Environmental Health:

High-level Strategy and Leadership Needed to Continue Progress toward Protecting Children from Environmental Threats

GAO-10-205, Jan 28, 2010

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Exposure to toxic chemicals or environmental pollutants may harm the health of the nation's 74 million children and contribute to increases in asthma and developmental impairments. In 2007, 66 percent of children lived in counties exceeding allowable levels for at least one of the six principal air pollutants that cause or aggravate asthma, contributing to medical costs of $3.2 billion per year, according to the Centers for Disease Control and Prevention. In 1997, Executive Order 13045 mandated that agencies place a high priority on children's risks and required that policies, programs, activities, and standards address those risks. In response, the Environmental Protection Agency (EPA) created the Office of Children's Health Protection and convened the Children's Health Protection Advisory Committee. This report assesses the extent to which EPA has institutionalized consideration of children's health through (1) strategies and priorities, (2) key offices and other child-focused resources, and (3) participation in interagency efforts. GAO reviewed numerous documents and met with EPA and other officials for this report.

EPA has developed policies and guidance to consider children, but it has not maintained attention to children through agency strategies and priorities. In 1996, EPA created a national agenda on children's health, and its 1997 and 2000 strategic plans highlighted children's health as a key cross-agency program. As a result, the agency's research advanced the understanding of children's vulnerabilities. However, EPA has not updated the agenda since 1996, and the focus on children is absent from the 2003, 2006, and September 2009 draft strategic plans. EPA has not fully used the Office of Children's Health Protection and other child-focused resources. The active involvement of managers from the office and experts from the Children's Health Protection Advisory Committee has been lacking, as has the involvement of key staff throughout EPA. Although EPA now has a new Director of Children's Health, the office had not had consistent leadership since 2002, hampering its ability to support and facilitate agencywide efforts and elevate matters of importance with senior officials. For example, a previous director established workgroups to bring together officials from the program offices and the children's health office, but a subsequent acting director eliminated these groups, effectively halting work on a key set of children's health recommendations. In addition, the regional children's health coordinators--who provide outreach and coordination for EPA--have no national strategy or dedicated resources. Finally, the advisory committee has provided hundreds of recommendations, but EPA has requested advice on draft regulations only three times in the last decade. While EPA leadership is key to national efforts to protect children from environmental threats, EPA's efforts have been hampered by the expiration in 2005 of certain provisions in the executive order. For example, the Task Force on Children's Environmental Health provided EPA with a forum for interagency leadership on important federal efforts, such as the National Children's Study. It also provided biennial reports that helped establish federal research priorities.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should update and reissue a child-focused strategy, such as the 1996 National Agenda, to articulate current national environmental health priorities and emerging issues.

    Agency Affected: Environmental Protection Agency

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should strengthen the data system that identifies and tracks development of rulemakings and other actions to ensure they comply with the 1995 policy on evaluating health risks to children.

    Agency Affected: Environmental Protection Agency

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should re-evaluate the 1995 policy to ensure its consistency with new scientific research demonstrating the risks childhood exposures can have on risks for disease in later lifestages.

    Agency Affected: Environmental Protection Agency

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should ensure that the EPA's 2009-2013 strategic plan expressly articulates children-specific goals, objectives and targets.

    Agency Affected: Environmental Protection Agency

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should re-evaluate the mission of the Office of Children's Health Protection and its director to make the office an agencywide champion for implementation of a reissued national children's environmental health agenda, policy, and related goals in the next EPA strategic plan.

    Agency Affected: Environmental Protection Agency

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should establish key children's environmental health staff within each program office and regional office, with linkages to the Office of Children's Health, to improve cross-agency implementation of revised priorities and goals, and ensure coordination and communication among EPA's program offices.

    Agency Affected: Environmental Protection Agency

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should use the Children's Health Protection Advisory Committee proactively as a mechanism for providing advice on regulations, programs, plans, or other issues.

    Agency Affected: Environmental Protection Agency

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To help ensure that EPA assumes high-level leadership and develops strategies and structures for coordinating efforts addressing children's environmental health both within the agency and throughout the federal government, and to maximize opportunities to institutionalize children's health throughout the agency, the EPA Administrator should ensure participation, to the fullest extent possible, by the Office of Children's Health or other key officials on the interagency organizations identified in Executive Order 13045.

    Agency Affected: Environmental Protection Agency

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Matter for Congressional Consideration

    Matter: Because EPA alone cannot address the complexities of the nation's challenges in addressing environmental health risks for children, Congress may wish to consider re-establishing a government-wide task force on children's environmental health risks, similar to the one previously established by Executive Order 13045 and co-chaired by the Administrator of EPA and the Secretary of Health and Human Services. Congress may wish to consider charging it with identifying the principal environmental health threats to children and developing national strategies for addressing them. Congress may also wish to consider establishing in law the Executive Order's requirement for periodic reports about federal research findings and research needs regarding children's environmental health.

    Status: Review Pending

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.