Office of Research and Development
Office of Science Advisor, Policy and Engagement
Public Health and Health
Care Partner Workshop
SUMMARY REPORT
SUMMER 2020
&EPA
United States
Environmental
Protection Agency
EPA620/S-21/001 | June 2021 | www.epa.gov/research

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SEPA
EPA 620/S-21/001 | June 2021 | www.epa.mv/research
United States
Environmental Protection
Agency
Public Health and Health
Care Partner Workshop
Summary Report
Summer 2020

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The Workshop Team
U.S. EPA Office of Research and Development
Christina Baghdikian
Wayne Cascio
Anna Champlin
Megan Christian
Kacee Deener
Helena (Helenka) Harmon, ORAU Student Services Contractor
Brie Reed, ASPPH Fellow
Bailey Stearns
Sarah Taft
Salina Tesfay, ORAU Student Services Contractor
Kelly Widener
Jose Zambrana

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Table of Contents
Authors	ii
List ofTables	iv
List of Figures	iv
Executive Summary	v
Disclaimer 	v
Introduction	1
Workshop Approach	3
Discussion	5
Break-Out Session One	5
Break-Out Session Two	6
Conclusions and Next Steps	7
References	9
Appendix A — Master Mind Map Primary Nodes	A-l

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List of Tables
Table 1. Questions used to guide discussion during break-out session one, which focused on the mind map	5
Table 2. Questions used to guide discussion during break-out session two, which focused on collaboration opportunities	5
List of Figures
Figure 1. Sectors of individuals and organizations represented in the public health and health care professional partner
meeting	1
Figure 2. Master Mind Map	3
Figure 3- Master Mind Map key	3
Figure 4. Primary Node — Climate Change	A-l
Figure 5- Primary Node — Built Environment	A-2
Figure 6. Primary Node - Natural Environment	A-2
Figure 7- Primary Node — Occupational Environment	A-3
Figure 8. Primary Node — Research, Data, & Implementation	A-4
Figure 9- Primary Node — Environmental Justice and Equity	A-5

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Executive Summary
From August 31 — September 2, 2020, the U.S.
Environmental Protection Agency's Office of Research
and Development (EPA-ORD) held a virtual workshop
with public health, health care, and health care system
practitioners to discuss environmental health priorities within
their fields and with their organizational members and to
build relationships for future dialogue and collaboration on
specific topics. Using a mind mapping exercise, workshop
participants identified six environmental areas of concern:
built environment; climate change; environmental justice
and equity; natural environment; occupational environment;
and research, data, and implementation. Conversations
during the workshop around the mind mapping results led
to a greater understanding of how environmental health
concerns are intensified during public health crises (such
as the COVID-19 pandemic) and existing cross-cutting
environmental health issues that impact each area of concern
[which include lead (Pb), environmental justice and equity,
children's health, mental health, and community design].
Opportunities were also identified for cross-sector and cross-
disciplinary communication, engagement, and collaboration
(such as establishing partnerships in non-emergency times
to help weather public health crises, training and workforce
development, information sharing, and communication and
risk communication). The information from this workshop
can help EPA-ORD and its partners better understand
mutual areas of interest and identify opportunities for more
targeted cross-disciplinary discussions around the specific
environmental health topics of mutual concern.
Disclaimer
This document reflects the proceedings of the Public Health
and Health Care Partner Workshop, including mind mapping
results, the discussions consequent to those mind mapping
results, and summaries of the individual breakout groups.
Statements included in this document reflect discussions
among participants in the workshop and should not be
interpreted as official views of the U.S. Environmental
Protection Agency.
v

