MHM, Texas A&M, unveil Colonia Safe Water Project findings

3 weeks ago 82

MCALLEN, Texas – A two-year study aiming to improve water, enhance wellness and strengthen communities was recently concluded and the findings were surprising.

The Colonia Safe Water Project is a collaboration between Texas A&M University School of Public Health and Methodist Healthcare Ministries (MHM).

During a presentation held in late January, MHM President and CEO Jaime Wesolowski spoke about the study, collaboration, and focus.

“We strive to improve wellness of the least served throughout central and South Texas,” he said. “Our focus is on broadening the definition of healthcare. It’s more than what happens in a doctor’s office. We really want to start way before that and do what we can. And that’s why what we’re doing today, talking about clean and safe water, is so vital.”

Methodist Healthcare Ministries is a private faith based, not for profit organization that began 30 years ago and is a partnership with HCA Healthcare.

“I should say the partnership that we have with HCA allows us to own 50 percent of Methodist Healthcare System, and that’s where we get our funds to do the things that we do. So, we own 50 percent of the hospital system. We also govern 50 percent of the hospital system. We get 50 percent of the distribution. So, we’re fortunate that, unlike many foundations, we don’t have to go out and fundraise. We get our money from the healthcare system,” Wesolowski said.

Methodist Healthcare System is the largest healthcare system in South Texas. It’s 11 hospitals. It’s in Bexar County, Atascosa, Gillespie, and they are growing.

“So, with Texas A&M University, our two organizations aligned to promote health and wellness, we both champion and empower the voices of local communities that’s very, very important to us. We want to shift power to our communities and truly listen to them, let them make the decisions on what’s important,” Wesolowski said. “So together, Texas A&M and Methodist Healthcare Ministries chose to address social inequities, and what we decided to do was focus on water safety first.”

A partnership was formalized with Texas A&M University three years ago and the first joint collaboration was to be clean water, he added.

Wesolowski told those present at the event that he had never been to a colonia before.

“When I came here, was just, I was honestly shocked. I was shocked at how some of the colonias had no water to not only drink, but to bathe in and use for their food preparation and things like that,” he said. “And I remember coming back from my trip and going to Chris and saying, we’ve gotta do something about this. And so that was really what the first thing we did from a policy standpoint.”

In 2019 legislation was sponsored by former Senator Eddie Lucio that authorized $200 million to fund water and wastewater projects in economically distressed areas.

“We are very proud to have worked very closely with Senator Lucio on that. MHM joined Senator Lucio and the former State Representative Mary Gonzales from El Paso funding public service announcements, trying to get the word out there to make sure we garner support for this legislation. And we are very, very proud that we were able to do that,” he said. “And then shortly after that, I found out from my friends at the School of Public Health at Texas A&M University that that was great, but we still have some problems, and so that’s why we are here today.”

The partnership began two years ago to address access to clean and safe water in two colonias.

Environmental Epidemiologist Dr. Garret Sansom spoke more in depth about the study.

“A lot of times back in College Station or other parts of the state, I’ll mention colonias, and their eyes sort of gloss over and they don’t even know what I’m talking about, even if folks have been living here for several different generations,” Sansom said. “And it’s true, colonias just means neighborhood translated.”

But the colonias specifically, in the context of the study, are typically characterized by unincorporated areas that don’t have the same type of city services that one would expect for most Texans living in the state. There are an estimated 2000 colonias, but this number is an estimate, he said.

“There are several different folks in these areas, again, don’t have the type of city services that you would expect, and that does include access to clean drinking water, either getting it through well services, privately, going out and purchasing it, or just not having the type of infrastructure to be able to ensure that you have clean water access within your neighborhood,” Sansom said.

There are many challenges that colonia residents have to deal with, he added.

“As mentioned, if you have an older piping system, an older infrastructure that’s bringing water into your home, unfortunately, particularly prior to the lead abatement program, you have the challenges of things like heavy metals or lead being in your water,” Sansom explained. “Or if you have a well, you have the challenges associated just with naturally occurring issues. We’re in a part of the world where arsenic is kind of just ubiquitous in the ground. So, if you pull up water out of the ground, there’s a very high likelihood that you’re gonna have certain types of exposures that are associated with negative health outcomes.”

Sansom said there are some issues where people who store water, but it’s not stored properly, they experience everything from gastrointestinal issues and more.

