California Children’s Environmental Health

California Children’s Environmental Health Profile

Did you know 89% of children under 18 in California live in counties with unhealthy levels of ozone pollution? Or that 3.3% of children under age 18 had Autism Spectrum Disorder (compared to the National average of 2.9%) in 2018-2019? There are 8.9 million children in California, and approximately 16% of them live in poverty. Poverty is an important social determinant of health; poverty hurts children and their families. Children of color and young children are disproportionately poor and experience many issues that lead to adverse health outcomes. All children deserve a safe and healthy environment to grow and develop.

This profile highlights key California children’s environmental health indicators, federal support received by the states for environmental health, health equity and climate and health programs, and a spotlight feature on a children’s environmental-health related topical issue.

Continue reading to learn more about environmental hazards, children’s exposures, and children’s health outcomes in California, or click the blue button to download the profile as a PDF.

Key Children’s Environmental Health Indicators for California

What is a Children’s Environmental Health Indicator?

See Indicator References

Safe Drinking Water: 21% of public water utilities had drinking water violations.
National average: 30%
Air Quality: 89% of children under age 18 live in counties with unhealthy ozone pollution
Warming Temperatures: 2.7 degrees F warmer in 2020 than in 1970.
National average 2.8 degrees F warmer
Toxic Chemical Releases: 39.2 million pounds of toxic chemicals were disposed of or released.
United States 3.4 billion pounds
Asthma: 7.4% of children under age 18 have asthma (2018- 2019)
Nationwide: 7.7%
Pediatric Cancer: 181 cases of pediatric cancer per 1 million population (2005-2015) Nationwide: 181 cases per 1 million
Blood lead levels: 1.48% of tested children under age 6 have elevated blood lead levels (2018)
Nationwide: 2.6%
Neurodevelopmental Disorders:5.6% of children age 3-17 have ADD or ADHD (2018-2019).
Nationwide: 8.7%.

3.3% of children age 3-17  have Autism Spectrum Disorder (2018- 2019)
Nationwide: 2.9%

California Spotlight: Climate Change and Health Vulnerability Planning Tool

The California Department of Public Health (CDPH) seeks to reduce and prevent adverse and inequitable physical and mental health impacts associated with climate change. With partial funding from the Centers for Disease Control & Prevention’s Climate Ready States and Cities Initiative, the CDPH Climate Change and Health Equity Section and its CalBRACE Project developed Climate Change & Health Vulnerability Indicators for California (CCHVIs) and an online interactive platform to visualize the data, CCHVIz, These tools assist with climate change planning and prioritizing actions to protect people most at risk, including children.

The CCHVIz displays three categories of indicators that influence vulnerability to health impacts of climate change: exposure indicators including heat, air quality, wildfires, and sea level rise; population sensitivity indicators including children, elderly, poverty, education, outdoor workers, vehicle ownership, linguistic isolation, disability, health insurance, and violent crime rate; and adaptive capacity indicators including air conditioning ownership, tree canopy, and impervious surfaces.

The CCHVIz provides health officials and planners with an online snapshot to compare their county’s indicators to the state average. They can view risk by census tract for specific indicators, such as children under age 5, and their breakdown by race and ethnicity. The tool also plots the intersections of exposure indicators (e.g., ozone concentration) with sensitivity indicators (e.g., population under 5 years of age) to learn where children are susceptible to air pollution, extreme heat, wildfire, or other threats. The CCHVIz is an excellent resource for State and local officials in California to plan to prevent and prepare for climate change-related health impacts to young children, especially children of color and children in under-resourced communities.

Federal Support to California within the past 5 years

CDC-funded Climate-Ready States & Cities Initiative
CDC-funded Lead Poisoning Prevention Program
ATSDR State Cooperative Agreement Program
CDC National Asthma Control Program
CDC-funded Environmental Public Health Tracking Program
CDC State Biomonitoring Cooperative Agreement Program

Children’s Environmental Health Indicators Selection Criteria
Children’s environmental health indicators (CEHIs) are measures that can be used to assess environmental hazards, exposures, and their resulting health outcomes in children.  The below criteria are used when determining which indicators to utilize:

    • Relevance: Each headline indicator should be a clear, understandable indicator of children’s environmental health, with broad relevance for a range of audiences at the state level – with relevance to the national level.
    • Representativeness: The indicators as a package should provide a representative picture of children’s health and relation to the environment.
    • Traceability: Each indicator should be calculated using an agreed-upon (and published) method and accessible and verifiable data.
    • Timeliness: Each indicator should be calculated regularly (at least biennially), with a short lag between the end of the period and publication of the data.
    • Data adequacy: The available data needed for the indicator must be sufficiently robust, reliable and valid.
    • Universality: Indicators must be comparable across all or very nearly all 50 U.S. states. [/expand]

Indicator Notes and References

Safe Drinking Water

Air Quality

Warming Temperature

  • Indicator Note: Warming matters — it drives most of the hazards associated with climate change such as extreme weather, heat days, droughts and heavy downpours. Children are more vulnerable to harm from extreme heat and to the other cascading effects of warming temperatures.
  • Reference: AMERICAN WARMING: NOAA National Centers for Environmental Information, Climate at a Glance: Statewide Time Series, retrieved July 2021 from https://www.ncdc.noaa.gov/cag/.

