Collaborative Agreement Between The U.S. Environmental Protection Agency, U.S.-Mexico Border 2020 Program And The U.S. Department of Health and Human Services, U.S.-Mexico Border Health Commission (U.S. Section) 2016 Purpose This document identifies areas of collaboration between the U.S. Environmental Protection Agency (EPA) and the U.S. Department of Health and Human Services' U.S.-Mexico Border Health Commission (BHC), U.S. Section, with particular focus on fulfilling and strengthening each organization's strategic frameworks along the U.S.-Mexico border, including EPA's Border 2020 Program and the BHC's Healthy Border 2020 initiative. The goal of this collaborative agreement is to advance efforts that address the important relationship between the environment and public health. Background EPA and its U.S. and Mexican partners have developed the Border 2020 Environmental Program, a binational partnership designed to improve the environment and public health along the U.S.-Mexico border. It includes five goals and fundamental strategies to improve children's health and promote environmental health through capacity building, community-based programs, partnerships, and reducing exposures to chemicals, heavy metals, pesticides and asthma triggers. Similarly, the BHC's Healthy Border 2020 program addresses public health issues prevalent among binational border populations by providing the necessary leadership to develop coordinated and binational actions including chronic diseases, research and data collection, access to care, and strategic planning. The program establishes the commission's border regional agenda on health promotion and disease prevention and comprises measurable and binational relevant goals and objectives that bring together key regional partners to develop and support policy change and culturally appropriate, evidence-based interventions. Program Collaboration Opportunities This document organizes specific opportunities into the following three general areas that have been identified by EPA and the BHC for our collaboration: Public Health and Environmental Leadership, Building Environmental Health Capacity, and Strengthening Institutional Resiliency and Accountability. ------- Public Health and Environmental Leadership Lead Environmental Health Efforts in the Border Region EPA and BHC will lead the implementation of environmental health goals included in the BHC's Healthy Border (HB) 2020 report and in EPA's Border 2020 program. The primary goal of these strategic frameworks is to provide international leadership to optimize public health and quality of life along the U.S.-Mexico border. EPA and BHC will collaborate to implement Healthy Border 2020 and Border 2020 focusing on environmental and public health challenges of mutual concern and priority in the border region. A report describing the frameworks is available on the BHC website: www.borderhealth.org and EPA website www2.epa.gov/border2020/. Specific goals include: Improve the quality of life for border residents and Eliminate the health disparities in border communities. Leaders across Borders (LaB) EPA and the BHC will collaborate on the Leaders across Borders program. Leaders across Borders is an advanced leadership development program aimed at building the binational leadership capacity of public health, health care, and other community-sector leaders working to improve the community health in the U.S.-Mexico border region. The annual program is open to experienced public health, health care, and other community-sector leaders working in the U.S.-Mexico border region. Application information is distributed by the BHC. Approximately 20 applicants are selected each year with approximately half originating from each side of the U.S.-Mexico Border. EPA and the BHC will identify priority projects and efforts on environmental health for incoming leadership cohorts. Specific goals include: Development of curriculum material on environmental health topics such as integrated pest management, air quality and asthma triggers, chemical and pesticide exposure and Pilot project technical support. Building Environmental Health Capacity EPA and BHC will strengthen the ability of local communities and stakeholders to learn about and manage environmental and environmentally-related public health issues by identifying training needs and providing support for training efforts to address these needs. Capacity building through environmental education and training is critical to long-term environmental protection and fostering greater community awareness and engagement on environmental issues at regional and local levels and their connections to public health. EPA and BHC will adopt a variety of capacity building tools and communication methods, including sponsoring training events and sharing information via the Internet, printed materials, and educational materials. Specific goals include: Chemical and Pesticide Exposure Prevention Partner with border communities to develop strategies to identify sources of chemical and pesticide exposure and actions that reduce exposure to lead, mercury, pesticides, and other heavy metals in the environment, Work with border communities to identify and implement best practices for the storage, handling, and disposal of excess pesticides and other chemicals used to control insect and rodent pests, Page 2 of 5 September 15, 2015 Final ------- Collaborate with state and local governments and communities to develop pilot projects that foster the adoption of integrated pest management in the school environment to reduce children's exposure to pesticides and asthma triggers while achieving effective pest control on school property, and Engage healthcare providers (physicians, nurses, promotores/community health workers) on the recognition and reporting of illnesses and poisonings caused by lead, pesticides, and other chemicals. Pediatric Environmental Health Specialty Units (PEHSU) EPA and BHC will engage the existing PEHSUs within EPA Region 6 and 9 to support environmental efforts along the border. The PEHSUs are composed of experts in children's environmental health and are funded in part by EPA and the Agency for Toxic Substances and Disease Registry (ATSDR) to improve the environmental health of children by enhancing educational and consultative services to clinicians, health professionals, and the community and providing evidence-based information from a network of experts in environmental health. The PEHSU's three-pronged approach consists of education of health professionals and communities, consultation to health professionals and communities, and referral to appropriate facilities for evaluation and treatment. Specific goals include: Assist in the implementation of the newly established pediatric environmental health resource unit in El Paso Texas, established as a collaborative effort between EPA Region VI, the BHC, Texas Tech University Health Sciences Center, the Southwest Center for Pediatric Environmental Health, the West Texas Regional Poison Center, the ATSDR and Explore opportunities to establish additional PEHSUs along the U.S.