The mission of the U.S. Environmental Protection Agency (EPA) is to protect human health and the environment. Characterizing and anticipating complex inter-relationships between changes in societal behavior and changes in human health and the environment are significant scientific challenges. Human health cannot be well protected in unsafe environments, and the environment cannot be well protected in the face of detrimental human activities.
To accomplish its mission, EPA must be equipped, through the work of the Office of Research and Development (ORD), to produce and access the highest-quality and most advanced science. And it must do that in a way that can effectively anticipate and address a range of complex challenges that environmental protection faces in coming decades, while providing science to support the numerous statutory environmental protection mandates for which EPA is responsible.
This chapter begins by describing several major challenges facing ORD that warrant the use of advanced scientific tools and approaches. It then presents an advanced framework ORD could use for developing and producing the science needed to address complex challenges, applying systems thinking to a One Environment–One Health framework for research. The chapter also describes two important steps that ORD should take to advance the application of systems thinking: better integrating social and behavioral sciences into its efforts and reimagining the ORD strategic planning process to take a more inclusive and anticipatory approach. Chapter 4 discusses actions ORD can take to implement the recommended framework. Chapter 5 identifies specific kinds of tools and approaches that could be applied in conducting the science to address complex challenges.
The committee describes three of the largest challenges EPA is facing to illustrate the need for ORD to identify and apply advanced scientific tools and methods for meeting these complex challenges: (1) holistically addressing interconnected human health and ecological risks, (2) characterizing and addressing environmental justice and cumulative risk, and (3) anticipating and responding to the human health and environmental impacts of climate change. These challenges all represent “wicked problems” requiring multi-disciplinary scientific approaches and systems thinking. Such problems are often characterized by being difficult to define, unstable, and socially complex; having no clear solution or endpoint; and extending beyond the understanding of one discipline or the responsibility of one organization (NRC, 2012).
Holistically Assessing Human Health and Ecological Risks
Most human health issues under the purview of EPA arise from environmental exposures that at the same time can cause effects in wildlife and ecosystems. The cumulative impacts of human activities, including chemical, physical, and biological stressors, are resulting in ubiquitous threats to human health and in massive declines in biodiversity and planetary sustainability (e.g., Antonelli et al., 2020; IPCC, 2021; Persson et al., 2022; UNCBD, 2020; WEF, 2021; WWF, 2020, 2021). Anticipatory science helps to identify the unintended consequences of rapidly evolving technologies and to inform actions to prevent or mitigate the introduction of environmental hazards that may result in harmful exposures over the full life cycle of a product or process. For example, current use and legacy “forever chemicals,” such as per- and polyfluoroalkyl substances (PFAS) and polychlorinated biphenyls (PCBs), are widespread in the environment, with human and environmental exposures through food-chain air, soil, and water contamination (NASEM, 2022a). Similarly, mass production and use of plastics over several decades has led to their widespread
Many species serve as sentinels providing an advanced warning that humans may be at risk. For example, neonicotinoids, the most widely used insecticides today, are an emerging concern for human health, including agricultural workers, communities, and consumers. Although there is a paucity of human health studies on this topic, there is some evidence of adverse human health effects associated with exposure to this class of highly neurotoxic insecticide (Abou-Donia et al., 2008; Cimino et al., 2017; Seltenrich, 2017; Zhang and Lu, 2022). Ecological evidence indicates that neonicotinoids leach into waterways, accumulate in soils, and have been found in the nectar and pollen of untreated plants. They can have negative impacts on a wide range of nontargeted organisms, including bees and vertebrates (Berheim et al., 2019; Bradford et al., 2020; Lundin et al., 2015; Millot et al., 2017; Muth and Leonard, 2019; Rogers et al., 2019; Simon-Delso et al., 2015). A wide range of acute to chronic adverse effects from neonicotinoids have been documented in bees, such as interference with flight and navigation (foraging); reduced taste sensitivity; slower learning; reduced survival, pupation and growth, reduced olfactory response; and reduced feeding (e.g., LaLone et al., 2017; Muth and Leonard, 2019; Stokstad, 2013; Woodcock et al., 2017). The totality of these examples indicates that solutions to these complex problems require consideration of co-occurring stressors and their feedback loops. These examples are just a few among tens of thousands of chemical compounds that present significant regulatory and risk assessment challenges, but can be of immense importance given ubiquitous exposures to humans. The exposures include vulnerable groups, such as pregnant women and children, as well as marginalized and highly exposed populations, along with concomitant threats to biodiversity and planetary ecosystems (Persson et al., 2022).
