overall goal of the Delta Project.

  4. Profile the education resources in the Region, including HBCUs, that have the capacity or potential to develop partnerships with communities and state agencies in support of the Delta Project's overall goal.

Using these profiles, Meharry will develop a list of key environmental hazards and associated public health concerns. This list will, in effect, represent the outcome of the identification component of the public health prevention model discussed previously. The list of needs will include recommendations to intervene in situations where adverse health effects are known to be associated with specific environmental hazards. Further, some needs will have to be addressed in terms of evaluating potential causal factors related to environmental hazards and public health consequences.

Phase 2 - Demonstration Interventions

This phase of the Delta Project will consist of selecting a number of needs identified in Phase I and developing intervention strategies appropriate for preventing health and environmental impacts. The profiles will be reviewed by the Steering Group, as advised by its Project Structure Workgroup (refer to the following section on architecture), to determine specific demonstration interventions recommended for the Region. The Steering Group in conjunction with local communities will select the problems to be addressed, help create partnerships for each demonstration intervention, and serve as a resource to evaluate the effectiveness of specific interventions.

Phase 3 - Regional Health and Environmental Promotion

Given the outcomes from the demonstration community-specific interventions, successful interventions will be identified and promoted for adoption within the Region. The specifics of this phase will be contingent on the outcomes and experiences of Phase 2.

Delta Project's Architecture

A Steering Group will provide guidance and advice to Meharry Medical School and other contractors. This group comprises representatives from government, academia, private sector organizations, and community advocacy groups. Federal agencies include ATSDR, CDC, NIH, and EPA. Each of the seven states has representatives from state health and environmental agencies. The HBCUs, community-based organizations, and other relevant groups are members of the Steering Group, which will choose its own chairperson.

The HBCUs will play a key role in the conduct of the Delta Project, particularly in efforts to educate Delta Region residents about environmental hazards. The HBCUs in the Delta Region have educated a large number of African-American professionals who teach, practice health care, and assume leadership roles in many of the Delta Region minority communities. These professionals have the credibility needed to ensure the success of the project and are strongly committed to supporting HBCUs in the Region. Meharry Medical College serves as the primary HBCU. Meharry's history of providing health care in the Delta Region provides the credibility needed to ensure the trust of the people in the Region.

Reporting to the Steering Group will be workgroups established to provide advice and guidance in support of the Delta Project's overall goal and long-term objectives. The following four workgroups have been established by the Steering Group:

  • Membership -This workgroup will ensure relevant and current representation of agencies and groups on the Steering Group.

  • Project Structure -This workgroup advises the Steering Group on the goals, objectives, purposes, tactics, and architecture of the Delta Project and its component activities.

  • Assessment -This workgroup provides advice to the Steering Group on the design, outcome, and adequacy of the Delta Project's individual activities, including information profiles and demonstration projects.

  • Executive -This workgroup serves as the primary agent of the Steering Group for the purpose of developing policies to recommend to the Steering Group and implementing actions determined by it. This workgroup consists of the co-chairs of the Steering Group, chairs of the other three workgroups, Meharry officials conducting the needs assessment, and ad hoc members as appropriate.

Collaborative Projects

Because creating partnerships for the purpose of developing regional excellence in public health and environmental protection is the heart of the Delta Project, many ongoing projects by federal, state, and private sector organizations are relevant to the overall goal. The Steering Group encourages the conduct of projects in support of the overall goal of the Delta Project. These collaborative projects, as they become known to the Steering Group, will be shared within the Region. Collaborative projects will be selected by the Steering Group, as recommended by the Structure Workgroup, based upon their project officers' knowledge of and commitment to meeting the Delta project's overall goal.

Some current examples are the following activities:

  • National Library of Medicine, NIH -Conducting an environmental information outreach program (a hands-on training course for staff and students in HBCUs).

  • Texas Southern University -Conducting environmental health training for pharmacists who serve in minority communities.

  • National Institute of Environmental Health Sciences -Sponsorship of the developmental environmental health science centers at Tulane and Xavier universities.

  • National Institute of Environmental Health Sciences -Sponsorship of a worker training site in Lavonia, Louisiana.

  • Morehouse School of Medicine and National Medical Association -Providing environmental medicine training for physicians in the Region.

  • Howard University College of Nursing -Conducting a train-the-trainer program to educate nurses in the Delta Region about environmental hazards.

  • Texas Southern University College of Pharmacy -Conducting a train-the-trainer program to educate pharmacists in the Delta Region about environmental hazards.

  • Mississippi Action For Progress (M.A.P.) , the largest Head Start agency in Mississippi_Developing an environmental health curriculum to be tested in 20 counties throughout the state. The program will focus on Head Start students and their families in 45 of the 82 counties in Mississippi.

