Closing the Gap on Health Disparities

written by Kathy Sykes
Senior Advisor for Aging and Public Health at the EPA Office of Research and Development

This post is shared with permission from the Association of State and Territorial Health Officials. It was originally posted on StatePublicHealth.org. Stylistic edits have been made.

What do health disparities, interest on the national debt, and gun violence have in common? Would you believe it’s economic impact, to the tune of $229 billion dollars? That is not small change. This figure demonstrates the magnitude of an issue that continues to burden our society.

The number comes from the Joint Center for Political and Economic Studies, which calculated that during 2003-2006, we would have saved $229 billion in direct healthcare expenditures if we had eliminated health disparities (MMWR). Surprisingly, it also happens to be the total annual cost of gun violence each year, ($8.6 billion in direct costs and $221 billion in indirect costs; Mother Jones). It also happens to be what our country spent as interest on the national debt in 2015 (National Priorities Project).

Commentary: 25 Years of Endocrine Disruptor Research – Great Strides, But Still a Long Way to Go

written by Laura N. Vandenberg, PhD
Assistant Professor and Graduate Program Director of Environmental Health Sciences, University of Massachusetts Amherst School of Public Health and Health Sciences

Laura Vandenberg (Credit: umass.edu)

Reprinted with permission from Environmental Health News

Cancer. Diabetes. Autism. Infertility. ADHD. Asthma. As the rates of these diseases increase over time, the public and researchers alike have focused on the role the environment might play in their cause and progression. Scientists in the field of environmental health sciences are not satisfied just to know that the environment contributes to human disease – they want to know how.

This week [ScienceSeptember 18-20], researchers, public health advocates, government officials, and industry spokespersons will meet at National Institutes of Health (NIH) to celebrate 25 years of scientific research on one aspect of environmental health: endocrine disrupting chemicals (EDCs). These are compounds that alter the way hormones act in the body, often by mimicking or blocking their actions. Just a few examples of widely used consumer products that contain EDCs are plastics, electronics, flooring, some personal care products, and furniture treated with some flame retardants.

Kids Are Not Just Substituting E-Cigs for Cigs; E-Cigs Are Expanding the Tobacco Epidemic

September 26th is World Environmental Health Day. The theme this year is “Tobacco Control… a response to the global tobacco pandemic”, and so we offer this commentary, shared with the author’s permission. The original post is available on his blog.

written by Stanton Glantz, PhD
Professor of Medicine and Truth Initiative Distinguished Professor of Tobacco Control at the University of California, San Francisco

Jessica Barrington-Trimis and her colleagues have published two important papers in Pediatrics on the link between e-cigarette and cigarette use, both based on a large longitudinal sample of Southern California youth who have been followed for many years.

Breast Cancer Prevention Begins in the Womb

written by Ted Schettler, MD, MPH
Science Director

As breast cancer awareness month ends with its primary emphasis on early detection I’ve been more interested in what we’ve learned about opportunities for prevention. Amidst all the pink ribbons and disagreements about optimal mammography scheduling an important theme seems to be finally taking hold. Although opportunities abound throughout life, breast cancer prevention begins in the womb.

This idea is not new. Twenty-five years ago Dimitri Trichopoulos proposed that breast cancer risk could originate in utero, influenced by maternal hormone levels.[1] Later studies linked hormone and growth factor levels with populations of breast stem cells in umbilical cord blood—a plausible mechanistic connection to cancer risk. A 2011 analysis reported a nearly two-fold increased risk of breast cancer in daughters of women who took estrogenic diethylstilbestrol (DES) during pregnancy before 1971.[2] This year, Barbara Cohn and colleagues reported that the highest maternal levels of the hormone-disrupting pesticide DDT during pregnancy were associated with a nearly four-fold increased risk of breast cancer in their daughters.[3]

Camp Lejeune Male Breast Cancer Study

written by Dick Clapp, DSc MPH
CHE Partner and member of the ATSDR Camp Lejeune Community Assistance Panel

A recent scientific report has shed some light on chemical exposures and breast cancer, this time on male breast cancer in Marines who had spent time at Camp Lejeune, North Carolina. Last month, the online journal Environmental Health published a study titled “Evaluation of contaminated drinking water and male breast cancer at Marine Corps Base Camp Lejeune, North Carolina: a case-control study,” by Perri Ruckart, Frank Bove and co-authors at the Agency for Toxic Substances and Disease Registry.  The study was based on information about 71 male breast cancer cases in Marines and 373 controls that were in the Department of Veterans Affairs (VA) cancer registry and diagnosed between 1995 and May of 2013.  For those subjects who were at Camp Lejeune, it was possible to assign exposure levels to various drinking water contaminants based on previous models developed for mortality studies published earlier.

