With contributions from Kristie Trousdale.

Environmental justice is achieved when all people, regardless of race, ethnicity, or socioeconomic status, are able to live, learn, work, play, and pray in places with clean air to breathe and safe water to drink and to benefit from equitable access to greenspace and safe and healthy food and products.

Environmental injustices are a product of systemic racism and current and historical racist practices such as redlining, which segregated neighborhoods and concentrated most polluting sources from industry or major roadways in or through communities of color. Designated as risky investments, and supported by a lower tax base, resources were either drained from or never infused into these neighborhoods, leaving many with crumbling infrastructure including housing and schools in poor condition and lack of safe and convenient access to adequate public transportation, parks, high quality affordable child care, and fresh groceries, among other amenities.

This disinvestment has left a legacy of impacts, cycling through generations, to children in these communities, who experience disproportionately higher levels of exposure (including prenatal exposures) to pollution and other environmental hazards. They are also more likely to experience additional risk factors for poor health rooted in racism, such as lack of access to quality health care and increased under- or malnutrition, toxic stress, or adverse childhood experiences.  These compounding factors contribute to health disparities in children. For example, consider asthma. Black children have two times the rate of asthma and are two times as likely to be hospitalized for—and four times more likely to die from—asthma than are white children.

Lead exposure. We have known about the serious neurotoxic harm from lead exposure for over a century, and yet children throughout the country continue to be unnecessarily exposed through lead-based paint hazards and lead in drinking water, soil, and other sources. I am encouraged by the new Administration’s commitment to removing 100% of the nation’s lead service lines, which represents an important source of lead in drinking water for millions of Americans. Our organization, the Children’s Environmental Health Network (CEHN) just wrapped up a three part virtual town hall series on lead in drinking water and the important role that public health professionals can play in accelerating lead service line replacement in their communities. We must also continue investment in addressing lead-based paint hazards in public housing and homes, schools, and child care facilities and  soil hazards in contaminated areas.

Air pollution. Air pollution has improved drastically in our country since the enactment of the Clean Air Act of 1970 and its Amendments. However, the American Lung Association’s State of the Air report finds that nearly half of Americans live in counties where the levels of particulate matter (PM) and/or ground level ozone (O3) exceed regulatory standards. In addition, communities of color or of lower wealth are often in closer proximity to polluting industry or roadways, and children in these communities are disproportionately exposed to higher levels of criteria air pollutants and other hazardous air pollutants.

Air pollution leads to multiple adverse health effects, including respiratory effects in children. It exacerbates asthma, leading to increased frequency and severity of symptoms, as well as contributes to the development of new asthma cases among children. Nearly 10% of school aged children currently have an asthma diagnosis, and the condition accounts for approximately 14 million missed days of school each year. Moreover, as previously mentioned, there are significant racial disparities associated with the condition.

Cancer. Childhood cancer is relatively rare, but it has increased 34% since 1975 and is the most common disease-related cause of death for children past infancy. Traffic-related air pollution is associated with childhood cancer risk, as is exposure to pesticides, paints, and solvents. Residential pesticide use, as well as parents’ occupational exposures, have been linked to various childhood cancers such as leukemias and brain tumors. It is often children in lower income and immigrant communities who have the highest levels of exposure to agricultural pesticides, whether through pesticide drift, child agricultural labor (legal or illegal), or take-home or prenatal exposures from agricultural worker parents. There are also many chemicals used widely in the marketplace that are known to cause cancer in adults, and to which children are exposed, such as PFOA (perfluorooctanoic acid).

Young children are notably vulnerable, especially those exposed in the perinatal period, during critical windows of development. During these periods, their bodies and organ systems are in a dynamic state of development and disruption from harmful exposures could cause severe damage with life-long effects. Young children have physiological and behavioral differences that also increase their exposures to certain toxicants. Pound for pound, they breathe, eat, and drink more than adults, they exhibit behaviors such as crawling and hand-to-mouth behaviors, and they have unique exposure routes, such as through breastfeeding. Those whose parents are occupationally exposed to environmental hazards are also at higher risk.

