The State of Children’s Environmental Health Today and the Urgent Need for a Better Tomorrow


BlueprintPic_Pg5Twenty years ago, the Children's Environmental Health Network (CEHN) convened leading researchers at the first-ever national symposium on children’s environmental health. The participants critically examined children’s environmental health in the United States and produced a blueprint for change1. Although progress has occurred since then, today’s children face an epidemic of illnesses and chronic diseases linked to environmental exposures.

The Federal Interagency Forum on Child and Family Statistics, established by Executive Order in 1997, recently published a compendium of indicators of children’s well-being in the U.S.2 This report provides critical information about children:



  • Children under 18 years of age number 74 million and comprise 23% of the population;
  • 53% are white, 24% are Hispanic, 14% are black, and 5% are Asian;
  • 22% of America’s children live in poverty.


Children experience increased rates of disease and disease risk factors:

  • Only 68% are fully immunized;
  • 18% are obese;
  • 10% suffer from asthma.


Too many children lack the basic necessities of life:

  • 46% reside in “hazardous housing”;
  • 22% are “food insecure”;
  • 686,000 suffer abuse/neglect;
  • 9% lack health insurance.


Children are routinely exposed to significant environmental hazards:

  • At least 4 million households include children exposed to high levels of lead - children of color and living in poverty are disproportionately at risk for elevated blood lead levels3;
  • 8,684 children die from injuries
  • 66% live in poor air quality areas.


Generally, children of color and those who live in poverty experience greater exposures and have poorer health outcomes4–7. To improve these conditions, all children must be at the forefront of our nation’s actions addressing health and environment, while taking into account the social determinants of children’s health – from research and education to policymaking.


Research, Science, and Policy Have Advanced, but Challenges Remain

Significant advancements in research and science since the last blueprint nearly 20 years ago highlight the urgency of taking action to improve children’s environmental health today.

BlueprintPic_Pg6Science now clearly demonstrates that children are disproportionately exposed to health risks and safety hazards from the environments where they live, learn, and play; children’s typical behaviors expose them to more environmental risks than adults. Environmental exposures are particularly damaging to children because their neurological, immunological, digestive, and other body systems are still developing, and because they breathe, eat, and drink three times as much per pound of body weight as adults8–12.

Public health research has also provided important new insights into how children’s environmental exposures affect children’s health. Studies have identified risks from exposures to very low doses of toxicants from before birth (in utero)13–16. Even preconception maternal and paternal exposures can have negative effects on children. In addition, science now shows links between early childhood exposures and chronic disease later in life17–21. These new insights support the urgency of finding new and different approaches to address children’s environmental health today.

In the 1980’s, it became clear that lead exposure poses a significant threat to children’s health. With this increased understanding of lead exposure came a number of policy and regulatory initiatives to address children’s environmental health. These initiatives were followed by several key meetings about children’s environmental health in the 1990s, which led to advocacy efforts among medical, environmental justice, and non-profit organizations and a number of important policies -- in particular the U.S. Environmental Protection Agency’s (EPA) Policy on Evaluating Risk to Children in 1995 -- which directed the agency to consider environmental health risks to infants and children in all risk characterizations. This was followed by President Clinton’s 1997 Executive Order 13045 – Protection of Children from Environmental Health Risks and Safety Risks, which called for increased federal agency engagement, especially by the EPA, on children’s environmental health and for the formation of a federal children’s advisory committee. The Executive Order resulted in the creation of the EPA/National Institute of Environmental Health Sciences (NIEHS) Children's Environmental Health and Disease Prevention Research Centers ("Children's Centers") in 1998. And, led to the formation of the Pediatric Environmental Health Specialty Units (PESHUS); pediatric research centers that have been, and continue to be, critical to understanding and advancing the protection of children’s health, and for establishing a scientific framework for research.

Several more recent policies and programs have helped to improve children’s health, such as the Safe Routes to School Program (SRTS). SRTS helps communities across the country make it possible for families and children to increase their physical activity by walking and biking safely to school22.

The world in which today’s children live has changed tremendously from that of previous generations. Changes in the built environment and in urban and suburban design have resulted in automobile-dependent communities where walking and biking are difficult and a vehicle is necessary to get around. A reliance on burning fossil fuels is contributing to poor air quality in many communities and to public health and environmental threats posted by climate change. If left unchecked, climate change will have devastating consequences for future generations. Tens of thousands of chemicals, many untested for their health and development effects on humans, have been introduced into commerce in recent decades23,24. In addition, the use of pesticides has become widespread25,26. Recent research supports urgent action to address these wide-ranging environmental exposures and to make children’s environmental health a priority for our nation’s policies and programs.


A Vision for Children’s Environmental Health

A historic meeting was convened by the Children’s Environmental Health Network at Wingspread, headquarters of the Johnson Foundation, in Racine, Wisconsin on October 21-23, 2014.

Over 30 visionary leaders representing perspectives from science, non-profit advocacy, environmental justice, child health, urban planning, academia, public health, business, economics, public policy, law, and agriculture gathered in urgent recognition that children are now suffering from an array of illnesses and chronic diseases linked to environmental exposures.

This diverse group of leaders drafted a dynamic vision statement calling for transformative change through renewed and collective action to provide all children with the protections from harm that they deserve. They also developed an outline of a blueprint for action that places children at the center of all key decision-making moving forward. In the weeks, and months that followed the retreat, this Blueprint for Action was developed to move the vision to reality.


