Eliminating health disparities through transdisciplinary research, cross-agency collaboration, and public participation.

Despite efforts to the contrary, disparities in health and health care persist in the United States. To solve this problem, federal agencies representing different disciplines and perspectives are collaborating on a variety of transdisciplinary research initiatives. The most recent of these initiatives was launched in 2006 when the Centers for Disease Control and Prevention's Office of Public Health Research and the Department of Health and Human Services' Office of Minority Health brought together federal partners representing a variety of disciplines to form the Federal Collaboration on Health Disparities Research (FCHDR). FCHDR collaborates with a wide variety of federal and nonfederal partners to support and disseminate research that aims to reduce or eliminate disparities in health and health care. Given the complexity involved in eliminating health disparities, there is a need for more transdisciplinary, collaborative research, and facilitating that research is FCHDR's mission.

Collaboration and importance of federally sponsored Superfund research programs.

Numerous studies have shown that the release of hazardous substances in the environment impact the environment and human health. Communities want to know if they have been exposed, if their health is affected, and how they can protect themselves. For environmental impacts the concerns include how best to clean up and manage the contamination, and protect the environment. The answers to these questions are complex and many times unknown. Three federal agencies conduct Superfund-related research to answer a wide range of questions from identifying contaminants of concern and health risks to determining effective cleanup and prevention strategies. This article discusses the research programs for the Agency for Toxic Substances and Disease Registry, U.S. Environmental Protection Agency (Office of Research and Development), and National Institute of Environmental Health Sciences (Superfund Basic Research Program). The three agencies collaborate on their research programs and research agenda setting activities. This introduction to Superfund-related research provides a foundation and context for the scientific articles in this special edition of the journal. Because of the magnitude of environmental and human health concerns, there is a critical need for additional research to address many challenging questions involving exposures, biological responses, and environmental technologies.

Population exposures to I-131 releases from Hanford Nuclear Reservation and preterm birth, infant mortality, and fetal deaths.

Communities surrounding the Hanford Nuclear Reservation in southeastern Washington were exposed to radionuclides, particularly iodine-131, released during the period 1945 to 1951. This study evaluated whether estimated iodine-131 exposures were risk factors for infant mortality, fetal death, and preterm birth in the years of highest releases, 1945 and 1946. Data on births, fetal deaths, and infant deaths, during the period 1940 to 1950, were abstracted from vital records for an eight county area surrounding the Hanford facility. The analysis included 56,320 births, 1,656 infant deaths, and 806 fetal deaths. The Hanford Environmental Dose Reconstruction project provided iodine-131 dose estimates for the 1,102 grid areas in the study area. The grid areas were collapsed into 4 exposure groups using estimated exposure to iodine-131 during 1945. Each birth and death record was assigned to one of the four grid groups based on mother's residence at the time of birth. Comparisons of preterm birth, infant death, and fetal death rates were made among the grid groupings for the primary exposure period (1945 to 1946) and for other years of the study period (i.e., 1940 to 1944 and 1947 to 1950). In the grid group with the highest estimated iodine-131 exposures, the mother's residence during the latter part of pregnancy was associated with preterm birth (OR = 1.74, 95% CI = 1.09-2.72). An association with infant mortality (OR = 1.26, 95% CI = 0.79-1.97) was suggested. No association was found for fetal deaths. This study found that iodine-131 exposure was associated with increased risk of preterm birth. This finding is biologically plausible because other studies have found that: (1) iodine-131 exposure can cause hypothyroidism, and (2) overt or subclinical hypothyroidism during pregnancy can increase a mother's risk of a preterm delivery.

Future directions of environmental public health research: ATSDR's 2002-2010 agenda for six priority focus areas.

Additional research on human exposures to hazardous substances in community settings and resultant adverse health effects is needed to fill an extensive number of information gaps. For example, information is needed to answer specific public health questions about the toxic effects of specific chemicals, who has been exposed, what the health risks might be, and what interventions are effective. The Agency for Toxic Substances and Disease Registry (ATSDR) is the principal federal agency responsible for addressing issues of public health concerning the human health risks associated with hazardous waste sites and unplanned releases of hazardous substances into the environment. Research is a critical component in how effectively the agency can identify persons exposed, determine health risks, and intervene to reduce exposures and adverse health outcomes. ATSDR has recently developed an agenda for public health environmental research for 2002-2010, divided into the following six research focus areas: exposure assessment; chemical mixtures; susceptible populations; community and tribal involvement; evaluation and surveillance of health effects; and health promotion and intervention. This article discusses the agenda's development, the research issues within each of the six focus areas, and preliminary implementation plans.