Black, Indigenous, and Latinx children and children in poverty or under-resourced communities are at even greater risk for harmful environmental exposures due to pervasive racist policies and programs.

Climate-related disasters. Black, Indigenous, and people of color (BIPOC) communities live on the frontlines of climate change. They are hit first and hardest by climate-related disasters such as hurricanes, flooding, and drought. The long history of disinvestment in their communities has left them with a dearth of resources and substandard housing and infrastructure. They are also more likely to be in closer proximity to industrial facilities and hazardous waste sites which can pose greater pollution exposures due to climate-disaster damage or breaches, and they also have a greater likelihood of living in hazardous zones, such as floodplains.

Wealthier white families are often able to bounce back from disasters more quickly and completely due to inherited wealth, employment flexibility and security, homeowner insurance policies, and disaster and recovery aid policies, among other privileges. This ability to bounce back is an important one, with implications to the trajectories of young lives. Many Black children who were displaced by Hurricane Katrina in 2005 continue to struggle today as young adults due to the severe disruption to their lives. Children in Puerto Rico reported increased anxiety, post-traumatic stress disorder, and other mental health concerns after Hurricane Maria in 2017.

Environmental health threats. In addition to increased intensity and/or frequency of climate-related disasters and their direct injurious and fatal effects, climate change increases environmental health threats such as air pollution. Warmer temperatures increase the production of O3 (the main ingredient in smog) and increases the length and productivity of pollen seasons which trigger more frequent and severe asthma attacks. We’ve also seen how the devastating wildfires in the West negatively impact air quality, and climate change serves to increase the frequency and intensity of these disasters.

Extreme heat. Extreme heat events are also increasing in frequency due to climate change, and Black, Latinx, and children of color living in urban areas with high urban heat indices are more likely to lack air conditioning and to be more vulnerable to heat-related illnesses. This is especially true for infants due to their physiology and young athletes due to their time and exertion outdoors.

Reproductive health. The maternal health crisis in this country for people of color is also exacerbated by extreme heat and other climate-related impacts. Black, Indigenous, and Latinx expectant mothers are at higher risk for death or severe complications to their own health, as well as to the health and development of their infants, including premature birth, low-birth weight, and other poor birth outcomes. Climate change serves to deepen the significant racial disparities in perinatal and reproductive health.

Our solutions to these problems must address the fact that wealthier, white communities are responsible for most of the consumption, and thus greenhouse gas emissions, that drive the accelerated warming of the planet and the associated impacts, and yet it is BIPOC communities who are disproportionately impacted by the adverse direct and indirect effects from climate change. Benefits from investments in clean energy and climate adaptations must prioritize under-resourced communities.

Air pollution. The COVID-19 pandemic underscored the importance of environmental health and environmental justice. In particular, researchers found an association between long term exposure to air pollution and higher COVID-19 mortality rates, and BIPOC communities are subject to higher exposures to air pollution. Critical decision-making and action to address air pollution includes the need for: stricter PM and O3 standards; improved siting and permitting of polluting facilities; more fenceline monitoring and enforcement to address poor air quality hot spots; stronger fuel economy standards; and support for EV and related infrastructure (including within EJ communities).

Clean and renewable energy. To address climate change via greenhouse gas reduction, decision makers need to focus on clean and renewable energy (waste and biomass incineration is not clean). It is critical to apply an environmental justice lens to ensure equitable benefits, at minimum, from this transition to clean energy. We also need to be better prepared. Adaptation requires community-led and informed research, outreach, and investment in under-resourced areas to increase resilience.

Access to safe drinking water. The importance of access to water, and especially safe drinking water, was also made evident during the COVID-19 pandemic. Approximately 2 million Americans have no indoor plumbing and lack easy access to potable water. Indigenous households on remote reservations are the most likely to lack plumbing, and on many reservations the ground water is contaminated from fossil fuel extraction and other activities.