EPA has begun to respond with improved assessments of chemical exposure outcomes and potential for toxicity. Novel computational methods, such as high-throughput screening (HTS) assays, untargeted high resolution mass spectrometry, chemometrics, and bioanalytical equivalent concentrations with effects based trigger values, can leverage advanced biological understanding of exposure–disease relationships and adverse outcome pathways (AOPs) to characterize potential wildlife and human health risks (e.g., Ankley et al., 2010; Edwards et al., 2016; Evich et al., 2022; Finckh et al., 2022; LaLone et al., 2017; Onjia et al., 2022; Zhu et al., 2014). In 2012, following exciting advances reported in the preceding few years, the Organisation for Economic Co-operation and Development (OECD) established a program on AOPs (Ankley et al., 2010; Carusi et al., 2018; OECD, 2021). Despite these advances by EPA and others, there is a paucity of research establishing AOP linkages to ecological populations and communities. In addition, they do not address multiple stressor effects and interactions. Nevertheless, mechanistic data can elucidate upstream (i.e., in an adverse outcome pathway) biological and physiological perturbations and key characteristics that are relevant for adverse human health outcomes including cancer, reproductive toxicity, and endocrine disruption (Arzuaga et al., 2019; La Merrill et al., 2020; Luderer et al., 2019; Rider et al., 2021; Smith et al., 2016). For example, characteristics of male reproductive toxicants can have key characteristics such as: altering hormones; genotoxicity; germ or somatic cell development; and inducing epigenetic alterations, oxidative stress, and inflammation. These key characteristics can be used to organize toxicological data for early identification of human health hazards. Improved approaches to advancing understanding of exposure–disease pathways are critical for
- Decision-making applications in multiple regulatory programs;
- Generation of mechanistic data through multiple technologies and computational methods by multiple EPA ORD laboratories in collaboration with external research entities (e.g., universities, U.S. Fish and Wildlife Service, and National Oceanic and Atmospheric Administration [NOAA]); and
- Integration of mechanistic data (in addition to AOPs) and frameworks of key characteristics to establish a weight-of-evidence, integrated approach to validate chronic and acute disease outcomes and characterize health risks in communities and larger populations. No one assessment approach can be used to understand multiple stressors and their interactions.
In addition to neonicotinoids, another example of the importance of taking this holistic approach revolves around the ecological and human health impacts of excess runoff of nutrients. The example of impacts of excess nutrients on manatee populations in Florida—and ultimately on the economy and human health—illustrates the challenges that can arise when the ecological and human health impacts of human actions are not fully understood and addressed (see Box 3-1).
ORD took a major step toward an integrated approach to these issues in the middle of the last decade with its efforts to construct a comprehensive Nitrogen Road Map designed to integrate their research efforts to understand the sources (in concert with the Offices of Water and Air and Radiation) and the exposures and effects in both ecological and human communities.1 In this program, leads from each of the four relevant ORD National Research Programs joined with leads from the program offices (Office of Water and Office of Air and Radiation) to catalog and prioritize all nitrogen-relevant research and monitoring and management programs and to set integrated research priorities. The Roadmap Program also included annual reports of progress and next steps. Following that initial work, and recognizing that the development of each such standalone document is a major undertaking, ORD integrated the Nitrogen Roadmap, along with other roadmaps they had developed, into a 2016-2019 Strategic Overview2 to the entire set of six Strategic Research Action Plans (StRAPs).