“If you bring remarkable people together in a remarkable place, then remarkable things can and do happen”

Roger Dower, 

President of the Johnson Foundation

(At Wingspread)



We believe that every child has an inalienable right to life, liberty, and the pursuit of happiness. Fundamental to that vision is the right of all children to play and learn, to breathe, eat and drink, and to dream safely cradled by their families and communities. All children should live free from violence, racism, poverty, hunger, life trauma, and poisons that will keep them from living up to their full potential. Indeed, society’s soul is truly revealed by the way in which it treats its children.

We believe that the next generation must be better off than the last. We believe that it is our moral obligation to protect and nurture our children’s health. And we believe that their health is a state of physical, mental, and social well-being, not merely the absence of disease.

We have gathered in urgent recognition that our children are gripped by an epidemic. It is a surge of illnesses and chronic diseases linked to environmental exposures. This may be the first generation of Americans to have a shorter life expectancy than their parents. We know that too many hazards in our homes, schools, child care facilities, businesses, and communities are threatening the health and well-being of our children and our nation. The water our children drink, the air they breathe, the food they eat, the schools and child care facilities in which they learn, the parks where they play, and the communities in which they live are in too many cases threatening their health during childhood and later in life. The security of their families, communities, and our nation’s future is further imperiled by climate change. We know that children are uniquely susceptible and especially exposed to too many toxics. We also know that many of these threats stem from parents’ exposures to pollutants before conception and children’s exposures throughout childhood and into late adolescence – and that these early exposures can trigger diseases and disrupt development, learning, and behavior both in childhood and later in life.


Based on these facts, we unanimously support the following principles:

  • All children have the right to breathe clean air, eat safe and healthful food, drink pure water, and enjoy toys and products free from environmental health and safety threats;
  • All children have the right to healthy, safe, and secure homes, child care facilities, schools, and communities;
  • All children and their parents and caretakers have the right to know about proven and potential hazards to their environmental health and safety and to protection from these threats.

It is our mutual responsibility to protect these rights and to act with forethought to protect children's health and development, regardless of their race or social circumstances. It is our special obligation to safeguard communities most at risk.


Our vision is of a society that puts children at the center. We urge renewed and collective societal action to make this vision real by:

  • Mobilizing society to take action on childrens environmental health -- placing a strong priority on children and families;
  • Creating knowledge essential for effective action and making use of the knowledge we have;
  • Marshaling the engine of the economy to achieve environments in which children can thrive and enjoy abundant opportunity for building a sustainable, economically secure future; and
  • Building the political will in our institutions of government for child-centered policies.



Participants (Institutions noted for informational purposes only)

Brenda Afzal, RN, MS
Nursing Consultant
Board Member
Children's Environmental Health Network

Deborah J. Bailin, PhD
Democracy Analyst
Center for Science and Democracy
Union of Concerned Scientists

Cynthia F. Bearer, MD, PhD
Mary Gray Cobey Endowed Professor of Neonatology
Associate Chair of Research Department of Pediatrics
Chief, Division of Neonatology in the Department of Pediatrics
University of Maryland School of Medicine

Tobie Bernstein, JD
Senior Attorney
Environmental Law Institute

Nisha Botchwey, PhD, MCRP, MPH
Associate Professor of City and Regional Planning
Georgia Institute of Technology
Built Environment and Public Health Clearinghouse

Ellen Braff-Guajardo, JD, MEd
Program Officer
W.K. Kellogg Foundation

Sylvia Brandt, PhD, MA
Associate Professor
Department of Resource Economics and
Center for Public Policy and Administration
University of Massachusetts Amherst

Deborah A. Cory-Slechta, PhD
Professor of Environmental Medicine and Pediatrics
Department of Environmental Medicine
University of Rochester School of Medicine

Ruth A. Etzel, MD, PhD
Integrative Health Sciences Facility Core
Children’s Environmental Health Sciences Core Center
University of Wisconsin

David D Fukuzawa, MDiv, MSA
Managing Director, Health
The Kresge Foundation

Angela Harris
President, All From One Inc.
Member of Southeast CARE Coalition

Kim Knowlton, DrPH
Senior Scientist, Health and the Environment Program
Co-Deputy Director, Science Center
National Resources Defense Council

Tracy Kolian, MPH
Health Policy Specialist and Consultant
Children’s Environmental Health Network

David Levine
Cofounder & CEO
American Sustainable Business Council

Vickie Leonard, RN, FNP, PhD
Program Coordinator, Pediatric Environmental Health Specialty Unit
Staff Specialist, Institute for Health and Aging
University of California, San Francisco

Mark Magaña
Executive Director

John A McLachlan, PhD
Celia Scott Weatherhead and Albert J. Weatherhead III Distinguished Chair in Environmental Studies
Professor, Department of Pharmacology, School of Medicine
Adjunct Professor, Department of Ecology and Evolutionary Biology, School of Science and Engineering
Tulane University

Elise Miller, MEd
Collaborative on Health and the Environment (CHE)

Danielle Miller Wagner, MS
Center for Environmental Policy
American University
School of Public Affairs

Cynthia Moices
Assistant Director

Denise O’Brien
Rolling Acres Farm

Erik Olson, JD
Senior Strategic Director for Health and Food
Natural Resources Defense Council

Jerome A Paulson, MD, FAAP
Medical Director for National & Global Affairs
Director of the Mid-Atlantic Center for Children’s Health & the Environment
Child Health Advocacy Institute
Children’s National Health System
Professor of Pediatrics and of Environmental & Occupational Health
George Washington University

Peggy Shepard
Executive Director
We Act for Environmental Justice, Inc.

Jerry Waukau
Health Administrator
Menominee Indian Tribe of Wisconsin
National Tribal Environmental Health (NTEH) Think Tank Member

Nsedu Obot Witherspoon, MPH
Executive Director
Children's Environmental Health Network (CEHN)