1.This Act may be cited as
the Healthy Places Act of
2006
.
2.In this Act:
(1)The
term Administrator means the Administrator of the Environmental
Protection Agency.
(2)The term built environment means an
environment consisting of all buildings, spaces, and products that are created
or modified by people, including—
(A)homes, schools,
workplaces, parks and recreation areas, greenways, business areas, and
transportation systems;
(B)electric
transmission lines;
(C)waste disposal
sites; and
(D)land-use planning
and policies that impact urban, rural, and suburban communities.
(3)The
term Director means the Director of the Centers for Disease
Control and Prevention.
(4)The term environmental health means the
health and well-being of a population as affected by—
(A)the direct
pathological effects of chemicals, radiation, and some biological agents;
and
(B)the effects
(often indirect) of the broad physical, psychological, social, and aesthetic
environment.
(5)The term health impact assessment means
any combination of procedures, methods, tools, and means used under section 4
to analyze the actual or potential effects of a policy, program, or project on
the health of a population (including the distribution of those effects within
the population).
(6)The
term Secretary means the Secretary of Health and Human
Services.
3.Interagency
working group on environmental health
(a)In
this section:
(1)The
term Institute means the Institute of Medicine of the National
Academies of Science.
(2)The
term IWG means the interagency working group established under
subsection (b).
(b)The
Secretary, in coordination with the Administrator, shall establish an
interagency working group to discuss environmental health concerns,
particularly concerns disproportionately affecting disadvantaged
populations.
(c)The
IWG shall be composed of a representative from each Federal agency (as
appointed by the head of the agency) that has jurisdiction over, or is affected
by, environmental policies and projects, including—
(1)the Council on
Environmental Quality;
(2)the Department of
Agriculture;
(3)the Department of
Commerce;
(4)the Department of
Defense;
(5)the Department of
Education;
(6)the Department of
Energy;
(7)the Department of
Health and Human Services;
(8)the Department of
Housing and Urban Development;
(9)the Department of
the Interior;
(10)the Department
of Justice;
(11)the Department
of Labor;
(12)the Department
of State;
(13)the Department
of Transportation;
(14)the
Environmental Protection Agency; and
(15)such other
Federal agencies as the Administrator and the Secretary jointly determine to be
appropriate.
(d)The
IWG shall—
(1)facilitate
communication and partnership on environmental health-related projects and
policies—
(A)to generate a
better understanding of the interactions between policy areas; and
(B)to raise
awareness of the relevance of health across policy areas to ensure that the
potential positive and negative health consequences of decisions are not
overlooked;
(2)serve as a
centralized mechanism to coordinate a national effort—
(A)to discuss and
evaluate evidence and knowledge on the relationship between the general
environment and the health of the population of the United States;
(B)to determine the
range of effective, feasible, and comprehensive actions to improve
environmental health; and
(C)to examine and
better address the influence of social and environmental determinants of
health;
(3)survey Federal
agencies to determine which policies are effective in encouraging, and how best
to facilitate outreach without duplicating, efforts relating to environmental
health promotion;
(4)establish
specific goals within and across Federal agencies for environmental health
promotion, including determinations of accountability for reaching those
goals;
(5)develop a
strategy for allocating responsibilities and ensuring participation in
environmental health promotions, particularly in the case of competing agency
priorities;
(6)coordinate plans
to communicate research results relating to environmental health to enable
reporting and outreach activities to produce more useful and timely
information;
(7)establish an
interdisciplinary committee to continue research efforts to further understand
the relationship between the built environment and health factors (including
air quality, physical activity levels, housing quality, access to primary
health care practitioners and health care facilities, injury risk, and
availability of nutritional, fresh food) that coordinates the expertise of the
public health, urban planning, and transportation communities;
(8)develop an
appropriate research agenda for Federal agencies—
(A)to
support—
(i)longitudinal
studies;
(ii)rapid-response
capability to evaluate natural conditions and occurrences; and
(iii)extensions of
national databases; and
(B)to review
evaluation and economic data relating to the impact of Federal interventions on
the prevention of environmental health concerns;
(9)initiate
environmental health impact demonstration projects to develop integrated
place-based models for addressing community quality-of-life issues;
(10)provide a
description of evidence-based best practices, model programs, effective
guidelines, and other strategies for promoting environmental health;
(11)make
recommendations to improve Federal efforts relating to environmental health
promotion and to ensure Federal efforts are consistent with available standards
and evidence and other programs in existence as of the date of enactment of
this Act;
(12)monitor Federal
progress in meeting specific environmental health promotion goals;
(13)assist in
ensuring, to the maximum extent practicable, integration of the impact of
environmental policies, programs, and activities on the areas under Federal
jurisdiction;
(14)assist in the