Examples of Applicable Tools and Methods
Relevant tools and methods include:
- Biological (subcellular) sensors to monitor laboratory and in situ populations (wildlife and
- humans) to link exposure with effects of stressors (e.g., temperature, total dissolved solids, target cations/anions, pesticides, PFAS, and other organic chemicals of concern);
- Stable isotopes to establish causality and energy flow through ecosystems;
- Chemical and biological sensors that document fluctuating exposure conditions and the influence of these parameters on population and community outcomes; and
- Computational toxicology to assist in establishing the class of chemicals that are accurately reflected with surrogate AOP test chemical and mixture interactions.
Evaluating adverse responses by focusing on initial molecular targets also provides a way to elucidate the cumulative effects of chemical and nonchemical stressors in producing a particular detrimental outcome (Ankely et al., 2010; Burton et al., 2012). The interactions of toxicants, genetic variants, nutritional status, and other host factors become obvious when it can be shown that all of them influence the function of a particular protein or biochemical process. Understanding biological responses at this fundamental level is also critical in determining the extent to which a response in one species is predictive of responses in others. Nevertheless, the reality of multiple stressor exposures dictates a suite of assessment tools and approaches be utilized. In Chapter 5, the committee provides examples of emerging tools and methods that could help address these challenges.
Environmental Justice and Cumulative Risk
Most adverse human health and ecosystem impacts are the result of the cumulative effects of multiple interactive environmental and social stressors. For more than two decades, EPA has been grappling with both the science and policy challenges of cumulative risk (EPA, 1997), and those efforts continue (EPA, 2022). Today, as the agency takes on the challenges of environmental justice, sustainable communities, and climate equity, the evidence of interactions between community vulnerability and the built environment and social stressors is clear. Mounting evidence shows that intrinsic factors (e.g., pre-existing disease, life stage, reproductive status, age, sex, and genetics) and extrinsic factors (e.g., poverty, racism/discrimination, social and income inequality, access to health care, geography, and workplace/occupational risks) can lead to differential susceptibility and exposures to environmental chemicals and other stressors (see, e.g., Clougherty et al., 2014). That, in turn, can lead to community and population differences in health risks (Morello-Frosch et al., 2011; Vesterinen et al., 2017). Yet, the toolbox for addressing cumulative risks is limited by media-specific and pollutant-specific statutes and regulations, addressing risks one pollutant at a time and one pollution source or environmental medium at a time. Today’s complex problem of cumulative impacts goes beyond the traditional risk assessment and risk management paradigm and requires a systems-based problem-solving approach (Burke et al., 2017).
