Environmental Public Health Policy Statement

September 01, 2016

Environmental public health programs protect communities from natural, man-made, unintentional, and deliberate threats and hazards in the environment. Responsibility for ensuring the public’s health from environmental factors underlying disease, disability, and is shared across federal, state, and local governments. Authority to regulate and respond to environmental threats to health resides not only in health agencies, but in environmental regulatory, agriculture, natural resources, transportation, planning, housing, and other agencies, and requires coordination and collaboration across governmental agencies, as well as with the non-profit and private sector.

Environmental Public Health Services

States and territories provide essential leadership and stewardship to protect the public’s health and important coordination, planning, and funding for community environmental public health services; in some states and territories, health agencies directly deliver environmental public health services. The many environmental threats to which state and territorial health agencies and the broader public health system respond are diverse, and the risks must be effectively communicated to policymakers and the public. Providing public health services to deal with environmental hazards requires a broad and fully integrated approach using tools ranging from regulation to health promotion, including informed public awareness and educational activities. State and territorial health agencies should work individually and cooperatively with other agencies and levels of government to:

1. Protect the public against hazards from the natural environment, including climate-related health impacts.
2. Controlling vectors that can carry or transmit diseases to humans through adaptation of integrated pest management principles and maintaining adequate infrastructure to carry out timely and effective prevention, surveillance and monitoring, and abatement services.
3. Promote improved health and protect the community against hazards associated with the built environment, community design, land use, and transportation infrastructure, including indoor and outdoor pollutants (i.e., pollutants that are airborne, soil-bound, waterborne, or inherent in building materials).
4. Ensure a safe and nutritious food supply for all through prevention of intentional and unintentional contamination.
5. Ensure safe water for all through prevention and minimization of health risks related to source water, drinking water, recreational water, wastewater, and water reuse.
6. Maintain and build crucial environmental public health infrastructure and capacity, including laboratory testing services and linkages, to prepare for, respond to, mitigate, and recover from the effects of intentional, unintentional, and natural events.
7. Assure the safe use of ionizing radiation and radioactive materials for the improvement of public health, public safety, and productivity.
8. Reach and sustain a state of readiness to effectively respond to, manage the consequences of, and recover from environmental health emergencies.
9. Provide timely, relevant, and accurate information to communities on the environmental public health impacts of toxic exposures.
10. Protect workers from occupational hazards and promote worksite wellness activities to improve the health of the workforce.
11. Promote effective measures to prevent and control environmental-associated exposures, infections, and injuries in both patients and workers in healthcare settings.

Environmental Public Health Infrastructure and Capacity

Public health issues linked to the environment are becoming increasingly complex. Globalization and increasing population size are placing significant stress on the environment in some areas, while emerging threats in chronic and infectious diseases, injury, and acts of terrorism all have environmental factors to be considered. To address a range of environmental challenges to public health, state and territorial health agencies must build strong and enduring relationships and partnerships among all levels of government, across agencies, and with both the private sector and the community. ASTHO supports:

1. Enhanced state and territorial public health capacity to address emerging environmental threats, while preserving fundamental environmental public health services.
2. Adequate, sustainable, and flexible funding streams to maintain minimum levels of services in addition to any dedicated, fee-based funding streams, for the ability to prevent and respond to difficult or emerging environmental threats to health or to address complex environmental health issues that do not lend themselves to fee-based structures.
3. Increased continuing education and training opportunities for the environmental health workforce and the development of policies and partnerships to attract and retain current and future talented environmental public health practitioners.
4. Public health access to research, data, technical assistance, and current and evolving technologies to maintain and advance state and territorial environmental health services.
5. Increased use of the best science and technology available to assess, plan, manage, and evaluate environmental health programs and services.
6. Investment and partnership in informatics to develop highly efficient, secure, and consistent knowledge and information transfer systems between local, state, and federal agencies; the private sector; and the community, as appropriate, to prevent, mitigate, or respond to environmental threats to health.