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Introduction
Hie environment provides us many life-sustaining services
including the air we breathe, the water we drink, shelter, and
sustenance. However, there is an existing and growing body
of scientific evidence that associates environmental stressors
to adverse health impacts. As examples, stressors may include
pesticides, poly- and perfiuorinated compounds, wildland fire
smoke, air pollution, and contaminants in drinking water.
Addressing these environmental stressors and protecting
against health concerns requires expertise from many sectors
and disciplines. For example, public health professionals
identify and assess the extent of exposure to such stressors and
attendant health impacts at a population-level. Health care
professionals treat the resultant clinical disease or recommend
preventive measures or treatments for their patients. Mental
health professionals, social workers, and others also play
important supportive and interventional roles in addressing
environmental health concerns.
Health care and public health professionals are often on the
front lines of discovering and addressing these environmental
health concerns. Health care providers, health care system
leaders, and clinical case managers address clinical diseases
at the individual level, while public health practitioners are
concerned with community and population health. Cross-
disciplinary dialogue can foster improved understanding of
mutual areas of concern and potential action between the
healthcare and public health professional communities.
As a case example, particulate matter (PM) is a ubiquitous
environmental pollutant recognized as a major risk factor for
adverse clinical health outcomes. The U.S. Environmental
Protection Agency's (EPA) Office of Research and
Development (ORD) and the broader scientific community
have conducted research on the health effects of PM,
specifically fine particulate matter (PM2.5; particles with
an aerodynamic diameter less than or equal to 2.5 [im), and
provided and evaluated a vast body of scientific evidence
that, when taken in its totality, yields a conclusion that both
short-term and long-term exposure to particulate increases
the risk of adverse cardiopulmonary health outcomes (U.S.
EPA, 2019). The scientific evidence of how inhaled PM
can impact human health has informed development of
regulatory actions such as the National Ambient Air Quality
Standards (NAAQS) for particulate matter (U.S. EPAa,
2021). Implementation of this regulation has a population-
level impact on public health. In parallel with these policies,
health care providers, have unique opportunities to support
the health of their patients with respect to air pollution
exposures. To raise awareness about the connection between
air quality and health with health care professionals, and
to provide resources to help these providers share this
information with their patients, EPA's Office of Air and
Radiation (OAR) and ORD, and the Centers for Disease
Control and Prevention (CDC) developed two web courses
that have been certified for continuing education for health
care professionals: "Particle Pollution and Your Patients'
Health" (U.S. EPA, 2020) and "Wildfire Smoke and Your
Patients' Health" (U.S. EPAb, 2021). Additionally, through
cross-disciplinary engagements on this topic, the Million
Hearts® initiative jointly led by CDC and the Centers for
Medicare and Medicaid Services (CMS) has incorporated
messaging on PM into their program, which identifies
"avoiding exposure to particulate matter" as recommended
advice for patients and their caregivers who have had a heart
attack or stroke (Centers for Disease Control and Prevention,
2021).
Based on the success of the cross-disciplinary dialogues
around PM, in Summer 2020, EPA-ORD convened a
meeting with partners from public health, health care,
and health care systems to identify environmental health
concerns of mutual interest and build relationships for
future dialogue and collaboration on specific topics. Figure
1 identifies the range of sectors or organization types
represented during the meeting, that was held virtually due
Figure 1: Types of Participants
¦	Medical Professional ¦Academia ¦ Public Health Association
¦	Health Care Association ¦ Federal ¦ State
Figure 1. Sectors of individuals and organizations represented in
the public health and health care professional partner meeting.
1