“We also have been seeing gaps in funding legislation. So, the current legislation doesn’t necessarily prioritize colonias,” he said. “There’s not a great cohesive voice, although I will say there’s been some Herculean efforts by both elected officials and nonprofit organizations on the ground to get these issues out there, and we have seen some improvements within certain locations, particularly over the last 30 or so years.”

Sansom pointed out that not every colonia is the same so the outcomes would be very different from county to county and neighborhood to neighborhood.

“There have been some positive outcomes in some areas. And despite this, I just want to highlight there’s a resilient and thriving community in a lot of colonias,” he said. “When I would go out in the colonias, the entire neighborhood would know I was there in like five minutes. So, they’re talking to each other. They know each other. And apparently, I stick out a little bit when I’m walking around the colonias, but I do just want to say how impressed I am with the folks who live in these areas and what they try to do for their families. So many of the homes will break bread with three generations under one roof, and I think that’s something to be admired.”

Roughly somewhere between about 20 to 60 percent of the colonia residents have employment challenges in comparison to others, significantly higher than the state as a whole. There’re also major educational challenges. Roughly 70 percent of colonia residents don’t have a high school education, Sansom said.

“So these are the types of situations, the types of variables, the types of experiences that, unfortunately, in conjunction with environmental health concerns, can really lead to an impoverished area that has major public health issues that really need to be responded to if we decide that we care about other taxes that we care about the future of public health in the state,” he added.

When choosing the colonias, Sansom said, everything was discussed with over 100 community advisory board members, more than a dozen different nonprofit and community organizations and built trust among them. The Community Health and Advisory Committee of Costco, Hand in Hand in San Carlos, and the Progreso Community Health Advisory Council were among those organizations that worked with the study.

“We picked two different colonias. We have one in Progresso and one in Alamo,” he said adding that participants were invited to participate in the study, it wasn’t forced participation.

The first phase of the study was a door-to-door visit where promotoras spoke with and recruited participants. A comprehensive health survey was conducted. Water was tested live using and EPA-approved method for field testing for Lead. The water samples were also taken back to the lab for a more comprehensive assessment of heavy metals. Then, an intervention was conducted by providing water filtration systems to residents such as pitcher filters and others.

During the second phase, biomarker data was collected, which included urine, toenails and blood samples, Sansom explained. In addition, baseline and follow-up dietary consumption surveys were conducted. If residents participated with all requirements, they were given a participant certificate and acknowledgement as well as a small stipend.

“So, in Progreso and Alamo, we had over 85, 84 plus percent of this water and survey testing, over an 80 percent baseline urine sample, over 80 percent dry blood sample, over 75 percent toenail and then the follow up 75 plus percent, which means these numbers mean, if it says 75 that means 75 percent of the people we approached agreed to give us that data,” Sansom said. “These types of numbers are literally unheard of. In fact, in the colonies, on previous research, anything over a 25 percent response rate is considered good.”

In Progreso, most of the participants were women, which according to Sansom is pretty typical with most work that happens in South Texas and the colonias. The education level was about 60 percent less than high school. The age distribution was 24 percent less than 40 years old, 26 percent between 40 and 49, 22 percent between 50 and 59, 20 percent between 60 and 69, and eight percent 70 and older. The income level was roughly 50 percent of residents make less than $15,000 per year.

“So, what do we find as we think about the home built? And the reason we asked this again is that if you have a home that was built prior to the lead abatement program actually even a little bit later, because they use lead in the soldering and piping, you’re more likely to have things like Lead exposure in your old pipe,” he said. “So, knowing how old the home is is important. We asked the question about how long you live there. Are you a smoker? Are you a drinker? The vast majority of folks are neither smokers nor drinkers.”

In Alamo, a very similar distribution was found. Income is about 61% of people make less than $15,000 per year. The age distribution is similar. The survey is very similar on the type of the home year built, most were after 1978 the vast majority are not smokers and not drinkers.

“And the reason it’s important to get this type of potential confounding variables, things like smoking, things like drinking, like that, is because those could be associated with negative public health outcomes and sort of on the back end statistically and then we can account for it,” Sansom added.

Sansom talked about the results obtained from Progreso and Alamo colonias. Hypertension was found in 32 percent of residents, along with 25% of residents in Progreso having Diabetes.