Funding and Adjusted Timelines

The funding for Phase I of the Delta Project will be provided by participating federal agencies. It is anticipated that the four profiles being developed by Meharry Medical College will be completed by the end of fiscal year 1995. Funds for Phases 2 and 3 will be sought from government and private sector organizations, based on the recommendations from the Steering Group. A timetable for other significant activities for the Delta Project will be developed by the Steering Group.


  1. Lower Mississippi Delta Development Commission. The Delta Initiatives: Realizing the Dream...Fulfilling the Potential (Final Report). Memphis (TN): Lower Mississippi Delta Development Commission, May 1990.

  2. Sexton K, Olden K, Johnson BL. "Environmental Justice": The central role of research in establishing a credible scientific foundation for informed decision making. Toxicol Ind Health 1993; 9(5):685-727.

  3. General Accounting Office (GAO). Siting of Hazardous Waste Landfills and Their Correlation with Racial and Ecomic Status of Surrounding Communities. Washington DC: GAO, 1983.

  4. Commission for Racial Justice, United Chirst of Church (UCC). Toxic Wastes and Race in the United States: A National Report on the Racial and Socioeconomic Characteristics of Communities with Hazardous Waste Sites. New York: United Church of Christ, 1987.
Appendix A

Delta Commission Report Goals on the Environment

Appendix B

5-Year Plan for the Office of the Associate Director for Minority Health

  • CDC/ATSDR Minority Health Strategic Plan 1989

    • Associate Director for Minority Health

    • Office of the Director

    • Centers for Disease Control and Prevention

    • Agency for Toxic Substances and Disease Registry

    • Public Health Service

    • U.S. Department of Health and Human Services

Mission Statement

The Mission of the Office of the Associate Director for Minority Health is to improve the health of the African-American (Blacks), Asian-American/Pacific Islander, Hispanic American, and Native American/Alaskan Native citizens, and where appropriate, similar ethnic/racial subgroups in and out of the United States, through policy development and program analysis at CDC and ATSDR.

The mission will be accomplished through the following major goal, subgoals, and objectives:

Major Goal

To enhance the overall health of the American public by reducing the burden of preventable disease and illness through health promotion and disease prevention initiatives geared specifically toward U.S. minority populations and, where appropriate, similar ethnic/racial subgroups inside and outside of the United States.


Measurable subgoals include the following:

  1. The assurance that policy at CDC and ATSDR appropriately directs the agencies' activities toward minority health.

  2. The enhancement of the research enterprise through innovative scientific investigations in health promotion, health protection, and disease prevention to reduce the disproportionate burden of disease and illness in minority group members.

  3. The development of an effective internal and external communication network related to minority health.

Philosophical Approach

The mission and goal of the Office of the Associate Director for Minority Health are based on the philosophy that to be effective, minority health initiatives must be operational in the centers, institutes, program offices, and programs at CDC and ATSDR. These initiatives, where appropriate, must be transferred to State and local government and non-government agencies and organizations. The Office, therefore, assumes an operational versus a programmatic management approach in actualizing its mission. This management approach demands ongoing interaction and communication between people at CDC, ATSDR, and Public Health Service, other Federal officials, and State and local government officials, and the leadership of non-government agencies and organizations (i.e., voluntary agencies, community based organizations, philanthropic groups, etc.). Programmatic authority and responsibility should be maintained at the program level to maximize fiscal and human resources. However, assessment, advocacy, coordination, and evaluation of processes and outcomes related to the efficacy of minority health activities are focused primarily in the Office of the Associate Director for Minority Health.


The objectives for the Office of the Associate Director for Minority Health related specifically to the three subgoals include the following:

Subgoal A

To assure that policy at CDC and ATSDR appropriately directs the agencies' activities towards minority health.


  1. To encourage minority health activities in each center, institute, and program office at CDC and ATSDR.

  2. To encourage the employment of significant numbers of minority senior professional and administrative persons at various policy and program levels within each center, institute, and program office at CDC and ATSDR and to assist in identifying and recruiting candidates.

  3. To facilitate the development of minority health programs in State
  4. and local health departments, national, civic, social, religious, and voluntary organizations, and local community based organizations.

  5. To maximize health services and resources available to minority populations.

Subgoal B

To enhance the research enterprise through innovative scientific investigations in health promotion, health protection, and disease prevention to reduce the disproportionate burden of illness in minority group members.


  1. To enhance applied public health research activities in health promotion and disease prevention among minority investigators.

  2. To advise on minority health related research in health promotion and disease prevention by non-minority investigators, particularly at CDC and ATSDR.

