The Icahn School of Medicine at Mount Sinai’s Pediatric Environmental Health Specialty Unit in New York City conducted an HIA to inform Puerto Rican policy makers on their decision to fund a comprehensive development plan for improving sanitation infrastructure, as well as dredging and removing heavily polluted sludge from a two-mile stretch of the Caño Martin Peña, an estuarine tidal channel located next to San Juan’s main financial district. The area is home to 25,000 impoverished residents and migrants from rural Puerto Rico and the Dominican Republic; they face overcrowding, unsafe housing, unsanitary living conditions, and exposure to significant environmental health hazards such as frequent flooding, untreated wastewater, and fecal content 60 times greater than the Environmental Protection Agency’s water-quality standard. Mount Sinai conducted the HIA in partnership with the Corporación del Proyecto ENLACE del Caño Martín Peña, a redevelopment authority, and the community-based organization Grupo de las Ocho Comunidades Aledañas al Caño Martín Peña, G-8, Inc. Support was also provided by key stakeholders, including the EPA, local health agencies, and community organizations. The assessment’s purpose is to ensure that public health information and community health concerns are considered in the decision-making process.
The HIA recommended that Puerto Rico, with federal support, finance the Comprehensive Development Plan in its entirety, including dredging. To minimize harmful exposure for residents and workers, it recommended safeguards such as improving roadways and sewer and stormwater drainage systems, and following ENLACE bylaws when demolishing structures and relocating households.
Nongovernmental organizations and community organizers used the HIA to highlight the need to improve sanitation and reframe the issue as a health concern. Federal agencies also used the HIA to call attention to the problem. As of the end of 2016, the plan had not been fully funded due in part to major financial hardships in Puerto Rico. Nongovernmental organizations are still advocating for full financing and the use of safeguards.
This Health Impact Assessment Report first appeared in The Cross-Sector Toolkit for Health. The Cross-Sector Toolkit for Health was originally developed by the Health Impact Project, formerly a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The creation of this resource was supported by a grant from the Health Impact Project. The views expressed are those of the author(s) and do not necessarily reflect the views of The Pew Charitable Trusts, or the Robert Wood Johnson Foundation.