National Environmental Public Health Conference

Opening and Acknowledgements
Good morning.

Thank you, Dr. Arias, for that kind introduction.
[Dr. Ileana Arias, Director of the National Center for Injury Prevention and Control, CDC]

Thank you all for being here at this very important National Environmental Public Health conference.

I bring you a message of gratitude and encouragement from the U.S. Department of Heath and Human Services, and my bosses Secretary Mike Leavitt and Assistant Secretary for Health Admiral John Agwunobi.

As you know, Secretary Leavitt came to us from the Environmental Protection Agency.

He brought a new challenge for H-H-S to revitalize environmental public health and to infuse environmental issues into our public health planning.

I think that we have gathered together the right people at the right time to meet this challenge.

I am impressed by the leadership that has gathered for this conference, and only wish that I could have joined you earlier.

Without a doubt, the partnerships and activities that result from this conference will help make a difference in protecting the health and well-being of all Americans.

Environmental Health Leadership in the Office of the Surgeon General
This gathering is very important to H-H-S and the Office of the Surgeon General.

We have been working tirelessly to raise awareness about environmental public health issues.

O-S-G Chief of Staff, RADM Bob Williams came to us after several years of dedicated service to the Agency for Toxic Substances and Disease Registry.

And as some of you may know, the Office of the Surgeon General oversees the 6,000-member Commissioned Corps of the U.S. Public Health Service.

Our mission is to promote, protect, and advance the health and safety of the nation.

We are one of the United States' seven uniformed services, like the Army, Navy, and Air Force.

And many of our officers are focused on improving environmental public health across our nation and throughout the world.

CAPT Craig Shepherd, our Chief Professional Officer for Environmental Health, leads a cadre of more than 350 environmental health officers who are working on diverse issues, and who are also standing ready for deployment in case of emergencies.

The Corps has a long, distinguished history of advancing and maintaining environmental public health.

During World War II our officers provided environmental health services for numerous federal housing projects.

And today our officers protect the environment through their work at C-D-C, the Indian Health Service, the F-D-A, A-T-S-D-R, the Environmental Protection Agency, and beyond.

These are not "just jobs" for our officers. In fact, the officers are passionate about their work. And they inspire me in countless ways every day.

Priorities
Our Commissioned Officers also support the Office of the Surgeon General's three overarching priorities for a healthy nation.

The three priorities that we have been working on relentlessly over the past four years are:

• Prevention,
• Public health preparedness,

and

• Eliminating health disparities.

Environmental health is one of the central tenets of prevention.

Everyone is this room knows that there are many factors that impact our health: genetics, our personal choices, and our environment.

All three are intertwined.

And when our environment is not healthy and safe, our bodies and minds are not either.

Healthy Homes
A healthy indoor environment is key to good health...

Yet, when Americans think of environmental health concerns, many people think of the outdoor environment.

They often think of global warming.

This is probably because global warming gets a lot of media attention.

And Americans often think of their homes as safe havens.

…A place where family can gather, a place where they rest… a place where they are safe.

In fact, we Americans spend between 85 and 95 percent of our time indoors.

But as we all know, there is a need to create greater awareness about the dangers that lurk within.

So while we need to be cognizant and concerned about our outdoor environment, including pollution and smog, we must put at least equal emphasis on the long-overlooked issue of safeguarding our indoor environment.

In just the past 25 years, the percentage of health evaluations that the National Institute for Occupational Safety and Health has conducted related to indoor-air quality has increased from 0.5 percent of all evaluations in 1978, to 52 percent of all evaluations since 1990.

This means that in those years, the evaluations related to air quality concerns have increased from one of every 200 evaluations to one of every two.

Disparities in housing quality can affect disparities in health:

• 1.2 million low-income family homes with children younger than age 6 have lead paint hazards. These children are at greatest risk for lead poisoning.
• And we also know that many of our nation's most vulnerable, low-income children are exposed to more than one allergen in their homes.

Unhealthy indoor environments can impact anyone's health, and our children are especially vulnerable.

Asthma accounts for 14 million missed school days each year.

The rate of asthma in young children has increased by 160 percent in the past 15 years, and today one out of every 13 school-age children has asthma.

Childhood lead poisoning, injuries, respiratory diseases, and quality-of-life issues all have been linked to inadequate, poorly maintained, and substandard housing.

Unhealthy indoor environments are not limited to older homes.

New building materials and construction practices are being introduced with little understanding of their impact on the indoor environment and the health of the occupants.

Building practices often change faster than scientists are able to evaluate their potential health impacts.

We need stronger partnerships between scientists, environmental public health specialists, and builders.

And just as there is a growing trend toward "green buildings," we need to create a trend of green healthy homes.

Surgeon General's Workshop on Healthy Indoor Environment
The Office of the Surgeon General is very concerned about these challenges.

That is why last year we gathered leading environmental health experts for the first-ever Surgeon General's Workshop on Healthy Indoor Environment.

