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Empowering Youth and Creating Healthy Environments in Northern Manhattan: WE ACT’s Youth Programs
University of California at Davis
West Harlem Environmental Action
West Harlem Environmental Action
Citation: Sze, Julie, Swati Prakash and Alice McIntosh. (2005). “Empowering Youth and Creating Healthy Environments in Northern Manhattan: WE ACT’s Youth Programs.” Children, Youth and Environments 15(1): 265-277. Retrieved [date] from http://www.colorado.edu/journals/cye/.
Comment on This Field Report Abstract
Racial minority children, youth and families in the United States suffer disproportionately from urban environmental health problems. This field report focuses on how one community-based environmental justice organization in New York City, West Harlem Environmental Action (WE ACT), has focused on youth organizing around environmental health issues to improve the lives of the individual participants in their youth programs, while supporting larger organizational and community goals for an improved urban environment. WE ACT's youth programs have come in two forms: the Earth Crew Youth Leadership Program and DIFFERENTT (Diverse Individuals Fighting for Environmental and Reproductive Rights Now 'Til Tomorrow) which focuses on relationships between reproductive, environmental, and community health. This report outlines the social, political, and geographic contexts for WE ACT’s youth programs. It also highlights their underlying experiential learning philosophy, as well as their connections to WE ACT’s community-based environmental health research and political agenda for improving the environment in Northern Manhattan.
Keywords: urban environmental health, community activism, the environmental justice movement, New York City, West Harlem, asthma, community-based research
© 2005 Children, Youth and Environments
while supporting larger organizational and community goals for an improved urban environment. environmental justice organization that is dedicated to building community power to fight environmental racism and to improve environmental health. to help them understand and feel a sense of ownership of how their environment affects their health. youth and families in the United States suffer disproportionately from urban environmental health problems.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 266 Introduction Racial minority children. and learn. pray. WE ACT was founded and incorporated in 1988 as a result of local community struggles around air pollution and other environmental threats created by the poor management of the North River Sewage Treatment Plant and the operation of six diesel bus depots in Northern Manhattan.” The environmental justice movement is active in many different places in the United States and on a multitude of issues. One consequence is a sense of alienation from an environment over which young people feel no control. communities of color have used the framework and language of the environmental justice movement to combat problems of environmental racism and health. One of the first environmental organizations in New York state to be headed by people of color. based on our experience and an appreciation of our diverse cultural perspectives. play. In 1991 at the First National People of Color Environmental Leadership Summit. Young people traditionally do not enjoy the right of full participation in decisions about their environment that can have serious impacts on their well-being. A central analysis of the environmental justice movement is that the historic exclusion or marginalization of certain populations from political decision-making processes is a root cause of the disproportionate burden of pollution to which these communities are exposed. This field report focuses on how one community-based environmental justice organization in New York City. feelings which can manifest in adulthood on a community-wide scale. WE ACT is a non-profit. In response. has focused on youth organizing around environmental health issues to strengthen and to improve the lives of the individual participants in their youth programs. and emotional—is especially vulnerable to the adverse impacts of damaged environments. protection and policy in communities of color. . and to help them develop their own voices to be effective partners in the decision-making process on matters related to their community and environments. community-based. young people are a population whose health—physical. In many ways. The environmental justice movement has recognized the need to foster a sense of belonging and to integrate young people of color into the environmental fabric of a community. It has redefined the environment as the places where people of color live. The environmental justice movement asserts that the disproportionate burden of pollution borne by people and communities of color in the United States is a manifestation of racism. the burgeoning environmental justice movement articulated 17 Principles of Environmental Justice. work. as well as unequal access to environmental amenities such as parks and playgrounds. These include elevated exposure to environmental health risks such as lead paint and air pollution. West Harlem Environmental Action (WE ACT). including a call for “the education of present and future generations which emphasizes social and environmental issues. mental.
