FY 2023 Annual Performance Plan and Report - Strategic Goal 2: Objective 2.4

Fiscal Year 2023
Released March, 2022

Topics on this page: Objective 2.4: Mitigate the impacts of environmental factors, including climate change, on health outcomes | Objective 2.4 Table of Related Performance Measures

Objective 2.4: Mitigate the impacts of environmental factors, including climate change, on health outcomes

HHS invests in strategies to mitigate the impacts of environmental factors, including climate change, on health outcomes.  HHS detects, investigates, forecasts, monitors, responds to, prevents, and aids in recovery from environmental and hazardous public health threats and their health effects.  HHS promotes cross-disciplinary and multi-stakeholder coordination to improve the outcomes of climate change and environmental exposures on workers, communities, and domestic and international systems.  Additionally, HHS expands awareness and increases knowledge of environmental hazards and actions that individuals and communities can take to reduce negative health outcomes.

The Office of the Secretary leads this objective.  The following divisions are responsible for implementing programs under this strategic objective: ASPR, ATSDR, CDC, CMS, FDA, HRSA, IHS, NIH, OASH, OCR, and OGA.  The narrative below provides a brief summary of any past work towards these objectives and strategies planned to improve or maintain performance on these objectives.

Objective 2.4 Table of Related Performance Measures

Number of public health actions undertaken (using Environmental Health Tracking data) that prevent or control potential adverse health effects from environmental exposures (Lead Agency - CDC; Measure ID - 6.C)
  FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY 2022 FY 2023
Target 30.0 21.0 21.0 40.0 40.0 45.0 45.0 60.0
Result 74.0 57.0 97.0 87.0 66.0 80.0 Oct 31, 2022 Oct 31, 2023
Status Target Exceeded Target Exceeded Target Exceeded Target Exceeded Target Exceeded Target Exceeded Pending Pending

The Environmental and Health Outcome Tracking Network covers over 185 million people, which made up about 57% of the population in the U.S. in 2021.  The Tracking Network serves as a source of information on environmental hazards and exposures, population data, and health outcomes.  CDC exceeded expectations for the number of data-driven actions to improve public health using the Tracking Network which is in keeping with previous years.  CDC is refining how public health actions are captured and anticipates that the total number of actions may be reduced or remain flat.  Performance for this measure is dependent on Environmental Health Tracking recipients reporting on the actions they undertake which may vary from year to year.  FY 2023 targets are increased slightly over previous year targets as a result.  From FY 2005 to FY 2021, state and local public health officials have used the Tracking Network to implement over 820 data-driven public health actions to save lives and prevent adverse health effects that are due to environmental exposures.

For example, in 2021 over 80 public health actions were reported, with COVID, heat stress illness, climate change, and air quality as the most common environmental health topics addressed.  Policies included requiring city agencies to use organic pest control measures in parks and requiring a licensure program for radon professionals to ensure they consistently and correctly measure home radon levels.  Programs or interventions described by Tracking recipients included hosting free COVID testing events in areas identified as high-risk based on sewer shed surveillance data and ensuring that K-12 public school locations with the highest lead exposure risk for receive prioritized testing of lead in drinking water.  The Tracking Network also serves as a source of information for health professionals, elected officials, researchers, parents, and the public on environmental hazards and exposures, population data, and health outcomes.

Increase training and resources to address the access and functional needs of electricity and healthcare service-dependent at-risk individuals who live independently and are impacted by incidents, emergencies, and disasters (Lead Agency - ASPR; Measure ID - 1.3)
  FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY 2022 FY 2023
Target N/A N/A N/A Set Baseline 81,720 trained 88,826 trained 110,322
Result N/A N/A N/A 71,061 trained 234,802 trained 130,610 trained Dec 31, 2022 Dec 31, 2023
Status Not Collected Not Collected Not Collected Baseline Target Exceeded Target Exceeded Pending Pending

ASPR measure 1.3 is part of ASPR’s National Disaster Medical System (NDMS) work to support communities nationwide.  When disaster strikes, NDMS is important because States, Localities, Territories, and Tribes (SLTT) may have medical infrastructure that becomes overwhelmed and requires assistance with their critical services.  At that point, they can request NDMS help for their communities as they respond and recover.  NDMS capabilities and tools deliver essential medical and emergency management services and subject matter expertise when requested by an SLTT agency.  As a tool within NDMS, the HHS empower Program’s federal health data are used to advance SLTT and community partner capabilities to anticipate and plan for healthcare system surge, including pre-emptively taking action to protect health and save the lives of at-risk populations that may be rapidly and adversely impacted during an emergency or disaster.  emPOWER provides public health agencies and their partners with Medicare datasets, mapping, rest service and artificial intelligence tools, training, technical assistance and best practices to protect the health of individuals who live independently and rely on life-maintaining electricity-dependent equipment (including ventilators) and healthcare services (such as dialysis and oxygen).  Baseline data was collected in 2019 and the target exceeded in 2020 and 2021.  The data source is stable with no delays or lags.  Quality checks are in place to assure the validity and reliability of the data.  For the FY 2022 HHS budget, the measure definition was slightly refined for clarity based on additional data sources, which are designed to improve the data collection processes and the accuracy of the data.  In May 2020, the methodology used to define targets was also slightly refined from baseline+ to the projected quantitative numbers (calculated in the same way).  This helped those who use the data to understand it more easily.  Such efforts strengthened the analysis, trending, and application of emPOWER data in ways that promote decision support and drive improvements.  The nationwide use of emPOWER data represents the rapid scientific advancement of data-driven mitigation strategies that help during a broad array of disasters, including the Covid-19 pandemic and events associated with climate change. 

By FY 2026, OCR will conduct a Title VI Environmental Justice/Public Health compliance review and undertake any needed steps for resolution.  (Lead Agency - OCR; Measure ID - TBD)
  FY 2018 FY 2019 FY 2020 FY 2021 FY 2022 FY 2023
Target N/A N/A N/A N/A Draft Title VI Environmental Justice/Public Health notice and data request letter; send notice and data request letter to the covered entity; review data responses; request supplemental data as needed; interview witnesses. Request additional data as needed; conduct outreach to community leaders and advocates; conduct onsite investigation; coordinate comprehensive public health response by federal partners, including CDC and HRSA; analyze the data and share results with the covered entity; provide technical assistance to the covered entity based on analysis of collected data.
Result Not collected Not collected Not collected Background investigation completed; joint meetings held with other partner federal agencies, including USDA, DOJ, and Office of Climate Change and Health Equity; follow-up interviews conducted with Complainants; compliance review opened September 2021.    
Status N/A N/A N/A Baseline    

The purpose of this initiative is to analyze data received from at least one Title VI/Section 1557 environmental justice/public health compliance review.  OCR will conduct an on-site investigation, identify corrective actions, if needed, and provide technical assistance to ensure that federally assisted health programs and activities are accessible to underserved racial and ethnic minority communities.  OCR will coordinate with HHS partner agencies to develop and implement a comprehensive public health response to improve community health outcomes.  These on-site investigations will provide initial and historical results to be used in strengthening this measure going forward.

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