Toxic Chemicals

  • Indicator Note: EPA’s Toxics Release Inventory (TRI) tracks the management of certain toxic chemicals that may pose a threat to human health and the environment. Certain industrial facilities in the U.S. must report annually how much of each chemical is disposed of or released on and off site. Many of these chemicals are known carcinogens, developmental toxicants, and neurotoxicants, such as arsenic, lead and mercury, that adversely impact children’s health.
  • Reference: Summary of 263 Toxic Release Inventory Facilities in California. Reporting Year 2019. Accessed June, 2021.

Neurodevelopmental Disorders

Asthma

Pediatric Cancer

Blood Lead Levels

Poverty

Federal Support to California

California Spotlight”]


All children deserve and need a safe and healthy environment to grow and develop. They need clean air to breathe, safe water to drink, nutritious food to eat, and healthy places in which to live, learn, and play. Early exposure to harmful agents can lead to acute and chronic adverse outcomes. Infants and children are especially vulnerable to environmental exposures because they breathe, eat and drink more, in proportion to their body size, than do adults, and because their bodies and brains are still developing.

A blueprint for Protecting Children’s Environmental Health Network set out to identify a set of CEHIs that can be used to provide an understanding of children’s environmental health at the state level. Through this process, CEHN found that robust, valid, and regularly updated state level data–that are comparable across most states–were not readily accessible. States need adequate funding and capacity to collect and make accessible reliable CEHI data in order to set goals and track progress towards improving children’s health.

Children are our future – society has a moral obligation to protect them. Exposure to environmental hazards can and must be prevented. Prevention requires strong environmental regulations, fully funded and supportive public and environmental health programs and a robust workforce.

Arizona Children’s Environmental Health

Arizona Children’s Environmental Health Profile


Did you know 87% of children under 18 in Arizona live in counties with unhealthy levels of ozone pollution? Or that 53% of public water utilities in the state experienced drinking water violations (compared to the National average of 32%) in 2019?  There are 1.7 million children in Arizona, and approximately 20% of them live in poverty. Poverty is an important social determinant of health; poverty hurts children and their families. Children of color and young children are disproportionately poor and experience many issues that lead to adverse health outcomes. All children deserve a safe and healthy environment to grow and develop.

This profile highlights key Arizona children’s environmental health indicators, federal support received by the state for environmental health, health equity and climate and health programs, and a spotlight feature on a children’s environmental health-related topical issue.

Continue reading to learn more about environmental hazards, children’s expoures, and children’ health outcomes in Arizona, or click the blue button to download the profile as a PDF.

Key Children’s Environmental Health Indicators for Arizona

What is a Children’s Environmental Health Indicator?

See Indicator References

Safe Drinking Water: 53% of public water utilities had drinking water violations.
National average: 32%
Air Quality: 87% of children under age 18 live in counties with unhealthy ozone pollution
Warming Temperatures: 3.2 degrees F warmer in 2018 than in 1970:
National average 2.5 degrees F
Toxic Chemical Releases: 170.6 million pounds of toxic chemicals were disposed of or released.
United States: 3.8 billion pounds
Asthma: 7.5% of children under age 18 have asthma (2017- 2018)
Nationwide: 7.6%
Pediatric Cancer: 176.9 cases of pediatric cancer per 1 million population (2005-2015)
Nationwide: 181.0 cases per 1 million
Blood lead levels: 0.3% of tested children under age 6 have elevated blood lead levels (2017)
Nationwide: 3%
Neurodevelopmental Disorders: 6.9% of children age 3-17 have ADD or ADHD (2017-2018).
Nationwide: 8.7%.


Neurodevelopmental Disorders: 3.1% of children age 3-17  have Autism Spectrum Disorder (2017- 2018)
Nationwide: 2.9% 

Arizona Spotlight: Navajo Community Groups Dine C.A.R.E and To Nizhoni Ani 

The Navajo Nation has faced years of environmental contamination from historical uranium mining and the placement of coal-powered incinerators on their lands. Their residents have suffered from breathing coal ash and polluted air. Uranium mining was banned in 2005 but has left a legacy of extraction contaminated water sources, including private wells.