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to the COVID-19 pandemic. The purpose of the workshop
was to share examples of how the public health community
has worked with health care professionals and/or health care
systems experts on environmental health issues of mutual
interest; provide a platform for participants to identify and
discuss current issues of mutual interest; and brainstorm
innovative and cross-disciplinary ideas for potential future
collaboration.
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Workshop Approach
Mind mapping was chosen as the approach used to identify
partners' environmental health topics and issues of concern,
build a common language across participants, and foster a
focused discussion before and during the workshop. Mind
mapping is a tool that is used to visually organize information
in a hierarchical manner using nodes and branches to
illustrate relationships between different topics (Crowe and
Sheppard, 2012). It is important to note that the mind map
exercise was not done in a way to prioritize one area over
another or to distinguish organizational or funding priorities
versus local priorities. Additionally, the mind map does not
illustrate the strength of cross-cutting themes.
Each participant was asked to create their own mind
map centered around "Environmental Health Topics of
Concern." To ensure a robust representation of perspectives,
participants were asked to work with colleagues from their
own organizations to brainstorm or collect feedback on their
mind map. Individual mind maps were then collected, and
organized into a "Master Mind Map" that was synthesized
using the following systematic process:
1.Each	"primary node" (or central theme) from individual
mind maps was identified and recorded.
2.	Nodes (or themes) with exact or similar language were
grouped
3.	These resulting groups were then evaluated and
consolidated under the primary nodes in the Master Mind
Map.
4.	These node (or theme) groups became secondary (or
tertiary, quarternary) nodes under the primary nodes.
Figu re 2 provides the Master Mind Map developed for
the meeting. It displays six primary nodes, denoting
Environmental
Health Concerns
Figure 2. Master Mind Map
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environmental health areas of concern: 1) built environment;
2) climate change; 3) environmental justice and equity; 4)
natural environment; 5) occupational environment; and 6)
research, data, and implementation. See Appendix A for a
closer look at each primary node. To facilitate discussion at
the workshop participants received this Master Mind Map
prior to the meeting.
The virtual workshop spanned three days with two-hour
sessions each day. The first day included an orientation to
the workshop goals, a case example presentation of particle
pollution (i.e., PM) as an environmental health issue, an
overview of the mind mapping process, and a presentation
describing the details of the master mind map that was
created for the workshop. The second and third days were
structured as focused break-out group discussions followed by
report-out sessions for all meeting participants.
Table 1 provides the discussion questions for break-out
session one. Table 2 provides the discussion questions for
break-out session two.
Table 1. Questions used to guide discussion during break-
out session one, which focused on the mind map.
Table 2. Questions used to guide discussion during
break-out session two, which focused on collaboration
opportunities.
Question 1
Question 2
Question 3
Question 4
Question 5
Question 6
You submitted your mind map in February
2020. Since then, would anything change on
the mind map that you submitted, and if so,
what?
Looking at the master mind map, identify
one element that makes the most sense to
you or that you think is a high priority.
Looking again at the master mind map,
identify one element that surprises you and
explain why.
Are there any elements missing from the
master mind map?
EPA staff identified a few topics that are in
our purview but that seem to be missing from
the master mind map. Do you think any of
these topics are important, and if so, where
might they fit on the master mind map?
Are there any other impressions from the
mind mapping exercise you would like to
share?
Question 1
One of the purposes of mind mapping is
to find areas of potential mutual interest.
Do you have examples from your own
experience and organization where you
have worked with professionals from other
disciplines to address an environmental
health concern? If so, what was the topic
and what made it successful (or not
successful)?
Question 2
What sources do you trust and go
to for help in understanding the
following environmental health topics:
emergencies, toxic chemicals, water
contamination, soil/land contamination,
air pollution, community environmental
health concerns, environmental justice,
children's health.
Question 3
In what forms is environmental health
information easiest to access and digest
(i.e. monthly emails, blogs, publications,
workshops or meetings, other)?
Question 4
What are possible ways to help the public
understand the connections between the
environment and public health?
Question 5
What topics are you/your organization
focused on right now?
Question 6
What outlets do you currently use to
engage with others around these topics?
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Discussion
This workshop was originally planned for March 2020 but
was postponed due to travel restrictions and health concerns
related to the COVID-19 pandemic. The mind mapping
exercise, which was conducted in February 2020 (prior to
the originally scheduled date of the workshop in March
2020), highlighted environmental health topics of concern at
that time for the public health and health care professionals
attending the workshop and served as the foundation for
discussion throughout the meeting. After the decision was
made to postpone the workshop, participants were not asked
to revise their mind maps with respect to the pandemic
and any issues that may have arisen in that time. Instead, it
was decided to include COVID-19 related issues into the
discussion during the workshop.
During the first break-out discussion, workshop participants
reviewed and discussed the master mind map, guided by the
questions in Table 1.
Break-Out Session One
Following is a high-level summary of each primary node and
major discussion points during break-out session one.
COVID-19: Participants discussed how the pandemic did not
lessen the importance of the environmental health priorities
they had identified. Rather, they noted that reacting to the
pandemic further elevated the prominence of environmental
exposures and environmental health concerns. Participants
discussed the growing importance of health equity issues
in light of the pandemic and other environmental topics
that have become more important as a result of the
pandemic, such as the indoor environment (indoor air
quality, environmental exposures in the home), community
design, and access to green space. However, the pandemic
also brought to light additional environmental health
considerations that were not previously included in the mind
map. Such environmental health topics include the need
for robust public health surveillance systems to identify future
pandemics, the importance of cleaning/disinfection practices
and guidance for the workforce (including essential workers
and those inspecting or visiting outside worksites), buildings,
schools, and daycares. Environmental guidance for building
reopening (for example, guidance for HVAC system cleaning
and flushing stagnant water pipes) was also highlighted as a
unique environmental health need.
Climate Change: Participants discussed the special challenges
facing communities and populations dealing with the physical
effects of climate change, such as flooding, sea level rise,
drought, and/or thawing permafrost. Participants also noted
that the impacts of climate change may be disproportionately
experienced by minority and low-income communities or
populations with existing environmental justice concerns.
Participants noted that some health care professionals do not
view climate change as a health issue; however, this could
be addressed by the incorporation of environmental health
modules into health care-related degree programs, post-
graduate residency training, and continuing education, and
maintenance of certification programs.
Built Environment: The conversation centered on
community design and green space, noise pollution, the
indoor environment, and infrastructure. Home and business
disinfection practices were also discussed, especially in the
context of COVID-19. Some participants noted that the
built environment — especially the indoor environment — has
become even more important during a global pandemic where
many individuals are working from home and spending more
hours per day inside their house.
Natural Environment: The discussion of this primary node
covered vector control surveillance, emerging pathogens, and
environmental policy and regulation to protect air, water,
and land quality. Food and nutrition, food security and food
safety also emerged as themes on the mind map and during
discussion.
Occupational Environment: Discussion under this primary
node focused on workplace exposures to dust, chemicals, and
other pollutants, personal protective equipment, work-life
balance, and mental and physical stressors in the workplace.
Preparing workers for potential or unanticipated exposures
when visiting or inspecting outside organizational spaces (and
therefore beyond their control) was another area of interest,
such as when food inspectors visit various restaurants and
the exposures at each location may vary. Participants also
discussed the importance of occupational data and electronic
health records for informing epidemiology and understanding
of disease. Finally, participants noted that health protection
should be a primary consideration in occupational policy
development.
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Research, Data, and Implementation: Participants
discussed the importance of data collection consistency and
transparency and data accessibility (providing data in an
organized way) to inform exposure and disease surveillance.
Development of the environmental health workforce was
discussed, and participants noted the need to train health care
professionals on environmental health topics.
Environmental Justice and Equity: Environmental justice
and equity was a thread that ran throughout the break-out
group discussions across all topics. Participants highlighted
the need to address the environmental health concerns
of vulnerable and at-risk populations and discussed the
important role of social determinants of health. Participants
also discussed the distribution of environmental health
services, equitable housing, and environmental justice
considerations in environmental protection policies.
Cross-cutting Issues: The mind mapping exercise and
related discussions also led to the identification of cross-
cutting environmental issues, or issues that were related to,
or impacted by, other topics within the mind map. These
cross-cutting issues included lead (Pb), environmental
justice and equity, children's health, mental health, and
community design. Lead relates to many environmental
media (air, water, soil) and exposures can come from various
sources (e.g., drinking water, food, lead paint, dust, and
soil). Lead exposure is a concern for children's health and has
ties to community design and environmental justice issues.
Environmental justice cuts across all nodes of the mind map,
with participants noting special connections to climate change
impacts and the built and natural environment. Finally,
participants discussed community design as a cross-cutting
issue related to pollutant exposure, environmental equity,
climate change, and the indoor environment.
Break-Out Session Two
Discussion during the second break-out session focused
on opportunities for cross-sector and cross-disciplinary
communication, engagement, and collaboration. Several
themes emerged during these discussions.
COVID-19: Participants discussed the current global
pandemic within the context of fostering cross-sector and
cross-disciplinary interactions by necessity that otherwise
might not have occurred. Participants noted benefits of
proactively pursuing cross-sector and cross-disciplinary
collaborations in non-emergency times so those trusted
relationships already exist when public health emergencies
arise. Participants also noted the importance of expanding
professional networks to include individuals from other
disciplines. It was noted that the COVID-19 pandemic
created an opportunity for these cross-sector/disciplinary
collaborations, and they should be fostered and strengthened.
Training and Workforce Development: The theme of
workforce development and training was a thread throughout
the break-out sessions. Participants discussed the need
for continued investment in the public health workforce,
and the need for training was identified as a priority by all
participants. The health care providers at the meeting noted
that environmental health is not frequently a focus in health
care training programs, and participants identified this as
an opportunity. Participants also noted the importance of
workforce investment and development considering the
COVID-19 pandemic.
Information Sharing: Participants discussed trusted sources
of environmental health information and noted the reliance
on the published peer-reviewed scientific literature as a
primary source of information. Participants also noted that
workshops, professional meetings, blogs, and newsletters were
platforms that foster information sharing and dialogue. An
underlying theme was the importance of seeking sources of
information that are scientifically rigorous and unbiased.
Communication and Risk Communication:
Communication and risk communication were strong
themes throughout the second break-out session focused on
collaboration opportunities. Participants noted that cross-
disciplinary efforts can strengthen risk communication
messaging to the public. It was noted that scientifically
rigorous information must be communicated in an unbiased
manner and may often need to be communicated to
populations with varying levels of expertise. Participants
noted the importance of providing health information in
various formats (written, verbal, graphic) to address the
differing preferences of recipients of the information. Overall,
collaboration across disciplines on communication and
risk communication was identified as an opportunity. For
example, clinicians participating in the workshop noted the
need for plain language summaries of environmental health
topics that they could share with patients and caregivers.
They noted that a resource library of environmental health
topics relevant to patient concerns could be helpful. Other
participants noted the importance of consistent messaging
across different sectors' disciplines, further highlighting a need
for cross-sector/disciplinary collaboration.
6

