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Statement Of Sandra J. Fulton Picot
Environmental Protection Agency
Aging Initiative Public Listening Session
Baltimore, Maryland
May 7, 2003
Sandra J. Fulton Picot, Ph.D, RN, FAAN
Associate Professor and Endowed Chair in Gerontology
University of Maryland, Baltimore School of Nursing
Associate Professor and Endowed Chair in Gerontology
University of Maryland, Baltimore School of Nursing
My name is Sandra J. Fulton Picot, PhD, RN, FAAN, and I am an Associate Professor and the Sonya Ziporkin Gershowitz Endowed Chair in Gerontology at the University of Maryland, Baltimore School of Nursing. I am a nurse researcher, and I study unpaid caregivers of elders. I wanted to address concern that researchers are not studying the environment's impact on the participants in their studies voiced by Dr. Sandra Black. She is the epidemiologist from the University of Maryland Division of Gerontology who spoke earlier. I wanted to provide some statistics from a study that I conducted in Cleveland, Ohio. However, I believe that the inner city of Cleveland and Baltimore are comparable in many ways.
I conducted an NIH funded study (1996-2002) of a random sample of 407 African American women (203 unpaid caregivers of dependent elders age > 65 and 204 potential caregivers of independent elders age > 65) with an average age 55 (range of 20-87) in the Greater Cleveland Area. They were comparable to the U.S. Census in demographics.
Among the questions regarding their demands, resources, perceptions, and coping strategies, I asked these women about their daily hassles. Daily hassles were defined as minor to major annoyances in people's lives (e.g., marital, parental, employment obligations, and other annoyances). Their daily hassles were closely related to personal health and daily survival issues. Examples of these daily hassles were concerns about weight (56%); not having enough energy or strength (56%); having too many things to do (55%); not getting enough rest or sleep (52%); concerns about money for emergencies (50% of subjects); having friends or relatives too far away (42.5%); declining physical abilities (41%); neighborhood running down (38%); traffic (37.5%); having problems with their children (32%); noise (30%); not enough money for health care (29%); watching out for criminals (29%), and not having enough money for basic necessities such as food, clothing and housing (28%).
Their concerns are relevant to EPA's new aging initiative to protect older persons from environmental health threats. Traffic concerns can lead to pollution, which can result in not having enough energy and strength and declining physical abilities. Added pollution, run down and crime-ridden neighborhoods serve as barriers to walking and other outdoor activities to facilitate weight loss. Seventy percent of these women met the criteria for being overweight or obese.
Run down neighborhoods often breed rat and other pest infestation which may affect the indoor housing environment. Rats and roaches are likely to bring indoor allergens, which would exacerbate chronic obstructive lung diseases (e.g. increase in the prevalence of asthma) for both older adults and children.
Noise pollution, along with the activity of looking out for criminals, can contribute to inadequate rest and sleep. We know that inadequate sleep has been associated with problems like hypertension. Cardiovascular disease is the number one morbidity among elders, especially African Americans.
These women had numerous concerns regarding inadequate funds for emergencies, health care, food, clothing, and housing. One of the most common coping mechanisms for African American families to address these situations is to combine households. Unfortunately, more than half of these women felt that their family and friends lived too far away to assist them. Thus, they are being forced to live in environments that are harmful to their health.
I urge the Environmental Protection Agency's Aging Initiative listening sessions include the concerns of these young old African American women living in an inner city.
As a nurse researcher in the field of gerontology, I believe that we have much to contribute in the areas of research and advocacy. I look forward to collaborating with my environmental colleagues in the School of Nursing and across the other five professional schools at the University of Maryland, Baltimore.