Two Navajo community groups —Dine C.A.R.E. (Navajo Citizens Against Ruining our Environment) and To Nizhoni Ani (Sacred Water Speaks)–have been working to address these injustices for years. An overarching goal of their efforts is to make sure that the Navajo Nation transitions from an over-reliance on coal as an economic engine to more affordable and sustainable sources of energy, They are prioritizing and promoting sources that do not pollute Navajo air, land and water – and that are in line with their Dine way of life and fundamental principles. These organizations are recognized as leaders on these issues They collaborate with national environmental organizations, travel to Washington DC to advocate on behalf of the Navajo Nation and are committed to finding clean energy solutions and associated jobs on Navajo lands.

Federal Support to Arizona within the past 5 years

CDC Funded Lead Poisoning Prevention Program
CDC Funded Environmental Public Health Tracking Program
CDC State Biomonitoring Cooperative Agreement Program
  ATSDR State Cooperative Agreement Program
  CDC National Asthma Control Program

Children’s Environmental Health Indicators Selection Criteria 
Children’s environmental health indicators (CEHIs) are measures that can be used to assess environmental hazards, exposures, and their resulting health outcomes in children.  The below criteria are used when determining which indicators to utilize:

    • Relevance: Each headline indicator should be a clear, understandable indicator of children’s environmental health, with broad relevance for a range of audiences at the state level – with relevance to the national level.
    • Representativeness: The indicators as a package should provide a representative picture of children’s health and relation to the environment.
    • Traceability: Each indicator should be calculated using an agreed-upon (and published) method and accessible and verifiable data.
    • Timeliness: Each indicator should be calculated regularly (at least biennially), with a short lag between the end of the period and publication of the data.
    • Data adequacy: The available data needed for the indicator must be sufficiently robust, reliable and valid.
    • Universality: Indicators must be comparable across all or very nearly all 50 U.S. states. [/expand]

Indicator Notes and References

Safe Drinking Water

Air Quality

Warming Temperature

Toxic Chemicals

  • Indicator Note: EPA’s Toxics Release Inventory (TRI) tracks the management of certain toxic chemicals that may pose a threat to human health and the environment. Certain industrial facilities in the U.S. must report annually how much of each chemical is disposed of or released on and off site. Many of these chemicals are known carcinogens, developmental toxicants, and neurotoxicants, such as arsenic, lead and mercury, that adversely impact children’s health.
  • Reference: Summary of 263 Toxic Release Inventory Facilities in Arizona. Reporting Year 2018. Accessed on April 28, 2020.

Neurodevelopmental Disorders

Asthma

Pediatric Cancer

Blood Lead Levels

Poverty

Federal Support to Arizona

Arizona Spotlight


All children deserve and need a safe and healthy environment to grow and develop. They need clean air to breathe, safe water to drink, nutritious food to eat, and healthy places in which to live, learn, and play. Early exposure to harmful agents can lead to acute and chronic adverse outcomes. Infants and children are especially vulnerable to environmental exposures because they breathe, eat and drink more, in proportion to their body size, than do adults, and because their bodies and brains are still developing.

A blueprint for Protecting Children’s Environmental Health Network set out to identify a set of CEHIs that can be used to provide an understanding of children’s environmental health at the state level. Through this process, CEHN found that robust, valid, and regularly updated state level data–that are comparable across most states–were not readily accessible. States need adequate funding and capacity to collect and make accessible reliable CEHI data in order to set goals and track progress towards improving children’s health.

Children are our future – society has a moral obligation to protect them. Exposure to environmental hazards can and must be prevented. Prevention requires strong environmental regulations, fully funded and supportive public and environmental health programs and a robust workforce.

California Children’s Environmental Health

California Children’s Environmental Health


Download California’s Children’s Environmental Health fact sheet.

Children’s Environmental Health Indicators Criteria.

California References (listed in the order in which they appear on the fact sheet):

Michigan’s children’s environmental health: Child care and beyond

Michigan’s children’s environmental health: Child care and beyond

Michigan’s child care industry was struggling even before COVID-19. The pandemic and the tumult of this past year has certainly heightened the issues, with child care closures and both parents and child care providers and staff struggling financially. It is of critical importance for Michigan to support families in accessing high quality affordable child care, and to support child care providers in remaining open, safe, and healthy.

It shouldn’t take a pandemic to remind us that child care is essential to children, families, and society. Crises have a way of revealing our problematic oversights and offer opportunities for true progress. Consider environmental health. Harvard researchers found that people exposed to higher levels of air pollution (disproportionately people of color and those living in poverty) are at greater risk from the coronavirus. Yet building the political will to enact protective, equitable environmental health policies is often a struggle. Everyone, and especially all children deserve clean air and water, safe food and products, a stable climate, and healthy places to live, learn, and play.

Eco-Healthy Child Care® (EHCC) assists child care professionals in their efforts to reduce or eliminate environmental hazards, such as lead and pesticides, in and around their facilities. Over this past year we have been guiding providers during this crisis with information about safe and effective cleaning and disinfecting and safe re-opening practices.

