How Some Southeast Asian Americans in Providence, RI Perceive the Risk of Mercury Exposure from Eating Fish - An Environmental Health Literacy Approach

Michael Jospeh
Bachelors of Arts in Environmental Studies
May 2003

The purpose of this study is to identify environmental health literacy (EHL) of Southeast Asian fishers in the context of mercury exposure from eating fish. This study is relevant because environmental health officials in Rhode Island (RI) suspect that Southeast Asian fishers in the state and their families are being exposed to hazardous levels of mercury due to high fish consumption and are concerned that this group is not aware of the risks of eating certain types of fish. The conclusions of this study are presented as recommendations to the Rhode Island Department of Health (HEALTH) and the Department of Environmental Management (DEM) on areas to focus further research and implications for current risk communication.

Small amounts of mercury are known to cause severe brain and nervous system defects. The vast majority of mercury humans are exposed comes from eating fish. Developing babies and young children are most sensitive to mercury and women of childbearing age are advised to limit their consumption of certain fish for risk to this sensitive group. A national biomonitoring study published by the CDC in January 2003 reports that while average exposures of Americans to mercury are below hazardous levels, certain subpopulations that consume higher-than-average amounts of fish such as subsistence fishers and certain ethnic populations may be exposed to unsafe levels of mercury.

Risk communication and education is one way to reduce public risk of mercury exposure by educating people to avoid eating fish that are high in mercury. Most states in the country issue fish consumption advisories. RI issued a fish consumption advisory for mercury in April of 2002. In order to effectively convey an environmental health message to a target population, risk communicators must understand the population's EHL. EHL is defined as the ability to use reading, writing, science, numeracy and civic skills to understand and act on environmental and health information in order to reduce personal risk and make informed decisions. This thesis identifies important fishing behaviors and assesses a discrete number of environmental and environmental health literacy levels among the target population.

Southeast Asian fishers are chosen as the study population for a number of reasons. National studies have found that Asian and Pacific Islanders (APIs) consume much more fish than the general population. Asian Americans are the fastest growing population in RI; about half are Southeast Asian. It is very probable that Southeast Asians are a low literacy group in the state. They are about four times as likely to be poor as the general RI population, many adults do not speak English and the group has a relatively short history in the United States and RI.

I interviewed 15 male fishers in the Providence area who belong to the three largest Southeast Asian groups in RI - Cambodians, Laotians and Hmong. I asked them questions about fishing practices and attitudes, family fish consumption and their EHL. All of the fishers and their families consume enough contaminated fish to be at risk of mercury exposure.

While most fishers were conversant about DEM-enforced fishing regulations, none were familiar with the fish consumption advisory. Most fishers did not fully understand the nature of mercury contamination, but trusted the information given by HEALTH and DEM. Most fishers showed high civic literacy and numeracy skills.

I have demonstrated that assessing aspects of environmental and environmental health literacy are critical. Recommendations for further research within EHL include focusing on high-risk populations such as women and subsistence fishers, measuring the reading ability of the study population and expanding the science literacy assessment. Outside of further research in EHL, RI should collect fish consumption data for Southeast Asians as well as the general state population. The state has an opportunity to integrate this data collection into the developing biomonitoring program.

Further risk communication and education to this and other populations should be a collaborative process with the population. This research indicates that the Southeast Asian fishing population will be receptive to such collaboration and that the product of this effort can be the advancement of people's environmental health literacy and thus their abilities to mitigate risk.