All children and their families need assistance from schools, pediatricians, and other medical and social work personnel. However, inner-city children and agricultural children also need specific nursing and environmental health assistance to help determine existing, problems related to the home and home environment, and how to resolve them.

There are at least three potential home and neighborhood environments that need to be examined. These are the urban environment, suburban environment, and agricultural environment.

Urban Environment

The urban environment for the purposes of this discussion is the overcrowded, older, congested neighborhood with older homes, especially those that were originally single-family and now are broken up into a multitude of apartments. A house that once held from two to nine people now holds 60 or 70.

The schools tend to be considerably older and have the types of problems that come with older school structures. The components of the structures that cause major health, safety, and learning problems are: inappropriate temperatures, indoor air quality, and outdoor air quality; poor lighting and acoustics; inadequate and outmoded science laboratories, workshops, and equipment; and overcrowded school buildings. In addition, the condition and operation of the equipment in the food service areas, the drinking water supplies and equipment, the number and condition of lavatories, the sewage disposal systems, the solid and hazardous waste materials disposal systems, and the hazardous materials storage areas may be questionable and cause additional hazards. Older facilities that are improperly maintained become an underlying factor in contributing to a variety of injuries. The oldest school buses with the greatest number of problems contributing to air pollution tend to be found in these areas. Fire safety is a serious concern. There is a lack of good communications systems for emergencies and security systems to protect the students, faculty, and other individuals within the structure. Many studies have shown that children in this type of environment perform at a lower level academically than children in better facilities. (See endnote 36.)

Socioeconomic factors cause more children to live in poverty than any other age group in the United States. Their families are more likely to live in public housing or older rundown housing in parts of the city which are in close proximity to industry and overcrowded conditions. The amount of environmental contamination is increased substantially because of locally heavier air pollution and increased levels of contaminants from automobiles and trucks. Benzene and particulate matter are especially of concern in these settings. Further, children living in poverty tend to underutilize healthcare services, and if they have asthma or other respiratory-type diseases, they have further complications. One of the triggers for asthma is exposure to roaches and mice and their droppings.

Over the last several years, studies were conducted by the Columbia University Center for Children’s Environmental Health in Northern Manhattan/South Bronx, New York involving African-American and Latino pregnant women and their children. Their health and conditions within their environment were measured on a regular basis and a determination was made concerning the environmental agents that affected the fetus, newborn, and small child. These research study participants were exposed on a regular basis to multiple common environmental pollutants that can affect fetal and child development and respiratory health, or increase cancer risk. They were exposed to polycyclic aromatic hydrocarbons in indoor air and outdoor air, pesticides, especially chlorpyrifos and diazinon, used in homes, phthalates, secondhand smoke, etc. The findings indicated that polycyclic aromatic hydrocarbon exposure resulted in reduced birth weight, reduced head circumference, especially in African-American babies, and lowered IQ. Pesticide exposure resulted in a delay in psychomotor and cognitive development, attention deficit hyperactivity disorder, and personality disorders. Secondhand smoke resulted in reduced cognitive development and potentially asthma. Overall, a risk of asthma and increased risk of cancer from exposure to environmental pollutant could be found in this group. The individuals within this study represent people living in these types of inner city areas everywhere. (See endnote 19.)

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