Environmental Health in the Nation s Prevention Strategies: Finding The Sweet Spot

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1 Environmental Health in the Nation s Prevention Strategies: Finding The Sweet Spot John M. Balbus, MD, MPH Senior Advisor for Public Health National Institute of Environmental Health Sciences February 26, 2013

2 Overview The problems- public health and environmental Finding the sweet spot in HHS strategies What will it take to get there?

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5 National Prevention Strategy- Active Living Encourage community design and development that supports physical activity Facilitate access to safe, accessible, and affordable places for physical activity

6 National Prevention Strategy-Healthy Eating Improve agricultural policies to better align with the nutrition goals of the Dietary Guidelines for Americans Support initiatives to increase the availability of healthy and affordable foods in underserved urban, rural, and frontier communities

7 Let s Move- Action Steps for Mayors and Local Officials Increase options for affordable transportation to parks and open spaces by discounting public transit, altering or expanding school bus routes, and incentivizing ride sharing Incorporate physical activity into the planning and design of every physical improvement to the city from municipal buildings and new parks to streets and sidewalks Incorporate pedestrian and bicycle lanes into street development Enhance public safety near parks and other public spaces Develop a park deserts map that indicates the distance from population centers to parks and green spaces

8 HHS Strategy to Reduce Health Disparities- Actions iii.a.1 Build community capacity to implement evidence-based policies and environmental, programmatic, and infrastructure change strategies iii.a.2 implement an education and outreach campaign regarding preventive benefits. iii.b.1 Adopt a health in all policies approach iii.b.2. evaluate use of health disparity impact assessment for proposed policies and programs

9 HHS Environmental Justice Strategy- Selected Goals and Actions Policy Development and Dissemination Goal #3 Support and advance a health in all policies approach Action A.4 Update the HHS NEPA Policy (HHS General Administration Manual 30) to incorporate relevant environmental justice guidance and the principles of environmental justice. Action B.8 Develop guidance on how state, local, territorial, and tribal public health departments can adopt policies and programs that minimize climate-related health impacts among vulnerable populations Action B.9 Build community resilience and sustainable, stronger health and emergency response systems in at-risk populations... Action C.1 Collaborate, where appropriate and feasible, with Federal partners on initiatives related to sustainability and healthy settings (e.g. communities, schools, housing and workplaces) to advance a health in all policies approach

10 Healthy People 2020 Social Determinants of Health Use of Health Impact Assessments to review needed, proposed, and existing social policies for their likely impact on health Application of a health in all policies strategy, which introduces improved health for all and the closing of health gaps as goals to be shared across all areas of government

11 At the center of these HHS prevention strategies Environmental Justice Strategy National Prevention Strategy Action Plan to Reduce Health Disparities Sustainable and Resilient Communities Healthy People 2020 National Security Strategy Let s Move!

12 Elements of sustainable and resilient communities Empowerment and equity Measures to reduce heat trapping gas emissions Promotion of bicycling and walking Urban heat island mitigation Improved housing and insulation Low or no energy wastewater management Measures to improve climate resilience All of the above, plus Opportunities for social networking and cohesion

13 What are the tools to get there? Health in all policies NEPA Health Impact Assessment Public health capacity building in environmental health Political and public health leadership Integration of sustainability, equity and climate resilience in wide array of health grantmaking and planning activities

14 Executive Order Signed October, 2009 Numerical and non-numerical targets for: energy and water efficiency, reduction of waste and greenhouse gas emissions, sustainable building design and comprehensive land use planning, electronic stewardship sustainable acquisitions Section 8(i): evaluate agency climate-change risks and vulnerabilities to manage the effects of climate change on the agency s operations and mission in both the short and long term; May 2011 CEQ guidance clarified Agency roles.

15 HHS Policy Statement on Sustainability and Climate Adaptation- June 3, 2011 At HHS, we understand the importance of sustainable, climate-resilient communities....our Department will adopt the Interagency Climate Change Adaptation Task Force guiding principles to integrate climate change adaptation and mitigation strategies into our sustainability and health programs, policies, and operations.

16 HHS Sustainability and Climate Resilience Initiative First Climate Adaptation Strategy Released February 7 Challenges to success: Barriers to integrating sustainability and climate adaptation into everyday operations EO13514 Implementation managed by ASA/Facilities Strategy to overcome those challenges: Secure high level support for integration Provide incentives and resources to incorporate climate change understanding into programs and planning

17 HHS Sustainability and Climate Resilience Initiative Still a work in progress: Empower HHS Sustainability Task Force with integrated mandate Reach out and engage relevant OpDIVs Pilots in most advanced OpDIVs- NIH, CDC, ASPR Pilot trainings, workshops in vulnerable HHS Regions

18 Conclusions HHS prevention strategies provide a framework for integrating sustainability, equity, and climate resilience Framework is not a roadmap; roadmap is not an engine with fuel in it Implementation is underway in many areas but further integration is needed Common tools and methods require further support and development

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