We also know that between 6-10 million homes in the U.S. get their drinking water from lead service lines which contribute the greatest percentage of lead to the tap. President Biden has made clear his commitment to replace all of the country’s lead service lines, and the U.S. Environmental Protection Agency (EPA) is currently reviewing the Lead & Copper Rule Revision, holding listening sessions, and inviting public comment, especially from impacted community members. While these are promising developments, it will be critical that lead service line replacement programs prioritize those communities at highest risk.

Safety of child care settings. Millions of children ages 0-5 attend some form of child care outside of their own homes, many for 40 hours or more per week. In addition to the need for improved access to quality and affordable care, child care settings need to be safe and healthy. Licensing is handled primarily at the state level, and typically, licensing standards do not comprehensively address environmental and climate change-related health hazards in child care facilities. Moreover, many children, including some of the most vulnerable, attend unlicensed facilities or have informal care arrangements and monitoring these programs is even more difficult.

CEHN’s Eco-Healthy Child Care® (EHCC) program is the only national program that provides education, training, and technical assistance to child care providers on simple, low-to-no-cost actions to reduce children’s and staff’s exposures to harmful environmental hazards in and around child care facilities. EHCC also offers an endorsement program for providers who meet a checklist of eco-healthy best practices and works at the national level to increase understanding and incorporation of environmental health policies within the child care field.

This past year underscored the essential role that the struggling and usually overlooked child care industry plays in families and within our economy. President Biden has pledged billions of dollars of support for the industry and also remains committed to free, high-quality, universal preschool and affordable child care. This nod to the vital role of child care in American society presents opportunities to expand the definition of “high-quality” to include measures of environmental health and safety.

School safety. Schools are also in dire need for investment to address the health and safety hazards posed by the aging and crumbling infrastructure of educational facilities across the country. Critical needs include ensuring effective HVACs and air filtration and ventilation systems, eliminating mold and dampness, and addressing exposures to toxics such as asbestos and PCBs in building materials and other media. Schools need increased assistance to adopt policies to: address lead in drinking water, safely maintain lead-based paint hazards, manage crowding and maintain indoor air quality, control pests without relying on chemical pesticides, clean and disinfect safely and effectively, promote and incentivize energy efficiency, and promote no idling policies, among other needed changes.

Funders can support efforts addressing the built environment and infrastructure, especially in under-resourced neighborhoods. Children need:

  • Safe and healthy housing
  • Safe access to nature and greenspace
  • Environmental health and safety in schools and child care
  • Environmental justice and equitable siting of hazardous polluting facilities and major roadways, as well as care in the safe siting of new schools and child care facilities

We also need increased support for climate action/solutions, including policies to prioritize:

  • Clean energy and energy justice
  • Clean and equitable transportation
  • Transformation of food production systems towards sustainability, health, and equity
  • Increased understanding of children’s unique climate change vulnerabilities—including mental and physical health impacts
  • Increased education, outreach, and capacity to improve preparedness, response, and recovery specific to children’s vulnerabilities and needs across settings, including health care, schools, and child care

Serious attention is needed with regard to chemical safety policy. There are over 84,000 chemicals registered for use in the US marketplace, and the majority of them have not been tested for safety to children’s health. Many are known carcinogens, neurodevelopmental toxicants, and other health hazards. Children are needlessly suffering from unnecessary exposures. More investment is needed in green chemistry and child health advocates need support to ensure that:

  • EPA exercises its authority and upholds the intent of new precautionary requirements under the Frank R. Lautenberg Chemical Safety for the 21st Century Act
  • EPA enacts and enforces strong regulations for polluting industries to limit harmful emissions to air, water, and soil
  • Researchers, healthcare professionals, elected officials, and business or community leaders support a prevention-oriented paradigm for childhood cancer and other environmentally mediated childhood chronic conditions

Funders play an important role in children’s environmental health protection, and strategic focus and prioritization is necessary for transformative change. CEHN, with assistance from federal partners and visionary leaders across sectors, developed a framework for the field (A Blueprint for Protecting Children’s Environmental Health: An Urgent Call to Action) to guide our collective work towards the health and well being of all children and livable futures for them and for future generations.