Environmental Health: High-level Strategy and Leadership Needed to Continue Progress toward Protecting Children from Environmental Threats
GAO-10-205
Published: Jan 28, 2010. Publicly Released: Mar 17, 2010.
Skip to Highlights
Highlights
Exposure to toxic chemicals or environmental pollutants may harm the health of the nation's 74 million children and contribute to increases in asthma and developmental impairments. In 2007, 66 percent of children lived in counties exceeding allowable levels for at least one of the six principal air pollutants that cause or aggravate asthma, contributing to medical costs of $3.2 billion per year, according to the Centers for Disease Control and Prevention. In 1997, Executive Order 13045 mandated that agencies place a high priority on children's risks and required that policies, programs, activities, and standards address those risks. In response, the Environmental Protection Agency (EPA) created the Office of Children's Health Protection and convened the Children's Health Protection Advisory Committee. This report assesses the extent to which EPA has institutionalized consideration of children's health through (1) strategies and priorities, (2) key offices and other child-focused resources, and (3) participation in interagency efforts. GAO reviewed numerous documents and met with EPA and other officials for this report.
EPA has developed policies and guidance to consider children, but it has not maintained attention to children through agency strategies and priorities. In 1996, EPA created a national agenda on children's health, and its 1997 and 2000 strategic plans highlighted children's health as a key cross-agency program. As a result, the agency's research advanced the understanding of children's vulnerabilities. However, EPA has not updated the agenda since 1996, and the focus on children is absent from the 2003, 2006, and September 2009 draft strategic plans. EPA has not fully used the Office of Children's Health Protection and other child-focused resources. The active involvement of managers from the office and experts from the Children's Health Protection Advisory Committee has been lacking, as has the involvement of key staff throughout EPA. Although EPA now has a new Director of Children's Health, the office had not had consistent leadership since 2002, hampering its ability to support and facilitate agencywide efforts and elevate matters of importance with senior officials. For example, a previous director established workgroups to bring together officials from the program offices and the children's health office, but a subsequent acting director eliminated these groups, effectively halting work on a key set of children's health recommendations. In addition, the regional children's health coordinators--who provide outreach and coordination for EPA--have no national strategy or dedicated resources. Finally, the advisory committee has provided hundreds of recommendations, but EPA has requested advice on draft regulations only three times in the last decade. While EPA leadership is key to national efforts to protect children from environmental threats, EPA's efforts have been hampered by the expiration in 2005 of certain provisions in the executive order. For example, the Task Force on Children's Environmental Health provided EPA with a forum for interagency leadership on important federal efforts, such as the National Children's Study. It also provided biennial reports that helped establish federal research priorities.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Because EPA alone cannot address the complexities of the nation's challenges in addressing environmental health risks for children, Congress may wish to consider re-establishing a government-wide task force on children's environmental health risks, similar to the one previously established by Executive Order 13045 and co-chaired by the Administrator of EPA and the Secretary of Health and Human Services. Congress may wish to consider charging it with identifying the principal environmental health threats to children and developing national strategies for addressing them. Congress may also wish to consider establishing in law the Executive Order's requirement for periodic reports about federal research findings and research needs regarding children's environmental health. |
Open
|
As of March 5, 2024, we have not identified actions by the Congress to establish in law requirements such as those in Executive Order 13045. |
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Environmental Protection Agency | To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should update and reissue a child-focused strategy, such as the 1996 National Agenda, to articulate current national environmental health priorities and emerging issues. |
Closed – Implemented
EPA has addressed this recommendation by taking the following actions. First, EPA updated its children's health agenda as described by the EPA Administrator in a February 2010 memo to staff. EPA's agenda focuses on protecting children through safe chemicals management, stating that the agency will use the best science to ensure that regulations protect children's environmental health, and coordinating national and international community based programs to eliminate threats to children's health. Second, in September of 2010, EPA submitted its FY2011-2015 strategic plan to the U.S. Congress and the Office of Management and Budget (OMB). The plan included a cross-cutting strategy entitled: "Working for Environmental Justice and Children's Health." The cross-cutting strategy guides EPA's children's health work and is supported by annual action plans and progress reports.