outspoken advocates for the clean and healthy environment necessary for good reproductive and overall health. was designed to develop the leadership potential of young women of color by empowering them to become trained. WE ACT staff noticed a significant difference between the dynamics of the group and that of the previous summer’s group. Another priority is to ensure that youth programs can enhance the individual development of their participants. youth leadership is a key component of WE ACT’s overall organizational goals. The 20 young women who have been involved in DIFFERENTT have all focused on a particular environmental and reproductive health . WE ACT's major youth programs have taken two forms (named by the youth themselves): the Earth Crew Youth Leadership Program (Earth Crew). environmental audits. Earth Crew was both a summer program. WE ACT’s youth group (then named Planet Rock Youth) comprised mostly young women. The Earth Crew Program has taught over 200 young people since 1993 such valuable skills as critical thinking. public speaking.to middle-low-income socioeconomic status. and one young person who was trained as a peer leader within the group. This observation coincided with a growing interest by other WE ACT programs in better understanding and addressing the specific impacts of environmental exposures and pollution on the health of women and of children. launched by WE ACT in 2002.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 267 WE ACT’s central belief is that preparing the next generation to understand and confront environmental racism is the key to sustaining hard-won environmental justice victories. pollution monitoring and community leadership. race and ethnicity (between African-American and Latino. ranging from 15 up to 35. and there was always a very deliberate effort to balance the group in terms of gender. and an after school program. Any young person from Upper Manhattan or the Bronx could be involved. There was always one staff youth coordinator. In the summer of 2001. and the more recently developed program. funded by the City of New York Summer Youth Employment Program. Young Women of Color Organizing Project (whose participants took the name Diverse Individuals Fighting for Environmental and Reproductive Rights Now 'Til Tomorrow—DIFFERENTT). with a limited number of White and Asian participants). Although this composition was not by design. which ran from 1993 through 2000. WE ACT’s involvement since 1998 as a community partner in a large Mothers and Newborns study by the Columbia Center for Children’s Environmental Health helped the organization begin to make connections between pollution exposure and birth outcomes as part of a growing body of evidence that suggests the long-term impact on reproductive and developmental health is linked to certain chemical and pollution exposures. and community meetings. The numbers of participants depended upon whether it was a summer or after school session. schools. DIFFERENTT. Earth Crew developed the leadership potential of youth of color (primarily AfricanAmerican and Latino) by using the urban environment as a classroom. the ten young women appeared much more comfortable with voicing their opinions and taking leadership within the group. The participants were overwhelmingly low. Thus. With only two young men present in the summer of 2001. Recruitment was conducted through churches.
Other environmental hazards include many chemical-intensive small businesses such as dry cleaners. metal shops and auto-body shops. New York City is often described as the epicenter of the nation’s asthma epidemic. The racialization of urban environmental health risks and their disproportionate impacts on children and youth are seen in Northern Manhattan in New York City. elderly. 2003). diverse neighborhoods. a large salt pile on the Harlem River near the Triborough Bridge. Northern Manhattan is also home to a dieselfueled Amtrak rail line. Political and Geographic Contexts for WE ACT’s Youth Programs Scholars have argued that the exposure of African-Americans and other minorities in metropolitan areas to high levels of pollution is an outcome of racialized urban development (Hamilton 1993). The median income ranged from $14.6 per 10. a large NY/NJ Port Authority bus station. This burden is felt particularly hard . Within New York City. On Harlem's west side is a dilapidated Hudson River waterfront that houses a recently closed marine transfer station and the North River sewage treatment facility.479 in 1999 (United States Census Bureau). asthma hospitalization rates in 2000 averaged 33.4 square miles of space. and 44 percent as Latino.7 per 10. is of particular concern in the asthma-burdened communities of Northern Manhattan. from public funding which focused on helping individual teenagers on an interpersonal level.000 residents of these communities live in just 7. five out of six of Manhattan’s Metropolitan Transportation Authority (MTA) diesel bus depots.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 268 issue around which they educated and organized their peers and communities (this group was 30 percent Latina. Northern Manhattan is a densely populated set of four neighborhoods—East Harlem. and multiple industrial land uses in the very Northern tip of Washington Heights such as the MTA Train Maintenance facility. young and minority residents (Bullard 1994). to funding that dovetailed with WE ACT’s broader communityoriented and organizational goals through support of staff resources and space rental.000 residents (Garg et al. This shift in program emphasis mirrored a shift in WE ACT’s funding sources. as well as an Interstate highway that crosses through Washington Heights.896 to $29. The more than 600. The communities of Northern Manhattan are home to a rich historical and cultural legacy and many thriving. Social. “toxic time bombs” are not randomly scattered across the urban landscape. These are also communities that have been burdened with environmentally hazardous land uses. more than twice the national average of 16. The presence of so many sources of diesel exhaust. The area is bounded on the west and east sides by highways and bridges. According to sociologist and environmental justice scholar Robert Bullard. but concentrated in communities that have high percentages of poor. nail salons. Central Harlem. On Harlem's east side the aging Wards Island sewage treatment plant emits hydrogen sulfides and nitrogen oxides that exacerbate respiratory disease. West Harlem and Washington Heights / Inwood—at the northern end of the island of Manhattan in New York City. Forty-four percent of these residents identify as African-American. 20 percent native Caribbean and 50 percent AfricanAmerican). a respiratory irritant and asthma trigger.000 residents.
