Prioritizing Children: Environmental Health Indicators for China
3.2 Application of the children’s environmental health indicators
Although analysis and visualization of the interactions among indicators is beyond the scope of this report, it is important to anticipate the
Stakeholders can use CEHIs to understand the
way that analytical frameworks can enable users
interactions among environmental exposures,
to understand the interactions among CEHIs, as
adverse health outcomes and contextual factors,
described by the Multiple Exposures Multiple
and thereby strengthen communities’ resilience
Effects model in Chapter 1 of this report. Figures
and responses to environmental hazards. Many of
6 and 7 demonstrate how analytical frameworks
these indicators make use of data at the provincial
can visualize the interactions among indicators
level. When data are available at a more granular
for two specific groups of health outcomes and
level, indicators can be assessed at the prefectural,
interpret data in scientifically defensible causal
county or township levels. However, for some
and attributional pathways. Regular evaluation
indicators, trends will be more important than
of children’s environmental health status using
spatial associations. In those instances, data can
CEHIs, reliable data and analytical frameworks
be assessed at the national level (e.g., percentage
will enhance our understanding of a country’s
of children’s products failing national standards).
challenges and its progress in addressing them.
Figure 6: Causal and attributional relationships among indicators for perinatal outcomes Contexts
• Poverty • Maternal education • Maternal malnutrition Exposures • • • • • •
Health outcomes
Climate: temperature Ambient air pollution Indoor air pollution Smoking environment Maternal heavy metals Maternal pesticide
• • • •
Causes Attributable to
• Congenital malformations • Low birth weight • Perinatal mortality • Preterm birth
Environmental health literacy Industrial pollution Hygiene city Garbage managemant Actions
Figure 6 simulates adverse perinatal outcomes with climate, air pollution, smoking and toxic exposures including heavy metals and pesticides. Exposures and outcomes are likely to vary by several important contexts including poverty. For example, high-income households will be much more likely to have access to clean fuels than lowincome households. Furthermore, actions by the Chinese government, including promotion of health literacy and enforcement of industrial pollution standards, are likely to affect these associations.
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