|
| Environmental Protection Agency | To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should strengthen the data system that identifies and tracks development of rulemakings and other actions to ensure they comply with the 1995 policy on evaluating health risks to children. |
Closed – Implemented
EPA has strengthened its data system and offered new training courses for rule writers. Together these efforts help rule writers identify workgroup actions involving children's health and comply with the 1995 policy on evaluating health risks to children. EPA has strengthened its data system that identifies and tracks the development of rulemakings and upgraded to the current Action Development Plan (ADP) Tracker. During this conversion, children's environmental health questions that are a part of the database were revised to be more informative and descriptive. Also the the Regulatory Development and Retrospective Review Tracker was established to provide information to the public on the status of EPA's rulemakings (http://yosemite.epa.gov/opei/rulegate.nsf/) and can be sorted by children?s health effort. In addition, OCHP worked with the Office of Policy and the Office of Environmental Justice to create the children?s health segment of the Action Development at EPA training course for new EPA rule writers, providing guidance on methods for ensuring children's unique vulnerabilities are appropriately considered in EPA?s regulatory actions. In the FY 2013 Action Plan for the agency's Cross Cutting Fundamental Strategy: Working for Environmental Justice and Children's Health, OCHP was tasked with developing an additional webinar-based training available to all EPA staff, but targeting rule developers. This training, which was presented to staff in September 2013, was designed to enhance understanding about applying children's environmental health principles within EPA's regulatory process. Both courses cover how to respond to children's health screening questions in the ADP.
|
| Environmental Protection Agency | To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should re-evaluate the 1995 policy to ensure its consistency with new scientific research demonstrating the risks childhood exposures can have on risks for disease in later lifestages. |
Closed – Implemented
Since our report, the 1995 policy was re-affirmed by Administrator McCarthy (http://www2.epa.gov/sites/production/files/2014-05/documents/reaffirmation_memorandum.pdf). In a memo on October 31, 2013 to senior staff, the EPA Administrator reaffirmed the 1995 Policy to ensure that EPA continues to consistently and explicitly consider the best-available science when evaluating the environmental health risks to infants and children in all the risk assessments and risk characterizations that help form the basis for the environmental and pulic-health standards that EPA sets for the nation.
|
| Environmental Protection Agency | To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should ensure that the EPA's 2009-2013 strategic plan expressly articulates children-specific goals, objectives and targets. |
Closed – Implemented
On September 30, 2010, EPA submitted its FY 2011-2015 strategic plan to the U.S. Congress. In it, EPA included children's health and environmental justice as a cross-cutting strategy. This cross-cutting strategy, "Working for Environmental Justice and Children's Health" is supported by annual action plans and progress reports. The action plans contain children-specific goals. For example, EPA committed to advancing the use of Integrated Pest Management (IPM) in settings where children are present with a focus on schools, with the long-term goal that every school in America is managed under a verifiable IPM program. Further, the strategic plan also contains children-specific goals. For example, one of EPA's goals related to children's health is to reduce the percentage of children with blood lead levels above 5 ig/dl to 1.0 percent or less by 2014. In addition, the Office of Children's Health Protection (OCHP) finalized its office-wide strategic plan in September of 2010. The plan describes the goals, objectives, and measures that OCHP will use to fulfill the office mission. Further, OCHP plans to set targets for the strategic plan measures to support the priorities of the Agency and OCHP. EPA's and OCHP's actions meet the intent of our recommendation.
|
| Environmental Protection Agency | To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should re-evaluate the mission of the Office of Children's Health Protection and its director to make the office an agencywide champion for implementation of a reissued national children's environmental health agenda, policy, and related goals in the next EPA strategic plan. |
Closed – Implemented
In a February 2010 memo to EPA senior managers, the Administrator reaffirmed EPA's commitment to protecting children's health, described EPA's children's health agenda, and identified OCHP as having the lead in ensuring that EPA programs and regions are successful in their efforts to protect children's health. Further, she identified the OCHP director as the main contact to assist in these efforts. In its role as the agency's lead, OCHP developed an office-wide strategic plan for fiscal years 2011-2013. The plan, which was finalized on September 2010, aligns with EPA's cross-cutting strategy on environmental justice and children's health.