5 percent children in central Harlem have asthma. and the communities with the highest rates of childhood asthma hospitalization are all low-income communities of color. The MTA’s dependence on diesel fuel is a health problem because it creates particulate pollution that can lodge deep in the lungs. and their impacts on children and youth. One study based at the Harlem Hospital Center found that 25. which garage an estimated 1. For WE ACT.000 people in 2000 (American Lung Association 2003). Challenging the disproportionate number of diesel buses garaged in Northern Manhattan became a priority for WE ACT in 1988 when the MTA built what at the time was the sixth diesel bus depot there.2 hospitalizations per 10. and specifically. WE ACT and other community-based organizations are active on air pollution and environmental health issues in Northern Manhattan. children’s environmental health in Northern Manhattan. O’Fallon et al. Of special concern is the diesel exhaust pollution from the five currently operational MTA bus depots in Northern Manhattan.” . Rather than participating in the “drive-by research” that characterized many academic studies in communities of color. WE ACT developed the position that communities of color are not “objects” of study. 2002). and hospitalization rates are linked to class and race. Both the youth program and the communitybased participatory research program at WE ACT have been strongly informed by the notion echoed throughout the Environmental Justice movement that “we speak for ourselves. 2003.000 population for children aged 0-14 in the year 2000. but must be active collaborators with researchers and institutions to assess and eliminate the causes of poor health. WE ACT’s youth programs grew alongside its programs in community-based participatory research and environmental health. as well as providing a community voice in study design. This facility was built on a site adjacent to a middle school and a 1. collaboration with research partners such as Columbia University results in better documentation of problems and strengthens the organization’s goal of an overall reduction in pollution exposures that negatively affect the community. double expected rate and one of highest ever documented in the United States (PerezPena 2003). The risks are greater for children who inhale more air on a per kilogram basis than adults. This position is not unique in that a multitude of participatory and community-based research projects have flourished in more general health studies as well as on environmental justice issues (Shepard et al.400 buses.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 269 by children of color. and garaged 240 diesel exhaust-emitting buses.).6 childhood asthma hospitalizations per 10. WE ACT has been engaged in collecting data.) and a national average of 33. Residents of low-income ZIP codes are hospitalized for asthma roughly five times more than residents of high-income ZIP codes (ibid. and who also may spend a larger proportion of their time outdoors. East Harlem heads the list at 170.200 unit subsidized housing development.200 buses out of the MTA’s entire five-borough fleet of 4. Asthma is the leading cause of hospitalizations for New York City children. compared to a citywide average of 64 (ibid.
dirty ones. even when buses were not actively driving to and from the facility. and conducted the traffic counting every day for a week. which is not necessarily representative of the air people are actually breathing. The findings from this study were published in a peer- .Empowering Youth and Creating Healthy Environments in Northern Manhattan… 270 In the summer of 1996. The highest level was measured at a site near the Manhattanville bus depot. and the pollution measured at each intersection. from relatively quiet intersections to extremely busy. The goal of the study was to see whether there was an association between the volume of traffic. the Earth Crew participants helped develop a “real” life and more accurate snapshot of what kinds and levels of pollution people were exposed to on a daily basis. WE ACT’s Earth Crew teamed up with researchers from the Columbia Mailman School of Public Health to measure air pollution at four intersections in Harlem. Data from the Earth Crew air pollution study The study found that levels of black carbon varied a great deal from site to site. They learned how to operate the air monitoring equipment. could learn new skills in the process of collecting “real world” data on pollution exposure. This finding suggested that the diesel bus depots were acting as a stationary source of diesel pollution. and black carbon (or soot). By helping select the intersections where data were collected and by wearing air monitoring backpacks. The members of the Earth Crew were trained as field technicians for this study. This study also showed how community residents. This is important since air monitors tend to be placed on top of buildings. especially youth. especially diesel exhaust. The intersections were chosen by community residents as being representative of a range of traffic density. Figure 1. which is used as an indicator of diesel exhaust. although relatively few buses were counted during the time the youth were counting traffic (see Figure 1). which they wore in backpacks as a way of indicating personal exposures. The study also included traffic counts. and were associated with diesel traffic density at all sites with one exception. The study measured two kinds of pollutants—fine particulate matter.
