and 1995. Also, the average number of annual person trips per household by the use of mass transit systems dropped from 2.6 percent in the 1970s to about 1.8 percent in 1995. Since then it has stayed relatively constant that the main mode of transportation is by car (DOT, FHWA, 1999).

Although the incidence of Type II diabetes among adults over the age of 40 years is increasing at an alarming rate, the gravest concern at the National Institute of Child Health and Human Development is the trend of an increasing incidence of Type II diabetes among children. This increase accounts for the rapidly expanding research and development efforts by the pharmaceutical industry into potential tools for the management of Type II diabetes. Although evidence clearly indicates that fat cells play a role in moderating the insulin response and insulin sensitivity, evidence also indicates that some of the factors that occur during the course of pregnancy play a role as well, noted Mattison.

In 2002, as a response to public health data indicating that prematurity is the one area in maternal and child health that has worsened, the Roundtable conducted a workshop on the role of environmental factors in premature birth (IOM, 2003). Although the incidence of prematurity has increased over the years, the incidences of all other health conditions of concern in maternal and child health, such as maternal mortality, infant mortality, and birth defects, have improved. The problem with prematurity is not only that a child is born before he or she has reached full term and needs special care, but also that the complications or impacts of prematurity, personal as well as familial and societal, are lifelong. The Roundtable activities revealed interesting, emergent themes around prematurity that suggest that gene–environment interactions and social factors affect prematurity.

The definition of environmental health has evolved with research; therefore, the goals of environmental health should be to establish and maintain a healthy environment, to promote an environment that improves well-being both in function and in structure, and to allow the environment to be sustainable, concluded Mattison.

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