“This is almost a threefold increase compared to the state as a whole, same with heart disease is roughly in line, as was a little bit higher,” he said. “So, what we’re seeing is these chronic conditions in Progreso and Alamo, are statistically significantly higher than other areas in the state, despite having low drinking rates, despite having low smoking rates, which are associated with these types of health outcomes, also, heavy metal exposure is associated with these type of negative chronic health outcomes as well, leading creating the potential exposure of these contaminants leading to these negative health outcomes.”

The perception of environmental quality in colonias is either fair or poor, Sansom said. Over half of residents think there are major issues with the infrastructure.

“So, we think about roads, we think of potholes, we think of piping is coming into your home, soil, negative soil, kind of contamination. A lot more people actually did think there might be some challenges associated, that it’s often associated with things like herbicides, pesticides and potential risks associated those sorts of things, and then water quality, again, fair or poor was the vast majority of folks thought there might be an issue with that,” he said. “And that’s also true in Alamo, with, again, well over 80% of people being very concerned, thinks, poor or fair quality with water conditions.”

In addition, the team conducted a validated general physical and mental health assessment that has been performed by federal health departments, the state, and internationally, Sansom said adding that the assessment has been proven to work with immigrant populations with different languages.

The assessment calculates a physical composite score as well as a mental composite score. The average is always normed at 50, he added. If the score is below 50, it is considered a reduced score compared to the nation. If the score is above 50 then it is considered an improved score. Sansom said the state of Texas is “really, really close, as a whole, to the national average.” The physical health composite score results for both colonias were less than the national average, he added.

“The mental health scores are above average; they almost always go one together. Very rarely do you have negative physical health outcomes and you’re mentally you’re doing well; they typically go in conjunction with one another. So, we started asking ourselves what could be causing this increase in mental health improvements, especially in a community that has serious, negative physical health composite scores,” he said. “And while we’re testing out the data, it’s everything from they’re more cohesive, as I mentioned, when I show up in the neighborhood, the whole neighborhood goes there very quickly, right? They’re talking to each other. They’re also predominantly communities of faith, which have been associated with positive mental health outcomes. So, there’s definitely something fascinating going on there that you don’t typically see in other communities in the colonias. And again, I think that speaks to their resilience. They’re looking out for each other. And again, all colonias are different, but that’s what we’re finding here.”

In terms as to how colonia residents view drinking water itself, 66 percent of them say tap water is unsafe to drink and about 71% think community tap water is unsafe to drink.

“These are shockingly high numbers. So regardless of any other conditions the community doesn’t trust the water to be good to drink, regardless of any kind of situation here,” Sansom said. “I have numerous quotes about people like washing their clothes and their wipes come out yellow or brown, like they can’t actually get clean clothes just because of how intensely it seems like there’s a lot of particulates in the water as they begin to drink it.”

There are concerns across the board of environmental exposures associated with drinking water patterns of use.

“Now I want you to think back this is Progreso to 50 percent to 67 percent of people make less than $15,000 per year in each of these locations, and yet bottled water is by far the number one consumed thing. Now, if you’re making $15,000 per year, spending all of your money on bottled water is actually a huge financial burden,” Sansom said.

“One of the things we’ve been discussing is also, you know, my grandma has to go out there and pick up a five-gallon thing of water. There’s no way, right? So, you have to get less water. So, you bring on less water, which means you have to drive more, right? So, there’s more gas costs. So, it’s not just something like, okay, just go get some water and you’re good to go. It actually does have cascading impacts across the board in a lot of different areas. And so the vast majority of people are drinking bottled water, and particularly for their kids, whereas they might be like, All right, I’ll go ahead and drink this water. They don’t want their kids to. Although if you look at cooking, then there’s a little bit more of a connection, which is why we provided the filters that go on to the faucet. So, if you want to pour water for your soup or beans or whatever, you can pull it from that.”

Alamo had very similar results as Progreso. As far as heavy metals in the water, the results were alarming.

“When we look at the water quality itself, here is Progreso. We found arsenic, nickel and uranium in 100% of the samples that we took in these colonias, all right, and they do range pretty dramatically,” Sansom said. “In Progreso, seven percent of people have lead levels. There are a couple important things to notice. One is there are no safe lead levels in drinking water, and there are no safe arsenic levels in drinking water period and the maximum contaminant level goals by the EPA, like their goal and the vast majority of all public health institutions, is zero. Because if you cannot advocate drinking Lead water and not expect some possible public health issues.”