Several decades of research indicate that the inequitable distribution of health and disease is linked to environmental and social conditions that are shaped by structural determinants, including social inequality, poverty, and legacies of racism (such as historical redlining), that put people, particularly marginalized populations, at “risk of risks” (Gonzalez et al., 2022; Lane et al., 2022; Payne-Sturges et al., 2021; Phelan et al., 2010). This combination of environmental hazard exposures and socioeconomic stressors has been described as a form of “double jeopardy” (IOM, 1999; Morello-Frosch and Shenassa, 2006). In 1992, EPA published a groundbreaking report, Environmental Equity: Reducing Risk for All Communities, which put forth the first set of proposals by a federal agency to address environmental justice (EPA, 1992). This report catalyzed the formation of the National Environmental Justice Advisory Council and the establishment of the Office of Environmental Equity (later renamed the Office of Environmental Justice and now elevated
to be a freestanding Office of Environmental Justice and External Civil Rights) within EPA, and then-President William Clinton’s executive order “Federal Actions to Ensure Environmental Justice in Minority Populations and Low-Income Populations,” which directed federal agencies to consider the environmental and human health effects of federal actions on racialized and low-income populations with the goal of achieving environmental protection for all communities (USEOP, 1994). In 2021, President Biden called on federal agencies to “take into account the distributional consequences of regulations … to ensure that [they] … do not inappropriately burden disadvantaged, vulnerable, or marginalized communities,” and urged the development of “programs, policies, and activities to address the disproportionately high and adverse human health, environmental, climate-related and other cumulative impacts on disadvantaged communities” (USEOP, 2021a,b). These federal initiatives have challenged scientists to move beyond source-by-source and pollutant-by-pollutant research and risk assessment and toward a fuller characterization of the cumulative and potentially synergistic health risks from multiple environmental and social stressors that disproportionately impact communities of color and the poor (First National People of Color, 1991; Freudenberg et al., 2011; Pulido, 1996). Together, these stressors are recognized as contributing to cumulative impacts, and studies have elucidated how they can interact additively or synergistically to produce health disparities (Goin et al., 2021; Morello-Frosch et al., 2011; Vesterinen et al., 2017). Four key concepts underlie emerging scientific knowledge about cumulative impacts:
- Health disparities among racial/ethnic, socioeconomic, and other marginalized groups are significant and exist for chronic diseases, such as asthma, cardiovascular disease, neurodevelopment, and maternal and perinatal health outcomes that are linked to social and environmental factors;
- Inequalities in exposures to environmental hazards are significant and linked to increased risk of adverse health outcomes;
- Intrinsic biological and physiological factors including underlying chronic disease, life stage, malnutrition, inflammation, and oxidative stress can amplify the effects of environmental factors and contribute to differences in the frequency and severity of environmentally mediated disease across population groups; and
- Extrinsic social and structural factors at the individual and community levels may amplify the effects of environmental hazards and contribute to health disparities.
These four concepts have complex interrelationships and feedback loops (see Figure 3-1). Work to develop more sophisticated analytical methods for measuring multiple exposures to environmental and social stressors and assessing their cumulative risks is in its infancy (Goin et al., 2021; Payne-Sturges et al., 2018); uncertainties remain over appropriate ways to model mixture effects, their potential interactions, and overlapping physiological pathways (Eick et al., 2021, 2022). Moreover, the combination of place-based factors (e.g., neighborhood and housing quality; Decker et al. 2018; Northridge et al., 2010), occupational and residential segregation (Casey et al., 2017; Morello-Frosch and Lopez, 2006; Morello-Frosch and Shenassa, 2006), redlining (Lane et al., 2022), limited access to high-quality food or safe drinking water (Jones-Smith et al., 2013; Kersten et al., 2012; Pace et al., 2022), and targeted marketing of consumer products (Zota and Shamasunder, 2017) can all lead to unique exposures to toxic chemicals among marginalized populations, particularly communities of color and the poor. For example, the lack of childcare for agricultural workers often forces parents to take their children to the fields while they work (NRC, 1999a), thereby increasing young children’s exposures to pesticides. Many of these pesticides are known endocrine disruptors, neurotoxicants, and carcinogens, and the potential long-term effects of childhood and prenatal exposures are just being understood (Marks et al., 2010; Thompson et al., 2014).
Examples of Applicable Tools and Methods
Fundamental to the consideration of cumulative impacts is the need to incorporate structural factors into environmental health research and risk assessments, using multi-disciplinary and holistic scientific methods. ORD has recently recognized the importance with the issuance of its new Cumulative Impacts Research: Recommendations for EPA’s Office of Research and Development.3 Some of the advanced tools and methods that could be used in pursuit of that objective include but are not limited to
- Exposure sensors for multiple stressors (e.g., fence-line monitoring);
- Geospatial tools/analysis to link multiple place-based stressors and sources of exposure, including quantification of social stressors;
- Development and assessment of alternative metrics of exposure that cannot be measured directly or holistically characterized (e.g., proximity);
- Artificial intelligence and machine learning tools combined with extensive exposure testing across different stressors and concentrations to examine real-world risks from multiple stressors;
- Nontargeted analysis of chemicals linked to biomarkers of exposure and health outcomes;
- Exposure modeling; and
- Genetic and epigenetic analysis to understand exposure and effect biomarkers of toxicity.
