[Congressional Record Volume 153, Number 140 (Thursday, September 20, 2007)]
[Senate]
[Pages S11860-S11862]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. CLINTON (for herself, Mr. Hatch, and Mr. Reid):
  S. 2082. A bill to amend the Public Health Service Act to establish a 
Coordinated Environmental Public Health Network, and for other 
purposes; to the Committee on Health, Education, Labor, and Pensions.
  Mrs. CLINTON. Mr. President, today, I am proud to join with my 
colleagues Senator Hatch and Senator Reid to introduce the Coordinated 
Environmental Public Health Network Act.
  More than 40 years ago, in her seminal work Silent Spring, Rachel 
Carson noted that ``For the first time in the history of the world 
every human being is now subjected to contact with dangerous chemicals 
from the moment of conception until death.''
  Her words remain true today. Not only are we subjected to chemicals, 
but we often don't have an understanding of the impact of these 
chemicals upon our health and the health of our children. I believe 
that it is past time for us to begin making the investments in research 
and technology that will allow us to understand the impact of the 
environmental exposures we face every day.
  We know that chronic diseases like asthma, heart and lung disease--
the chronic diseases that result in more than $750 billion in health 
care costs every year--are caused by three factors: genetics, behavior, 
and the environment.
  Since the publication of Silent Spring in 1962, we have come a long 
way in understanding two of those three factors. Through initiatives 
like the Human Genome Project, we have been making incredible strides 
in our understanding of the science of genetics, so that we can better 
prevent and treat diseases. We have made strides in behavior change, 
with initiatives like smoking cessation campaigns resulting in a 
reduction of some of these behavioral threats to our health.
  But we need to make more progress in our understanding of how the 
environment impacts our health. Far too often, these are silent health 
hazards that manifest themselves in unexpected cancers or other 
diseases. Yet we have no systematic way to collect and analyze the data 
that will allow us to make the linkages between environmental hazards 
and chronic illness clusters in various communities.
  Take, for example, central Harlem, where one out of every four 
children has asthma. Or Fallon, Nevada--a small town with about 8,000 
residents--where I attended an Environment and Public Works Committee 
hearing back in 2001 where we examined the high rates of leukemia among 
children in that community. There are examples like this from all over 
the country--often from minority or low-income communities that bear a 
disproportionate burden of environmental pollution--and we need to do 
more to protect the health of Americans who are daily living with 
environmental hazards. But if we don't have information to identify 
areas of high disease incidence and understand what environmental 
pollutants exist in those neighborhoods, we cannot adequately address 
the risks posed to our health.
  The legislation I am introducing today will help us to understand 
those links. In establishing a coordinated environmental public health 
network, we can better track chronic diseases like cancer, asthma, and 
autism. We can establish critical information sharing between the 
Centers for Disease Control and Prevention and the Environmental 
Protection Agency, so that those agencies can pool the information that 
can help researchers and the public identify and address risks. We can 
increase our resources for biomonitoring, so that we can measure levels 
of exposure to chemicals. And we can improve our environmental public 
health capacity, so that we have professionals who are trained to 
engage in rapid response to environmental health risks across our 
country.
  The Coordinated Environmental Public Health Tracking Network will 
allow us to make enormous gains in our understanding of environmental 
health, and give us the data necessary to make improvements for the 
health of our communities.
  I would like to thank Senators Hatch and Reid for joining me to raise 
awareness about these issues, and I look forward to working with my 
colleagues on the Health, Education, Labor and Pensions Committee to 
move this bill forward.
  I ask unanimous consent to have printed in the Record a letter of 
support.
  There being no objection, the material was ordered to be placed in 
the Record, as follows:
                                               September 19, 2007.

     Hon. Hillary Clinton,
     U.S. Senate,
     Washington, DC.
     Hon. Orrin Hatch,
     U.S. Senate,
     Washington, DC.
       Dear Senators Clinton and Hatch: The undersigned 
     organizations join in supporting the Coordinated 
     Environmental Public Health Network Act of 2007. We are 
     pleased that your bill would require the Secretary of Health 
     and Human Services to establish and operate a Coordinated 
     Environmental Public Health Network and operate and maintain 
     National Environmental Health Rapid Response Services.
       Chronic diseases cause 70 percent of deaths in the U.S. and 
     are responsible for three-quarters of health care spending. 
     Yet, our public health system lacks the tools it needs to 
     gather sufficient information about these diseases. The air 
     that we breathe and the water that we drink can jeopardize 
     our health if contaminated with chemical, biological or other 
     hazards. It is critical that we have the ability to track the 
     relationship between environmental exposures and the 
     incidence and distribution of disease.
       In Fiscal Year 2002, Congress provided the Centers for 
     Disease Control and Prevention (CDC) with funding to develop 
     the National Environmental Public Health Tracking Program to 
     coordinate local, state, and federal health agencies' 
     collection of critical data. CDC selected pilot programs as 
     testing grounds for the tracking program. Unfortunately, 
     despite important information