implementation of the recommendations from the reports of the Institute of
Medicine entitled Does the Built Environment Influence Physical
Activity? Examining the Evidence
and dated January 11, 2005, and
Rebuilding the Unity of Health and the Environment: A New Vision of
Environmental Health for the 21st Century
and dated January 22, 2001,
including recommendations for—
(A)the expansion of
national public health and travel surveys to provide more detailed information
about the connection between the built environment and health, including
expansion of such surveys as—
(i)the
Behavioral Risk Factor Surveillance System, the National Health and Nutrition
Examination Survey, and the National Health Interview Survey conducted by the
Centers for Disease Control and Prevention;
(ii)the American
Community survey conducted by the Census Bureau;
(iii)the American
Time Use Survey conducted by the Bureau of Labor Statistics;
(iv)the Youth Risk
Behavior Survey conducted by the Centers for Disease Control and Prevention;
and
(v)the
National Longitudinal Cohort Survey of American Children (the National
Children's Study) conducted by the National Institute of Child Health and Human
Development;
(B)collaboration
with national initiatives to learn from natural experiments such as
observations from changes in the built environment and the consequent effects
on health;
(C)development of a
program of research with a defined mission and recommended budget,
concentrating on multiyear projects and enhanced data collection;
(D)development of
interdisciplinary education programs—
(i)to train
professionals in conducting recommended research; and
(ii)to prepare
practitioners with appropriate skills at the intersection of physical activity,
public health, transportation, and urban planning;
(15)not later than 2
years after the date of enactment of this Act, submit to Congress a report that
describes the extent to which recommendations from the Institute of Medicine
reports described in paragraph (14) were executed; and
(16)assist the
Director with the development of guidance for the assessment of the potential
health effects of land use, housing, and transportation policy and
plans.
(e)
(1)The IWG shall meet at least 3 times each year.
(2)The Secretary, acting through the Director and in
collaboration with the Administrator, shall sponsor an annual conference on
environmental health and health disparities to enhance coordination, build
partnerships, and share best practices in environmental health data collection,
analysis, and reporting.
(f)Authorization
of appropriationsThere are authorized to be appropriated such
sums as are necessary to carry out this section.
4.Health impact
assessments
(a)Definition of
eligible entityIn this section, the term eligible
entity means any unit of State or local government the jurisdiction of
which includes individuals or populations the health of which are or will be
affected by an activity or a proposed activity.
(b)The
Secretary, acting through the Director and in collaboration with the
Administrator, shall—
(1)establish a
program at the National Center of Environmental Health at the Centers for
Disease Control and Prevention focused on advancing the field of health impact
assessment, including—
(A)collecting and
disseminating best practices;
(B)administering
capacity building grants, in accordance with subsection (d);
(C)providing
technical assistance;
(D)providing
training;
(E)conducting
evaluations; and
(F)awarding
competitive extramural research grants;
(2)in accordance
with subsection (f), develop guidance to conduct health impact assessments;
and
(3)establish a grant
program to allow eligible entities to conduct health impact assessments.
(c)The
Director, in collaboration with the IWG, shall—
(1)develop guidance
for the assessment of the potential health effects of land use, housing, and
transportation policy and plans, including—
(A)background on
international efforts to bridge urban planning and public health institutions
and disciplines, including a review of health impact assessment best practices
internationally;
(B)evidence-based
causal pathways that link urban planning, transportation, and housing policy
and objectives to human health objectives;
(C)data resources
and quantitative and qualitative forecasting methods to evaluate both the
status of health determinants and health effects; and
(D)best practices
for inclusive public involvement in planning decision-making;
(2)not later than 1
year after the date of enactment of this Act, promulgate the guidance;
and
(3)present the
guidance to the public at the annual conference described in section
3(e)(2).
(d)The Secretary, acting through the Director and in
collaboration with the Administrator, shall establish a program under which the
Secretary shall provide funding and technical assistance to eligible entities
to prepare health impact assessments—
(1)to ensure that
appropriate health factors are taken into consideration as early as practicable
during any planning, review, or decision-making process; and
(2)to evaluate the
effect on the health of individuals and populations, and on social and economic
development, of decisions made outside of the health sector that result in
modifications of a physical or social environment.
(e)
(1)To receive a grant under this section, an eligible entity
shall submit to the Secretary an application in accordance with this
subsection, in such time, in such manner, and containing such additional
information as the Secretary may require.
(2)
(A)An application under this subsection shall include an
assessment by the eligible entity of the probability that an applicable
activity or proposed activity will have at least 1 significant, adverse health
effect on an individual or population in the jurisdiction of the eligible
entity, based on the criteria described in subparagraph (B).