Sansom explained there’s something called the Action Level. This is a product of both the health potential, health implications, as well as the cost, and financial issues of it.

“So, what we found is we’re seeing people exposed to arsenic, nickel, and uranium and lead to a lesser extent in seven percent of the homes, in areas that are higher that we know can cause negative public health outcomes yet below the Action Level that might be able to trigger financial assistance.”

Sansom added that lead exposure and arsenic exposure are the type of exposures that are there for the rest of your life. So, if you have Lead exposure when you’re a child, those types of exposures will continue into adulthood, even if you stop being exposed.

Arsenic exposures in 100% of participants were found when their toenails were analyzed in both Alamo and Progreso. In order to counteract the levels of arsenic exposure, residents were given an intervention in the shape of water filtration systems, such as pitchers and faucet filters. A month later, the exposure levels dropped by half, Sansom reported.

Vitamin D deficiency is associated with heavy metal exposures, and that is something that was also found while conducting the study.

“We see 28% of people have vitamin D deficiency, which is higher than the state of the nation as a whole and Progreso, and we would look in Alamo, about 26 percent of folks have vitamin D deficiencies, the type of deficiencies that you would expect if you have heavy metal exposures,” Sansom said.

The findings show there are issues with the water quality and public health implications both with specific diseases as well as chronic conditions that are happening in the area.

“There are some things you can do at the individual level. You can keep using the personal filters we shot half the half the level, and the folks in the higher risk zones, or the high-risk levels of arsenic department, after they use the filters, you can change your faucet filter, you can flush out your pipes, just running the water for a few minutes first thing in the morning does reduce the levels, because a lot of the certain types of metals, for instance, Lead, is almost certainly from older piping. And yeah, there’s dietary issues, like supplementation.”

As a result of the study, a two-day policy program workshop was held at the Texas A&M San Antonio Campus where representatives from TCEQ, water purification plants, community leaders and others gathered to hear a presentation of the results of the colonia study.

“Just as an example, there’s lots of data about the colonias that are all over the place, so we could be the clearinghouse for that information. If we can do what’s called a systematic review, meaning, look at every single piece of research that’s come out, then we could be have a very clear and easy to digest in comparison, understanding of the health issues, healthcare access issues, environmental health issues, that are in there, as well as all the connections and the work to be able to improve these that have been talked about moving forward,” Samson said.

Wesolowsi reaffirmed that the study is just a first step.

“I was told by more than one person that, you know, a lot of organizations come down here and try to do something, and then they leave. We don’t hear from them ever again. And I want you to know that we are invested here. We are invested. We have many team members that work here. We have a board member that represents you on our board and brings your issues to us. We have a community council down here,” he said. “And what I’m very happy to announce is that we are moving forward with Texas A&M University. This is the beginning, so our board was nice enough to accept a proposal from us to extend this partnership for an additional four years at $5 million to get more study done, to dig deeper.”

The Colonia Safe Water Project uncovered much more than what researchers thought.

“When we put together this project, it was focused on heavy metals, but we quickly found out there’s soil contamination issues associated with things like polycyclic aromatic hydrocarbons or PAS that have been seeping into the water system. Yes, of course, heavy metals, septic and sewer issues were something that rose right to the top. So, there’s lots that we’re not looking at in these last two years that we want to incorporate,” Sansom added. “Moving forward, we’ll be able to do a much better job spatially assessing cancer risks as well as chronic condition risks that infiltrate into the water systems. We’ll be looking at hundreds of different types of contaminants and analytes in the soil in the water. We’ll be looking at much larger issues associated with the health assessment within the communities, and we’re going to be moving into places like Willacy, Cameron County, Star County, and we’re not leaving the colonies that we’re working on here in Hidalgo. So, we want to make it bigger and better. We want to be working with the communities. We want to make sure we engage with all the families to be able to have that synergistic impact. So, it’s not just a study. It’s how do we actually make them ambassadors for their own communities and improve it? How do we get to the expansive communities that nobody’s been able to go into before, and I have to say, in large part to the success of this. These other colonias, these other counties, are now asking us to come in, and as I said at the very top, we don’t force our way in. We come in by invitation, and we receive the invitation. So, I’m very, very excited and happy that we’re going to be again working for another four years to be able to improve the lives of the vulnerable and make sure every Texan has access to healthy water, healthy soil, and they have the opportunity to live a full and flourishing life.”