To do so. DIFFERENTT In 2002 WE ACT launched a new incarnation of its youth group. Women of color often live in communities that are disproportionately exposed to lead. Earth Crew designed and built a Green Oasis in front of the Adam Clayton Powell Jr.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 271 reviewed scientific journal (Kinney et al. DIFFERENTT focused on the relationship between environmental hazards and the health of young women of color. . and senior citizens. made a formal public presentation to the Community Board that gained the Board’s support. This is no small task in the primarily minority and low-income population that Earth Crew represents which faces many educational and social barriers that lead to poor self-esteem. teen pregnancy. In one project. domestic violence. shared personal experiences. 2000). Earth Crew participants have traveled to Boston to participate in a Youth Summit. focused on cultivating new voices and advocates for issues that affect the environmental health. spoken word artists. The Young Women of Color Project (whose participants chose the name DIFFERENTT) fostered a desire among these girls to challenge the status quo. In other years. Earth Crew identified abandoned city lots it wished to reclaim for community use. distributed. mercury. reproductive health and environmental knowledge of the participants. its members researched City land-transfer regulations. State Office Building on 125th Street. and programmed it with activities for rappers. outings. the MTA recently committed to converting the entire fleet of buses at the Manhattanville bus depot to hybrid electric models that produce considerably fewer emissions than traditional diesel buses. handed out flyers and educated community residents about the toxins in fish found in waters off Harlem’s shores. They also informed the development of a five-year epidemiology study now being conducted by WE ACT and its Columbia University research partner that assesses diesel exposure in four high schools in Northern Manhattan and tests for an association between diesel exposure and asthma symptoms. while at the same time mentoring and enriching the knowledge base of 20 young women of color aged 15-18. Notably. and filed a formal request with the City for the lots. It is particularly important for women of color that the reproductive health agenda encompass the unmistakable connection between environmental exposures and reproductive disorders. and guest speakers—to facilitate the young women’s active involvement in the learning process. look critically at and analyze their communities. The work of the Earth Crew in conducting this study has also been a critical tool in WE ACT’s ongoing struggles with the MTA to convert its fleet to clean fuels and reduce the disproportionate numbers of diesel buses garaged uptown. and rap music. which are widely thought to contribute to miscarriage. and designed. In another project. The program prioritized experiential learning and an interactive teaching approach—utilizing group discussions. Earth Crew’s history is rich with examples of youth projects that develop and demonstrate leadership skills and concrete accomplishments. recognize the importance of being active participants in shaping the norms within their immediate environments and organizing around issues that are important to themselves and their families. collected and analyzed peer surveys on smoking. industrial solvents and dioxin.
