Development of Environmental Health Indicators In the U.S.-Mexico Border Pan American Health Organization U.S. Mexico Border
Methodology for selecting environmental health indicators and dates collections
Framework for the Selection of the Environmental Health Indicators Border XXI Program: General Objectives 1.- Assess exposures and risk levels 2.- Assess human biological exposure and levels of related diseases and population at risk 3.- Identify priority groups 4.- Reduce exposure/disease
Framework for the Selection of the Environmental Health Indicators Border 2012 Program: Mission Statement • To protect the environment and public health in the U.S.-Mexico border region, consistent with the principles of sustainable development* • *In this program, sustainable development is defined as “conservation-oriented social and economic development that emphasizes the protection and sustainable use of resources, while addressing both current and future needs and present and future impacts of human actions.”)
Public Environmental Health for the U.S.-Mexico Border BORDER 2012 PROGRAM A NEW APPROACH • Border 2012 emphasizes a bottom-up approach, anticipating that local decision-making, priority setting, and project implementation will best address environmental issues in the border region • The ten-year Border 2012 program was created by EPA and SEMARNAT in partnership with other federal agencies including the U.S. Department of Health and Human Services and the Mexican Secretariat of Health, the ten border-state governments, and U.S. tribal governments • Border 2012 has evolved from previous binational programs: the Integrated Border Environmental Plan and Border XXI.
Framework for the Selection of the Environmental Health Indicators BORDER XXI PROGRAMSPECIFIC OBJECTIVES PER CATHEGORY • Water • Air • Hazardous wastes • Food • Natural/Technological risks • Resources (Financial, human, institutional)
Framework for the Selection of the Environmental Health Indicators BORDER 2012 PROGRAMGOALS and OBJECTIVES • Reduce water contamination • Reduce air pollution • Reduce land contamination • Improve environmental health • Reduce exposure to chemicals as a result of accidental chemical releases and/or acts of terrorism • Improve environmental performance through compliance, enforcement, pollution prevention and promotion of environmental stewardship
Public Environmental Health for the U.S.-Mexico Border BORDER 2012 PROGRAM GOAL #4: IMPROVE ENVIRONMENTAL HEALTH • Border environmental health efforts focus on reducing the risk to border families, especially children, that may result from exposure to air pollution, drinking water contaminants, pesticides and other toxic chemicals. • Environmental health efforts under Border 2012 improve capacity to conduct surveillance, monitoring, and research on the relationship between human health and environmental exposures; deliver environmental health intervention, prevention and educational services; and enhance public awareness and understanding of environmental exposure conditions and health problems. • Program activities focus on strengthening data gathering (including the development/application of indicators to assess changes in specific human exposure and health conditions), training and education to build infrastructure; and provision of critical information to decision makers to achieve improved environmental health in the border region.
Public Environmental Health for the U.S.-Mexico Border DEFINING AUDIENCE • MACRO AUDIENCE – Political officials, general public • MICRO AUDIENCE – Environmental and public health practitioners and managers
Public Environmental Health for the U.S.-Mexico Border - GENERAL SELECTION CRITERIA - SCIENTIFICUSE BASED Data availability and suitability Feasibility Validity Resource with audiences Representativeness Manageability Reliability Balance Ability to disaggregate Catalyst for action
Criteria used to score initial list of indicators
Catalyst for action in public health programs within Border XXI / Border 2012 initiative 3 - if related impact or consequences can lead to death directly or in the short term; 2 - if related impact is potentially severe and/or a large population is impacted; 1 -if related impact is likely reversible or benign.
Resonance with public health and environment practitioners and managers 3 - if high burden of disease and high level of attributable risk; 2 - for moderate; 1- for low.
Resonance with political officials and public needs and concerns 3 - if perceived as very important in public mind; 2 - if somewhat important; 1- if probably not perceived as important.
Appendix A: Selection of Environmental Public Health Indicators - first round of scoring and review
Criteria used to score indicators retained in Table 1 (following first round review)
Feasibility and manageability of collection and integration for U.S. – Mexico Border region 3-if already collected; 2-if data collection needs major improvement or if special survey needed; 1-if also needs lab data and/or specific epidemiologic investigation.
Ease of implementation over time 3-if can be implemented in the short term; 2-if can be implemented in mid-term (2-3 years); 1-if requires long-term for implementation (more than 3 years).
Synergy and Complementarity for Border XXI / Border 2012 Program and other Border initiatives and national and federal surveillance systems 3-if strongly supports the achievement of three or more objectives; 2-if it helps to achieve one to two objectives; 1-otherwise.
Appendix B: Selection of Environmental Public Health Indicators - second round of scoring and review
52 Indicators • 4General indicators • 8 Water • 11 Air • 6 Food • 9 Waste • 7 Multiple Exposure • 7 Occupational Health
Draft list of core environmental public health indicators for the U.S.-Mexico Border region as developed at the El Paso Workshop, July 26-27, 2001 OBJECTIVE WATER AIR FOOD WASTE MULTIPLE OCCUPATIONAL EXPOSURES
Draft list of core environmental public health indicators for the U.S.-Mexico Border region as developed at the El Paso Workshop, July 26-27, 2001 (Cont.) OBJECTIVE WATER AIR FOOD WASTE MULTIPLE OCCUPATIONAL EXPOSURES OBJECTIVE 4. REDUCE EXPOSURE/DISEASE THROUGH: -adaptive information support -protective and control measures -preventative, corrective measures (at inds, community, state levels) -promote adaptive behaviours and institutional responses
Pan American Health Organization World Health Organization U.S.-Mexico Border Field Office