While we focus on the child care space, our parent organization, the Children’s Environmental Health Network (CEHN), has been the leading national voice for children’s environmental health across all settings for nearly three decades. Recently, CEHN has embarked on a project to provide a profile of children’s environmental health (CEH) for each of the 50 U.S. states, and Michigan made their first batch of six.

How do you craft a state’s CEH profile? CEHN staff carefully combed through collections of data on environmental hazards, environmental exposures (biomonitoring), and children’s health outcomes and identified 9 children’s environmental health indicators (CEHI) that met their inclusion criteria of being meaningful, regularly collected, robust data that is uniformly defined across all 50 states. This proved difficult, and one key takeaway is the need for more intentional focus on nationally coordinated CEH surveillance at the state and local levels.

You might be wondering how Michigan fared in their CEH profile? Make sure you check it out and share with others in the state. Below are a few key points.

Drinking Water

Michigan’s drinking water gets a lot of attention since the Flint lead crisis, and the CEH profile points out that Michigan has the most PFAS contaminated water sites of the states. However, it is important to note that the state has responded rapidly and strongly via the Michigan PFAS Action Response Team (MPART), a multi-agency collaboration that has provided communities with alternative drinking water sources and filters. Recently, Governor Whitmer announced a $25 million grant program to invest in water infrastructure and projects that remove or reduce contaminants such as PFAS under Michigan’s Clean Water Plan.

Air Quality

While overshadowed by drinking water concerns, Michigan’s air quality is important to note. According to the CEH profile approximately 73% of the state’s children live in counties with unhealthy levels of ozone pollution. This is meaningful, because the profile also imparts that 8.3% of Michigan’s children has asthma (which is exacerbated by, and in some cases even caused by ozone exposure), compared with a nationwide rate of 7.5%.  

Climate Change

Climate change has caused Michigan to have warmed 2.7 degrees (F) since the 1970s. Higher temperatures increase the formation of ozone, and lengthen pollen season, contributing to asthma exacerbations. More frequent and hotter days increase children’s risk for heat illnesses, especially those in urban areas and those in homes without air conditioning. Michigan recently became the 9th state to pledge carbon neutrality, as Governor Whitmer declared plans to meet this goal by 2050.

Toxic chemical release and childhood conditions

The state’s rates for childhood cancers and for ADHD/ADD are also above national rates. In addition, according to the CEH profile, 79.3 million pounds of toxic chemicals were disposed of or released in Michigan in 2018. Only one other state out of the 6 states assessed released a greater amount. How might these toxic chemical releases be contributing to the level of childhood disease and disability among Michigan children?

These profiles are designed to help state leaders take stock and then track their progress over time in reducing environmental hazards and improving health outcomes for their youngest residents, and especially those most vulnerable. Nearly 20% of Michigan’s children live in poverty. These children, and children of color, bear disproportionate burdens of pollution and other environmental health risks, and clear and intentional efforts to address poverty and environmental racism must be prioritized.

There are some promising signs for the state’s progress on CEH issues. In addition to some of the governor’s actions on drinking water and carbon neutrality, Michigan has received support from the CDC and ATSDR within the past 5 years for their lead poisoning prevention program, their asthma control program, and their efforts to reduce toxic exposures, as well as for their environmental public health tracking and biomonitoring programs. Federal support to states is critical now more than ever, as the worst months of the pandemic lay before us. Thankfully, it looks as though 2021 may bring eventual relief from the pandemic, and the new year also signals hope for renewed attention to public health and environmental and climate concerns at the federal level. There is a lot of talk about “building back better” post-pandemic. Addressing racism, poverty, pollution, lack of universal affordable accessible high-quality child care, underfunded public health systems, and an economy centered around toxic chemicals and fossil fuels need to be centered in those plans. This would bode well for Michiganders and indeed families and communities in all states across our nation, and especially the children whose very futures require safe and healthy communities to thrive.

See the full Michigan CEH profile.

Protecting Colorado Children’s Health

Protecting Colorado Children’s Health

We are all reeling from the COVID-19 pandemic–grieving the loss of loved ones, of jobs, stability, social gatherings, and peace of mind. And we are struggling to adjust to our “new normal” amidst heightened anxiety and persisting uncertainties. One of the truly sobering takeaways is that this crisis has exposed critical gaps in our nation’s ability to effectively protect our most vulnerable. It is urgent that we act on preventable health outcomes to promote the safest and healthiest futures for our children.

That’s why I’m so excited about the new Colorado State Profile for Children’s Environmental Health from The Children’s Environmental Health Network (CEHN). CEHN is a national non-profit organization that has been at the frontlines of children’s environmental health for nearly three decades. They are developing profiles for each state around currently available children’s environmental health indicators (CEHIs).  

Children’s Environmental Health & CEHIs

Over the past several decades, childhood chronic diseases, such as asthma and leukemias, and developmental conditions, such as attention-deficit-hyperactivity-disorder, have become far more common in the U.S. Improved testing and genetics do not account entirely for these worrisome trends.The World Health Organization estimates that 34% of all children’s health issues are the result of modifiable environmental factors.

