Empowering City Leaders to Address Children's Environmental Vulnerabilities

In this episode host Stephen Goldsmith talks with Grace Robiou, director of the EPA’s Office of Children's Health Protection. They discuss how local governments can leverage EPA resources to prioritize children's health in environmental policies. Robiou highlights the unique vulnerabilities children face from environmental hazards, the importance of localized engagement, and the tools available to cities for data visualizations. The conversation covers practical steps cities can take to address issues like extreme heat and poor air quality with a focus on using data to direct resources and attention.

Listen here, or wherever you get your podcasts. The following is a transcript of their conversation.

Stephen Goldsmith:

Welcome back to the Data-Smart City Pod. This is Stephen Goldsmith, professor of Urban Policy at the Bloomberg Center for Cities at Harvard, and we're glad to have you back. Today we have a special guest, Grace Robiou, who's the director of EPA's Office of Children's Health Protection. Grace has been at the EPA for more than 20 years, has worked on national projects around drinking water, pesticide exposure, marine pollution, and many more subjects. This spring, she spoke at the Harvard Climate Action Week on Environmental Justice.

We're pleased to have her on the podcast today to talk about local governments, how they can be connected with EPA, its resources that are available for cities, how to prioritize children's health when making environmental policies. Grace, welcome to the podcast.

Grace Robiou:

Thanks, Steve. I'm happy to be your guest today.

Stephen Goldsmith:

We have been working with a number of cities on what the mayor's office, what city governments can do that relates to children's health. We've had other guests, Dr. Lindsey Burghardt and Dr. Kelly Turner, who have spoken to us about the unique vulnerabilities that children have to extreme heat, and lead, and poor air quality, and how that affects their educational attainment, their public health and their future opportunities in life, their productivity, and just the overall sense of fairness. So what role does your office play in helping to identify, and then eliminate, or mitigate at least these threats?

Grace Robiou:

Thanks, Steve. As you know, human health and the health of our environment are interconnected. Our vision at EPA is that all children, especially those in communities that are underserved, thrive, by living, learning, and playing free from environmental exposures. And we think of life as consisting of a series of life stages. So life stages are like windows of an individual's life.

So in each of these stages, and I'm talking here about conception, infancy, childhood, adolescence until people are 21 years of age, the human body is at greater risk from contaminants, causing damage. So there's also behaviors that are common at each of these stages that contribute to risk. So what my office does at the EPA is to consider early-life exposures and the lifelong health generally in decisions that we make at EPA that impact human health. So, for example, making sure that standards or regulations are set to be protective of children, developing policies that address how simultaneous or cumulative exposures faced by children are addressed, doing research or science to address knowledge gaps about vulnerability of children, working with healthcare providers, professionals to give them up-to-date information, and in the case of this podcast, sharing information with city leaders so that they can consider the unique vulnerability of children as they make decisions and implement programs.

Stephen Goldsmith:

Grace, I want to talk about specific contaminants, but we have this project, Community Data Health Initiative, involving several cities funded by Robert Wood Johnson Foundation and somewhat by Kresge Foundation. But one of the challenges, even if you're a mayor who cares is, "How do you think about this? Do you focus on lead, or heat, or air, or do you focus on cumulative pollutants and their effect on children's health?" So you've got a broad portfolio, but in a similar but different way, mayors have a broad portfolio. So how should they think about where to focus their energies in order to make a difference for children?

Grace Robiou:

I recommend that there's a need to understand what data you have and what communities you have and their health profile. The answer is not going to be the same everywhere. I often get asked this question when we talk about national priorities on children's environmental health, Steve, because I try not to provide a list, because a list for New England is going to be very different for a list out in the Pacific Northwest, for example. Last week I was meeting with the Seattle and King's County Health Department, for example, and their priorities led, which we're going to talk about, air pollution from wildfire smoke. Well, those are not the realities that are faced in other places. So you got to look at your community, what their health profile is, what their behaviors are, and decide on your priorities based on that.

Stephen Goldsmith:

So we've worked a bit on data visualization and mapping as crucial tools, right? So how can you visualize the pollutants or the cumulative effect of the pollutants perhaps? But there are lots of challenges cities have around data collection and organization. What tools does EPA have to offer, either data or visualization tools, that cities could utilize?

Grace Robiou:

I thought that maybe we could take some examples and walk through some specific data and data visualization tools to illustrate what's available. And as a general statement, I will say that some data are local data that are GIS-mapped. Sometimes it's national trend information. So there is a need, I think, for mayors and city leaders to understand what data they have for a specific issue, and to work at it in a multi-layered capacity. So let's talk about extreme heat, which we know, it's a big issue everywhere in this country now.