  3. To investigate social/behavioral approaches to reducing adverse health and health care indices in the minority populations.

  4. To increase the number of minority undergraduate and postgraduate students interested and engaged in minority related public health research.

  5. To enhance the quality and quantity of publications in the scientific literature related to minority health.

Subgoal C

To develop an effective internal and external communication network related to minority health.


  1. To facilitate the establishment of a minority health component in each agency within the Public Health Service (PHS).

  2. To encourage the development of a minority health focus in each State health Department, and where appropriate in local health departments.

  3. To encourage the implementation of a structured minority health network within the academic community.

  4. To promote minority health educational initiatives in civic, social, religious, community, and voluntary agencies and organizations in both minority and non-minority communities.

  5. To assure that information systems provide data adequate to assess the need for, and evaluate the impact of programs directed to members of minority groups.

Strategies (Strategies and Tactics developed in 1989 with the CDC/ATSDR Strategic Plan)

Strategies address the question "How do we met objectives?" "How do we get it done?" They should be supported by a composite of action plans and programs. Strategies are primarily qualitative and can be translated into quantified tactics and action plans. They should be listed in rational and priority order. (See Strategies and Tactics)


Tactics detail how the strategies will be implemented and what specific activities are planned. They must be operational in nature and lend themselves to evaluation. Tactics are subject to change in direction and emphasis. They must lend themselves to qualified activities that can be monitored and controlled. (See Preliminary Assessment of 1989 Strategic Plan under Evaluation)


For the purpose of this report, evaluation is defined as the process of determining the value or amount of success in the achievement of predetermined objectives. This includes at least the following steps: formulation of the objectives; identification of the proper criteria to be used in measuring success; determination and explanation of the degree of success; recommendations for future program activities.

The following five areas will be used in evaluating the activities in the Office of the Associate Director for Minority Health:

  1. Effort -the evaluations in this category have as their criteria of success the quantity and quality of activities that take place. This represents an assessment of input or energy regardless of output that is intended to answer the questions "What did you do?" and "How well did you do it?"

  2. Performance -the performance or effect criteria measures the results of the effort rather than the effort itself. This requires a clear statement of ones objective. How much is accomplished relative to an immediate goal? Did any change occur? Performance can be measured at several levels-the number of cases found, the number hospitalized, the number cured or rehabilitated. Performance standards often involve several assumptions; however, in general, evaluation of performance involves fewer assumptions than evaluation of efforts.

  3. Adequacy of performance -this criteria for success refers to the degree to which effective performance is adequate to the total amount of need. Adequacy is obviously a relative measure depending upon how high one sets ones goals.

  4. Efficacy -a positive answer to the question, "Does it work?" often gives rise to the following questions: Is there any better way to obtain the same results? Efficacy is concerned with the evaluation of alternative paths or methods in terms of cost and money, time, personnel, and public convenience. In a sense, it represents the ratio between effort and performance, output divided by input.

  5. Process -in the course of evaluating the success or failure of a program, a great deal can be learned about how and why a program works or does not work. The analysis of process can have both administrative and scientific significance particularly when the evaluation indicates that a program is not working as expected. The analysis of process will be made according to four main dimensions beginning with: 1) the attributes of the program itself; 2) the population exposed to the program; 3) the situation or context within which the program takes place; and 4) the different kinds of effects produced by the program.

These five criteria will be utilized to measure the impact of each objective for administrative, programmatic, and outcome purposes.

Appendix C: Presidential Document ( Federal Actions to Address Environmental Justice in Minority Populations and Low-income Populations (Executive Order 12898) )

Appendix D: Historically Black Colleges and Universities in the Lower Delta Region


  • Arkansas Baptist College
  • Philander Smith College
  • Shorter College
  • University of Arkansas at Pine Bluff

  • Kentucky State University

  • Dillard University
  • Grambling State University
  • Southern University System
  • Southern University A & M College
  • Southern University at Baton Rouge
  • Southern University at New Orleans
  • Southern University at Shreveport
  • Xavier University

  • Alcorn State University
  • Coahoma Community College
  • Hinds Community College
  • Jackson State University
  • Mary Holmes College
  • Mississippi Valley State University
  • Rust College
  • Tougaloo College

  • Harris-Stowe State College
  • Lincoln University

  • Fisk University
  • Knoxville College
  • Knoxville College-Morris Town
  • Lane College
  • Lemoyne-Owen College
  • Meharry Medical College
  • Tennessee State University

Appendix E: President Clinton's Executive Order on Historically Black Colleges and Universities (HBCUs) Executive Order 12876

Questions? - Call the ATSDR Information Center toll free at 1-888-422-8737, or e-mail

Revised March 18, 2002

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