Children are especially vulnerable to environmental exposures because they breathe, eat and drink more than adults, in proportion to their body size. Their bodies and brains are developing and thus at risk from toxic exposures, while in the womb through adolescence. Exposures to harmful toxicants in our water, food, and everyday products (such as lead, pesticides, brominated flame retardants, and PFAS) and to air pollutants (such as particulate matter, mercury, and ozone) increase children’s risk of  adverse health and developmental outcomes and exacerbate existing health conditions. Children and pregnant women from low income communities, tribal communities, and communities of color are disproportionately exposed to these harmful toxicants, placing them at higher risk for illness and disability.

Our changing climate intensifies these environmental hazards and exacerbates existing inequalities–bringing stronger storms, extreme heat waves, more numerous and intense wildfires, and flooding. These effects and others threaten our air and water quality, food security, family and community stability, and physical and mental health. Climate change can also set the stage for more pandemics, as droughts and extreme temperatures  increase our risks of zoonotic diseases. In the case of COVID-19, environmental factors can also influence a patient’s prognosis. Mounting scientific evidence demonstrates that exposure to air pollutants directly affects our ability to survive a virus that attacks our respiratory system, as is common with many emerging zoonotic diseases.

In order to reduce our children’s risk of illness and disability, federal, state, and local leaders need to address existing environmental hazards and better plan for children’s needs in the face of climate change. Unfortunately, the current federal administration is reversing nearly 100 environmental regulations that influence the health of our families and pose a serious threat to our impact on the climate. It is up to state and local officials to provide the environmental health protections that our children deserve. And it is up to us to speak out, demanding that children’s health be a priority. 

For Colorado’s decision-makers to effectively address children’s environmental health concerns they must first understand the current state of these issues in their jurisdiction.Comprehensive information, including state-by-state comparisons of uniformly defined data points (CEHIs) about environmental hazards, environmental exposures, and relevant children’s health outcomes, is needed. Unfortunately there are very few accessible sources of robust, valid, and regularly updated state-level comparisons of CEHIs, but CEHN has compiled the most meaningful ones into their state profiles.

Colorado’s Profile

The Colorado profile offers interesting insights. The first thing that stuck out to me was that nearly 70% of Colorado children live in counties with unhealthy ozone levels as of 2020. Another 12% live in counties that either don’t monitor or have incomplete monitoring data for ozone pollution. That means that over 1 million of our 1.3 million Colorado children could be at risk for air-quality related health issues.

I was also startled that Colorado children are more likely than most in the  U.S. to be drinking unclean water. The profile shows that 40% of all public water systems in Colorado reported violations of clean water standards (U.S. average is 31%). These reported violations include health-based violations (for example, exceedances of the maximum contaminant levels or exceedances of the maximum residual disinfectant levels), and monitoring and reporting violations.1

Clean air and water are such foundational human rights. They are at the root of our health and wellbeing. Our state is so rich in natural resources that people travel from all over the country to access our “pristine nature.” Why can’t we offer our children these very basic resources?

Indicators like access to clean air and water set the stage for other health related outcomes that can change the course of a child’s life forever. Mounting scientific research links environmental exposures with risk of Attention-Deficit Hyperactivity Disorder (ADHD), Attention-Deficit Disorder (ADD), and Autism Spectrum Disorder (ASD). In 2009, The President’s Cancer Panel’s Annual Report pointed to environmental causes for the worrying increase in the pediatric cancer rate since the ‘70s, which is now the leading disease-related cause of death past infancy in U.S. children. Poor outdoor air quality, including high concentrations of ground-level ozone, are linked with the exacerbation of children’s respiratory illnesses, including asthma, as well as the survivability of respiratory illnesses like COVID-19. These issues are all related. They all stem from the places in which our children play, live, and go to school, the food, water, clothes, and toys we give them, the ways in which we clean our homes, and what industries surround our neighborhoods. 

As with the COVID-19 pandemic, our least privileged communities shoulder the worst of environmental hazards. Poverty is an important social determinant of health, and one that disproportionately affects indigenous communities and communities of color. As of 2019, 12% of Colorado’s children were living in poverty. They are less likely to be able to access quality health care, electrical power, nutritious food, and safe drinking water. They are also likely to live in unsafe homes and are more likely to learn, play, and live adjacent to polluting industries. 

In addition, they are often left untested for associated exposures. For example, CEHN’s profile shows that 1% of Colorado’s children tested positive for elevated blood lead levels (BLL) in 2016, but if you read the footnotes you’ll see that only 6.6% of Colorado children under age 6 were tested. It’s also worth considering that not all children who are tested get reported to public health authorities, so the true scope of children’s lead poisoning in our state is likely higher. By the way, CEHN’s profile includes lots of helpful context, scientific studies, and links to more information, both in the report itself and on their website.