Of course, extreme heat is related to air quality, but I'd like to kind of separate air quality for a minute so we could focus on heat itself. So EPA published a national-scale report last year that quantifies projected health effects to children from climate change. So this report considers factors such as extreme heat, air quality, changing seasons, flooding, infectious diseases, and then analyzes the extent to which these risks disproportionately fall on children from overburdened communities. And we have three versions of the executive summary of this tool. In fact, I was looking at them before this podcast, and there's a general version, there's a version for parents, and there's a version for clinicians, and I was thinking maybe we should have a version for city managers.

One of the beauties of this report is that you can download the data, and you can export it technically and apply it to your situation. Extreme heat, of course, negatively impacts children through learning. In this report, we quantify how he experienced, during the school year, Steve, reduces learning. The report provides values for how we quantify learning losses in terms of lost future income for the children, and also, we demonstrate how important air conditioning is, in fact, in schools, and homes in facilitating effective learning. So it's interesting because we sometimes think of air conditioning as perhaps exacerbating climate change.

In this case, we put it into a more holistic context, and we quantify by looking at different temperatures, how learning loss is related to extreme heat and how much future lost income again is attributed to these learning losses. It's very interesting, and again, the data can be downloaded. In the air quality space, we look at how the warming climate will change childhood exposures to both particulate matter and ground-level ozone, and quantify the health effects for respiratory conditions. So we link this data back to health. Again, all of this can be downloaded and can be used.

So EPA came out with a Climate Change Indicators report, that has data, again, and maps about heat related deaths and heat related illnesses, and puts it into the context of interconnections and cost and effect relationships with the environment. Another one is AirNow. That's an interactive map. It's based on local air quality monitors, and you can zoom in and out because you can go local, state, national. And the usefulness of that, I think out of these tools, that's probably the most useful in the sense that it's an air quality index.

It's color-coded images, designed to communicate whether the air quality for that specific day or the next day is healthy or not. People use that a lot.

Stephen Goldsmith:

Let's stay with this, but let me twist it just a little bit. So we've spent a fair amount of time in our project on community engagement, and one of the challenges we've seen, I think, is that where there is community engagement around these issues is relatively superficial in the sense that the city and the experts are not bringing to the community graphic information about the harm, right? So the community is at a disadvantage because it doesn't have access to the science, and some of the things we've seen are just horrible about school temperatures and learning loss or asthma rates. So how has your office worked to kind of drive home the connection between these pollutants and the harm on children, and then how to use that to activate or create activists out of the community?

Grace Robiou:

It's definitely a challenge. I think EPA has a new focus on meaningful community engagement. In fact, last week we published a policy on this, how to do community engagement in a manner that it's not one way communication, but it's a process by which we are listening and responding to the issues that the community is describing. It's not a one system approach, Steve. This is EPA, of course, has 10 regional offices and several field offices.

We're not only in Washington D.C.. This is where our headquarters are, of course. We have several methods in which we do this, but specifically, I want to talk about our community engagement coordinators, because that's kind of, I think, where the rubber meets the road, so to speak, on the work that we're doing. These individuals are on the ground, working with communities to listen to their needs and to integrate children's health considerations into the work-planning process and the prioritization. We also have at a little bit higher level, various different mechanisms for engagement, and one engagement that I want to highlight, because we're proud of it, is the National Environmental Youth Advisory Committee.

This is our work to bring the voice of our youth to the environmental topics of the day. We formed this Advisory Counselor Committee about a year ago. Great leaders from communities across the country. Each one of them represents a different region or area of the country, and what they're doing is also bringing their reality to our decision-making process. We also have something called the Pediatric Environmental Health Specialty Units, which is a network of healthcare providers, physicians, pediatricians, community engagement coordinators, who are available to parents, caregivers, schools, city officials, to advise on issues that a community may be facing.

So, for example, in the Flint water crisis several years ago, our PEHSU, for short, was there to provide support to the community and help answer medical questions. It's not only there for emergencies, however. It's there for community support. So we're finding that this resource, having trusted health professionals in the communities is really critical to building trust with people and providing information that's accurate and advice generally.

Stephen Goldsmith:

So those resources are obviously available to cities. Let's switch for a second here from data to something almost as important to data, which is money, right? So cities want to address these issues. We're trying to catalyze more activity on the part of cities. There's been a lot of grants and funding notices from EPA.

Where does cities see what's still available? How do they go about accessing resources around children's environmental health?

Grace Robiou:

This is an area that...it's interesting. It's just overwhelming. I think the amount of resources that have been provided, I would say, particularly through the Inflation Reduction Act, but prior to that, through the American Rescue Plan and through the Bipartisan Infrastructure Bill. But I'll focus on the Inflation Reduction Act because I think that's where most of the funding is still available.

Awards have been given, but not all the money has been given out, and some application processes are still open. So the Inflation Reduction Act, of course, is the prime climate justice legislation, and there are several grant programs running at the same time. Most of the ones...I'll speak to a couple that are under the EPA's mandate. I would say that the one that I know has the most potential to impact children at this time is the Community Change Grants.

