Summary and Conclusion

Over 140 communities from around the country responded to River Network's Health Needs Assessment. A high percentage of communities responding (52%) indicated that they felt their situation was serious; many cited cancer (34%), birth defects (20%) and other serious illnesses as examples of illness in their community likely more related to environmental contamination that natural sources. Despite the potential serious nature of these concerns, there was a great deal of uncertainty about various aspects of the connection between the health problems and contamination. Thirty percent were unsure about whether or not their health problems were serious. Most respondents were uncertain about what was known about the likelihood of a connection between the contamination and health problems. Relatively few respondents knew about the possible pathways of human exposure. Clearly communities need more information to assess their circumstances.

Some 45 groups had done work to address their concerns. Background research, public education and monitoring were reported to be the most effective actions communities had taken. Many had received useful help from universities, consultants and non-profits. Help from EPA and State environmental agencies was rated to be modestly helpful, and ATSDR and local health departments were found to be unhelpful to most.

Most communities indicated that there were many areas where they wanted help. Over 70% of respondents indicated that help was either "somewhat needed" or "very needed" on almost every item we asked about. One quarter to one-half of all respondents indicated that help was "very needed" on every item asked about. The areas where help was most needed was:

• Monitoring
• Health surveys
• Identifying discharges
• Hazard identification
• Guidance to web resources

These results substantiate River Network's plan for the development of health assessment tools. Our plan has been to develop tools that are in fact targeted at these very areas. These results may suggest that we shift our priorities some. We were originally not planning to put as much initial emphasis on monitoring; however, given that most groups indicate that this is the area they need most help with, we will place more emphasis there.

Lastly, we are gratified that so many groups, 91%, indicated an interest in potentially working with River Network intensively on health assessment, 43% indicating that they were certain about wanting to do so immediately.

The results of the needs assessment confirm the direction of our project. A need clearly exists for tools we are developing and the type of assistance we seek to be able to offer communities.