Environmental Equity

The public health system must protect the health of all persons from environmental threats. To accomplish this, ASTHO supports:

1. The application by public health agencies of risk assessment and risk management techniques that account for increased environmental sensitivities and vulnerabilities in certain populations to ensure that their exposure to hazards in natural and built environments are minimized or eliminated.
2. The use of developing technologies and surveillance strategies, such as biomonitoring, environmental public health tracking, and genetic screening, to further define and refine the environmental risks to sensitive populations.
3. Efforts that address disparities and ensure no one group bears a disproportionate share of exposure to or health effects from environmental contamination. 

Science and Data

It is imperative that the public health community gain a better understanding of the effects that environmental factors have on human health. The ability of science to link human health effects to exposures in natural and built environments is currently limited by the lack of comprehensive disease surveillance systems, environmental monitoring systems to track hazards, and data on the actual exposure of any given community of people. ASTHO supports:

1. Continued research into evolving scientific methods, such as biomonitoring and genetic screening, and their interplay with the environment and human health, with strong consideration for ethical, legal, and social issues surrounding availability of genetic information.
2. Continued development and expansion of the Environmental Public Health Tracking Network across all states and territories.
3. Engagement in evidence-based practice in which existing research is translated and applied to environmental health practice.
4. Continued research into the human health effects of discrete contaminants and the interaction of mixtures and/or contaminants from multiple media.
5. Enacting reasonable measures to mitigate the effects of environmental exposures and protect the public’s health in parallel with further development of the science base where scientific consensus is weak but plausible risk associated with certain environmental exposures exist to cause harm to the public.
6. Evaluation of environmental health interventions that is based on the best available science but takes existing information into account so that decisions are dynamic and structured to ensure reevaluation when additional and relevant scientific evidence becomes available.
7. Continued development of indicators to measure the effects of interventions on the natural and built environments and of methods to measure health outcomes from these interventions.
8. Using health impact assessments (HIA) as a tool to gauge potential public health impacts of plans, projects, and policies that fall outside of traditional public health arenas, including transportation, land use, and energy, and bring these considerations to the decision making process in an effort to achieve health in all policies.

A Comprehensive Environmental Public Health Perspective

Public health issues linked to the environment are increasingly complex. Globalization has introduced new complexities to public health as portions of our food supply and many consumer products enter our communities from across the world. Global climate change is affecting public health in ways that demand new preparation and adaptation strategies to minimize the impacts to the health of our communities. Public health issues linked to the environment frequently involve a multitude of contaminants, media (e.g., air, water, food, land use), health outcomes, and affected populations and require a comprehensive approach. Public health must expand its understanding of the health impact of multiple environmental factors to ensure that the cumulative effects and relative contributions of multiple environmental media and exposure pathways are considered. By improving understanding of these processes, public health will be able to identify the opportunities for greatest environmental risk reduction for human health. ASTHO supports:

1. Flexible local, state, and federal funding sources that enable public health practitioners to take a broad view of environmental hazards. Funding limited to a specific environmental medium or disease hinders the ability to respond to emerging and multisystem threats.
2. Additional research and interventions undertaken into the built environment that broadly consider the implications of land use, transportation, and housing trends on the public’s health.
3. Development of public health preparedness and response measures and adaptation plans for all hazards including extreme weather events, wildfires, floods, drought and disease outbreaks related to climate , as well as development and enhancement of surveillance and response systems to mitigate the health impacts of these events.
4. Development of a public health research agenda to ensure that public health is included in national discussions that shape policy, trade, and infrastructure investment. The inclusion of public health in key decisions is critical to limiting unintended public health consequences of these actions.
5. Development of initiatives and approaches to strengthen integration and collaboration across human medicine and veterinary medicine to improve the lives of all species, and thereby enhance protection afforded to the community from zoonotic diseases and other diseases of environmental origin.
6. Strengthening of risk communications expertise across local, state and federal environmental health programs and activities.

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Approval History:

ASTHO approved and ratified its initial Environmental Health Policy Statement in 1997. The recent approval history appears below. 

Environmental Health Policy Committee Review and Approval: March 2016 
Board Review and Approval: June 2016
Ratified by the ASTHO Assembly of Members: September 2016
Position Expires: September 2019
Expiration Date Extension due to COVID-19: September 2022