(B)The
criteria referred to in subparagraph (A) include, with respect to the
applicable activity or proposed activity—
(i)any
substantial adverse effect on—
(I)existing air
quality, ground or surface water quality or quantity, or traffic or noise
levels;
(II)a significant
habitat area;
(III)physical
activity;
(IV)injury;
(V)mental
health;
(VI)social
capital;
(VII)accessibility;
(VIII)the character
or quality of an important historical, archeological, architectural, or
aesthetic resource (including neighborhood character) of the community of the
eligible entity; or
(IX)any other
natural resource;
(ii)any increase
in—
(I)solid waste
production; or
(II)problems
relating to erosion, flooding, leaching, or drainage;
(iii)any requirement
that a large quantity of vegetation or fauna be removed or destroyed;
(iv)any conflict
with the plans or goals of the community of the eligible entity;
(v)any
major change in the quantity or type of energy used by the community of the
eligible entity;
(vi)any hazard
presented to human health;
(vii)any substantial
change in the use, or intensity of use, of land in the jurisdiction of the
eligible entity, including agricultural, open space, and recreational
uses;
(viii)the
probability that the activity or proposed activity will result in an increase
in tourism in the jurisdiction of the eligible entity;
(ix)any substantial,
adverse aggregate impact on environmental health resulting from—
(I)changes caused by
the activity or proposed activity to 2 or more elements of the environment;
or
(II)2 or more
related actions carried out under the activity or proposed activity; and
(x)any
other significant change of concern, as determined by the eligible
entity.
(C)Factors for
considerationIn making an assessment under subparagraph (A), an
eligible entity may take into consideration any reasonable, direct, indirect,
or cumulative effect relating to the applicable activity or proposed activity,
including the effect of any action that is—
(i)included in the
long-range plan relating to the activity or proposed activity;
(ii)likely to be
carried out in coordination with the activity or proposed activity;
(iii)dependent on
the occurrence of the activity or proposed activity; or
(iv)likely to have a
disproportionate impact on disadvantaged populations.
(f)
(1)An eligible entity shall use assistance received under
this section to prepare and submit to the Secretary a health impact assessment
in accordance with this subsection.
(2)The
purposes of a health impact assessment are—
(A)to facilitate the
involvement of State and local health officials in community planning and land
use decisions to identify any potential health concern relating to an activity
or proposed activity;
(B)to provide for an
investigation of any health-related issue addressed in an environmental impact
statement or policy appraisal relating to an activity or a proposed
activity;
(C)to describe and
compare alternatives (including no-action alternatives) to an activity or a
proposed activity to provide clarification with respect to the costs and
benefits of the activity or proposed activity; and
(D)to contribute to
the findings of an environmental impact statement with respect to the terms and
conditions of implementing an activity or a proposed activity, as
necessary.
(3)A
health impact assessment prepared under this subsection shall—
(A)describe the
relevance of the applicable activity or proposed activity (including the policy
of the activity) with respect to health issues;
(B)assess each
health impact of the applicable activity or proposed activity;
(C)provide
recommendations of the eligible entity with respect to—
(i)the
mitigation of any adverse impact on health of the applicable activity or
proposed activity; or
(ii)the
encouragement of any positive impact of the applicable activity or proposed
activity;
(D)provide for
monitoring of the impacts on health of the applicable activity or proposed
activity, as the eligible entity determines to be appropriate; and
(E)include a list of
each comment received with respect to the health impact assessment under
subsection (e).
(4)In
preparing a health impact assessment under this subsection, an eligible
entity—
(A)shall follow
guidelines developed by the Director, in collaboration with the IWG,
that—
(i)are
consistent with subsection (c);
(ii)will be
established not later than 1 year after the date of enactment of this Act;
and
(iii)will be made
publicly available at the annual conference described in section 3(e)(2);
and
(B)may establish a
balance, as the eligible entity determines to be appropriate, between the use
of—
(i)rigorous methods
requiring special skills or increased use of resources; and
(ii)expedient,
cost-effective measures.
(g)
(1)Before preparing and submitting to the Secretary a final
health impact assessment, an eligible entity shall request and take into
consideration public and agency comments, in accordance with this
subsection.
(2)Not
later than 30 days after the date on which a draft health impact assessment is
completed, an eligible entity shall submit the draft health impact assessment
to each Federal agency, and each State and local organization, that—
(A)has jurisdiction
with respect to the activity or proposed activity to which the health impact
assessment applies;
(B)has special
knowledge with respect to an environmental or health impact of the activity or
proposed activity; or
(C)is authorized to
develop or enforce any environmental standard relating to the activity or
proposed activity.
