Healthy People Consortium Meeting
"Implementing Healthy People 2010"
November 11, 2000

Summary of Breakout Group Discussion Concerning:
Environmental Health


Background -- Overview

Environmental Health (EH) has had a long history in the Healthy People agenda. The focus area is naturally broad and has been developed through stakeholders in government, private sectors, academia, and public health organizations. This year there were numerous public comments and in conjunction expanded to nearly 75 objectives that later had to be refined to 30 objectives. The importance of EH is evidenced by its contribution as one of the Leading Health Indicators for Healthy People 2010.

1. What does implementing Healthy People mean to you?

When implementing Healthy People, States typically focus on the objectives most important to them, with an eye toward resources.

States often must refine objectives from the national level, and this can prove problematic depending on the objective and the data available.

Implementing Healthy People also means collecting and tracking data.

When implementing objectives, in particular those from the EH chapter, encouraging the use of safer and more environmentally friendly products among the business community is important.

For many, implementing Healthy People meant facilitating community partnerships among all public health stakeholders.

2. How do you suggest we work with local community groups in implementing the Healthy People 2010 objectives?

Working with community groups is very important to acquiring resources and, by explaining the significance of Healthy People activities at the local level, will help to involve more local groups.

Educate health professionals (including practitioners and health educators) and help provide them tools for action.

Meet with local health groups on a regular basis and cultivate the importance of Healthy People objectives within their communities.

Work with Healthy People groups such as the "Healthy Communities Group"--Healthy Community Web site: http://www.healthycommunities.org/).

Work with community-based groups that focus on particular issues in their towns (e.g., groups that specifically work to reduce indoor air pollution).

Poison control centers are a good example of how efforts can be combined to form a cohesive unit. These centers usually have clinical expertise, poison control prevention/education, messages to community (community outreach), target needy areas, and intervention activities.

Sometimes there is no EH capacity because of lack of data or lack of priorities, therefore, tools for EH assessment and encouraging the use of tools should be prompted.

The use of grants and other funding is often helpful for communities to pull resources together and implement objectives. For instance, in the Robert Wood Johnson grants--"turning point sites"--EH was one of top five elements among communities; brought people and coalitions together.

Conference grants from CDC (get more info).

3. What are the challenges/barriers to meeting the Healthy People 2010 objectives? And how do you suggest we work to overcome them?

Need more resources, especially funding.

Establishing partnerships with private industry and business can be difficult yet also critical because of the assistance they can provide.

Other barriers include identifying where money can be provided, lack of technical resources, and lack of technical assistance.

Local and State health departments could hire a Healthy People coordinator to conduct and manage the Healthy People issues and processes yet resources are, again, problematic for a single job to be allocated for these duties.

By combining similar departments and personnel, barriers are sometimes broken. For example, in Vermont, the environmental department combined with the human resources department and the public health nursing department to form one comprehensive public health section.

There are barriers in the education of health professionals regarding the importance of public health and environmental issues in disease issues.

The more coordinated and integrated State and local health agencies are, the more likely are their chances of success.

In some instances the challenge is simply lack of awareness of the problems involved.

The lack of national health surveillance data for outcomes that relate to EH (e.g., asthma) was mentioned as an issue that must be addressed.

Pew Environmental Health Commission made a recommendation to President Clinton and Congress in the fall of 2000 that a national tracking system be developed to explore the link between chronic diseases and environmental sources. One of the trends they identified in children was the estimated increase of 50 percent in autism and mental retardation in the past decade. Research supports that 25 percent of this increase may have environmental linkages.

By profiling certain health issues across the State (State and local cooperation) more awareness can be encouraged. Using Web sites such as the Earth Resources Observation Systems (EROS) Data Center http://edcwww.cr.usgs.gov is also a big help in overcoming information barriers.

Other philanthropic organizations that provide funding for nonprofit agencies such as the Pew Charitable Trusts (http://www.pewtrusts.com/) are also helpful in achieving funding.

Furthermore, by illustrating the relationship of chronic disease and EH, local organizations and businesses are more likely to provide resources.