|
| Environmental Protection Agency | To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should establish key children's environmental health staff within each program office and regional office, with linkages to the Office of Children's Health, to improve cross-agency implementation of revised priorities and goals, and ensure coordination and communication among EPA's program offices. |
Closed – Implemented
EPA established Regional Children's Environmental Health and School coordinator positions in all regions and have Points of Contact for children's health issues in each program offices. The points of contact represent informal relationships with program offices, and therefore do not include position descriptions. While OCHP has identified a point of contact in each program office, they do not have ongoing relationships with some offices that don't have a mission directly tied to children's health (example - Office of Administration and Resources Management or the Office of Environmental Information). OCHP reported that it has closer relationships with offices that are engaged in ongoing children?s health issues (example - Office of Air and Radiation and the Office of Chemical Safety and Pollution Prevention), where it has multiple contacts at management and staff levels to cover regulatory and outreach issues.
|
| Environmental Protection Agency | To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should use the Children's Health Protection Advisory Committee proactively as a mechanism for providing advice on regulations, programs, plans, or other issues. |
Closed – Implemented
EPA is using the Children's Health Protection Advisory Committee proactively, as we recommended. For example, in March 2012, EPA sought advice form CHPAC in developing lead regulations and in coordinating agency programs to prevent childhood lead exposure. Additionally, at the request of the OCHP Director, CHPAC assisted in developing information about asthma disparities among racial and ethnic groups for EPA to use as part of its work on the President's Task Force on Environmental Health Risks and Safety Risks to Children, which was established in 1997 and charged with recommending strategies for protection children's environmental health and safety. In May 2012, the task force published hate Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities. Furthermore, EPA program offices have also worked more closely with CHPAC on a number of issues related to children's health since we issued our January 2010 report, according to CHPAC's Co-Chair. For example, EPA"s Office of Air and Radiation provided a briefing to CHPAC on indoor air quality to help the committee identify priority areas. CHPAC's Designated Federal Office (DFO) also works with other federal advisory committee, such as EPA's Clean Air Scientific Advisory Committee and the Science Advisory Board on other issue to coordinate as needed.
|
| Environmental Protection Agency | To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should ensure participation, to the fullest extent possible, by the Office of Children's Health or other key officials on the interagency organizations identified in Executive Order 13045. |
Closed – Implemented
OCHP officials told us they have been active participants in two key interagency organizations-the Federal Interagency Forum on Child and Family Statistics (Forum) and the President's Task Force on Environmental Health Risks and Safety Risks to Children. Through their work with the Forum, OCHP officials have helped to prepare statistical data and descriptive text on children's well-being, such as lead levels in the blood of children that are included in the Forum's biennial publications: America's Children (2011) and America's Children in Brief (2010). Additionally, an OCHP official is a member of the Forum's reporting committee, which works on a number of issues involved in the creation of these reports, and has the responsibility to write and edit the Physical Environment and Safety section of America's Children in Brief. OCHP also contributed to the 2012 edition of America's Children in Brief: Key National Indicators of Well-Being and is working on the 2013 edition of America's Children. OCHP officials also told us that they have had a major role in reinvigorating the President's Task Force Steering Committee. The Task Force officially expired in 2005. Although the task force has not been officially reauthorized, EPA and other agencies that were members of the task force have been participating in various efforts to address children's health concerns since January 2010. For example, OCHP's Director has served as the Co-Chair of the Task Force that, among other things, addresses healthy homes, chemical exposures, and asthma disparities. For example, the task force held a workshop on asthma disparities in December 2010 and, as we stated previously, in May 2012, published the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities. OCHP officials said the office also played a major role in the task force's 2012 efforts to coordinate federal action on lead exposure.
|
Full Report
Office of Public Affairs
Topics
Advisory committeesAsthmaChemical exposureChildrenEnvironmental lawEnvironmental monitoringFederal regulationsHealth hazardsHealth policyHealth statisticsInteragency relationsMonitoringPerformance measuresPollutantsPollution controlProgram evaluationResearch programsRisk assessmentRisk factorsRisk managementSafety regulationStrategic planningToxic substances