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 he Pew Environmental Health Commission at the Johns
Hopkins School of Public Health has called on Congress and the
White House to protect Americans from chronic diseases the No.
1 cause of death in the United States by tracking where and when
these health problems occur and possible links to environmental
factors.
 In its
third report, the Commission charged that the nation faces an
environmental health gap and proposed a Nationwide Health Tracking
Network to provide the critical information now lacking in nearly
every state. Without this Network, the Commission said the United
States will remain unable to mount effective prevention efforts
for asthma, birth defects, developmental disabilities, cancers,
and neurological disorders such as Alzheimer's and Parkinson's,
among other chronic diseases.
"We responded
quickly to the threat of West Nile virus, tracking and monitoring
every report of infected birds and people, but 20 years into
the asthma epidemic this country is still unable to track where
and when attacks occur and what environmental links may trigger
them," said Lowell Weicker Jr., the Commission chairman
and former US senator and Connecticut governor.
The recommended
Network would include the following components:
- Nationwide baseline tracking of priority
diseases - asthma and chronic respiratory diseases; birth defects;
developmental disorders; cancers, especially childhood cancers;
and neurological diseases such as Alzheimer's, multiple sclerosis
and Parkinson's nd priority exposures such as PCBs, and dioxin;
heavy metals such as mercury and lead; pesticides and water and
air contaminants.
- Monitoring of immediate health crises such
as heavy metal and pesticide poisonings to serve as an early
warning system.
- Establishing 20 state pilot tracking programs
to address regional environmental health concerns.
- Developing a federal, state and local rapid
response capability to investigate clusters, outbreaks and emerging
threats.
- Supporting community interests and scientific
research to further health tracking efforts.
The
Commission estimated that the Network will cost $275 million
annually - less than one-tenth of a percent of the $325 billion
that chronic disease costs the United States annually in health
care and lost productivity.
"It is
time to make the investment in our public health that matches
the threat from chronic disease," Weicker said.
As examples
of the environmental health gap, the nation's failure to deal
with chronic diseases and their potential links to environmental
hazards, the Commission noted:
More
than half the states (27) lack ongoing tracking and monitoring
of asthma even though it is a rapidly growing national epidemic.
Most states fail to track developmental disabilities such as
autism and mental retardation despite an estimated 50 percent
rise nationwide in these disabilities in the last decade, and
research indicating that 25 percent are related to environmental
exposures. California, District of Columbia, Kentucky, Mississippi,
Nebraska, New Jersey, North Carolina, South Carolina and South
Dakota reported tracking at least some of these disorders.
Only four
states reported tracking autoimmune diseases such as lupus, even
though rates for these diseases are rising. The four states are:
Arizona, Massachusetts, New Mexico and South Dakota.
Less than
half the nation's population is covered by birth defect registries
even though birth defects are the leading cause of infant mortality
in the US and rates for certain birth defects and related conditions
are increasing.
"This
is Public Health 101, and as a nation we are flunking,"
said Louis Stokes, former 15-term US House member from Ohio and
a member of the Pew Environmental Health Commission.
In calling
for the Nationwide Health Tracking Network, the Commission has
the support of many voluntary disease support groups and national
public health organizations, including: Allergy and Asthma Foundation
of America; Allergy and Asthma Network; Mothers of Asthmatics;
American Academy of Pediatrics; American Autoimmune and Related
Diseases Association; American Cancer Society, Inc.; American
Lung Association; American Public Health Association; Association
of State and Territorial Health Officials; Candlelighters Childhood
Cancer Foundation; Council of State and Territorial Epidemiologists;
Joint Council of Asthma, Allergy and Immunology; National Association
of City and County Health Officials; and Public Health Foundation.
"The
support for health tracking is broad and deep. It should command
the attention of every candidate for President and every candidate
for Congress," Weicker said.
"Tracking
on a nationwide basis will enable our medical system to focus
on a critical area of health care that has long had insufficient
emphasis, the prevention of the diseases that cause the most
suffering and death," said Dr. Neil Schlackman, the senior
corporate medical director for Aetna US Healthcare and a member
of the Commission.
The Commission's
recommendations were based on an analysis conducted under the
guidance of Thomas A. Burke, associate professor at the Johns
Hopkins School of Public Health and chairman of the Director's
Advisory Committee to the National Center for Environmental Health
at the Centers for Disease Control and Prevention (CDC). The
analysis examined public health tracking capacity at the national,
state and local levels.
"We need
to know when and where diseases occur, what are the environmental
hazards, and what are the actual exposures we have to those hazards,"
said Burke. "This is a basic right to know issue for our
communities and our public health professionals."
"Americans
have a right to this information about the health of their communities,"
said the Rev. Michael D. Place, STD, president and chief executive
officer of the Catholic Health Association of the United States,
representing the nation's largest group of not-for-profit healthcare
systems, facilities and related organizations, and a member of
the Commission. "These recommendations will enlighten our
research and make possible disease prevention efforts that will
save lives and spare much suffering."
Later this
year, the Commission will release its final recommendations on
improving the ability of the public health system to combat environmental
threats to health. Its two previous reports examined the increases
in birth defects and related conditions and the asthma epidemic,
focusing on the need for national environmental health tracking.
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