(3)
(A)Request by
eligible entityAn eligible entity may request comments with
respect to a health impact assessment from—
(i)affected Indian
tribes;
(ii)interested or
affected individuals or organizations; and
(iii)any other State
or local agency, as the eligible entity determines to be appropriate.
(B)Any interested or affected agency, organization, or
individual may—
(i)request an
opportunity to comment on a health impact assessment; and
(ii)submit to the
appropriate eligible entity comments with respect to the health impact
assessment by not later than—
(I)for a Federal,
State, or local government agency or organization, the date on which a final
health impact assessment is prepared; and
(II)for any other
individual or organization, the date described in subclause (I) or another
date, as the eligible entity may determine.
(4)A final health impact assessment shall describe the
response of the eligible entity to comments received within a 90-day period
under this subsection, including—
(A)a description of
any means by which the eligible entity, as a result of such a comment—
(i)modified an
alternative recommended with respect to the applicable activity or proposed
activity;
(ii)developed and
evaluated any alternative not previously considered by the eligible
entity;
(iii)supplemented,
improved, or modified an analysis of the eligible entity; or
(iv)made any factual
correction to the health impact assessment; and
(B)for any comment
with respect to which the eligible entity took no action, an explanation of the
reasons why no action was taken and, if appropriate, a description of the
circumstances under which the eligible entity would take such an action.
(h)Health impact
assessment databaseThe Secretary, acting through the Director
and in collaboration with the Administrator, shall establish and maintain a
health impact assessment database, including—
(1)a catalog of
health impact assessments received under this section;
(2)an inventory of
tools used by eligible entities to prepare draft and final health impact
assessments; and
(3)guidance for
eligible entities with respect to the selection of appropriate tools described
in paragraph (2).
(i)Authorization
of appropriationsThere are authorized to be appropriated to
carry out this section such sums as are necessary.
5.
(a)In
this section:
(1)The
term Director means the Director of the Centers for Disease
Control and Prevention, acting in collaboration with the Administrator and the
Director of the National Institute of Environmental Health Sciences.
(2)The term eligible entity means a State or
local community that—
(A)bears a
disproportionate burden of exposure to environmental health hazards;
(B)has established a
coalition—
(i)with not less
than 1 community-based organization; and
(ii)with not less
than 1—
(I)public health
entity;
(II)health care
provider organization; or
(III)academic
institution;
(C)ensures planned
activities and funding streams are coordinated to improve community health;
and
(D)submits an
application in accordance with subsection (c).
(b)The
Director shall establish a grant program under which eligible entities shall
receive grants to conduct environmental health improvement activities.
(c)To
receive a grant under this section, an eligible entity shall submit an
application to the Director at such time, in such manner, and accompanied by
such information as the Director may require.
(d)An eligible entity may use a grant under this
section—
(1)to promote
environmental health; and
(2)to address
environmental health disparities.
(e)Amount of
cooperative agreement
(1)The Director shall award grants to eligible entities at
the 2 different funding levels described in this subsection.
(2)Level 1
Cooperative Agreements
(A)An eligible entity awarded a grant under this paragraph
shall use the funds to identify environmental health problems and solutions
by—
(i)establishing a
planning and prioritizing council in accordance with subparagraph (B);
and
(ii)conducting an
environmental health assessment in accordance with subparagraph (C).
(B)Planning and
prioritizing council
(i)A prioritizing and planning council established under
subparagraph (A)(i) (referred to in this paragraph as a PPC) shall
assist the environmental health assessment process and environmental health
promotion activities of the eligible entity.
(ii)Membership
of a PPC shall consist of representatives from various organizations within
public health, planning, development, and environmental services and shall
include stakeholders from vulnerable groups such as children, the elderly,
disabled, and minority ethnic groups that are often not actively involved in
democratic or decision-making processes.
(iii)A
PPC shall—
(I)identify key
stakeholders and engage and coordinate potential partners in the planning
process;
(II)establish a
formal advisory group to plan for the establishment of services;
(III)conduct an
in-depth review of the nature and extent of the need for an environmental
health assessment, including a local epidemiological profile, an evaluation of
the service provider capacity of the community, and a profile of any target
populations; and
(IV)define the
components of care and form essential programmatic linkages with related
providers in the community.
(C)Environmental
health assessment
(i)A PPC shall carry out an environmental health assessment
to identify environmental health concerns.
