Pediatric Environmental Health Interactive Curriculum

This easy to administer environmental health curriculum, meets ACGME requirements, is adaptable to multiple sites, and doesn’t require expertise in environmental health to administer. The curriculum aims to teach pediatric residents proficiency in environmental health and establish a foundation of knowledge upon which they will expand during their careers.

The Community Environment

Downloads
Community Environment Module (pdf)
Faculty Guide (pdf)

Objectives
Appreciate how features of the neighborhood and community impact children’s health

• Physical design
• Access to health promoting resources
• Social structure

Introduction
A comprehensive view of a child’s life lends understanding of how a given risk affects a given child. An environmental health perspective helps the provider take this broad view as it allows exploration of the interplay between genetics, demographics, toxic exposures, positive influences, the built environment, chronic illness, maternal exposures, prior exposures, age, and behavior. These influences function at both the individual and community level. To appreciate the complex interplay of these influences at the community level, the pediatrician’s best tool is her observation skills. These skills, honed in the clinic, can help a pediatrician begin to understand how the built environment impacts children’s health.

Preparation
Before visiting the neighborhood, prepare by becoming familiar with key concepts in environmental health, key concepts of the built environment, and learn some of the characteristics of the neighborhood you will visit.

1. Environmental hazards as they relate to children.
   Read: Pediatric Environmental Health Toolkit: Key Concepts
2. The Built Environment and Health:
   Review: AAP Committee on Environmental Health: “Statement on The Built Environment.” Pediatrics June 2009
3. Your instructor with provide you with a patient to be considered during this exercise.
4. Spend 20 minutes on Google and Google maps familiarizing yourself with the chosen neighborhood. Use the worksheet to mark important places on your Google map.
5. Familiarize yourself with online tools for neighborhood evaluation. Learn about the pollutants in the zip code you have been given and how your patient’s neighborhood compares to others.

• Climate and Economic Justice Screening Tool: made by the President’s  Council on Environmental Quality, this is a national map of disadvantaged communities including indicators for climate change, pollution, transportation, water and health among many others.
• CalEnviroScreen (California only): Census tract level percentile scores based on environmental health concerns, and demographic vulnerabilities.
• EPA Enviromapper Storefront: Interactive mapping tools for querying environmental information by zip code. It includes an environmental justice database.
• Air Quality Index: Check the local Air Quality Index and forecasts for air quality in your patient’s zip code.
• ATDSR ToxFAQs: Detailed information about hazardous wastes.

Neighborhood visit

Visit your patient’s neighborhood. Look for neighborhood features that impact children’s health. Use the worksheet to guide your thinking as you walk. Consider the relationship between your patient’s health and the greater community.