their rates have led many people to look at the role of the environment in determining health status.

What we know now is that too often there is little information on exposure with which to understand causal effects between the complexity of our environment and the reported increase of various diseases. In Fallon, Nevada, the drinking water contains 100 parts per billion of arsenic—10 times the recommended level proposed by the previous administration. Further, because of agricultural activity, pesticides are on the ground as well as aerially applied. At the Congressional hearing, it became evident that in order to understand these linkages, we will require more information about environmental factors, their effects on the population, and resulting health outcomes. Similarly in Long Island, researchers do not have the answer as to why breast cancer is higher than the national average. One can look at what is unique to the environment. Long Island was an agricultural center and still produces more agricultural dollars than any place in New York. It also was the center of war-time industry, resulting in heavy metal and chemical usage. Further, an aquifer that runs the length of the island has been contaminated for decades by pesticide runoff and, more recently, by fuel additives, such as methyl tertiary-butyl ether (MTBE). These are a few of the questions that members of the public have in their minds about the possible causal effects of breast cancer in this region.

What we know now is that too often there is little information on exposure with which to understand causal effects between the complexity of our environment and the reported increase or various diseases.

-Hon. Hillary Clinton

What we must do is establish a nationwide network to track chronic diseases, environmental exposures, and other risk factors. This will allow researchers and health officials to identify the causes of chronic diseases and, ultimately, develop strategies to prevent these diseases in the future. Through investigation of incidences in Fallon and Long Island, we discovered that most states are well equipped to track infectious diseases but are not able to track chronic diseases. We will have to provide states with environmental health tracking grants so that they are able to develop the infrastructure they need to participate in the nationwide network. As part of the Nationwide Health Tracking Network Act (U.S. Senate, 2002), we will have to create a national environmental health rapid-response service to develop and implement strategies for coordinated rapid responses to public health and environmental concerns. There will



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