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Conclusions and Next Steps
EPA-ORD convened this workshop to better understand
the environmental health priorities of various public health
and health care professionals and to inform approaches to
coordinate with these partners as prevention (public health)
and treatment (healthcare professionals) all play a role in
protecting and improving our nation's environmental health.
The mind mapping approach and subsequent workshop
provided a visual and interactive way to identify and discuss
mutual environmental health issues of concern across
disciplines and explore collaboration opportunities around
these common areas. Major themes that emerged were:
•	There are multiple environmental health topics that are
common priorities for public health practitioners, health
care professionals, and public health agencies. Cross-sector/
disciplinary network building and dialogue should be
fostered over time and not emerge only during times of
public health crisis.
•	The emergence of a global pandemic did not diminish the
environmental health priorities of the participants. Rather,
the importance of these environmental health priority areas
was illuminated and strengthened because of the pandemic.
•	Communication and risk communication are themes that
cut across the entire workshop. There may be opportunities
to convene topic-specific cross-sector/disciplinary dialogue
around the idea of communicating risk on specific issues.
•	Actionable information is an important resource. Federal
agencies with an environmental health mandate may be
well-positioned to play an important role in developing and
sharing this information with public health and health care
professional partners.
While the workshop had to be rescheduled due to the
pandemic, it became a critical discussion point about lessons
learned and areas of opportunity illuminated by the pandemic
for closer collaboration in the future. The information from
this workshop can help EPA-ORD inform research plans
and outreach strategies and may lead to further, more refined
cross-disciplinary and cross-organization discussions, research,
and action around the specific environmental health topics of
mutual concern.
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References
Centers for Disease Control and Prevention. (2021). Million Hearts [Website], https://millionhearts.hhs.gov/.
Crowe, M; Sheppard, L. (2012). Mind mapping research methods. Qual Quant 46: 1493—1504. https://doi.org/10.1007/
si 1135-011-9463-8.
U.S. EPA (U.S. Environmental Protection Agency). (2019). Integrated Science Assessment (ISA) for Particulate Matter [EPA
Report]. (EPA/600/R-19/188). https://cfpub.epa.gov/ncea/is a/recordisplay.cfm?deid=347534#tab-3.
U.S. EPA (U.S. Environmental Protection Agency). (2020). Particle Pollution and Your Patients' Health [Website], https://
www.epa.gov/particle-pollution-and-your-patients-health/course-outlinekey-points.
U.S. EPA (U.S. Environmental Protection Agency). (2021). Particulate Matter (PM) Air Quality Standards [Website].
https://www.epa.gov/naaqs/particulate-matter-pm-air-quality-standards.
U.S. EPA (U.S. Environmental Protection Agency). (2021). Wildfire Smoke and Your Patients' Health [Website]. https://www.
epa.gov/wildfire-smoke-course.
9