Strategic combinations of these tools, combined with community-engaged and participatory research methods, can be used to better characterize and understand drivers of cumulative risks and implications for environmental health disparities (see Chapter 5).
Human Health and Environmental Impacts of Climate Change
Climate change affects the health and well-being of the global human population as well as the structure and function of ecosystems. Its effects span multiple dimensions including the global economy, food production, energy, transportation, water, sociopolitical structures, human migration, and biogeochemical cycles (NASEM, 2021). In 2021, there were 20 weather/climate disaster events in the United States with losses exceeding $1 billion for each event (NOAA-NCEI, 2021). Smith and Katz (2013) estimated that floods cost the U.S. economy a total of $85 billion, and droughts and heat waves cost $210 billion, from 1980 to 2011. In 2012, a drought in the United States resulted in a 21 percent reduction in the yield of maize (corn), relative to the previous five nondrought years (Boyer et al., 2013; Gilbert, 2012). In the case of marine and freshwater environments, scientists predict that climate change may result in more widespread, frequent, and intense harmful algal blooms (HABs) (e.g., Gobler, 2020). The toxic blue-green algae that underpin HABs thrive in warm, slow-moving water. In 2014, a cyanobacterial (blue green algal) HAB in Lake Erie affected the drinking water for more than 500,000 people in Toledo, Ohio. In 2016, a massive HAB in Florida’s Lake Okeechobee negatively impacted tourism and aquatic life. HABs have been recorded in every state and have become a concern nationwide (CRS, 2020).
People have experienced climate change impacts through extreme-precipitation and heat-wave events; increased frequency of severe flooding in coastal areas due to sea level rise and storm surge; and more frequent and devastating wildfires due to hotter, drier, and longer fire seasons. Heat and aerosols produced from wildfires in turn might lead to more severe weather hazards and storms in downstream regions (Zhang et al., 2022).
Incomplete combustion during wildfires generates particulate matter (PM), oxides of nitrogen, polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds, trace metals, and other pollutants. PM2.5 (particles with diameters that are generally 2.5 micrometers and smaller) and absorbed PAHs can travel long distances, potentially threatening human health hundreds of kilometers from the wildfire (Cascio, 2018; Liu et al., 2015; Naeher et al., 2007; Reid et al., 2016). PM2.5 from wildfire smoke may be more harmful to respiratory health in humans than ambient PM2.5 resulting from other sources, such as motor vehicles and power plant emissions (Aguilera et al., 2021). Although environmental regulations have led to a decrease in PM2.5 concentrations in the United States, wildfire-related PM2.5 concentrations have increased, particularly in the western states (McClure and Jaffe, 2018). For example, wildfires now account for 71 percent of total fine particulate matter on poor air quality days in California (Liu et al., 2016). Sea level rise and flooding due to storm surge pose additional threats to human health due to the flooding of sites that store, utilize, or emit hazardous materials. Releases of toxic chemicals from hazardous waste sites and industrial facilities into local air and floodwaters can occur accidentally or intentionally (e.g., to prevent explosions). For example, 166 releases of hazardous substances, including 10 onshore oil spills totaling 8 million gallons, were reported on the U.S. Gulf Coast during flooding due to Hurricanes Katrina and Rita, primarily as a result of emergency shutdown and startup operations at industrial facilities (Manuel, 2006; Ruckart et al., 2008; Sengul et al., 2012). Similar extensive flooding arose from Hurricane Harvey in 2017, causing explosions at petrochemical plants and contributing to significantly increased metals and other contaminants from many of the region’s 43 Superfund sites (Blake and Zelinsky, 2017).
