CHE Director to Step Down April 1

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Dear Colleagues,

I’m writing to let you know I plan to step down as CHE director as of April 1, 2017. It’s hard to believe I’ve worked almost 24 years on environmental health issues in different capacities. I’ve truly loved it. It’s not only been meaningful and fulfilling for me personally, but also a great privilege to engage with exceptionally bright and dedicated colleagues, learn the emerging science, catalyze strategic initiatives and work collaboratively to push the needle towards improved health and well-being in a world that faces a very uncertain future.

That said, it’s become clear to me that I would like to serve the Commons in other ways as well—in ways that will allow different core interests, experience and skill sets of mine to be expressed. Though I don’t have a specific position waiting in the wings, I’m looking to pick up where I left off in my graduate work, which was focused on the experience of girls living in Northern India on the borderline of Western and traditional Indian cultures. More broadly, I have a strong desire to engage with girls and young women nationally and globally, supporting efforts to foster ethical leadership, compassionate action and greater gender equality. I will be exploring various opportunities over the next months.

Most important at this time, however, is my commitment to skillfully transition CHE into its next phase of service before I leave. I’ve chosen to allow ample lead time to ensure that the right people and systems are in place to carry CHE successfully forward with new energy, perspectives and experience.

Along those lines, I’m very pleased to announce that my successor has already emerged. Karen Wang, PhD, is a Stanford University graduate with a Bachelor of Arts in economics and a Master of Science in earth sciences. She received her doctorate last year in strategic management from the Foster School of Business at the University of Washington. Her dissertation focused on the changing nature of hospital-physician relationships and implications for public health. Previously she worked for Columbia University and the United Nations Development Program on program evaluation in Sub-Saharan Africa. Karen recently moved back to the Bay Area with her husband and now seven-month old daughter. After careful mutual consideration, CHE has decided to hire Karen to serve as our next director. She will start on a very part-time basis in January and then serve full-time as of April 1, when I depart. You will no doubt hear more from her in the coming months, but we are confident she will bring critical new skills to amplify CHE’s work in this next chapter. In the meanwhile, I will be as engaged as ever meeting CHE’s goals and deliverables for the New Year, while bringing Karen up to speed.

To close I’ll simply say this decision is bittersweet. I will greatly miss getting to work more closely with extraordinary colleagues like you on issues that will always remain close to my heart. As with many major decisions, knowing it’s the right thing to do doesn’t necessarily make it the easy thing to do. Please know I very much look forward to staying in touch wherever I next land.

With deep gratitude for sharing this journey with me over the years and heartfelt wishes for the holiday season to you and your families,


P.S. If you haven’t already, please do visit our robust new website:

Unprecedented Alliance of Scientists, Health Professionals, & Advocates Agree Toxic Chemicals Are Hurting Brain Development

written by Ted Schettler, MD, MPH
Science Director

Ted SchettlerAn unprecedented alliance of leading scientists, health professionals, and children’s health advocates has come together to publish a consensus statement concluding that scientific evidence supports a causal link between exposures to toxic chemicals in food, air and everyday products and children’s risks for neurodevelopmental disorders. The alliance, known as Project TENDR, is calling for immediate action to significantly reduce exposures to toxic chemicals to protect brain development for today’s and tomorrow’s children.

Neurodevelopmental disorders include intellectual disability, autism spectrum disorder, attention deficits, hyperactivity, other maladaptive behaviors, and learning disabilities.  Project TENDR’s consensus statement is available on the Project TENDR website.

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A Story of Health Wins CDC Communications Award

The National Center for Environmental Health (NCEH) and the Agency for Toxic Substances and Disease Registry (ATSDR) have honored A Story of Health multimedia eBook/continuing education course with an “Excellence in Communications” award.

NCEH and ATSDR are agencies of the Centers for Disease Control and Prevention (CDC). The award was given at the annual NCEH/ATSDR Honor Awards on February 3, 2016, to A Story of Health Team for excellence in communication for the development of a medical education product that highlights the importance of environmental health.

