What is the importance of understanding environmental risk for children’s health?
- Despite improvements in sanitation, vaccination, nutrition, surveillance and monitoring of disease as well as and the development of antibiotics, there continue to be increases in diseases and disorders that affect children, e.g., asthma, cancer, low birth weight, vehicular and other homicides, developmental disabilities, smoking and obesity.
- Accumulating evidence that environmental factors, e.g., the use of fossil fuels, lead-based paints, solvents, pesticides and polychlorinated biphenyls (PCBs), and over-dependence on television to provide entertainment, contribute to these increases.
- Little attention is paid to environmental health in medical schools, and few doctors are trained to recognize and respond to environmental issues.
- Typically, environmental health problems are cumulative and subtle, appearing long after initial exposure to the offending substance, and requiring training to recognize.
- Furthermore, the training of new medical professionals in the office setting gives them little opportunity to observe seasoned professionals in the role of community advocate.
- The current structure of the health care delivery system, which views primary care as beginning when the patient first seeks medical care, pays inadequate attention to the environment into which the child is born.
What can health providers do to reduce environmental risks to children?
- Get out of the office and into the neighborhoods in which the children live to witness the environmental conditions and health risks.
- Strengthen advocacy efforts even in the face of political realities that bring resistance to change in influential segments of the community. For example, advocacy for child health could threaten the profits and jobs of those manufacturing pesticides, solvents and PCBs, causing uncomfortable pressure on local and national politicians.
- Begin advocacy early, which is when science has shown that a substance, product or activity is more likely to cause problems, rather than waiting until such has been proven beyond doubt.
- Develop a mechanism to study and formulate responses to legislation favoring industries producing substances, products and activities that threaten children’s health.
- Expand the time spent in medical schools on environmental health issues. Develop opportunities for medical students and house staff to get out into the community.
- Have medical students and house staffs undertake environmental scans and assessments of pesticide use in areas where their patients live. Use the data to communicate with residents and policymakers and organize exposure studies in school districts, housing projects, apartment buildings and other places where children routinely spend time.
- Encourage medical school pediatrics departments to link with such community groups, as educators, social workers, residents and other community organizers to provide research expertise and data on various environmental exposures.
- Collaborate with colleagues in other disciplines to increase understanding of threats to children’s health from environmental degradation.
- Make participation in an advocacy experience among the requirements of residency.
Crain, E.F. (2000). Environmental threats to children’s health: A challenge for pediatrics: 2000 Ambulatory Pediatric Association (APA) presidential address. Pediatrics, 106(4), 871-875.