Minnesota Children's Environmental Health State Profile

Did you know 48% of Minnesota's children live in counties that do not monitor ozone pollution levels? Or that while the national average temperature increase since 1970 is 2.8 degrees F, Minnesota's temperature increase is 3.3 degrees F? There are 1.3 million children in Minnesota, and approximately 11% 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 Minnesota 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 exposures, and children's health outcomes in Minnesota, or click the blue button to download the profile as a PDF.

Key Children's Environmental Health Indicators for Minnesota

What is a Children's Environmental Health Indicator?

See Indicator References

	Safe Drinking Water: 3% of public water utilities had drinking water violations (2020). National average: 31%
	Air Quality: 48% of children under age 18 live in the 72 (out of 87 total) counties that do not monitor ozone pollution (2021).
	Warming Temperatures: 3.3 degrees F warmer in 2020 than in 1970. National average 2.8 degrees F warmer
	Toxic Chemical Releases: 20.4 million pounds of toxic chemicals were disposed of or released (2020). United States 3.1 billion pounds
	Asthma: 7% of children under age 18 have asthma (2018- 2019) Nationwide: 7.7%
	Pediatric Cancer: 185.7 cases of pediatric cancer per 1 million population (2005-2015) Nationwide: 181.0 cases per 1 million
	Blood lead levels: 1.4% of tested children under age 6 have elevated blood lead levels (2018) Nationwide: 2.6%
	Neurodevelopmental Disorders: 6.8% of children age 3-17 have ADD or ADHD (2019-2020). Nationwide: 8.9%. 2.7% of children age 3-17 have Autism Spectrum Disorder (2019- 2020) Nationwide: 2.9%

Minnesota Spotlight: Minnesota Department of Health Drinking Water Guidance

Minnesota is one of only a few states that develops its own drinking water guidance in addition to existing EPA standards. State law specifies that the guidance must adequately protect the health of infants and children. To this end, the Minnesota Department of Health (MDH) has developed drinking water guidance that considers developmental “windows of sensitivity” to toxicants as well as periods of high exposure.

The state is particularly aggressive in its monitoring of per and poly-fluoroalkyl substances (PFAS), a class of persistent chemicals that pose significant health risks. MDH toxicologists uniquely consider placental transfer and transfer through formula-feeding and breastmilk in their risk assessment of PFAS in water sources.

MDH has a long-term goal of sampling all community water systems in the state for PFAS. Under this goal, MDH aims to cover 90% of CWS customers under its PFAS monitoring program by 2025. They will also sample noncommunity water systems in areas that are most vulnerable to PFAS contamination to address the highest potential public health risks.

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


	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: Minnesota 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. Out of Minnesota's 87 counties, 72 did not monitor for ozone. None of the 15 counties that monitored had unhealthy ozone pollution.
Reference: Ozone Pollution. American Lung Association. 2021 State of the Air. Report card: Minnesota. 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: AMERICAN WARMING: The Fastest-Warming Cities and States in the U.S. 2020. Climate Central. Data from National Centers for Environmental Information, National Oceanic and Atmospheric Association.

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 509 Toxic Release Inventory Facilities in Minnesota. 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 Minnesota 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. Accessed on October 28, 2019.

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: Asthma prevalence. 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. Accessed on October 28, 2019.

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: Minnesota 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).

Blood Lead Levels

Indicator Note: In 2017, 21.9% of Minnesota children under age 6 were tested for blood lead levels (BLLs). Of those tested, 0.6% had a BLL>= 5 µg/dL. Often the most vulnerable children are not tested, and not all who are tested get reported, so 0.6% is likely an underestimate of the true scope of children's elevated blood lead in Minnesota. 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. Minnesota (2018). Centers for Disease Control and Prevention.

Poverty

Reference:
- Number of Children in Minnesota. U.S. Census Bureau. 2019. Quick Facts Minnesota.
- Percent of Children in Minnesota Living in Poverty. The Annie E. Casey Foundation. 2019 KIDS COUNT Data Book: 2019 State Trends in Child Well-Being: Minnesota

Federal Support to Minnesota

References:

Minnesota Spotlight

References:
- Minnesota Guidance Values and Standards for Contaminants in Drinking Water. Minnesota Department of Health. 2020.
- Minnesota State Law. Health Standards. 2021 Minnesota Statutes. Office of the Revisor of Statutes. Minnesota Legislature.
- Minnesota Risk Assessment. Focus on Chronic Exposure for Deriving Drinking Water Guidance Underestimates Potential Risk to Infants. Helen Goeden. Int J Environ Res Public Health. 2018 Mar; 15(3): 512.
- Minnesota PFAS water guidance. A transgenerational toxicokinetic model and its use in derivation of Minnesota PFOA water guidance.Goeden HM, Greene CW, Jacobus JA. J Expo Sci Environ Epidemiol. 2019 Mar;29(2):183-195.

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.