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Appendix A - Master Mind Map
Primary Nodes
Exhaustion
Heat Stroke
Elderly
Susceptible
Populations -
03 Pollution
Vectors
Mold
Disease
HeatWaves/UV 0
Flood/
Storm Events ©
Drought
Frequency
Climate
Refugees
Wildfires©
Extreme Weather
Wildfire
Smoke
Marine
Biotoxins
Pollen
Effects of
Repeated
Exposure
Cumulative
Impacts
Season
Health
Vector Borne/
Infectious Disease
Sea Leve
Climate
Communication
Patients
Climate Change
Health Impacts
Distrust of
Science
Interventions
Summer
Exercise
Disaster
Preparedness
Sustainable
Food System
Agricultural
Practices
Weatherization
Health Sector
Resilience
Irrigation
Emissions
Interdisciplinary
Partnership
Research
Environmental Determinants
of Child Health Disparities
LHD
Collaboration
Fossi Fue
Government
Policy	Subsidies
Consider
Education
Distributed Energy
Generation
on Issues
Force of
Health
Change
Impacts
Urban
Renewable
Transportation
Carbon
Pricing
Investment
Transition
Sustainable Healthy
& Inclusive Housing
Geothermal
Economy Job/Training
Figure 4. Primary Node - Climate Change
A-l