(ii)The PPC shall—
(I)define the goals
of the assessment;
(II)generate the
environmental health issue list;
(III)analyze issues
with a systems framework;
(IV)develop
appropriate community environmental health indicators;
(V)rank the
environmental health issues;
(VI)set priorities
for action;
(VII)develop an
action plan;
(VIII)implement the
plan; and
(IX)evaluate
progress and planning for the future.
(D)Each
eligible entity that receives a grant under this paragraph shall evaluate,
report, and disseminate program findings and outcomes.
(E)The Director may provide such technical and other
non-financial assistance to eligible entities as the Director determines to be
necessary.
(3)Level 2
Cooperative Agreements
(A)
(i)The Director shall award grants under this paragraph to
eligible entities that have already—
(I)established
broad-based collaborative partnerships; and
(II)completed
environmental assessments.
(ii)To be eligible to receive a grant under this
paragraph, an eligible entity is not required to have successfully completed a
Level 1 Cooperative Agreement (as described in paragraph (2).
(B)An eligible entity awarded a grant under this paragraph
shall use the funds to further activities to carry out environmental health
improvement activities, including—
(i)addressing
community environmental health priorities in accordance with paragraph
(2)(C)(ii), including—
(I)air
quality;
(II)water
quality;
(III)solid
waste;
(IV)land use;
(V)housing;
(VI)food
safety;
(VII)crime;
(VIII)injuries;
and
(IX)healthcare
services;
(ii)building
partnerships between planning, public health, and other sectors, to address how
the built environment impacts food availability and access and physical
activity to promote healthy behaviors and lifestyles and reduce obesity and
related co-morbidities;
(iii)establishing
programs to address—
(I)how environmental
and social conditions of work and living choices influence physical activity
and dietary intake; or
(II)how those
conditions influence the concerns and needs of people who have impaired
mobility and use assistance devices, including wheelchairs and lower limb
prostheses; and
(iv)convening
intervention programs that examine the role of the social environment in
connection with the physical and chemical environment in—
(I)determining
access to nutritional food; and
(II)improving
physical activity to reduce morbidity and increase quality of life.
(f)Authorization
of appropriationsThere are authorized to be appropriated to
carry out this section—
(1)$25,000,000 for
fiscal year 2007; and
(2)such sums as are
necessary for the period of fiscal years 2008 through 2011.
6.Additional
research on the relationship between the built environment and the health of
community residents
(a)Definition of
eligible institutionIn this section, the term eligible
institution
means a public or private nonprofit institution that
submits to the Secretary and the Administrator an application for a grant under
the grant program authorized under subsection (b)(2) at such time, in such
manner, and containing such agreements, assurances, and information as the
Secretary and Administrator may require.
(b)
(1)In this section, the term health
includes—
(A)levels of
physical activity;
(B)consumption of
nutritional foods;
(C)rates of
crime;
(D)air, water, and
soil quality;
(E)risk of
injury;
(F)accessibility to
healthcare services; and
(G)other indicators
as determined appropriate by the Secretary.
(2)The
Secretary, in collaboration with the Administrator, shall provide grants to
eligible institutions to conduct and coordinate research on the built
environment and its influence on individual and population-based health.
(3)The
Secretary shall support research that—
(A)investigates and
defines the causal links between all aspects of the built environment and the
health of residents;
(B)examines—
(i)the
extent of the impact of the built environment (including the various
characteristics of the built environment) on the health of residents;
(ii)the variance in
the health of residents by—
(I)location (such as
inner cities, inner suburbs, and outer suburbs); and
(II)population
subgroup (such as children, the elderly, the disadvantaged); or
(iii)the importance
of the built environment to the total health of residents, which is the primary
variable of interest from a public health perspective;
(C)is used to
develop—
(i)measures to
address health and the connection of health to the built environment;
and
(ii)efforts to link
the measures to travel and health databases;
(D)distinguishes
carefully between personal attitudes and choices and external influences on
observed behavior to determine how much an observed association between the
built environment and the health of residents, versus the lifestyle preferences
of the people that choose to live in the neighborhood, reflects the physical
characteristics of the neighborhood; and
(E)(i)identifies or develops
effective intervention strategies to promote better health among residents with
a focus on behavioral interventions and enhancements of the built environment
that promote increased use by residents; and
(ii)in developing the intervention
strategies under clause (i), ensures that the intervention strategies will
reach out to high-risk populations, including low-income urban and rural
communities.
(4)In
providing assistance under the grant program authorized under paragraph (2),
the Secretary and the Administrator shall give priority to research that
incorporates—
(A)interdisciplinary
approaches; or
(B)the expertise of
the public health, physical activity, urban planning, and transportation
research communities in the United States and abroad.
(c)Authorization
of appropriationsThere are authorized to be appropriated such
sums as are necessary to carry out this section.