Promote a Healthy and Safe Environment Action Plan

Introduction

The 2013-2018 State Health Improvement Plan to "Promote a Healthy and Safe Environment" in New York State focuses on four core areas that impact health. These are: the quality of the water we drink, the air we breathe, and the built environments where we live, work, learn and play; and injuries and occupational health. 'Environment,' as used here, incorporates all dimensions of the physical environment that impact health and safety. In addition to addressing the six cross-cutting issues identified by ad hoc Committee (access to quality health services and early identification of health problems; life course perspective; health disparities; social determinants of health; a gender perspective; and oral health), the healthy and safe environment committee proposed the impact of and adaptation to climate change as another cross-cutting issue within this action plan.

The Plan was developed by the 'Promote a Healthy and Safe Environment' Committee, whose members represent a diverse group of environmental, occupational health, and violence and injury prevention experts from local, State and Federal government agencies; business; labor; community-based organizations; and academic and research organizations. The Committee acknowledged several complexities and challenges in developing this Plan:

• First, the impact of the physical environment on health is multi-faceted. While the causes of some environmentally related health problems are well established (e.g., neurological damage due to lead poisoning, asphyxiation due to carbon monoxide poisoning), others are indirect, multi-factorial, chronic, and not routinely tracked (e.g., long-term impacts of various forms of energy usage on climate change and health in New York State). This Plan incorporates issues at both ends of the spectrum. In some cases, interventions are well established; in other cases, the Plan involves establishing surveillance systems to track and better document progress and health impacts.
• Second, environmental conditions can have immediate, short-term and long-term impacts on health. The direct health benefits of some of the interventions proposed here are expected to be measurable within the five-year timeframe of this plan. Others may not have measurable impacts on health for many years to come, although we believe we will be able to track changes in environmental conditions and exposures in the interim.
• Third, some environmental conditions vary markedly between regions, communities and populations across the State (e.g., urban vs. rural, upstate vs. downstate, children, elderly, and the poor). Accordingly, not all interventions are appropriate for all communities. The Committee has attempted to establish a framework and a range of proposed interventions that individual communities can tailor to their own needs.
• Fourth, progress will require a multi-sector approach, involving diverse public and private partners across housing, transportation, energy, insurance, health care and other sectors. The Committee was fortunate to have representation by some but not all stakeholders. The success of this Plan in meeting its proposed goals and objectives lies in the ability to mobilize stakeholders to work together.

We are greatly indebted to DOH staff and to the members of the 'Promote a Healthy and Safe Environment Committee' for their time and expertise.