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Physical
Mental
Food Desert
Community
Design
Recreationa
Ecosystems
Safe Distance	Monitor
Housing, Schools Health Risk
Reflective
Green Spaces
Active
Near-Road
Pollution
Porous
Accessible
Pub ic
Pavement
Smart
Multimodal
Infrastructure
Transit
Transportation ©
Surfaces
Outdoor
Affordable
vehicular &
Pedestrian Safety
Road Signs
Childcare ©
Asbestos
Mold
Schoo s
Superfund
Healthy
Housing
Waste
Management
Lead
Prevention
vu nerab e
Environmentally
Damaging
Consumer Products
Quality
Populations
Unsafe
Disposal
Policy, Regulation,
& Enforcement
Involve LHDs
Affordability
Availability
Figure 5. Primary Node - Built Environment
(Re)Emerging
Pathogens
LHD Input
-— /
Lakes Standard Pool
Beaches Code (MAHC)
Swimmer
Health
Recreational
Water
Legionella
Outbreak
Sanitation Public Drinking
Environmental
Primary fg \ Mitigation
Prevention \ , r . . ,
Environmental
.... Detection
\
Epidemiolog
Surveillance ^	_
Prevention A
LHD Preparation
Disease
Clustering
;mergency
'reparation
\
Affordability