to help them identify the links between their health and exposure to environmental hazards and to enrich their interest in political and community organizing to reduce exposure. DIFFERENTT reinforced a value that there are both treasures and potentially harmful facilities and land uses in their neighborhood. clear information about the issues involved in reproductive health.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 272 infertility. In conducting both of these tours. “Why is all this stuff up in our hood? I have a lot of questions I didn’t have before the treasure hunt and toxic tour—now I want to do something and not just ask questions!” Participants in the first year of the program translated their concern around the disproportionate number of diesel-fueled bus depots into a . Overall the main objectives of the curriculum for this project were to provide health education and advocacy skills training that incorporates messages and issues that give voice to the perspectives. As one 17year old asked. An understanding of the reproductive system and how it works. 2. and education about the impact of the environment on reproductive health are essential to helping young women of color become advocates within their communities and throughout the United States. The treasure tour was integrated with a “toxic tour” to highlight sites that may be harmful to individual and community health. to ensure that they recognize and learn to expose the environmental factors that contribute to poor overall and reproductive health. There were three distinct modules in the program. reproductive and environmental health. ideas and realities of young women of color in the realm of sexual. The lesson topics for this module included: • • • • • • Lesson Lesson Lesson Lesson Lesson Lesson 1. and to transforming the reproductive health rights agenda to reflect the full range of concerns of women of color. 6. During this unit. 3. 5. menstrual abnormalities and birth defects. DIFFERENTT was designed to give the young women a working understanding of how their bodies function. The activities succeeded in getting participants to look deeply at their surroundings. The “Environment” Defined Lead Poisoning Pesticides Asthma Diesel/Diesel Organizing Campaign Overview of Environmental Justice Each of the experiential learning activities was developed by WE ACT staff to provide a balance between individual and group activities.1 The curriculum in the “Environment and Environmental Health” unit was designed by WE ACT’s Youth Coordinators and the Environmental Health Director to provide a solid knowledge base of basic environmental and advocacy tools in order to make connections between environmental and reproductive health. foster curiosity and make the experience fun. 4. The information was then mapped onto a life-size map drawn by the young people themselves and then the youth visited these sites. The activity began with the young people sharing information with their peers about things and places in the community that they liked or treasured and why. DIFFERENTT members engaged a group of their peers in a community treasure hunt activity.
Justice Now! banner In addition to the lessons.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 273 vivid. and share their thoughts on areas that could be improved. These assignments helped broaden the perspective of the young women and stimulated their thinking about the issues covered during the session. Figure 2. The quantitative survey focused on how much information the young women were able to retain. The young women were also encouraged to keep a journal and record their feelings and thoughts as the information was presented. This practice reinforced their presentation. and the qualitative survey provided an opportunity for the young women to evaluate the instructor and educational materials. The group was also given a qualitative and quantitative survey. public speaking and communication skills. . Youth Coordinators gave participants take-home assignments based on current events relevant to the topic at hand. painted banner reading “Justice Now! Don’t let MTA diesel depots destroy our health. All members of DIFFERENTT made a presentation to the rest of their peers in the group at the end of each module on a topic of their choosing that had either been discussed during the module or was related to it. 12-story diesel bus depot opening in East Harlem on September 7. 2003 (see Figure 2).” This banner was featured as the centerpiece of a WE ACT-led protest against a new.
Empowering Youth and Creating Healthy Environments in Northern Manhattan… 274 The quantitative evaluation revealed that 100 percent of the participants were able to identify local environmental pollutants and how they impact health. Chloe. Environment. This workshop focused on the reproductive and environmental health impacts of phthalates in beauty products (see Figure 3). and develop their organizing and advocacy skills through a public presentation. “I believe all women have the rights to make their own choices—but that means being aware and involved. Lauren and Alice facilitating workshop At the end of the module the young women made group presentations on asthma. and Communities of Color” conference co-sponsored by WE ACT and the Columbia NIEHS Center for Environmental Health in Northern Manhattan. For example. the principles of environmental justice.” Another 15year old participant said. According to one 17-year old participant: “I never really thought the environment was everything around me and that I had the right—no I mean the responsibility—of making sure everything was alright in it.” Figure 3. explore their local environments and ways they can make their environments safer and cleaner. DIFFERENT participants Lauren Lisbon and Chloe Marcano facilitated a workshop at WE ACT’s “Breast Cancer. . Exit interviews revealed that the program further succeeded in expanding previously narrow definitions of environment and health. chemicals like phthalates in beauty products. identify skills needed to run an environmental justice campaign. connect local and community health issues with global struggles. diesel depots. and childhood lead poisoning.