-Mexico Border. Community-based Healthy Border Initiatives EPA and BHC will participate in Community-based Healthy Border Initiatives (CBHBI), Border Binational Health Week (BBHW), and other binational and regional workshops, environmental health fairs and expositions, including planning efforts to enhance environmental health awareness focused on lead, pesticides, asthma triggers, worker safety, integrated pest management, and other relevant environmental health topics. Specific goals include: Work with local NGOs engaged in efforts on agricultural worker "take home" exposure and personal safety, Showcase proven and/or innovative Integrated Pest Management (IPM) programs in schools and/or the home, Hold joint regional stakeholder meetings, when appropriate, to communicate program successes, outputs and outcomes while seeking input from stakeholders and communities on pressing issues, and Utilize health care providers, staff, and promotores/community health workers to identify and abate asthma triggers and indoor air quality. Air Quality ancl Asthma Education Awareness Poor air quality may contribute to and exacerbate asthma. Increased risk factors in the border region include air pollution, dust, agricultural burning, and various household hazards (such as indoor mold, pests, pet dander, and household chemicals) which can contribute to disparities in asthma rates Page 3 of 5 September 15, 2015 Final ------- between communities living along the border and those in other parts of the U.S. or Mexico. Specific goals include: Partner with state and local governments and border stakeholders to identify and reduce exposure to hazardous chemicals and asthma triggers in and around the home and schools through education, awareness, and the use of best practices for vector control. Leverage existing federal resources towards actions that address environmental and public health challenges along the U.S.-Mexico Border by implementing the guiding principles and recommendations of the President's Task Force on Environmental Health Risks and Safety Risks to Children including coordinating and collaborating across federal agencies, building on existing and effective federal programs and partnerships, and doing "more of what we know works." Climate Change EPA and BHC climate change efforts will focus on actions to help border communities become more resilient to the effects of climate change. The risks posed from climate change are well- documented and vast. These risks may include increases in smog levels, rising sea levels, increased precipitation intensity and droughts, which can also pose significant economic, environmental and public health challenges to border communities. By making choices that reduce greenhouse gas pollution, and preparing for the changes that are already underway, we can reduce risks from climate change. Specific goals include: Identify and develop tools and trainings to identify emerging public health and environmental challenges to reduce the expected toll that climate changes would make in the Border Region. Strengthening Institutional Resiliency and Accountability Identify Project Funding and Leveraging Opportunities EPA and the BHC will collaborate and leverage their respective and external resources and partnerships to fulfill joint efforts that achieve EPA and BHC environmental health priorities and goals, as outlined in this agreement. This collaboration will consider respective budget constraints and will focus on maximum leveraging of external resources. Specific goals include: Engage philanthropic organizations to build donor knowledge and support of border environmental and public health efforts and Engage internal and external partners to support project and efforts that help fulfill commitments within this collaborative agreement. Leverage Binational Expertise and Resources EPA and the BHC will leverage their existing resources to facilitate binational knowledge exchange on environmental and public health issues, through existing binational mechanisms and fora. Specific goals include: Task Forces and COBINAS: EPA and the BHC will identify opportunities to share information and identify and address regional concerns and priorities, taking into account input from the Border 2020 task forces, local stakeholders, and the binational health councils (COBINAS). Page 4 of 5 September 15, 2015 Final ------- U.S.-Mexico Border Health Activities of Mutual Interest: EPA and the BHC will partner during activities of mutual interest, such as seminars, conferences, workshops, trainings, etc., to share scientific information and findings and explore linkages between the environment and health impacts, such as asthma, cancer, obesity, diabetes, and others. Develop Public Access to Environmental and Public Health Data Public access to environmental and public health data empowers the public by helping them to understand the magnitude and health effects of pollutants in the environment and highlights disproportionate environmental and health impacts where they exist. The access to this information also helps community leaders and decision-makers to recognize and work to address and reduce these disparities. Specific goals include: EPA and BHC will work towards compiling existing border environmental health information from credible sources (such as local and state health statistics from public health authorities) to better document environmental health conditions along the U.S.-Mexico border in order to identify vulnerable communities, and target collaborative interventions. The agencies will share epidemiological/surveillance and indicator data for agreed-upon priorities (i.e., water, air quality, and public health). Page 5 of 5 September 15, 2015 Final ------- |