[[Page S11861]]

     gleaned from the pilot programs, due to limited funding, in 
     August 2006 CDC was able to award funding to only 16 states 
     and one city. This important program must be expanded to all 
     50 states.
       The Network would provide valuable information that health 
     officials and communities could use to monitor where and when 
     chronic diseases occur and to assess their potential links to 
     environmental hazards. It would coordinate among existing 
     surveillance and data collection systems. The Rapid Response 
     Services would provide an important service by helping to 
     develop strategies and protocols for a coordinated rapid 
     response to higher than expected incidence of chronic 
     conditions and potential environmental exposures.
       Your bill also recognizes the value of expanding the scope 
     and amount of biomonitoring data collected by the CDC and 
     State laboratories. Through biomonitoring techniques, CDC can 
     measure with great precision actual levels of chemicals in 
     people's bodies, investigate exposures, and study the causes 
     of diseases. Enhancing our biomonitoring capacity will help 
     expand our knowledge of chemical exposures in people and how 
     these chemicals affect their health.
       Finally, your bill addresses another need of public health 
     infrastructure--assuring a well-trained public health 
     workforce--by developing centers of excellence, a scholarship 
     program and an applied epidemiology fellowship program. 
     Providing support and incentives to ensure the availability 
     of a well-trained and robust environmental and public 
     health workforce is a critical component of establishing a 
     well-equipped, modern public health system.
       It is the Federal Government that must provide the national 
     leadership and resources to initiate the action required to 
     protect Americans from environmental hazards. The Coordinated 
     Environmental Public Health Network Act of 2007 is a 
     necessary step that will help provide potentially lifesaving 
     information and also improve our public health 
     infrastructure. We appreciate your leadership on this 
     important issue and look forward to working with you on this 
     and other important public health initiatives in the future.
           Sincerely,
         Trust for America's Health, Action Now, Adapted Physical 
           Activity Council, Alliance for Healthy Homes, American 
           Association on Intellectual and Developmental 
           Disabilities, American College of Occupational and 
           Environmental Medicine, American College of Preventive 
           Medicine, American Lung Association, American Public 
           Health Association, Association of Public Health 
           Laboratories, Breast Cancer Action, Breast Cancer Fund, 
           California Safe Schools, Catholic Healthcare West, 
           Center for Science in the Public Interest, Clean Water 
           Action Midwest Office, Coalition for Clean Air, 
           Commonweal, Council of State and Territorial 
           Epidemiologists, Environmental Defense, Environmental 
           Health Network, Families Against Cancer and Toxics, 
           Healthy Building Network, Healthy Homes Collaborative, 
           Healthy Schools Network--Washington, DC, Institute for 
           Agriculture and Trade Policy, Institute for Children's 
           Environmental Health, Institute of Neurotoxicology & 
           Neurological Disorders, March of Dimes Foundation, 
           Minnesota Center for Environmental Advocacy, MOMS 
           (Making Our Milk Safe), National Association for Public 
           Health Statistics and Information Systems, National 
           Association of County and City Health Officials, 
           National Association of Health Data Organization, 
           National Disease Clusters Alliance, National Research 
           Center for Women & Families, Olympic Environmental 
           Council, Oregon Environmental Council, Pesticide Action 
           Network North America, Physicians for Social 
           Responsibility, PTAirWatchers.org, Research Institute 
           for Independent Living, Sciencecorps, Tulane Center for 
           Applied Environmental Public Health, Tulane School of 
           Public Health and Tropical Medicine, Women's Voices for 
           the Earth.

  Mr. HATCH. Mr. President, I am pleased to join my colleagues, Senator 
Clinton and Senator Reid, in introducing today the Coordinated 
Environmental Health Network Act.
  In modern society, we often take for granted the advances in public 
health measures made during the last century. Initiatives like drinking 
water protections and food safety programs have helped to counterattack 
infectious disease and add up to 25 years to the average human life 
expectancy.
  Yet America today is faced by new public health challenges along with 
recurrence of chronic and infectious diseases. Chronic diseases account 
for approximately 70 percent of all deaths every year, most of which 
are preventable. These diseases also cause major limitations in daily 
living for about 25 million Americans and contribute more than $750 
million to annual health care costs.
  As an example of a new health threat, the West Nile virus had never 
before been detected in this hemisphere before the 2000 outbreak in New 
York. In 2007 alone, 1,982 human cases have been reported in almost 
every State and the District of Columbia.
  Food-borne illnesses are estimated to cause 5,000 deaths a year; and 
asthma, a chronic condition, is the number one reason children miss 
school and is also expected to affect 29 million Americans within the 
next decade--more than twice the current number of people with asthma.
  We know that the environment plays an important role in health and 
human development; but we do not know to what extent. Scientific 
researchers have linked specific diseases and health effects to certain 
environmental causes--for instance, infected mosquito bites and the 
West Nile virus, or asbestos and lung cancer--but many other links 
remain unproven, such as those between aluminum and Alzheimer's 
disease, or exposure to disinfectant byproducts and bladder cancer.
  The bottom line is that, if we are going to prevent disease, 
researchers need more complete information about environmental factors, 
their effect on people, and the resulting health outcomes.
  The environmental exposure, biomonitoring, and incidence of chronic 
and infectious diseases data that do exist are not readily accessible 
by all the appropriate systems. Although the Centers for Disease 
Control and Prevention, CDC, has begun efforts in this area through its 
National Environmental Public Health Tracking Program--in which my home 
State of Utah is a participant--currently, no network exists to track 
environmental health data full-scale at the national level. 
Furthermore, at the state and local levels, environmental quality 
programs and classic public health programs are almost always based in 
different agencies.

