2 year Anniversary of the Knights Landing Environmental Health Project

Skye Kelty and Alfonso Aranda are graduate students at UC Davis, and Campus Affiliates of the Center for Community and Citizen Science. In this post they describe their multi-year collaboration with community members in Knights Landing, a wonderful example of student-led community science that has crossed many disciplinary and institutional boundaries.

A group of women, Grupo de Mujeres, gathers once a week at the Family Resource Center in Knights Landing, CA. They talk about their families, their town, and their health. Knights Landing is an unincorporated agricultural community located 25 miles from Sacramento and UC Davis. Residents range from families who have farmed the area for 4+ generations to migrant and permanent Mexican farm workers.  Like many unincorporated agricultural communities in the CA Central Valley, Knights Landing faces a number of challenges including transportation, access to medical care, access to healthy foods and water, immigration, poverty, housing shortages, and environmental pollution.About 5 years ago Grupo de Mujeres recruited Juanita Ontiveros of California Rural Legal Assistance Foundation and Dr. Natalia Deeb-Sossa of UC Davis Chicana/o Studies to support the Knights Landing community by organizing and establishing community resources to improve conditions. Since then, Grupo de Mujeres has worked with these organizers to re-open a local elementary school together with a youth tutoring program and to re-establish the community’s health clinic.

During this time, Grupo de Mujeres reported to Dr. Deeb-Sossa their concern about a perceived high incidence of cancer in the community: young people appeared to be getting cancer, rare cancers had occurred, and high exposures to environmental carcinogens were suspected. Dr. Deeb-Sossa subsequently recruited two PhD students to address community needs through their dissertation research in cancer prevention and environmental justice: Skye Kelty, PhD candidate in Pharmacology and Toxicology mentored by Dr. Laura Van Winkle, and Alfonso Aranda, PhD student in Environmental Health Geography mentored by Dr. Jonathan London. Prior to this, Skye and Alfonso worked independently in Dr. Deeb-Sossa’s Community-Based Participatory Research class to produce a pair of proposals that appeared to be jointly focused on the goal of investigating community concerns but from contrasting disciplinary perspectives. Alfonso planned to use qualitative research—art, focus groups, interviews, mapping, and history. Skye planned to use quantitative research—laboratory modeling, epidemiology, environmental sampling, risk assessment, and toxicology. To get the project started, they spent the summer of 2016 proposing their research to the community and partnering with community stakeholders, notably Grupo de Mujeres.

The Knights Landing Environmental Health Project was founded in 2016 by Skye and Alfonso as a community-engaged, mixed-methods research project under the mentorship of Dr. Deeb-Sossa. They spent the fall of 2016 seeking funding and eventually won a $7,500 idea pitch sponsored by the UC Davis Environmental Health Science Center. With the procurement of flexible funding, together with IRB approval, the research team expanded to include 5 community promotoras (health advocates) who would be compensated for their time. During the summer of 2017, the team conducted promotora trainings which consisted of both the students teaching promotoras about the research process and promotoras teaching students about the community. Through this process, the team re-fashioned the project to include additional community concerns and to make participation as easy as possible. Presently, the team hosts promotora meetings twice a month to ensure the research preformed is responsive to community needs and includes community perspectives. Additionally, promotoras have been involved in hypothesis development, research design, data collection, analysis of data, and dissemination of results for the Knights Landing Environmental Health Project and subsequent research projects.

Along the way Sevana Manukian, a Masters of Public Health student, was recruited to lead the development, administration, and analysis of an Environmental Health Survey in collaboration with the promotoras. This survey was conducted in the summer of 2017 with 100 participants (almost 10% of the adult population of Knights Landing!). Promotoras were able to administer the survey in a total of 3 weeks spending about a half hour with each participant (an amazing feat!). Promotoras split the town into geographic areas that represented the diverse Knights Landing community and their sample was consistent with census demographics. Survey results indicate agricultural pesticide exposures on the job and in homes adjacent to fields; high sun exposure at work; water pollution; lack of fruits and vegetables; a high rate of smoking; truck traffic; and a general lack of cancer screening opportunities.

Alfonso’s dissertation research compliments survey data by documenting community-level perceptions of environmental health risks through the administration of promotora-led, exploratory focus group sessions (n=6) and individual photovoice projects (n=8). The goal of this phase is to assess community health status, environmental health mediators, and barriers to healthcare among residents of the unincorporated town. Additionally, results of this phase will be used to identify variables for quantitative development through environmental sampling (see below).