Reproductive Health Professionals around the World Take a Stand on Toxic Chemicals

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

written by David Tuller, DrPH, and Tracey J. Woodruff, PhD, MPH

In recent years, a growing body of research has documented that the in utero environment has a critical impact on future health and development. A strong body of evidence shows that prenatal exposure to toxic chemicals can usher in a host of adverse effects in childhood and across the lifespan, as well as in subsequent generations.

Now the world’s leading organization of reproductive health specialists, the International Federation of Gynecology and Obstetrics (FIGO), is urging medical professionals to demand stronger government regulation of toxic environmental chemicals.[1] FIGO’s call to action resonates with the theme of this year’s World Environmental Health Day—Children’s Health and Safety and the Protection of Their Environment.

One Voice: Prioritize the Health of Our Children

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

written by Maida Galvez, MD, MPH
CHE Partner

As an environmental pediatrician and mom, I worry about the thousands of chemicals that get put in our environment. I worry that many of these chemicals are universally detectable in the US population, that higher levels can often be found in children and racial/ethnic minorities, and that the majority have not been tested for basic safety for health effects, especially in vulnerable populations like pregnant women, infants and children. I worry that products are put into the marketplace and decades later we find that they may impact children’s health, their intelligence, their behavior and their risk for chronic conditions like asthma, ADHD, autism and obesity. I hear this worry directly when families, health care providers, communities and schools call our Pediatric Environmental Health Specialty Unit (PEHSU) and ask, “Did exposure to this chemical harm my child?”

Brains Needed for the Future

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

written by Philippe Grandjean, MD, PhD
CHE Partner

Climate change and chemical pollution are serious challenges that require tough decisions, and the solutions will depend on human ingenuity. In other words, we need smart people to help clean up the problems that present and previous generations have created.

But counter to this notion, we are promoting toxic chemicals that can damage human brain development. So we are essentially generating a vicious circle: industrial chemicals damage the development of the brains of the future that should have helped us design safer uses of chemicals that would not endanger the nervous system of the next generation.

We already know that more than 200 industrial chemicals can detrimentally affect brain functioning in adults. Although we have so far gathered enough evidence only on a dozen or so substances that can damage a child’s developing brain, we know that such toxicity occurs at much lower doses than those that affect the adult brain. Still, only a few of these chemicals have so far been regulated in order to protect the brains of the next generation.

On World Environmental Health Day: The Call to Protect Children’s Environment and Health

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

Dr. Perera’s son

written by Frederica Perera, DrPH
CHE Partner

The protection of children, and especially poor children, from air pollution and climate change resulting from the massive burning of fossil fuel is an urgent moral imperative. The large and mounting health and economic costs of pollution and climate change necessitate bold policy change.

The entire global population is affected; however, the first thousand days of life represent the greatest window of susceptibility both to toxic exposures and stressors from climate change. The developing fetus and young child undergo very rapid development during which time they lack the innate defense mechanisms operating in older children and adults. Thus, they tend to be the most affected both by toxic air pollutants and climate change. The impacts of exposure to air pollution include adverse birth outcomes, cognitive and behavioral disorders, asthma and other respiratory problems in children, while climate change increases the likelihood of heat waves, floods, drought, malnutrition, infectious disease, and social and political instability. These early impacts can translate to lifelong consequences for the young.

We Need a Rational Policy on Chemical Safety

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

written by Philip J. Landrigan, MD, MSc, FAAP
CHE Partner and Chair of CHE’s Science Advisory Committee

Children’s health and the environment is a most fitting topic for World Environmental Health Day 2015. Children are the most vulnerable among us to degradation of the environment. Any actions that we take to protect infants and children against health threats in the environment will protect not only children, but will also safeguard all of us and preserve the health and well-being of future generations.

Toxic chemicals are a particularly serious threat to children’s health. More than 80,000 new synthetic chemicals have been invented in the past 50 years. These chemicals are found in thousands of products that we use every day. They have become widespread in the earth’s environment. They are routinely detected in the bodies of all Americans in annual surveys conducted by the Centers for Disease Control and Prevention. And time and time again synthetic chemicals that we carelessly incorporated into consumer products with no premarket safety testing have been found to cause disease in children—cancer, birth defects, learning disabilities, attention deficit/hyperactivity disorder (ADHD) and impairment of the reproductive organs.