Department of Health and Human Services
	Research, Demonstration, and Evaluation Activities FY 2003 Plan and Budget February 2002

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RESEARCH AND DEMONSTRATIONS

(by HHS Strategic Plan Objective)

REDUCE THE IMPACT OF ENVIRONMENTAL FACTORS ON HUMAN HEALTH (OBJECTIVE 1.8)

FY 2003 Priorities

NATIONAL CENTER FOR ENVIRONMENTAL HEALTH (CDC)

1. Childhood Lead Poisoning Prevention

   Research: CDC will support research focused on reducing the risk of childhood lead exposure including:

   • primary prevention to identify cost-effective approaches to prevent lead exposure in children.
   • secondary prevention to improve screening of high risk children and case management of children with lead poisoning.

   Demonstrations: CDC has identified one approach to improving targeted screening of children for lead poisoning: High Intensity Targeted Screening (HITS). HITS has identified several Chicago neighborhoods where groups of low income children live in older housing. Teams of CDC staff, local childhood lead poisoning prevention program staff and community members will visit homes to screen children for elevated blood lead levels to identify the prevalence of lead poisoning in these communities.

   Evaluations: CDC will evaluate:

   • screening rates among high-risk children in the United Sates, especially Medicaid enrolled children.
   • case management of children with elevated blood levels to assess the impact of case management recommendations made by the CDC Advisory Committee on Childhood Lead Poisoning Prevention.
   
   

2. Asthma

   Research: CDC will support research focused on better understanding the determinants of asthma severity. Priorities include:

   • development of methods for tracking the severity of asthma and the quality of asthma management among persons diagnosed with asthma.
   • research on factors promoting adherence to prescribed medication and environmental modification guidelines.
   • determining the impact of managed care companies’ programs to reduce the severity of asthma among adult women.

   Evaluations: CDC will support an evaluation of state-based asthma control programs and document the ability of state health departments to monitor the effectiveness of health department sponsored asthma interventions.

3. Environmental Health Tracking Network

   CDC will develop a national environmental health tracking (surveillance) system of state-based programs; build core capacity in state health and environmental agencies to cooperate on addressing environmental health problems.; and prevent known or suspected adverse public health events associated with environmental exposures:

   Research: CDC will support an research to:

   • establish standards, specifications, and working prototypes for automating and linking hazards, exposure, and health outcome data.

   HEALTH SERVICES RESEARCH (NIH)

   Research: In FY 2003, NIH will continue to support interdisciplinary, population-based research on environmental determinants of diseases such as asthma and cancer and related means for prevention. FY 2003 priorities include:

   The National Institute of Environmental Health Studies (NIEHS) research will include:

   • a pilot study to evaluate a targeted approach to home cockroach eradication and home cockroach allergen mitigation, and a combined acaricide/carpet cleaner treatment to reduce dust mites numbers and dust mite allergen levels in residential carpeting;.
   • a study on Environmental Intervention in the Primary Prevention of Asthma in Children to determine if environmental intervention aimed at reducing dust mite and cockroach allergen levels in low income homes can prevent sensitization to these aeroallergens and decrease the prevalence of asthma in high risk children.
   • a prospective cohort study of childhood asthma in Mexico City to examine the causes of early-onset asthma, such as exposure to dust mites and cockroaches, airborne pollutants, dietary factors, childhood infections, and genetic susceptibility.

   The National Cancer Institute (NCI) will continue to support research studies to:

   • explicate the role of environmental factors in geographic variations in cancer mortality patterns.
   • develop and refine Geographic Information Systems for use in identifying geographic areas where environmental factors may pose health problems.