environmental health

by Laura Anderko , PhD , RN , professor and Scanlon Endowed Chair in Values-Based Health Care , School of Nursing & Health Studies , Georgetown University ; director , Mid-Atlantic Center for Children ’ s Health and the Environment ; and co-chair , National Environmental Health Partnership Council

The Value of Environmental Health Services : Exploring the Evidence is a report recently issued by the National Environmental Health Partnership Council ( NEPHC ), which was formed to increase awareness and understanding of environmental health services . 2 NEHPC is comprised of a variety of agencies and organizations — including APHL — that aims to support healthier environments through education , policies and practices related to environmental health . The American Public Health Association ( APHA ) provides logistical support to NEHPC , which is funded through a cooperative agreement with the US Centers for Disease Control and Prevention ( CDC ). 3

This report was created as one component of a larger strategy for expanding and sustaining awareness of environmental health problems and programs . A review was conducted on economic evaluation studies , including return on investment and cost / benefit analyses to better articulate the worth of environmental health programs to the general public and policymakers .

Several environmental public health program areas were explored including : a ) housing ; b ) lead exposures ; c ) food safety ; d ) mercury exposures ; e ) climate change ; f ) housing ; and g ) special populations including children and environmental justice communities . There were significant findings for several interventions , including the following :

• Housing : The National Asthma Control Program ’ s return on investment is compelling : for every dollar spent on national and state-level programs , $ 71 in asthma-related expenditures is saved . 4

• Lead : A return of investment of $ 12 –$ 155 / household or a net savings of $ 124 – 188 billion resulted for every $ 1 invested in lead paint hazard control . 5

• Food Safety : Higher local health department spending on food safety and facility sanitation activities was related to a lower incidence of restaurant related foodborne illness in Washington and a lower incidence of facility inspection-related waterborne disease in New York . 6

• Children : A 10 percent increase in public health spending over 17 years led to a 4.3 percent reduction in infant mortality . Health gains were 20-44 percent greater when funding was targeted to lower-income communities . 7

• Climate change : Costs of climate change have been slow to emerge in the research literature . Ebi et al . ( 2004 ) reported that the cost of running a heat – health warning system for Philadelphia was relatively small ( USD $ 210,000 ) compared with the benefits of saving lives ( USD $ 468 million ) from 1995 – 1998 .

• Environmental justice : Urban development strategies and reduction of pollution exposure from roadways would significantly cut health care spending , particularly in low-income neighborhoods . 8

Initial studies provide powerful findings , but there is a lack of economic research . Environmental interventions are crucial for lowering both the number of deaths and reducing health care costs , saving 90 percent more lives than health care . 9 It is essential that positive impacts from environmental health interventions are shared with the public and policymakers to increase understanding of the value of environmental health services to public health .

APHL is a member of the National Environmental Health Partnership Council , and also sits on the Council ’ s steering committee .

References 1 . New York Times / CBS News ( November 18-22 , 2015 ). New York Times / CBS News Poll on the Environment . Retrieved from : https :// assets . documentcloud . org / documents / 2623880 / full-resilts-of-the-new-york-times-cbs-news-poll . pdf 2 . National Environmental Health Partnership Council ( NEHPC , 2016 ). The Value of Environmental Health Services : Exploring the Evidence . American Public Health Association : Washington , DC . Retrieved from : https :// www . apha . org /~/ media / files / pdf / topics / environment / eh _ values . ashx 3 . American Public Health Association ( APHA ). ( 2016 ). The National Environmental Health Partnership Council . Retrieved from : https :// www . apha . org / topics-and-issues / environmental-health / partners / national-environmental-health-partnership-council . 4 . Centers for Disease Control and Prevention ( CDC ). ( 2013 ). CDC ’ s National Asthma Control Program : An Investment in America ’ s Health . Available at : http :// www . cdc . gov / asthma / pdfs / investment _ americas _ health . pdf . 5 . Gould E . ( 2009 ). Childhood lead poisoning : conservative estimates of the social and economic benefits of lead hazard control . Environmental Health Perspectives , 117 ( 7 ), 1162-1167 . 6 . Bekemeier , B ., Yip , M . P . Y ., Dunabr , M . D ., Whitman , G ., & Kwan-Gett , T . ( 2015 ). Local health department food safety and sanitation expenditures and reductions in enteric disease , 2000-2010 . American Journal of Public Health , 105 ( S2 ), S345-S352 7 . Mays , G . ( 2013 ) Who Benefits from Public Health Spending and How Long Does it Take : Estimating Community-Specific Spending Effects , 141st Annual American Public Health Association Annual Meeting . Boston , MA . Nov . 2013 . Available at : http :// works . bepress . com / glen _ mays / 119 . 8 . Perez , L ., Lurman , F ., & Wilson , J . et al . ( 2012 ). Near-roadway pollution and childhood asthma : Implications for developing “ win-win ” compact urban development and clean vehicle strategies . Environmental Health Perspectives , 120 ( 11 ), 1619-1626 . 9 . Milstein , B ., Homer , J ., Briss , P ., Burton , D . & Pechacek , T . ( 2011 ). Why Behavioral and Environmental Interventions Are Needed to Improve Health At Lower Costs . Health Affairs , 30 , ( 5 ), 823-832 .