Michigan Children's Environmental Health State Profile

Did you know 50% of children under 18 in Michigan live in counties with unhealthy levels of ozone pollution? Or that 9.1% of children under age 18 had asthma (compared to the National average of 7.7%) in 2018-2019? There are 2.1 million children in Michigan, and approximately 18% 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 Michigan 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 in a children's environmental health-related topical issues.

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

Key Children's Environmental Health Indicators for Michigan

What is a Children's Environmental Health Indicator?

See Indicator References

	Safe Drinking Water: 24% of public water utilities had drinking water violations (2020) National average: 31%
	Air Quality: 50% of children under age 18 live in counties with unhealthy ozone pollution (2021)
	Warming Temperatures: 2.9 degrees F warmer in 2020 than in 1970. National average 2.8 degrees F warmer
	Toxic Chemical Releases: 61.9 million pounds of toxic chemicals were disposed of or released (2020). United States 3.1 billion pounds
	Asthma: 9.1% of children under age 18 have asthma (2018- 2019) Nationwide: 7.7%
	Pediatric Cancer: 184.8 cases of pediatric cancer per 1 million population (2005-2015) Nationwide: 181.0 cases per 1 million
	Blood lead levels: 4% of tested children under age 6 have elevated blood lead levels (2016). Nationwide: 3.8%
	Neurodevelopmental Disorders: 9.7% of children age 3-17 have ADD or ADHD (2019-2020). Nationwide: 8.9%. 2.6% of children age 3-17 have Autism Spectrum Disorder (2019- 2020) Nationwide: 2.9%

Michigan Spotlight: Michigan PFAS Action Response Team (MPART)

Contamination of drinking water by per- and polyfluoroalkyl substances (PFA) has been a high-visibility issue in Michigan and across the country over the past few years. PFAS are a group of highly toxic persistent chemicals and a significant public health concern. Although the EPA anticipates issuing PFAS regulation in Fall 2023, there are currently no federal regulations in place for PFAS in drinking water. A 2021 report found that Michigan has among the most PFAS-contaminated water sites in the country. However, the high number of confirmed sites is at least partly attributed to MI's aggressive search for PFAS contamination.

Since 2017, the state has acted to protect its drinking water via the Michigan PFAS Action Response Team (MPART), a multi-agency collaboration. MPART actions that have successfully reduced statewide exposure include the provisioning of alternative water sources and the regulation of PFAS discharges into drinking water supplies, While the state drinking water standards only apply to public water supplies, MPART actions that have successfully reduced statewide exposure include the provisioning of alternative water sources and the regulation of PFAS discharges into drinking water supplies. While the state drinking water standards only apply to public water supplies, MPART investigators also assist private well owners by testing wells in areas with known PFAS contamination, providing educational information about PFAS, and helping those with tainted well water to consider solutions. Michigan is one of only 16 states to set enforceable standards for certain PFAS substances in drinking water. These standards are stricter than the EPA's for current unenforceable health advisory levels.

Federal Support to Michigan within the past 5 years (click to expand):

	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 (click to expand):

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.

Indicator Notes and References (click to expand):

Safe Drinking Water

Reference: Michigan Drinking Water Performance Dashboard. Public Water Systems with Any Violation – Fiscal Year 2020. Enforcement and Compliance History Online (ECHO). U.S. Environmental Protection Agency.

Air Quality

Indicator Note: In this fact sheet, counties with "unhealthy" ozone pollution are those receiving a grade of D or F for ozone pollution in the American Lung Association's 2021 State of the Air report. Approximately 566,278 or 26% of Michigan children live in counties where ozone pollution is not monitored for which there is less than 3 years of data.
Reference: Ozone Pollution. American Lung Association. 2021 State of the Air Report Card: Michigan. Data from U.S. Environmental Protection Agency’s Air Quality System.

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: Warming Temperatures. Climate at a Glance | National Centers for Environmental Information (NCEI). Statewide Haywood Plots: Michigan (2020).

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 759 Toxic Release Inventory Facilities in Michigan. Reporting Year 2020.

