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1 INTRODUCTION It has been 20 years since the 1992 Earth Summit in Rio de Janeiro when world leaders gathered to reaffirm the Declaration of the United Nations Conference on the Human Environment that was adopted in Stockholm on June 16, 1972. The summit built on this effort with the “goal of establishing a new and equitable global partnership through the creation of new levels of cooperation among states, key sectors of societies and people, working towards international agreements that respect the interests of all and protect the integrity of the global environmental and developmental system, and recognizing the integral and interdependent nature of the Earth” (UN, 1992). From this meeting, the member states adopted Agenda 21, an unprecedented framework for the transition to a more sustainable world. Ten years later, the Johannesburg World Summit on Sustainable Development provided an opportunity for identification and adoption of concrete steps and targets to implement aspects of Agenda 21. As world leaders prepared to gather again in 2012 in Rio de Janeiro, to assess and reaffirm the importance of the world’s progress toward these efforts, the Institute of Medicine’s Roundtable on Environmental Health Sciences, Research, and Medicine held a workshop to inform the policies that would be discussed at the conference. The Roundtable was established in 1998 and provides a structured opportunity for regular and open communication among interested experts from a variety of government, academic, industry, and consumer groups in a neutral setting. Through meetings and workshops, the Roundtable facilitates discussion of current and emerging issues in environmental health sciences and decision making, identification of vulnerable populations to environmental hazards, and translation of environmental health research into public health practice. The Roundtable defines the environment broadly—one that incorporates the natural, the built, and the social environments—and considers how 1

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2 PUBLIC HEALTH LINKAGES WITH SUSTAINABILITY changes in our environment can impact human health through direct and indirect pathways (IOM, 2006). The Roundtable sponsored a workshop in Woods Hole, Massachusetts, on July 25-26, 2011, to consider the issue of sustainability and health. The term “sustainability” comes from the concept of sustainable development, defined in 1987 by the World Commission on Environment and Development (commonly known as the Brundtland Commission) as “development which meets the needs of the present without compromising the ability of future generations to meet their own needs” (WCED, 1987). Sustainability is built on three pillars—economic, social, and environmental—with health subsumed under the social pillar, though it can be argued that health is a cross- cutting theme or outcome of sustainability (UN, 2012). In an effort to move the topic forward within higher-level policy discussions, the workshop gathered speakers and participants to provide varied perspectives on the connections between human health and sustainability. The presentations covered alternative frameworks of sustainability in which health and public health are more centrally considered across the spectrum of sustainability policies and decisions. In particular, the workshop emphasized the intersections between sustainability and toxicology, noncommunicable diseases, energy options and air quality, food and water resources, occupational and childhood health, and the role of climate change and urbanization across these topic areas. The workshop was organized by an independent planning committee, whose role was limited to planning the workshop, in accordance with the procedures of the National Research Council (NRC). This summary was prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. All views presented in the summary are those of the workshop participants. The summary does not contain any findings or recommendations by the planning committee or the Roundtable. The statement of task of the workshop was as follows: An ad hoc committee will plan and conduct a public workshop on linkages between sustainability and public health. The workshop will feature invited presentations and discussions to look at the state of the science of the intersection of public health and sustainability. In addition, the workshop will focus on when sustainability and public health do not overlap (i.e., when being green

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INTRODUCTION 3 is not healthy), the health messages in this area, and the impact for the global community. Further, the Roundtable and its discussants will explore the impli- cations of this intersection for the upcoming Rio+20 meeting. The committee will develop the workshop agenda, select invited speakers and discussants, and moderate the discussions. A workshop summary will be prepared by a designated rapporteur in accordance with NRC policies and procedures. The presentations and discussions that occurred during the workshop are summarized in the subsequent chapters. Chapter 2 provides an overview of the conceptual issues and frameworks for sustainability and health, and the role that climate change plays in these discussions. Chapter 3 explores connections between energy options, air quality, and human health with additional ties to climate change mitigation. Chapter 4 considers the linkages between sustainability and food and water resources. Chapter 5 follows with further links between sustainability and occupational and childhood health. Chapter 6 presents a new framing for sustainability from a U.S. perspective. Chapter 7 concludes with health messages and strategies for dissemination. The workshop agenda can be found in Appendix A and the workshop speaker biosketches are included in Appendix B. REFERENCES IOM (Institute of Medicine). 2006. Rebuilding the unity of health and the environment in rural America. Washington, DC: The National Academies Press. UN (United Nations). 1992. Report of the United Nations conference on environment and development, Rio de Janeiro, Brazil, 3-14 June 1992. A/CONF.151/26. New York: United Nations. UN. 2012. Report of the United Nations conference on sustainable development. Rio de Janeiro, Brazil, 20-22 June 2012. A/CONF.216/16. New York: United Nations. WCED (World Commission on Environment and Development). 1987. Our common future. Edited by G. H. Brundtland. Oxford: Oxford University Press.

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