particularly environmental health. Despite this support, there is little doubt that in this country the science issues in environmental health and the functions of our environmental regulatory system are extremely adversarial. Too often we are fighting with each other rather than searching for solutions to problems.

Those in the profession of environmental health are very much a part of the problem. All too often we are not engaged in the real issues in environmental health—such as land and energy use, transportation, and consumption. Rather, we tend to focus narrowly on specific issues—for example, the question of which oxygenate should be present in fuel—rather than on the question of how to reduce pollution from our transportation system and energy use. So although we are focused on the details of how to ensure environmental health, we have lost sight of the big picture.

There are some positive signs of change in federal agencies, such as the environmental justice initiatives, urban health centers, and children’s health centers at the National Institute of Environmental Health Sciences. In addition, the Centers for Disease Control and Prevention and the Healthy People 2010 plan define objectives for environmental health protection using public health goals that can be tracked. However, these efforts do not go far enough. During the last decade, despite a near doubling in the size of the National Institutes of Health budget, there has not been a comparable increase in the investment in public and environmental health, particularly in the area of prevention.

One of the great challenges facing environmental health is population growth. According to the recent National Research Council (1999) report, Our Common Journey: A Transition Toward Sustainability, we need to begin today and have only two generations in which to complete action in order to cope with the changes associated with the enormous success that we have had as a species on this planet. While we have a strong infrastructure for building a global economy, we do not have the necessary infrastructure for managing the environmental impacts of that economy. This workshop aims to address the connections between human health and the natural environment.

Another issue is the relationship between human health and the built environment; this is where the discussions must focus on acting locally. Most of the things that need to be done to address environmental issues, even global problems, have to be done at a local level. We need to understand the environmental consequences of how we build our homes, buildings, and cities.

The social environment and its impact on human health also deserve consideration. Because it is our species that is shaping the evolution of the planet, the major problems that face us frequently involve human behavior. Thus, we must find better ways of educating the population about consumption and resource use. We need to recognize the broad range of people who are involved in environmental health, especially the general public and communities at all levels.

We have only two generations in which to act. This means that we and the next generation will shoulder much of the responsibility for solving the problems that we have both inherited and created. We need nothing less than a new vision of environmental health for the 21st century.

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