Emerging Issues in Environmental Public Health

1. Emerging Issues in Environmental Public Health Environmental Public Health Leadership Institute October 21, 2010 Cohort VI, Session II St. Louis, MO

2. Emerging Issues in Environmental Public Health Can environmental public health leaders prepare their organizations for emerging issues?

3. Emerging Issues in Environmental Public Health How do we identify emerging issues? What is happening in my environment that may affect my future and the future of this program and organization?

4. Emerging Issues in Environmental Public Health Information collected by scanning process: • Informs higher-level decision-makers and staff about emerging issues and possible future conditions. • Prepare for challenges • Take advantage of opportunities

5. Emerging Issues in Environmental Public Health • Issues that may someday be of concern but that have not yet been generally recognized • Scientists (Yes!); Policy makers (No!); Public (Unsure?) • Global, regional, state, tribal, local • Systems think – we focus on environmental and health issues • But challenges and opportunities arise from political, social, economic, technological, financial, institutional, cultural changes

6. Emerging Issues in Environmental Public Health Information scan • Government documents, reports, studies, congressional testimony and bills • Professional journals • Newspapers and magazines • Environmental and public health websites • EPHLI reports • NGO reports, newsletters • Conference agendas and proceedings • Talk with experts • Forecasting and future study organizations • Internal data and information sources

7. Emerging Issues in Environmental Public Health Emerging issue or Current issue? • Sooner or later time frame

8. Emerging Issues in Environmental Public Health Four step process: • Collection and review of information from a variety of sources • Organize, understand, and share information with process participants • Develop list of important issues • Rank issues

9. Emerging Issues in Environmental Public Health Condensing step (1) collection and review of information; and step (2) sharing information. Steps 1 and 2 are ongoing and continuous processes. Focus on the process of step (3) list important issues; and step (4) rank issues.

10. Emerging Issues in Environmental Public Health Issue categories by exposure media and environmental health activities • Water • Wastewater • Recreational water • Air quality • Food • Vector-related diseases • Emergency preparedness and response • Materials management • Injury prevention • Mass gathering/special events • Built environment

11. Emerging Issues in Environmental Public Health Other categories to group issues • Workforce • Community involvement • Policy, regulations, standards • Evaluation and accreditation • Economic conditions • Energy • Climate change • Transportation • Health Impact Assessment • Program planning and effectiveness

12. Emerging Issues in Environmental Public Health • First group decisions • How will we group issues? • Develop categorical list (group could later add or combine categories). • Do we need to add any additional media/environmental health/other activities to the list of categories (quickly now and revisit later)?

13. Emerging Issues in Environmental Public Health Form groups to discuss and share information about topic, develop list of emerging and current issues, and report back to large group.

14. Emerging Issues in Environmental Public Health Focusing questions: What is happening in my environment that may affect my future and the future of my organization? What challenges will these issues present to the environmental public health services system? What opportunities will these issues present to the environmental public health services system?

15. Emerging Issues in Environmental Public Health • Small group discussion and feedback from larger group used to complete and refine issues list. • Use time-frame ranking method to order issues by importance and urgency (report pages 10-18) • Each group selects top 3 issues

16. Emerging Issues in Environmental Public Health Issue ranking method: probability and population Expert opinion - for the 3 issues in each category: What is the probability that this issues will impact human health (Impact = disease, acute illness, disability, quality of life, length of life) low probability 0 .1 .2 .3 .4 .5 .6 .7 .8 .9 1 high probability

17. Emerging Issues in Environmental Public Health Issue ranking method: probability and population Expert opinion – for the 3 issues in each category: What percent of U.S. population may be affected by this emerging or current issue (0% to 100%)? 2007 U.S. population estimates: 300 million Northeast: 18% Midwest: 22% South: 37% West: 23%

18. Emerging Issues in Environmental Public Health • Small and large group discussions • List of issues by categories • Time frame ranking - sooner or later method • Top 3 issues in each category • Use probability and population estimates to rank issues • Develop top 10 issues list (Table 10., page 19)