and eventually in a nearby church basement. WE ACT recently acquired an abandoned. particularly in a space-constrained place like New York City. This relationship between space and spirit is manifested in negative terms. and to create a space that minimizes impact on natural resources while promoting the health and sense of belonging of the users of the space. It will serve as WE ACT’s future offices. The absence of a permanent space for the young people to call home directly conflicted with a central philosophy of WE ACT’s work as articulated by Executive Director Peggy Shepard—that “the spaces in which we live affect our spirit and our actions” (Shepard 1994). The core philosophy of the environmental justice movement that “we speak for ourselves” provides an important frame of reference in ensuring that adults remain accountable to and supportive of young people in the movement. The process by which our habitat is planned and built keeps people isolated. in talking about the environmental problems that West Harlem faces. particularly community organizing work. the youth program sought out other space—first in a conference room in the same office building.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 275 Conclusion With the close of the 2004 year of the DIFFERENTT youth program. For example. As commercial rents in the Central Harlem neighborhood where WE ACT is based steadily rise as a result of gentrification and other factors in Northern Manhattan. affordable space for the youth program has remained a challenge. WE ACT has been unable to secure additional. Further information about WE ACT’s learning modules is available from the authors. private. as well as a youth center. five-story brownstone in its West Harlem neighborhood and is in the process of renovating and rebuilding the building using green building design and principles. Securing suitable.” This philosophy has helped shape WE ACT’s commitment to creating a sufficiently large. separate space just for the youth program. One is to engage in long-term strategic planning to ensure that youth work is integrated into other programmatic activities of the organization. Shepard says. Another commitment is to include the voices and perspectives of young people as decisionmakers in the planning and execution of its youth work. yet integrated space for a youth program in its next office space. . WE ACT’s experiences with its youth programs has informed several commitments it has made for future youth activities. As the organization rapidly grew between 2000 and 2002. WE ACT made the difficult decision to put its youth program on hiatus pending a move to a new office space. the design of which will emphasize computer skills and information technology. a community center and exhibition space. “oppressive physical surroundings perpetuate and reinforce their residents’ oppression. Endnote 1. In addition to this fundamental lesson about space and creating a sense of belonging. An entire floor of the building has been earmarked for the youth program. disempowered and depressed. as well as positive ones. The goal is to reclaim the process by which one particular habitat is planned and built.
With 15 years of experience as a health educator. Swati Prakash is Director of Environmental Health and Community-Based Research Programs at West Harlem Environmental Action (WE ACT). and children’s health. race and urban environmentalism. She lives in Harlem. in Environmental Health from the Harvard School of Public Health. Unequal Protection: Environmental Justice and Communities of Color. McIntosh plans..A. Formerly the Senior Program Director at the national office of the American Lung Association and Senior Public Health Educator with The Harlem Hospital Lung Center in New York City. “Environmental Consequences on Urban Growth and Blight. In addition to providing technical support for local organizing around air pollution and asthma. in Environmental Science and Public Policy from Harvard College. Toxic Struggles: The Theory and Practice of Environmental Justice. “Trends in Asthma Morbidity and Mortality. Ms. and her B. globalization and deregulation.. Her forthcoming book on the environmental justice movement in New York City will be published by MIT Press.org/data/asthma/asthma1. social movements and community activism. (1994). ed.Empowering Youth and Creating Healthy Environments in Northern Manhattan… 276 Julie Sze is an Assistant Professor in American Studies at the University of California at Davis.pdf Bullard. San Francisco: Sierra Club. Epidemiology and Statistics Unit (2003). It looks at the intersection of planning and health.S. Ms. air pollution. Alice Y. risk and health. both locally and nationally. especially through the prism of asthma. coordinates and administers many activities that foster community involvement. R. C.” Available from: http://www. Her research focuses on the culture and politics of environmental justice activism. (1993). and has worked with Teen Voices magazine. ed. and changes in garbage and energy systems as a result of privatization.” In Hofrichter. Swati collaborates with the Columbia School of Public Health on several community-based research projects focused on asthma. Hamilton. McIntosh is an independent health educator and executive proprietor of Health Education Consulting. She received her M. a Boston-based magazine written by and for teenage women. where she serves as a bridge between community organizing efforts and the scientific community.lungusa. 67-75. References American Lung Association. Philadelphia: New Society. R. She is currently consulting for and administering a health module for West Harlem Environmental Action’s youth program. Swati is a senior fellow and current member of the Board of Trustees of the national Environmental Leadership Program. McIntosh is an advocate who aims to increase knowledge and awareness of health education. .
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This action might not be possible to undo. Are you sure you want to continue?