FY 2024 Annual Performance Plan and Report - Strategic Goal 2: Objective 2.4

Fiscal Year 2024
Released March, 2023

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.  In consultation with OMB, HHS has determined that performance toward this objective is progressing.  The narrative below provides a brief summary of progress made and achievements or challenges, as well as plans to improve or maintain performance.

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 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 FY 2024
Target 21 21 40 40 45 45 60 60
Result 57 97 87 66 80 45 Oct 31, 2023 Oct 31, 2024
Status Target Exceeded Target Exceeded Target Exceeded Target Exceeded Target Exceeded Target Met 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 2024 targets remain level with FY 2023 but are increased slightly over previous year targets as a result.  From FY 2005 to FY 2022, state and local public health officials have used the Tracking Network to implement over 850 data-driven public health actions to save lives and prevent adverse health effects that are due to environmental exposures. 

For example, in 2022 45 public health actions were reported, with COVID, heat stress illness, environmental justice, radon, and lead poisoning as the most common environmental health topics addressed.  Policies included developing county Strategic Plan for Equity and Social Justice based on Tracking’s Environmental Health disparities map, and a clean air standard to reduce vehicle emissions and expand the market for electric vehicles. Programs or interventions described by Tracking recipients included developing a map used by the state’s Oil and Gas Health Information and Response Program to identify new sites for collecting air quality measurements, identifying counties at high-risk of childhood lead poisoning and testing their drinking water, and providing guidelines and recommendations for establishing cooling centers in at-risk communities. 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 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 FY 2024
Target     Set Baseline 81,720 trained 88,826 trained 110,322 trained 102,150
Result     71,061 trained 234,802 trained 130,610 trained 152,461 Dec 31, 2023 Dec 31, 2024
Status     Baseline Target Exceeded Target Exceeded Target Exceeded Pending Pending

ASPR’s mission is to lead the country through public health emergencies.  ASPR measure 1.3 is part of ASPR’s National Disaster Medical System (NDMS) support of nationwide communities.  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.  The HHS emPOWER Program is a mission-critical partnership between ASPR and the Centers for Medicare and Medicaid Services (CMS) that provides public health agencies and their partners with Medicare datasets, mapping, rest service and artificial intelligence tools, training, informational resources, technical assistance and best practices to protect the health of 4.3 million at-risk individuals who live independently in the community and rely on life-maintaining electricity-dependent equipment (including ventilators) and or essential healthcare services (such as dialysis and oxygen tank services). These tools and technical assistance have advanced preparedness and community mitigation activities nationwide and have directed informed and supported over 250 local to national emergencies and disasters.  Baseline data was collected in 2019 and the target exceeded in 2020 and 2021.  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 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 FY 2024
Target N/A N/A N/A N/A N/A Conduct Title VI/Section 504 compliance review through on-site inspections, interviews, and data analysis. Coordinate comprehensive public health response by HHS partners, including CDC and HRSA. Provide technical assistance to the covered entity based on analysis of collected data to establish safe and effective sewage management and nondiscriminatory policies and practices. Additional environmental justice  compliance reviews are under consideration for FY 2024.
Result N/A N/A N/A N/A 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. Onsite investigation completed in April of 2022; approximately 50 witness interviews conducted, data request letters submitted and responses received.  Interim Voluntary Resolution Agreement (VRA) drafted formalizing public health response, federal coordination efforts, and changes to policies and procedures. The interim CRA is currently being negotiated with the Alabama Department of Public Health (ADPH). Pending
Status Not Collected Not Collected Not Collected Not Collected Baseline Completed Pending  

This initiative supports the HHS objective of mitigating the impacts of environmental factors on health outcomes by addressing the health impact of environmental hazards, such as inadequate sanitation systems, that result from discriminatory practices.  As part of this initiative, OCR is conducting an environmental justice/public health compliance review under Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act.  Through on-site investigation, interviews, and document reviews, OCR will 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 and partner with other federal agencies involved in environmental justice.  This compliance review will provide baseline results to use in strengthening this measure going forward.

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