Developing comprehensive, uniformly-defined children’s environmental health indicators and regularly collecting and updating the data is critical to creating strong child-protective policies and to track our progress as we improve our children’s health. All of Colorado’s children deserve a safe and healthy environment to grow and develop. They need clean air to breathe and safe water to drink, nutritious food to eat, and healthy places in which to live, learn, and play. We know this is possible. In order to make it a reality we must hold our elected officials at all levels of government accountable and demand increased investment in under-resourced communities, in our crumbling infrastructure, and in our public health systems. We need to respect the interconnectedness of environmental and human health and prioritize the health of our planet so that our children and future generations have the healthiest possible start to life.

Looking for ways to get involved? Children’s Environmental Health Day is on October 8th this year. Demand that children’s health be put at the center of governmental issues: request a proclamation from Colorado’s governor or from your mayor. You can also host or join into a children’s environmental health day activity with your family, church, scout troop, or neighbors. Get ideas at www.cehn.org/cehday/

Protecting Arizona Children’s Health

Protecting Arizona Children’s Health

We are all reeling from the COVID-19 pandemicgrieving the loss of loved ones, of jobs, stability, social gatherings, and peace of mind. And we are struggling to adjust to our “new normal” amidst heightened anxiety and persisting uncertainties. One of the truly sobering takeaways is that this crisis has exposed critical gaps in our nation’s ability to effectively protect our most vulnerable. It is urgent that we act on preventable health outcomes to promote the safest and healthiest futures for our children. 

That’s why I’m so excited about the new Arizona State Profile for Children’s Environmental Health from The Children’s Environmental Health Network (CEHN). CEHN is a national non-profit organization that has been at the frontlines of children’s environmental health for nearly three decades. They are developing profiles for each state around currently available children’s environmental health indicators (CEHIs).  

Children’s Environmental Health & CEHIs

Over the past several decades, childhood chronic diseases, such as asthma and leukemias, and developmental conditions, such as attention-deficit-hyperactivity-disorder, have become far more common in the U.S. Improved testing and genetics do not account entirely for these worrisome trends.The World Health Organization estimates that 34% of all children’s health issues are the result of modifiable environmental factors.

Children are especially vulnerable to environmental exposures because they breathe, eat and drink more than adults, in proportion to their body size. Their bodies and brains are developing and thus at risk from toxic exposures, while in the womb through adolescence. Exposures to harmful toxicants in our water, food, and everyday products (such as lead,  pesticides, brominated flame retardants, and PFAS) and to air pollutants (such as particulate matter, mercury, and ozone) increase children’s risk of  adverse health and developmental outcomes and exacerbate existing health conditions. Children and pregnant women from low income communities, tribal communities, and communities of color are disproportionately exposed to these harmful toxicants, placing them at higher risk for illness and disability.

Our changing climate intensifies these environmental hazards and exacerbates existing inequalities–bringing stronger storms, extreme heat waves, more numerous and intense wildfires, and flooding. These effects and others threaten our air and water quality, food security, family and community stability, and physical and mental health. Climate change can also set the stage for more pandemics, as droughts and extreme temperatures  increase our risks of zoonotic diseases. In the case of COVID-19, environmental factors can also influence a patient’s prognosis. Mounting scientific evidence demonstrates that exposure to air pollutants directly affects our ability to survive a virus that attacks our respiratory system, as is common with many emerging zoonotic diseases.

In order to reduce our children’s risk of illness and disability, federal, state, and local leaders need to address existing environmental hazards and better plan for children’s needs in the face of climate change. Unfortunately, the current federal administration is reversing nearly 100 environmental regulations that influence the health of our families and pose a serious threat to our impact on the climate. It is up to state and local officials to provide the environmental health protections that our children deserve. And it is up to us to speak out, demanding that children’s health be a priority. 

For Arizona decision-makers to effectively address children’s environmental health concerns they must first understand the current state of these issues in their jurisdiction.Comprehensive information, including state-by-state comparisons of uniformly defined data points (CEHIs) about environmental hazards, environmental exposures, and relevant children’s health outcomes, is needed. Unfortunately there are very few accessible sources of robust, valid, and regularly updated state-level comparisons of CEHIs, but CEHN has compiled the most meaningful ones into their state profiles.

Arizona’s Profile

The Arizona profile offers interesting insights. One for the first things I noticed was the percentage of Arizona children between the ages of 3 and 17 with Autism Spectrum Disorder (ASD). It is greater than the percentage of children nationwide with ASD (3.1% vs. 2.9%). Could this higher rate be linked to the other insights–for example, the more than 170 million pounds of toxic chemicals disposed of or released in the state in 2018, or the fact that in 2019 over 50% of all public water systems in Arizona reported violations of clean water standards (U.S. average is 31%)? Might our rate of ASD diagnoses be reduced by improving environmental health in our state and reducing children’s exposures to toxicants? 