The Community Change Grants, again, under the Inflation Reduction Act, provides funding for community-based organizations, to do work, to address issues in their community, air quality, climate change. It doesn't have to be specific to children, it's broad, but what's key is that it has to be a community-based organization that applies for funding. So I think that one overall intent of this is that there's been a critique that you always give money to the same usual suspects. Well, here, we're trying to provide funding for organizations that are all kinds of development. It could be a new grassroot organization, an organization that has been around for a few years and is just stepping up in the game, or organizations that want to expand their work beyond what they have traditionally been doing, or partner with new people, new entities to do additional work.

Stephen Goldsmith:

So, Grace, just in closing, thread throughout your comments today, is vulnerability, right? And children are vulnerable, but children in certain areas are more vulnerable. So as cities think about targeting resources, how should they think about the Environmental Justice Screen as a priority forcing mechanism in their decision-making?

Grace Robiou:

This tool is an EPA resource that's online, that allows you to map and screen communities based on whatever your priorities may be at the local level. It allows you to combine environmental health data with socioeconomic data. So that's, again, bringing together the health and socioeconomic determinants of health. So, for example, one way in which you might use EJScreen would be, I have a certain amount of funding, limited amount of funding to spend on lead prevention awareness, and I need to decide where to make that investment. I cannot invest it everywhere.

If I invest it everywhere, it'll be diluted, won't have the same impact. So, I want to pick a community where I want to make this investment. So you can use EJScreen to pick a zip code, or more than one zip code, and based on the tool that the tool allows you to add layers and indices of data, GIS-based, of course, to inform your decision-making, so it would help you understand where the children are in your area, where the exposures for lead might be higher, maybe where the Superfund site is, or factors that might affect the health of that community. And, of course, you need to decide on what your priorities are, but you use the tool to help you guide decision-making. It might help guide investments, it might also help guide evaluation of past investments.

Stephen Goldsmith:

In the last few minutes…you're uniquely qualified; your experience, your training, your expertise, and your perspective has been national. Let me ask you to kind of flip this. Our work is with cities, and it's focused around, "What can be done at the city level?" Right?

Climate, obviously, is a universal problem. What can be done at the city level? So if we got 10 mayors in front of us, and they say, "Okay, I actually care about the opportunities of children, particularly those in underserved communities and communities of color." On these issues, where should they start? What should they do? Just what two or three things, or if you want to, you can be mayor for a day and tell us what you would do, that might make the most difference.

Grace Robiou:

I think that my overall one-sentence piece of advice is that the health of the children, in whatever it is, the scope of place you're managing, is really the measure to use to evaluate the effectiveness of your programs. We tend to talk as, "Let's protect the general population." We think, "Well, children are part of their general population, so we're protecting children if we protect the general population." I think that's a misconception. Children are more vulnerable.

They don't have a voice, and we need to think about them, not as a subpopulation of that general population, but as uniquely susceptible and vulnerable to environmental hazards. So I tend to recommend that people move away from this general population concept and pivot to the demographics of your area. "How many children do I have? What is their health profile, their ethnicity profile?" Because the ethnicity comes into play also in other behavioral and societal considerations that are important to risk.

So let's take lead as an example. In some cultures, people use cookware or cosmetics that have lead, because that's their cultural practice. So that's a risk pathway that is not in existence for other community groups, for example. So that's kind of at the general level. I think data availability is a real challenge at the local level, and I think that government needs to be partnering with all kinds of organizations in their region, to look at the problem from a multi-sector perspective.

Shouldn't be looking at, "Oh, I don't have any data on lead, and therefore, I cannot act." Well, we know what are the sources of exposure of lead. You don't need to know how many children you have that exceed the recommended blood lead level. If you know that there are sources of lead in your community, you should be addressing those sources to prevent exposure. So I think that sometimes people think of data limitations as immediately like it freezes you to action, and I think that that should not be seen – I mean, it is an issue, but it should not paralyze you. There are organizations working with communities that might have data that you have not tapped. Government sometimes cannot do it all. You need to partner with other people to provide the community with the resources and the information that they need also. They need to be empowered to take action, at the parent level or community level.

So I think there's no single magic bullet here, Steve. I think that, but I do encourage mayors to think about children as almost like canaries in a coal mine, that might be telling you something is wrong.

Stephen Goldsmith:

Grace, thank you. I mean, just listening to you and to Lindsey Burghardt and Kelly Turner as well. If more people were aware of what you just said, the tangible, real harm to a specific population caused by these pollutants, and that those pollutants could be mitigated locally, I think there'd be much more demand for action. So we so much appreciate the work you do every day, and that you're taking some time to help educate our listeners about it. So this is Stephen Goldsmith from the Harvard Bloomberg Center for Cities, and we're with Grace Robiou.

We've been really fortunate to have Grace with us today from the EPA's Office of Children's Health Protection. Thank you for making our listeners aware, not just of your knowledge, but of the resources that you have to offer cities. Thank you so much.

Grace Robiou:

Thank you, Steve.