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Top 10: 4th Quarter 2015

This is the last of CHE’s public quarterly Top 10 lists. We have selected studies and issues that we feel are significant in the field of environmental health, either because of their impact, their implications or their insight. Topics are listed in no particular order. Comments are welcome, as is always true with our blog posts. Corrected in an update 1/6/2016.

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Type 1 Still on the Rise in US Kids

written by Sarah Howard
Coordinator of the Diabetes-Obesity Spectrum Working Group

Sarah HowardYou may have seen the recent articles about the CDC data that found that type 2 diabetes incidence has recently started to decline in the US (e.g., New diabetes cases, at long last, begin to fall in the United States). That New York Times article notes that, “Type 1 diabetes, often diagnosed in childhood and adolescence and not usually associated with excess body weight, was also included in the data.”

Well, there has been a lot of talk about CDC data relating to type 1 diabetes. While it is technically true that type 1 diabetes is “included” in the CDC numbers, the CDC data do not tell us anything about type 1 diabetes. Since type 2 makes up about 90-95% of diabetes cases in the US, and the CDC does not distinguish between type 1 and type 2 diabetes, the CDC data do not tell us if type 1 is increasing or not.

A new Medpage Today article notes that a new study finds that type 1 prevalence increased between 2002-2013 in US children: Type 1 diabetes prevalence on the rise in kids: group complains about reports that lump type 1 together with type 2 (See the study: Prevalence of diabetes and diabetic nephropathy in a large US commercially insured pediatric population, 2002–2013.)

Type 2 in children increased until 2006 and then began to fall. Thus the two types do not show the same pattern in the population, and should not be lumped together.

This study also finds that diabetic nephropathy is also increasing in children, starting at age 12.

Other data, from the SEARCH for Diabetes in Youth study, also continue to find type 1 increasing in US children.

And almost no one is looking at type 1 incidence in US adults.

NHANES also does not distinguish between type 1 and type 2 diabetes, making it difficult for researchers to analyze whether or not chemicals play a role in type 1 diabetes. Type 1 diabetes is an autoimmune disease that often is diagnosed during childhood. Type 2 diabetes is associated with insulin resistance and obesity. We cannot assume that these separate processes have identical or even similar responses to chemical or other environmental exposures.

Type 1 diabetes incidence in children is increasing in at least 61 countries/regions worldwide. To see these studies or more on diabetes incidence/prevalence in the US and around the world, see Diabetes Incidence and Historical Trends

I Am Now a Bionic Woman

written by Sarah Howard
Coordinator of the Diabetes-Obesity Spectrum Working Group

Sarah HowardJust in time for World Diabetes Day (#WDD, November 14th), I have started wearing an artificial pancreas to help manage my type 1 diabetes. Normally I wear an insulin pump along with a continuous glucose monitor (cgm), but the two gadgets do not actually talk to each other. That means I still have to manage my diabetes manually 24/7, like everyone else with diabetes. While manufactured artificial pancreases are being developed and are now performing well in clinical trials, they are not yet available to the public.

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Can a Cow Virus Increase the Risk of Breast Cancer?

Can a Cow Virus Increase the Risk of Breast Cancer?

TedSchettlerwritten by Ted Schettler, MD, MPH
CHE Science Director

updated September 25, 2015

Exposures to known and suspected risk factors for breast cancer begin early in fetal development and continue throughout life. Some relate to individual choices and lifestyle while others are encountered as an inevitable result of the way we design our communities and society more generally. In The Ecology of Breast Cancer I explored this multifactorial, multilevel complexity with an eye toward lessons learned from complex systems analysis while proposing practical interventions that may help prevent breast cancer and improve outcomes after diagnosis and treatment.

Risk factors are not experienced in isolation. They co-occur and interact in complex ways, creating system conditions in which breast cancer is more or less likely—in individuals and populations. When we attempt to take this complexity apart for purposes of research or decision-making, we often miss the properties that emerge from the whole.

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