Noting that children may be affected by environmental contaminants in ways quite different from the way adults are affected, this report is the second on trends in measures reflecting environmental factors that may affect the U.S. children's health and well-being. A list of measures and key findings begins the report, followed by five main sections. Several measures throughout the report are analyzed by children's race/ethnicity and family income. Section 1 presents measures showing incidence of exposure to critical concentrations of contaminants in outdoor air, indoor air, water, food, and soil. Section 2 presents measures of lead, mercury, and cotinine (marker of environmental tobacco smoke exposure) measured in the bodies of children and women. Section 3 presents trends in asthma, other severe respiratory illnesses, childhood cancers, and neurodevelopmental disorders such as attention deficit/ hyperactivity disorder and mental retardation. Section 4 concerns the emerging issues of mercury in fish and attention deficit/hyperactivity disorder. Section 5 presents data specific to California and Minnesota. The final section of the report discusses improvements in the measures and data sources and new measures for inclusion in future reports. Major findings presented in the report include declines throughout the 1990s in the percentage of days with unhealthy air quality, median blood lead levels for children under 5, and median blood levels of cotinine; and overall increases in the percentage of children with asthma. The frequency of new childhood cancer cases has been stable since 1990. Recent data indicate that .6 percent of children are diagnosed with mental retardation and 6.7 percent of children are diagnosed with attention deficit/ hyperactivity disorder. State data revealed that 32 percent of California public elementary schools have deterioration of lead-based paint, and 47 percent of Minnesota schools sprayed pesticides in classrooms. A glossary of terms completes the report. Four appendices include data tables and a list of environmental health objectives in the Energy Protection Agency's strategic plan. Each report section contains references. (KB).

This EPA report marks the progress the U.S. has made as a nation to reduce environmental risks faced by children. It contains good news including the continued decline in children's exposure to secondhand smoke, & decreases in exposures to air pollution & contaminants in drinking water. But asthma rates are increasing, too many children continue to have elevated blood lead levels, the potential for mercury exposure in the womb is of growing concern, & there is a disproportionate impact of childhood diseases on low-income & minority children. Also includes Glossary of Terms; Data Tables; Data & Methods; Environmental Health Objectives in Healthy People 2010; & Environmental Health Objectives in EPA's Strategic Plan.

"America's Children and the Environment (ACE)" is EPA's report presenting data on children's environmental health. ACE brings together information from a variety of sources to provide national indicators in the following areas: Environments and Contaminants, Biomonitoring, and Health. Environments and Contaminants indicators describe conditions in the environment, such as levels of air pollution. Biomonitoring indicators include contaminants measured in the bodies of children and women of child-bearing age, such as children's blood lead levels. Health indicators report the rates at which selected health outcomes occur among U.S. children, such as the annual percentage of children who currently have asthma. Accompanying each indicator is text discussing the relevance of the issue to children's environmental health and describing the data used in preparing the indicator. Wherever possible, the indicators are based on data sources that are updated in a consistent manner, so that indicator values may be compared over time.

The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.

Though overall cancer incidence and mortality have continued to decline in recent years, cancer continues to devastate the lives of far too many Americans. In 2009 alone, 1.5 million American men, women, and children were diagnosed with cancer, and 562,000 died from the disease. There is a growing body of evidence linking environmental exposures to cancer. The Pres. Cancer Panel dedicated its 2008¿2009 activities to examining the impact of environmental factors on cancer risk. The Panel considered industrial, occupational, and agricultural exposures as well as exposures related to medical practice, military activities, modern lifestyles, and natural sources. This report presents the Panel¿s recommend. to mitigate or eliminate these barriers. Illus.