Currently, the GFW neighborhood in Northeast Houston is primarily Hispanic and Black/AA (Fig. 1). It is one of the oldest communities in Houston and has a culturally rich history. Historically, the community has long been a majority Black/AA neighborhood, settled by freed slaves in the mid-1800s, and was thriving with railyard and industrial workers [12]. The GFW is within close proximity to a former creosote wood treatment facility, Houston Wood Preserving Works, which has potentially led to environmental contamination. The GFW is close to two Superfund sites on North and South Cavalcade Street that participated in known activities that lead to contaminated soil and groundwater with volatile organic compounds, polycyclic aromatic hydrocarbons, and various metals such as arsenic, chromium, copper, lead, and zinc [13, 14]. Another site, Many Diversified Interests, Inc. is a former foundry within the GFW boundary that operated from 1926 to 1992, the site’s groundwater is still being monitored by the U.S. Environmental Protection Agency (U.S. EPA) [15]. In 2020 and 2021, the Texas Department of State Health Services (DSHS) discovered and confirmed a cancer cluster in the GFW [16]. The DSHS investigations found higher rates of cancer (i.e., acute myeloid leukemia, lung, bronchus, esophagus, larynx, liver, and childhood acute lymphoblastic leukemia) than expected across 21 census tracks including the GFW [16, 17].

Study area of the Greater Fifth Ward Neighborhood, Houston, TX

Today, the population of the GFW neighborhood is 96% minority and has a median income household income of $27,668 compared to the median household income of $52,338 in Houston [18]. Roughly, 12% of residents have obtained a bachelor’s degree. Even given these challenges, two community organizations, the Coalition for Community Organizations (COCO) and Impact have been deeply involved with community engagement, working with residents to improve public health and neighborhood conditions. The organizations helped establish the GFW block captains, who are neighborhood leaders who work to make their neighborhood livable and safe from environmental hazards, and contaminants. The GFW block captain program was modeled after the Houston Health Department’s Block Captain Network and was leveraged by COCO to meet the needs of their community. Thus, the longstanding partnership between the research team and the community organizations provided an opportunity to better understand and identify the community’s mental and physical health concerns related to existing vulnerabilities and helped establish relationships with local community-based EJ organizations.

The survey instrument contained four sections. In the first section, respondents were asked to provide demographic information (e.g., gender, race/ethnicity, and age), and information about the number of years they lived in their homes and neighborhood. The second section recorded information about the respondent’s health history and included questions about chronic illness (e.g., kidney or liver damage diagnosis, seizures, mental health concerns, mental confusion, etc.), cancer diagnoses, and self-rated physical and mental health. The SF-12v2 is a validated questionnaire to predict mental and physical health outcomes of populations and was shown to be reliable in the U.S., in low socio-economic communities, and different languages [19]. The third section pertained to behavioral and health habits such as smoking, alcohol, and drug use. The last section of the survey was used to gauge participants’ perceptions of environmental concerns and ascertain the respondent’s awareness of the chemical creosote and their knowledge of the joint Houston Health Department and DSHS investigation into cancer clusters in the neighborhood.

A complete census was conducted in the GFW neighborhood between July and November 2021. Community partnerships were developed with the COCO and Impact approximately one year before the project began. The GFW block captains were instrumental in the process and were involved with survey design, surveying, and research translation. The survey teams consisted of three individuals: a graduate assistant, a GFW block captain, and at least one individual who was fluent in Spanish. The GFW block captains, along with Texas A&M University students recruited from the Texas A&M University School of Public Health EpiAssist program [20, 21], received face-to-face training, online training, and pre-recorded training videos in addition to research ethics and compliance training. The Texas A&M University students and GFW block captains received training each day before the fieldwork began. The trained survey teams walked every public road and passed every home within the geographic boundary of the GFW during twelve sampling campaigns. Homes that were completely fenced off, abandoned, or deemed unsafe by the survey teams were not approached during canvassing. Participants received a $10 gift card for participating in the survey. The survey was approved by the Texas A&M University Institutional Review Board (IRB2021-0357D).

Descriptive statistics were calculated for each variable, including demographics. Race was coded as either Black/AA or White. Asians, American Indian/Alaska Natives, Native Hawaiian or Pacific Islanders were excluded from the study to account for the low number of respondents in these groups. Hispanic/Latino/a were included in the demographics table to present a holistic view of the neighborhood’s ethnicity but were not included in the other analysis. Educational attainment was coded as less than a high school degree, high school diploma or equivalent, college degree or none. The respondents’ mean age and years lived in the neighborhood were calculated and reported in years. Their preferred language was coded as either English or Spanish. Responses to the SF-12v2 questions were used to estimate a mental composite score (MCS) and physical composite score (PCS) for each subject on a 0- to 100-point scale using methods developed by Ware et al. (2001) [22]. The SF-12v2 uses a norm-based algorithm and produces a composite score for self-reported mental and physical health between 0 and 100, and a mean value normalized to 50 which allows for comparison between groups in the study population and national averages [22]. MCS and PCS values for respondents were calculated and compared to the national mean using two-tailed t-tests. A complete case analysis was used, so that covariates with missing values were dropped before analysis. Multiple linear regressions were used to assess the impact of gender, age, race, and time living in the neighborhood on MCS and PCS. Statistics were calculated using STATA 17 SE (College Station, TX: StataCorp, LLC).