Effective strategies and interventions: environmental health and the private housing sector

Effective interventions in environmental health and housing work necessitate a range of methods and approaches to research and understand social and economic issues, how the complexities of peoples’ changing lives are represented in their housing and communities and the involvement of others in their housing, health and social care needs. Developing an evidence base and its application in practice can help deliver available resource to where it is most needed in addressing the complex needs of some of the most vulnerable members of society. This publication, edited by Dr Jill Stewart at the University of Greenwich, draws together a range of methods and good practice in adding to the environmental health and housing evidence base. It showcases examples of innovative environmental health practices, including partnership working to demonstrate the fundamental importance of re-focusing on housing as a social determinant of health and the potential for improved health outcomes and impacts. It draws together practical examples founded on a range of evidence sources from those working at strategic and practitioner level in the private housing sector in demonstrating how early, proactive interventions are successful on both economic and social fronts in supporting the case for additional resource for these fundamental front line services

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES HEALTH DISPARITIES STRATEGIC PLAN

Health disparities exist between citizens of lower socioeconomic status (including minorities and other medically underserved citizens) and those more economically advantaged. Examples where health disparities exist include: shorter life expectancy, higher cancer rates, more birth defects, greater infant mortality, and higher incidence of asthma, diabetes, and cardiovascular disease. These health discrepancies involve increased morbidity and mortality rates associated with increased incidences of disease. The ways in which poverty and other factors create these health disparities are still poorly understood. There is increasing evidence that these groups are burdened with a disproportionate share of residential and occupational exposure to hazardous substances such as lead, PCBs, wood dusts, and air pollutants. Thus, both social and physical environmental exposures represent an important area of investigation for understanding and ameliorating the health disparities suffered by the disadvantaged of this nation

Lead in drinking water and human blood lead levels in the United States

"Lead is a pervasive environmental contaminant. The adverse health effects of lead exposure in children and adults are well documented, and no safe blood lead threshold in children has been identified. Lead can be ingested from various sources, including lead paint and house dust contaminated by lead paint, as well as soil, drinking water, and food. The concentration of lead, total amount of lead consumed, and duration of lead exposure influence the severity of health effects. Because lead accumulates in the body, all sources of lead should be controlled or eliminated to prevent childhood lead poisoning. Beginning in the 1970s, lead concentrations in air, tap water, food, dust, and soil began to be substantially reduced, resulting in significantly reduced blood lead levels (BLLs) in children throughout the United States. However, children are still being exposed to lead, and many of these children live in housing built before the 1978 ban on lead-based residential paint. These homes might contain lead paint hazards, as well as drinking water service lines made from lead, lead solder, or plumbing materials that contain lead. Adequate corrosion control reduces the leaching of lead plumbing components or solder into drinking water. The majority of public water utilities are in compliance with the Safe Drinking Water Act Lead and Copper Rule (LCR) of 1991. However, some children are still exposed to lead in drinking water. EPA is reviewing LCR, and additional changes to the rule are expected that will further protect public health. Childhood lead poisoning prevention programs should be made aware of the results of local public water system lead monitoring measurement under LCR and consider drinking water as a potential cause of increased BLLs, especially when other sources of lead exposure are not identified. This review describes a selection of peer-reviewed publications on childhood lead poisoning, sources of lead exposure for adults and children, particularly children aged <6 years, and LCR. What is known and unknown about tap water as a source of lead exposure is summarized, and ways that children might be exposed to lead in drinking water are identified. This report does not provide a comprehensive review of the current scientific literature but builds on other comprehensive reviews, including the Toxicological Profile for Lead and the 2005 CDC statement Preventing Lead Poisoning Among Young Children. When investigating cases of children with BLLs at or above the reference value established as the 97.5 percentile of the distribution of BLLs in U.S. children aged 1-5 years, drinking water should be considered as a source. The recent recommendations from the CDC Advisory Committee on Childhood Lead Poisoning Prevention to reduce or eliminate lead sources for children before they are exposed underscore the need to reduce lead concentrations in drinking water as much as possible.." -p. 1Introduction -- Background -- Historical trends in blood lead levels -- Lead in the environments of children -- Lead in drinking water -- Conclusion -- ReferencesMary Jean Brown, Stephen Margolis, Division of Emergency and Environmental Health Services, National Center for Environmental Health."August 10, 2012.."Also available via the World Wide Web as an Acrobat .pdf file (349.49 KB, 12 p.).Includes bibliographical references (p. 7-9)

NNIP

"In January 2001, the Pew Environmental Health Commission called for the creation of a coordinated public health system to prevent disease in the United States by tracking and combating environmental health threats. In response, the U.S. Congress appropriated funding to the Centers for Disease Control and Prevention (CDC) in Fiscal Year (FY) 2002. This funding enabled CDC to develop the National Environmental Public Health Tracking Program (referred to as Tracking Program). The purpose of the CDC's Tracking Program is to establish a nationwide tracking network to obtain integrated health and environmental data and use it to provide information in support of actions that improve the health of communities. CDC is establishing the Tracking Network by drawing from a wide range of stakeholders with expertise from federal, state, and local health and environmental agencies; nongovernmental organizations (NGOs); state public health and environmental laboratories; and schools of public health. The difference between the Tracking Program and the Tracking Network is that the Tracking Program is much broader and includes not only the Tracking Network but the people, resources, and program management involved in building this network. The Tracking Network is a discrete product of the Tracking Program. The Tracking Program can use data gathered from the Tracking Network to identify areas and populations most likely to be affected by environmental contamination and to provide important information on the health and environmental status of communities. Analyses of data from the Tracking Network will provide valuable information on changes or trends in levels of pollutants, population exposure, and occurrence of noninfectious health effects and enable environmental public health practitioners and researchers to examine the possible relations among them. The information can be used to drive public health policy and actions that ultimately will reduce the burden of adverse health effects on the American public. This document, CDC's National Environmental Public Health Tracking Program: National Network Implementation Plan (NNIP), outlines the path that the Tracking Program is taking to develop and implement the Tracking Network over the next 5 years. The plan supports achieving success in both immediate and long-term time frames while providing direction and guidance to the many stakeholders who contribute to the Tracking Network's ongoing development as well as the overall program's implementation. The NNIP gives insight into the topics and approaches that lead to improved network performance, sustainability, quality, and focus. The NNIP outlines CDC's strategy for developing and implementing the Tracking Network by clarifying functions and components and describing approaches to developing the components. Specifically, the NNIP describes the background, context, needs, and goals of the Tracking Network; outlines the principal functions and components of the Tracking Network; discusses the steps needed to implement the components; and identifies the entities responsible for taking the implementation steps." - p. iiiExecutive summary -- 1. Introduction -- 2. What are the functions and uses of the tracking network? -- 3. What are the components of the tracking network? -- 4. How is the tracking network accessed? -- 5. What services does the tracking network provide? -- 6. What content is on the tracking network? -- 7. Implementation activities -- Appendix A: Summary of activities by responsible entities for tracking network development -- Appendix B: Overview of NNIP development -- Appendix C: Acronyms and abbreviationsTitle from PDF title screen (CDC, viewed Dec. 29, 2011)."August 2006.""C5116250."Available via the World Wide Web as an Acrobat .pdf file (PDF 1.27 MB, 71 p.)