I was unsurprised that Arizona faces a greater rate of warming than the national average (3.5℉, the national average is 2.5℉), but I am concerned about it. In general, warming drives most of the hazards associated with climate change such as extreme weather, heat days, and droughts. Children, especially the youngest children, are especially vulnerable to harm from extreme heat and to the other cascading effects of warming temperatures.

Just like the COVID-19 pandemic, our least privileged communities shoulder the worst of environmental hazards. Poverty is an important social determinant of health, and one that disproportionately affects indigenous communities and communities of color. As of 2019, 20% of Arizona’s children were living in poverty. They are less likely to be able to access quality health care, electrical power, nutritious food, and safe drinking water (if any running water at all).They are also likely to live in unsafe homes and are more likely to learn, play, and live adjacent to polluting industries. Even more worrying, they are often left untested  for associated exposures. For example, CEHN’s profile shows that 0.3% of Arizona children tested positive for elevated blood lead levels (BLL) in 2017, which seems impressively low, but if you read the footnotes, you’ll see that only 11.4% of Arizona children under age 6 were tested. It’s also worth considering that not all children who are tested get reported to public health authorities, so the true scope of children’s lead poisoning in our state is likely higher. By the way, CEHN’s profile includes lots of helpful context, scientific studies, and links to more information, both in the report itself and on their website.

Developing comprehensive, uniformly-defined children’s environmental health indicators and regularly collecting and updating the data is critical to creating strong child-protective policies and to track our progress as we improve our children’s health. All of Arizona’s children deserve a safe and healthy environment to grow and develop. They need clean air to breathe and safe water to drink, nutritious food to eat, and healthy places in which to live, learn, and play. We know this is possible. In order to make it a reality we must hold our elected officials at all levels of government accountable and demand increased investment in under-resourced communities, in our crumbling infrastructure, and in our public health systems. We need to respect the interconnectedness of environmental and human health and prioritize the health of our planet so that our children and future generations have the healthiest possible start to life.

Looking for ways to get involved? Children’s Environmental Health Day is on October 8th this year. Demand that children’s health be put at the center of governmental issues: request a proclamation from Arizona’s governor or from your mayor. You can also host or join into a children’s environmental health day activity with your family, church, scout troop, or neighbors. Get ideas at www.cehn.org/cehday/

Protecting Florida Children’s Health

Protecting Florida Children’s Health

We are all reeling from the COVID-19 pandemic–grieving the loss of loved ones, of jobs, stability, social gatherings, and peace of mind. And we are struggling to adjust to our “new normal” amidst heightened anxiety and persisting uncertainties. One of the truly sobering takeaways is that this crisis has exposed critical gaps in our nation’s ability to effectively protect our most vulnerable. It is urgent  that we act on preventable health outcomes to promote the safest and healthiest futures for our children.

That’s why I’m so excited about the new Florida State Profile for Children’s Environmental Health from The Children’s Environmental Health Network (CEHN). CEHN is a national non-profit organization that has been at the frontlines of children’s environmental health for nearly three decades. They are developing profiles for each state around currently available children’s environmental health indicators (CEHIs).  

Children’s Environmental Health & CEHIs

Over the past several decades, childhood chronic diseases, such as asthma and leukemias, and developmental conditions, such as attention-deficit-hyperactivity-disorder, have become far more common in the U.S. Improved testing and genetics do not account entirely for these worrisome trends.The World Health Organization estimates that 34% of all children’s health issues are the result of modifiable environmental factors.

Children are especially vulnerable to environmental exposures because they breathe, eat and drink more than adults, in proportion to their body size. Their bodies and brains are developing and thus at risk from toxic exposures, while in the womb through adolescence. Exposures to harmful toxicants in our water, food, and everyday products (such as lead,  pesticides, brominated flame retardants, and PFAS) and to air pollutants (such as particulate matter, mercury, and ozone) increase children’s risk of  adverse health and developmental outcomes and exacerbate existing health conditions. Children and pregnant women from low income communities, tribal communities, and communities of color are disproportionately exposed to these harmful toxicants, placing them at higher risk for illness and disability.

Our changing climate intensifies these environmental hazards and exacerbates existing inequalities–bringing stronger storms, extreme heat waves, more numerous and intense wildfires, and flooding. These effects and others threaten our air and water quality, food security, family and community stability, and physical and mental health. Climate change can also set the stage for more pandemics, as droughts and extreme temperatures  increase our risks of zoonotic diseases. In the case of COVID-19, environmental factors can also influence a patient’s prognosis. Mounting scientific evidence demonstrates that exposure to air pollutants directly affects our ability to survive a virus that attacks our respiratory system, as is common with many emerging zoonotic diseases.

