Author:Berman, Laurel

Part 1: A 5-Step Land Reuse and Redevelopment Model: Resources to Spur Local Initiatives


People who live near or access land reuse sites such as brownfields often experience disproportionate exposure to environmental pollution that can result in poor health outcomes, including higher rates of chronic disease, toxic exposures (e.g., mercury or lead-based paint) that result in adverse health effects, and cancer (de Leon & Schilling, 2017; Massey, 2004; New Jersey Department of Health and Senior Services, 2007). To address health risks and exposures related to land reuse sites, for over a decade the Agency for Toxic Substances and Disease Registry (ATSDR) internally integrated a public health model in land reuse and redevelopment--the 5-Step Land Reuse Strategy to Safely Reuse Land and Improve Health (5-Step Land Reuse Model).

In June 2015, ATSDR introduced the 5-Step Land Reuse Model during a 3-day training facilitated by the American Public Health Association. The purpose of the training was to introduce the 5-Step Land Reuse Model as a national model that could expand resources for health-focused land reuse at the local level.

The 5-Step Land Reuse Model Training

Over 65 individuals participated in the training. Participant came from ATSDR's Brownfields and Reuse Opportunity Working Network (BROWN), community partnerships, and grantees (an ATSDR funding program from 2008-2016). The authors represent each of these participant groups. The training was based around the 5-Step Land Reuse Model shown in Figure 1. A brief description of the training based on each of the model's steps is provided below.

Step 1: Engage With the Development Community

Participants shared and practiced using community engagement techniques, such as plain language ( and community engagement games. ATSDR grantees shared successful community engagement techniques, such as funding of promotores de salud (community health workers), in which community members educate and engage their communities about land reuse sites, environmental concerns, and associated health outcomes.

Step 2: Evaluate Environmental and Health Risks

This session was grounded in environmental health basics that included definitions and significance of exposure sources, media, pathways, toxicology, and cancer and non-cancer risks. Participants learned about and practiced using the following tools:

* health impact assessment (Centers for Disease Control and Prevention [CDC], 2016),

* Protocol for Assessing Community Excellence in Environmental Health (CDC, 2017),


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