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California is developing a plan to control emissio

California is developing a plan to control emissions related to major seaports, such as the Port of Los Angeles/Long Beach and oil refineries in the harbor area. Next to the two harbors is the very large Long Beach oil refinery which processes the oil that is shipped in. The refinery is another significant source of emissions for the region. The refinery has also submitted plans to expand and modernize their operations to accommodate the anticipated expansion of the ports. The southern portion of Los Angeles is a heavily industrialized region, and there are many communities living in close proximity to these major facilities. Many of the local communities consist primarily of low-income public housing. Community groups from these areas have strongly objected for years about being exposed to air emissions from these facilities. Some groups offer scientific studies that cite a variety of health risks associated with living near refineries and ports. Some groups claim that people living near refineries suffer higher death rates and higher cancer rates (anecdotal reports). The State of California and the officials of the County of Los Angeles have received a number of Environmental Impact Reports (EIRs) concerning the expansion of the refineries, and the expansion of the Los Angeles and Long Beach ports. None of the EIRs address the claims (in scientific and anecdotal reports) of adverse health impacts associated living near a refinery and a port. You are an expert on community health assessment, and have been asked to advise the Board on why some reports (such as anecdotal reports on the web) show increased disease and death rates while other reports do not. It is essential to consider the effects of both projects and examine them in a Multi-Source Context, and to explore the application and limitations of Risk Assessments. Characterize the health risks potentially associated with living near a refinery and a large harbor. (Focus on the environmental health related health risks.) Define and explain the difference between a scientific study and anecdotal reports (that is, those from reputable journals and organizations, and those from newspapers, personal testimonies, and web postings). Explain why the communities living close to refineries and/or the harbor/ports might actually experience higher rates of morbidity and mortality due to such confounders as age, race/ethnicity, social economic level, and access to care. Discuss how Multi-Criteria Integrated Resource Assessment (MIRA) could change the decision-making process concerning individual plans for the refinery and port.

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