In order to reduce our children’s risk of illness and disability, federal, state, and local leaders need to address existing environmental hazards and better plan for children’s needs in the face of climate change. Unfortunately, the current federal administration is reversing nearly 100 environmental regulations that influence the health of our families and pose a serious threat to our impact on the climate. It is up to state and local officials to provide the environmental health protections that our children deserve. And it is up to us to speak out, demanding that children’s health be a priority. 

For Florida decision-makers to effectively address children’s environmental health concerns they must first understand the current state of these issues in their jurisdiction.Comprehensive information, including state-by-state comparisons of uniformly defined data points (CEHIs) about environmental hazards, environmental exposures, and relevant children’s health outcomes, is needed. Unfortunately there are very few accessible sources of robust, valid, and regularly updated state-level comparisons of CEHIs, but CEHN has compiled the most meaningful ones into their state profiles.

Florida’s Profile

The Florida profile offers interesting insights. The first thing that struck me was our rate of asthma. Nine and a half percent of Florida’s children are diagnosed with asthma. The national average is only 7.6%. A related and also unnerving statistic: over 20% of Florida’s children live in counties with unhealthy ozone levels, while nearly 10% live in counties without sufficient air quality monitoring. That means that up to a third of Florida’s children may be at risk for air quality-related health issues.

I’m glad that CEHN’s profile touches on climate change in Florida. They’ve included a state spotlight on the Southeast Regional Climate Change Compact, which has put together an impressive plan with extensive guidelines for the many Florida communities facing the effects of climate change.1 Our state is uniquely situated to face some of the most extreme effects of climate change in the U.S., from sea level rise to extreme weather to heat days. Children, especially the youngest, are particularly vulnerable to harm from extreme heat and to the other cascading effects of warming temperatures. In fact, we are home to 10 of the hottest cities in the country and more than 620,000 of our residents are especially vulnerable to extreme heat (meaning those under 5, over 65, or living in poverty).2  

And just like with the COVID-19 pandemic, our least privileged communities shoulder the worst of environmental hazards and climate change risks. Children in low-income communities are more likely to face trauma, community loss, and mental health issues unsupported after natural disasters. Did you know that Florida has more people at risk for a 100 year flood than any other state? That’s about 5 million people if you count both inland and coastal flooding risks.3  

Poverty is an important social determinant of health, and one that disproportionately affects indigenous communities and communities of color. As of 2019, 20% of Florida’s children were living in poverty. They are less likely to be able to access quality health care, electrical power, nutritious food, and safe drinking water. They are also likely to live in unsafe homes and are more likely to learn, play, and live adjacent to polluting industries. 

In addition, many marginalized children are often left untested  for associated exposures. For example, CEHN’s profile shows that 1.7% of Florida children tested positive for elevated blood lead levels (BLL) in 2012, but if you read the footnotes, you’ll see that only 13.7% of Florida children under age 6 were tested. It’s also worth considering that not all children who are tested get reported to public health authorities, so the true scope of children’s lead poisoning in our state is likely higher. Getting an accurate assessment is further confused because no BLL data is available through the CDC after 2012 for Florida (most other states are up to date through at least 2017). By the way, CEHN’s profile includes lots of helpful context, scientific studies, and links to more information, both in the report itself and on their website.

Developing comprehensive, uniformly-defined children’s environmental health indicators and regularly collecting and updating the data is critical to creating strong child-protective policies and to track our progress as we improve our children’s health. All of Florida’s children deserve a safe and healthy environment to grow and develop. They need clean air to breathe and safe water to drink, nutritious food to eat, and healthy places in which to live, learn, and play. We know this is possible. In order to make it a reality we must hold our elected officials at all levels of government accountable and demand increased investment in under-resourced communities, in our crumbling infrastructure, and in our public health systems. We need to respect the interconnectedness of environmental and human health and prioritize the health of our planet so that our children and future generations have the healthiest possible start to life.

Looking for ways to get involved? Children’s Environmental Health Day is on October 8th this year. Demand that children’s health be put at the center of governmental issues: request a proclamation from Florida’s governor or from your mayor. You can also host or join into a children’s environmental health day activity with your family, church, scout troop, or neighbors. Get ideas at www.cehn.org/cehday/

Colorado’s Children’s Environmental Health

Colorado Children’s Environmental Health


Download Colorado’s Children’s Environmental Health fact sheet.

Children’s Environmental Health Indicators Criteria.

Colorado References (listed in the order in which they appear on the fact sheet):

Arizona Children’s Environmental Health

Arizona Children’s Environmental Health


Download Arizona’s Children’s Environmental Health fact sheet.

Children’s Environmental Health Indicators Criteria.

Arizona References (listed in the order in which they appear on the fact sheet):

Florida Children’s Environmental Health

Florida Children’s Environmental Health


Download Florida’s Children’s Environmental Health fact sheet.

Children’s Environmental Health Indicators Criteria.

Florida References (listed in the order in which they appear on the fact sheet):