We rolled up our sleeves and tackled some very difficult issues.

• We identified and culled the scientific data related to indoor environments.
• And when we did that we discovered that there were a lot of holes and knowledge gaps.
• So we gathered information about the contributing factors and potential solutions to health concerns related to the indoor environment.
• We reviewed the progress we have made in understanding secondhand smoke, lead, radon, and asbestos as threats to the indoor environment.
• And perhaps most importantly, we began building collaborations around the common goal of improving our indoor environments.

We all know that the relationship between the indoor environment and health is complex.

It encompasses a broad range of chemical, physical, and biological agents; interactive factors and individual susceptibilities.

We also know that data is lacking on dose-effect relationships for many known toxic indoor agents and the interplay of genetic and other health risk factors.

The scientific evidence demonstrates a link between specific housing conditions and health.

That evidence is compelling enough to put what we know into action to help protect the health of the American people.

The Surgeon General's Workshop on Healthy Indoor Environment crystallized, focused, and provided a strong foundation for our H-H-S environmental public health efforts and partnerships.

And it continues to guide our framework for action.

Health Literacy
One of the key action items we are working on is the need to increase health literacy about healthy indoor environments.

Health literacy is the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions.

Putting it slightly differently, health literacy is the ability of health professionals to communicate with those we serve, so they hear, understand, embrace, and put into action the information and science we share with them, so they will make good choices for their health and safety.

Many of us have been working in the field of public health and environmental health for decades.

We have a sense of urgency; we know the need is great…

But, for the public at large, indoor environment issues are not widely recognized or understood.

In that sense, and in many others related to indoor environment, our society is "health illiterate."

We need to turn this problem around, and with the expertise in this room and beyond, I know that we will succeed.

Our first step must be to make healthy choices the easy choices.

Because today… right now… more than 90 million Americans don't know how to take care of their own health, or how to prevent disease.

Low health literacy is a threat to the health and well-being of Americans.

And the low health literacy crosses all sectors of our society.

People of all ages, races, incomes, and education levels are challenged by low health literacy.

When it comes to improving environmental public health, I am convinced that improving health literacy is critical to our success.

The more people know about what defines a healthy home and what is a health hazard, the better they can take care of themselves, their friends, their families, and their communities.

Every day, researchers and health professionals are witnessing the health literacy gap…the chasm of knowledge between what professionals know and what people understand.

We have to make sure that good health information is getting into the hands of the people who need it.

From researchers… to practitioners…to the public…we all have a role to play.

We have tremendous influence on the health messages that professionals and consumers receive, and we must communicate the messages effectively, so that the people we serve can put the concepts into action.

But the challenge is getting that science into the hands of the American people in ways that they can understand and use.

Not every American is a scientist, so it is our job to help all Americans put the best health research into practice at home and at work, and as a part of daily life.

We also need to improve the health literacy of the builder, the maintenance staff, the architect, and the city planner.

Very broad outreach is needed.

That is why I've been working with colleagues throughout the nation to improve Americans' health literacy.

I strongly believe that by improving health literacy, we can save lives.

And I'm here to ask for your continued support to improve health literacy.

The issues are clear, the need is great, and the time is now, if we will have an impact on our current and future generations for healthy indoor environments.

That is the reason I and the Office of the Surgeon General, are teaming up with Dr. Henry Falk, the Coordinating Center for Environmental Health and Injury Prevention, and the Centers for Disease Control and Prevention, to begin work on a document for the American people - for improving and safeguarding the health of our nation - targeted to be a Surgeon General's Call To Action on a Healthy Indoor Environment.

This document, which we anticipate taking about a year to prepare, will help us link the importance of a healthy indoor environment, with our priorities of prevention, public health preparedness, and eliminating health disparities. It will help inform the American people of the science, the evidence, and the data, to help improve our health literacy about this issue. And it will call the American people to action, based upon this science, evidence, and data.

The issues are clear, the need is great, the time is now!

Charge and Closing
In closing, together, we can and must shape a new vision for environmental public health.

When you leave this conference today, please keep the contacts you have made, share ideas, and continue to make a difference.

Connect the dots - for a more informed picture of this issue, and a clearer path ahead.

It is the responsibility of leaders like us to map out a course of action and involve others in achieving it.

I believe that is why you are here today.

Please continue to think imaginatively and critically. Keep educating, innovating and collaborating.

Keep asking the right questions: those that need to be answered, not just those that can be answered easily.

Our success in asking ? and answering ? the right questions will be measured in the health of the entire nation.

I can think of no greater challenge and no more noble pursuit in our time.

Winston Churchill once said, "We shape our buildings and, in time, our buildings shape us."

We must work to ensure that we shape our buildings to provide a safe haven - a safe and healthy haven, a healthy place to live, work, and play.

In turn, our buildings will keep us safe and healthy.

I look forward to working with you during this conference and beyond.

Thank you for your continuing work, and for your commitment to protecting, promoting, and improving the health all Americans.

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Last revised: September 04, 2008