Neurodevelopmental Disorders

Indicator Note: Mounting scientific research links environmental exposures with risk of Attention-Deficit Hyperactivity Disorder (ADHD). Attention-Deficit Disorder (ADD) and Autism Spectrum Disorder (ASD). Neither genetics nor changing diagnosis or other artifacts fully account for the increased incidences of these conditions. ADHD, ADD and ASD data are for Michigan children aged 3-17 ages.
Reference: ADHD, ADD, and ASD prevalence. 2019-2020 National Survey of Children's Health. Title V Maternal and Child Health Services Block Grant National Performance and Outcome Measures. Prevalence of current ADD or ADHD, age 3-17 years; and Prevalence of current Autism or Autism Spectrum Disorder (ASD), age 3-17 years. Data Resource Center for Child and Adolescent Health. Maternal and Child Health Bureau, Health Resources and Services Administration. Environmental exposures contribute to ADHD/ADD, ASD, and asthma. NIEHS/EPA Children's Environmental Health and Disease Prevention Research Centers. 2017 Impact Report .

Asthma

Indicator Note: A wealth of research links exposure to poor outdoor air quality, including high concentrations of ground-level ozone, with the exacerbation of children's respiratory illnesses, including asthma. Several studies link it with the onset of childhood asthma.
Reference: 2018-2019 National Survey of Children's Health. Title V Maternal and Child Health Services Block Grant National Performance and Outcome Measures. Prevalence of current asthma, age 0-17 years. Data Resource Center for Child and Adolescent Health. Maternal and Child Health Bureau, Health Resources and Services Administration.

Pediatric Cancer

Indicator Note: Although cancer in children is rare, the rate of pediatric cancer has been increasing since the 1970s. It is the leading disease related cause of death past infancy in U.S. children, Neither genetics nor improved diagnostic techniques can explain the increased rate. According to the President's Cancer Panel's 2008-2009 Annual Report, "the true burden of environmentally induced cancer has been grossly underestimated"
Reference: Michigan Childhood Cancers Incidence. Request for children age 0-19. Age-adjusted rate for 2005-2015. Centers for Disease Control and Prevention. Wide-ranging Online Data for Epidemiologic Research (WONDER).President's Cancer Panel. 2008-2009 Annual Report. Reducing Environmental Cancer Risk. National Cancer Institute, National Institutes of Health.

Blood Lead Levels

Indicator Note: In 2016, 21% of Michigan children under age 6 were tested for blood lead levels (BLLs). Of those tested, 4.0% had a BLL>= 5 µg/dL. Often the most vulnerable children are not tested, and not all who are tested get reported, so 4.0% is likely an underestimate of the true scope of children's elevated blood lead in Michigan. There is no safe level of lead exposure for children. A potent neurotoxicant, lead reduces IQ and impairs other cognitive, behavioral and developmental functions. In 2021, the CDC lowered the BLL reference value from 5 to 3.5 µg/dL.
Reference: National Childhood Blood Lead Surveillance Data. 2016. Centers for Disease Control and Prevention. Under-testing and under-reporting of children's blood lead levels. Assessing Child Lead Poisoning Case Ascertainment in the US, 1999–2010. Eric M. Roberts, Daniel Madrigal, Jhaqueline Valle, Galatea King and Linda Kite. Pediatrics April 2017, e20164266; DOI: https://doi.org/10.1542/peds.2016-4266. Blood Lead Reference Value. 2021. Centers for Disease Control and Prevention.

Poverty

Reference: Number of Children in Michigan. U.S. Census Bureau. 2019. Quick Facts Michigan.,
- Percent of Children in Michigan Living in Poverty. The Annie E. Casey Foundation: 2019 Kids COUNT Data Center.

Federal Support to Michigan

References:
- CDC-funded Climate-Ready States & Cities Initiative. 2021.
- CDC Childhood Lead Poisoning Prevention. 2019.
- ATSDR State Cooperative Agreement Program. 2021.
- CDC National Asthma Control Program. 2020.
- CDC Environmental Public Health Tracking Network. 2020.
- CDC State Biomonitoring Programs. 2019.

Michigan Spotlight

References:

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.