  This disconnection among environmental health projects at local, 
state, and Federal levels jeopardizes our protection against 
environmental health threats. The threat of terrorist attacks with 
biological or chemical weapons has most certainly become a major public 
health concern; but it is important to keep in mind that weaknesses in 
the environmental public health infrastructure have led to large-scale 
vector-, water-, and food-borne outbreaks of infectious disease.
  In the 1998 Institute of Medicine, IOM, Report ``The Future of Public 
Health'', and the Pew Environmental Health Commission report 
``America's Environmental Health Gap: Why the Country Needs a 
Nationwide Health Tracking Network'', this fragmentation is clearly 
outlined as contributing to disjointed policy development, imbalanced 
service delivery and a generally weakened public health effort.
  The IOM report recommended that state and local health agencies 
strengthen their capacities for identification, understanding and 
control of environmental problems as health hazards.
  The Pew Commission report concluded that the environmental health gap 
results from the lack of basic information that could document possible 
links between environmental hazards and chronic disease, as well as 
information that our communities and health professionals need to 
reduce and prevent such health problems. In response to this problem, 
the Pew Commission proposed a nationwide health tracking network.
  Thirteen top public health groups, including the American Cancer 
Society, American Lung Association, and American Public Health 
Association endorsed the Pew report. This endorsement makes clear the 
message that the complexity of today's environmental public health 
problems requires coordinated responses from multiple agencies and 
organizations.
  The scientific community has also been asking for the ability to 
bridge this environmental health gap. In a 2004 Environmental Health 
Perspectives article, a consortium of public health researchers wrote:

       The ``building blocks'' of knowledge provided by a 
     nationwide environmental public health tracking network will 
     enable scientists to answer many of the troubling questions 
     we are asking today about what is making us sick. The result 
     will be new prevention strategies aimed at reducing and 
     ultimately preventing many of the chronic diseases and 
     disabling conditions that afflict millions of Americans.


[[Page S11862]]


  The common theme from these reports, and the message received from 
top public health organizations and researchers, is that there is a 
pressing need to establish environmental public health leadership at 
the Federal level.
  This legislation will help provide that leadership by establishing a 
Coordinated Environmental Public Health Network. It will make available 
the infrastructure by which local, state, and Federal agencies can 
share environmental public health information.
  This bill is designed to build upon the recommendations from the 
scientific and public health communities, as well as the program that 
the CDC has already begun to carry out.
  The Coordinated Environmental Health Network will connect state 
systems that are tracking chronic diseases, environmental exposures, 
and other risk factors so that the causes of priority chronic diseases 
can be identified, addressed, and ultimately prevented. Public health 
officials, scientific researchers, and the general public will have the 
information they need to fight against chronic disease.
  The Coordinated Environmental Health Network Act will provide states 
with grants to help develop the infrastructure they need in order to 
participate in the Nationwide Network.
  In order to educate the public and provide the information needed to 
fight chronic disease, this bill calls for a National Environmental 
Health Report that will provide annual findings of the Nationwide 
Health Tracking Network.
  This bill also aims to expand our environmental health infrastructure 
through the establishment and operation of regional biomonitoring labs, 
Environmental Health Centers of Excellence, applied epidemiology 
fellowships, and the John. H. Chafee Environmental Health Scholarship 
Program.
  A survey of registered voters conducted for the Pew Environmental 
Health Commission indicated that most Americans say that taking a 
national approach to tracking environmental health should be a priority 
of government at all levels.
  Without comprehensive environmental health tracking, policymakers and 
public health practitioners lack information that is critical to 
establishing sound environmental health priorities. In addition, the 
public is indirectly denied its right to know about environmental 
hazards, exposure levels and health outcomes in their communities--
information they want and have every reason to expect.
  Our country has one of the best health care systems in the world. 
Doctors are now successfully treating illnesses that were once 
considered debilitating or even terminal because we have made great 
investments in researching cures and finding treatments. It is time to 
make the same investment in preventing people from becoming sick in the 
first place. This bill is an important step forward in making that 
investment in the health of America, and I urge my colleagues to 
support it.

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