Integrated assessment of environment and health: America's children and the environment.

Abstract

The significance of the environment for health is increasingly being recognized. There is a need for systematic approaches to assessment of environmental factors most relevant to health, health outcomes most influenced by the environment, and the relationships between them, as well as for approaches to representing the results of such assessments in policy deliberations. As a step in the development of such methods, we used findings and data from the environmental protection and public health sectors to develop a set of measures representing topics relevant to children’s environmental health. We used a definition of the environment that emphasized contaminants and a process that involved both analytic and deliberative elements. The steps in this process were to a) develop a conceptual framework to depict relationships between environment and health with relevant types of data and information, b) select topic areas of significance for children, c) identify best available data sources and devise measures, d) assess possible surrogate data sources and measures when needed, e) design and implement metrics for computation of measures using specified data elements, f) select graphical representations of measures, g) identify related measures, and h) identify data gaps. Representatives of policy and stakeholder audiences participated in this process. The measures are presented in three groups that reflect contaminants in the environment, contaminants in human tissues, and diseases and disorders. The measures present scientifically based representations of data understandable to stakeholders and policy makers that integrate key information from the health and environment sectors in a consistent format.