Educating community practitioners to educate legislators is particularly useful in developing legislation and policy toward accomplishing Healthy People objectives.

4. What can we do to support the elimination of health disparities in Environmental Health among racial and ethnic population groups?

Making alliances with grassroots organizations that are involved in environmental justice issues, for instance, will support elimination of health disparities. This approach also supplies information to those populations that in all probability need it the most.

Also, providing data to legislators on the issues and extent of health disparities among their constituents gives them a powerful tool to develop legislation actively and provide funding to local agencies that combat disparities. Similarly, offering and translating data to the State and local media is another avenue to breakdown barriers.

Environmental Justice and Health Disparity grants from Federal agencies (e.g., NIEHS www.niehs.nih.gov/dert/programs/translat/home.htm) help provide key funding to eradicate health disparities.

5. How do we measure progress of Healthy People 2010 in the future? And what is progress?

Continuing to measure the objectives through the use of data seems to be the best method. Nonetheless, there seem to be some inherent problems with various objectives that cause them to be difficult to measure at the State level. If a better system could be developed of compiling data at the State level as well as refining the objectives so they better correspond to State data collecting systems, then better progress could be made.

A question of what baseline would be used for the EH objective relating to PM and ozone nonattainment areas (i.e., pre- or post-1997 NAAQS) was also raised.

6. How can we work more effectively with the media in implementing the Healthy People 2010 objectives?

Community-level leaders should work with editors and media groups to make the objectives more visible to the public and to increase awareness.

Educate the stakeholders who are involved as to the importance of the objectives regarding health outcomes.

Educate the media (get the right message across) in translating data and how to refine messages about Healthy People into "plain" language that enlivens the audience.

Start small--at the district level and work up to State level.

Help to translate and transmit the data to the media and encourage editors and other media authorities to become involved in the process.

Presentation by Tom Doremus, Public Health Foundation

Environmental Health Companion Resources to Healthy People 2010
A presentation for the Healthy People Consortium
By Tom Doremus, M.S.
Information and Communications Specialist
Public Health Foundation
1220 L Street, NW., Suite 350
Washington, DC 20005
Phone: (202) 898-5600 X3014
Fax: (202) 898-5609
E-mail: tdoremus@phf.org

November 10, 2000

Overview of Proposed Project

Healthy People 2010 Environmental Health Companion Resource

Proposed Formats

Potential Content

Current Web Resource

Developing EH Objectives

Implementing EH Objectives

Comments on Presentation/Web Site

Participant List


John Aberle-Grasse
CDC/NCHS
johna@cdc.gov

Liz Blackburn
EPA, Office of Children's Health Protection
blackburn.elizabeth@epa.gov

Ellen Ceppetelli
Dartmouth-Hitchcock Medical Center
elien.ceppetelli@hitchcock.org

Tom Doremus
Public Health Foundation
tdoremus@phf.org

Kristen Dunne
EROS, Environmental Council of States
kdunne@sso.org

David Evans
ATSDR
dae3@cdc.gov

Marion Harnois
MA DEP
marion.harnois@state.ma.us

Bill Jirles
NIH/NIEHS
jirles@niehs.nih.gov

Steven Macdonald
Washington State Department of Health
steven.macdonald@doh.wa.gov

Alan S. Pernick
DEY L.P.
aspern@banet.net

Anne Peterson
Virginia Department of Health
eapeterson@vdh.state.va.us

Laurie Robinson
Office on Women's Health, DHHS
lrobinson@hrsa.gov

Beth Sanders
South Carolina Department of Health & Environment
saundelc@columb20.dhec.state.sc.us

John Schelp
NIH/NIEHS
schlep@niehs.nih.gov

Tom Sieger
Wisconsin Division of Public Health
siegetl@dhfs.state.wi.us

Rose Soloway
American Association of Poison Control Centers
ras@poison.org

Ron White
American Lung Association
rwhite@lungusadc.org

Richard Wittenberg
American Association for World Health
rlw@aawhworldhealth.org

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