Retail Environment and Hair Styling Exposure (RESTYLE) Study: Exploring the Community and Neighborhood-level Drivers of Safer Hair Product Availability and Use in Boston, MA

Abstract

Personal care products commonly contain chemicals of concern including endocrine disrupting chemicals (EDCs).1,2 Inequities in exposure to EDCs are well-documented with communities of color, specifically, Black individuals, more highly exposed to personal care product-associated EDCs (i.e., phthalates and parabens).2–5 Differences in exposure to EDCs may be driven by differences in personal care product use patterns, notably hair products.6,7 Use of certain hair products (e.g., hair oils, hair relaxers), that are reported to contain EDCs,8,9 may be a risk factor for developing a variety of reproductive and cardiometabolic outcomes, where racial/ethnic inequities persist.10–13 Previous research has predominantly considered personal care product use as an individual-level behavior and risk factor—however, various factors at the neighborhood/community and societal-level contribute to hair product purchasing and use patterns.7,14 Additionally, while previous research has documented inequities in exposure to EDCs and associated health outcomes,2,6,7 little research has used a mixed methods community-based approach to identify solutions and interventions. Through the Retail Environment and Hair Styling Exposure (RESTYLE) Study, we aimed to fill these gaps and identify barriers, facilitators, and solutions to inequities in EDC exposure from hair products among Black communities. Thus, this dissertation aimed to explore the community and neighborhood-level drivers of safer hair product availability and use patterns and to identify potential community-based interventions in Boston, MA. The following three studies described in this dissertation were a part of the RESTYLE study, a mixed methods community-based study in Boston, Massachusetts (MA). Chapters 2 through 4 describe the three studies conducted. In Chapter 2, we detailed the process of developing a database on the safety of almost 40,000 hair products throughout the city of Boston. We then examined the role of historic and contemporary resource allocation practices (historical residential redlining and contemporary gentrification) on access to safer hair products. We found that stores in areas that were historically redlined (received Home Owners’ Loan Corporation (HOLC) grades of D indicating “hazardous” or high risk for investment) and have not been contemporarily gentrified had increased access to high hazard (containing chemicals of concern, such as EDCs) hair products and decreased access to low hazard hair products. Next, in Chapter 3, we used photovoice—a qualitative community-based participatory method consisting of photography, individual interviews, and focus groups—to identify the barriers and facilitators to safer hair product purchasing and use among Black women in the greater Boston, MA area. We identified five barriers ranging from the individual to societal level (including the costs of purchasing safer hair products and unsafe ingredients allowed in US products), two concepts underlying the barriers, and two facilitators that span the individual to neighborhood/community level (including back to our community and cultural roots). Finally, in Chapter 4, we described our use of photovoice to develop a survey that aimed to identify community reflections, attitudes, and priorities regarding key actors and solutions to overcome the barriers to safer hair product purchasing and use. The survey respondents resonated with the time investment required to identify safer products from the photovoice project. Additionally, we reported the top three rank ordered key actors (including policymakers) who should be involved in developing and implementing interventions and top three rank ordered solutions (including the US government enacting stronger personal care product safety laws) identified by the survey respondents as priorities. Differences in the top three rank ordered key actors and solutions were observed based on the respondents' sociodemographic characteristics.