Chemical
Pollutants
Particulate
Pollutants
Allergies
Outdoor
Support
Seasonal Staff
Radon
Indoor
Sustainable
^ Programs
Lanopy
Biomonitoring Q
Carcinogens
Obesogens
Endocrine Disruptors
Consumer Products
Industrial Byproducts
Extrapolation
Toxicology
Research
HD Training
Emerging Trends
Laboratory
Infrastructure
Microplastics
PFAS
Unknown Hazards
Forever Chemicals
hjv/.r /
Inspection
Environmental
Fate & Degradation
Standard Retail
Framework
(FDA Food Code)
Agricultural
Practices
Trasnport
Food Security
/
Affordability
Exposure Pathway
Modeling
Biological
Agricultural
Exposure
-Xposuie
Clinical Testing
Clinical Diagnosis
Follow-up & Registry
Drug Therapy
Organ Systems Affected
Comorbid Disease
Prevention/Screening
Figure 6. Primary Node - Natural Environment
A-2

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Injuries
HRI -
Safety
^Undocumented
Workers
Crop
Workers
Policy/Regulation/
Enforcement
Particulate
Matter
Nanoparticle Massive Pulmonary
Exposure Fibrosis
Whistle
Blowing
Extreme
Heat
Potential
Toxicants
Known
Toxicants
Dust Exposure Pesticides
Mental & Physical
Stressors
o
\
%
Mechanical
Risks
Noise
Exposure
\
%
Figure 7. Primary Node - Occupational Environment
A-3

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Useful
Interoperable
Timely
Birth Defect
Clusters
Risk
Communication
Evidence-
Based
Information
Technology
Data
Accessibility
Peer Reviewed
Articles
Accessible
Cancer
Clusters
Storytelling
/
Dissemination Q
Disease
Surveillance
Conferences
Thought
Leadership
Program
Evaluation
Evaluation &
Research 2
C
12
c
QJ
E
QJ
Q.
5
Resource
Sharing
Citizen
Science
ROI for
Locals
Internships/ Education
Mentorship
Credibility
Tracking
Network
Training
Attrition
Local
Workforce
EH Workforce
Development
REHS/RS
Credentials
ndustrial
Sites
Include
LHD
Chemical
Spill
PCP EH
Inquiries
Radiation/
Nuclear
Emerge
Prepare
Emergencies
Resilient EH
Prog rams
Community
Resilience
EH Strike
Teams
Schools
Best
Practices
Local Level
Capacity
Medical School
Curriculum (2)
Extreme
Weather
Workforce
Training
Figure 8. Primary Node - Research, Data, & Implementation
A -4

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Investment in
Remediating Hazards
in Marginalized Communities
Jim Crow
POC
Tribes/Territories
LGBTQ
Disabled
Pre-existing Conditions
Elderly ^
Children
Pregnant
Houseless
Rural
Undocumented
Refugee
Low Income ^
""Developmental
Sensitivity ^
Housing ^
Prevention
Inequity
NYT1619
Project
Intergenerational
History
Disparate
Exposure
Social
Capital
Financia
Social/Behavioral
Policy/Economics
Resources
Capital
Mental health
Voting
Advocacy
Sustainable, Inclusive
Urban Planning
"V
Basic
r
Drinking

Needs
Water
Structural
Racism
Gentrification
Labor -
Unions
Self
Determination
Action
Disenfranchisement
Consumer
Choice
Figure 9, Primary Node - Environmental Justice and Equity
A-5

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v>EPA
United States
Environmental Protection
Agency
PRESORTED STANDARD
POSTAGE & FEES PAID
EPA
PERMIT NO. G-35
Office of Research and Development (8101R)
Washington, DC 20460
Official Business
Penalty for Private Use
$300
Recycled/Recyclable Printed on paper that contains a minimum of
50% postoonsumer fiber content processed chlorine free

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