Skye’s dissertation is following up the Environmental Health Survey data by measuring the levels of carcinogens in tap water from private wells and household dust from homes in Knights Landing. Skye will compare Knights Landing pesticide and heavy metal results to a neighboring primarily organic farming community, Capay Valley. Sampling occurred in both communities during the planting season (Spring) and the harvest season (Fall) to document the change in carcinogenic pesticides during the peak application periods of the year. Additionally, Skye is analyzing publicly available pesticide application data and water quality data for the public water system to supplement the sampling data, with the help of undergraduate volunteer researchers—especially Tiffany Jow and Danny Moher. Additionally, Skye is developing a line of research to address the high tobacco smoking rates in Knights Landing (~3 times the county rate). Skye plans to document exposures to carcinogens for tobacco-smokers, cannabis-smokers, and folks exposed to second-hand smoke.

As of now our research has moved slowly and deliberately especially because we are funded primarily by a patchwork of ~$2,000 grants. However, the Knights Landing Environmental Health Project and its collaborators are committed to working with community partners in a sustainable and responsive manner.  In 2018, for example, the team focused on responding to additional environmental health concerns while we completed our initial study of suspected carcinogenic exposures.

In years past, community organizers including the Empower Yolo Youth Group and the Grupo de Mujeres built enthusiasm with a plan to establish a community garden. The effort dwindled after the group faced challenges in finding a space in the small town, developing an irrigation system, and raising startup funds.  Nevertheless, passion for gardening and developing a shared community space remained. The Knights Landing Environmental Health Project took on this challenge to leverage UC Davis resources and the resources of our many supportive partners throughout Yolo County. We recruited Ana Maria Guerrero, an undergraduate in Landscape Architecture, to develop a plan for the garden in collaboration with the Knights Landing residents and the Youth Engagement Program from the student-run UC Davis Knights Landing One Health Center.  Together we built the first phase of the garden in April 2018 at the Knights Landing United Methodist Church and we are currently fundraising to build the main lot garden for the upcoming year.

As noted above, the Knights Landing Environmental Health Project has developed in conjunction with community concerns. Presently Dr. Deeb-Sossa, together with the HATCH Feminist Art and Science Research Shop, have attempted to document the mental/emotional health concerns that have emerged during our time in the community. As such, we completed a survey in Spring 2018 to document the utilization of health care in addition to the association between mental/emotional health and environmental exposures. Using the same sampling strategy as the Environmental Health Survey, the administration of this survey was led by promotoras and Dr. Deeb-Sossa’s undergraduate Community-Based Participatory Research class as a service-learning project. Jason Tang and Eva Pardo, MPH students, assisted with the development and analysis of the 2018 survey data. Katie Rivas, an undergraduate in Global Disease Biology and Executive Administrator of the UC Davis Knights Landing One Health Center, generated a summary report documenting access and utilization of health care services by Knights Landing residents, including mental health services. Juan Carlos Ruiz Malagon, an undergraduate in Chicana/o Studies, and promotoras are currently conducting personal interviews with Knights Landing residents to discuss challenges to mental/emotional services at the individual level. We will also conduct focus groups to discuss mental/emotional health challenges at the community level. We hope this documentation will allow our partners at the student-run UC Davis Knights Landing One Health Center and other community organizations to develop culturally-humble, affordable, and structurally-competent mental/emotional health services for the Knights Landing community.

Into the future, we hope to continue a sustainable research collaboration with Knights Landing as we move from documentation of challenges into implementation of solutions. We are currently crafting grants to more sustainably fund our research and especially hope to provide stable support for our promotoras, student researchers, and participants. We look forward to working with Environmental Justice Coalition for Water to reduce exposures to water pollution in private wells. We look forward to working with local farmers, regulators, and UC Davis agricultural researchers to bring pesticide-reduction strategies to the agricultural fields in Knights Landing. We look forward to building a community garden and strengthening community ownership over the space to improve access to healthy foods and to provide a safe outdoor space for exercising. We look forward to working with California Rural Legal Assistance Foundation and the Western Center for Agricultural Health and Safety to improve occupational safety for the many farm workers in the Knights Landing community.  We look forward to strengthening the One Health model with the student-run UC Davis Knights Landing One Health Center.  And most of all, we look forward to building community research capacity in Knights Landing with the support of the UC Davis Citizen Science Center so that the amazing Knights Landing residents currently classified as “participants” in our research can truly be agents of change and use their own talents to research challenges they face and implement solutions.  We look forward to serving this Knights Landing and creating solutions to challenges here that may be useful for other communities facing similar environmental health challenges.