Climate change also poses significant environmental justice challenges; the climate gap refers to the ways in which climate change and climate change mitigation strategies can disproportionately impact marginalized people, such as people of color and the poor (Shonkoff et al., 2012). Vulnerability to climate change is determined by the ability of a community or household to anticipate, cope with, resist, and recover from the direct and indirect impacts of stressors such as sea level rise, hurricanes and floods, heat waves, air pollution, and infectious diseases. Low-income urban communities and communities of color are especially vulnerable to extreme weather events, including heat waves and higher temperatures, in part due to
legacies of racist housing policies, that have led to their segregation in neighborhoods that are more likely to experience lack of green space and increased risk of “heat-island” effects (Hoffman et al., 2020; Nardone et al., 2021). Studies indicate that technological adaptation is another critical extrinsic factor in heat-associated health outcomes; lack of access to air conditioning is correlated with risks of heat-related morbidity and mortality among communities of color (O’Neill et al., 2005).
Across the country, low-income households and people of color experience greater hazardous pollutant exposures and are more likely to live near hazardous waste and industrial facilities (Cushing et al., 2015). This suggests that storm events including coastal flooding due to sea level rise of contaminated sites is likely to disproportionately impact socially disadvantaged populations and their community infrastructure (Buchanan et al., 2020), presenting environmental justice concerns (Heberger et al., 2012; San Francisco Bay Conservation and Development Commission, 2012).
Finally, strategies to mitigate climate change by reducing greenhouse gas (GHG) emissions can yield significant short- and long-term public health benefits by also reducing emissions of hazardous co-pollutants, such as air toxics and particulate matter (Nemet et al., 2010; Smith and Haigler, 2008; Smith et al., 2013). Several studies estimate that the economic cost savings of reduced air pollution–related illness and death often outweigh the costs of GHG mitigation (Burtraw et al., 2014; Nemet et al., 2010; Zapata et al., 2013). Because socioeconomically disadvantaged communities and communities of color are often disproportionately exposed to criteria and hazardous air pollutants and their mobile and stationary emission sources (Hajat et al., 2015; Morello-Frosch and Jesdale, 2006; Tessum et al., 2019), research that forecasts how best to structure reductions in GHG emissions could maximize the ancillary health benefits of reducing these social inequalities in exposure to air pollutants that have persisted despite decades of regulation.
Examples of Applicable Tools and Methods
Because EPA has the authority to regulate GHG emissions from certain sectors, such as CO2 from mobile sources, agency decision-making can benefit from a greater understanding of how actions within the framework of built systems, such as energy-use choices, will likely affect air quality, human health, food, and water in a changing climate. The design of effective mitigation strategies relies on understanding the contributions of natural and built systems that influence climate change, as well as important feedbacks between climate, atmospheric chemistry, and ecosystems.
Also, little anticipatory research has systematically characterized the implications of extreme weather events for industrial facilities handling hazardous waste and contaminated sites—including the additional threat posed by flooding, storm surge, rising sea levels—for disadvantaged populations who are more likely to live near hazardous waste and industrial facilities (Cushing et al., 2015).
There is a need for better collaboration and communication to address climate change issues, between EPA and agencies such as the U.S. Department of Energy and NOAA, which use different modeling frameworks (e.g., high-resolution forecasting models and the integrated assessment models) for designing future policy actions. EPA currently is involved with different federal and state agency offices responsible for air quality and water quality, such as the California Air Resources Board, the Bay Area Air Quality Management District, and it can play a pivotal role in leveraging the science from measurements and modeling programs across agencies for regulatory decisions. Machine learning applications (see Chapter 5) to integrate information from different predictive models will help provide a better understanding of the potential effects of policy actions taken today on climate and air quality in the future, especially for disproportionately affected and urban communities. In addition, there is significant value in the regular communication of findings on climate change, water and air quality, and ecosystems across government agencies, the U.S. Global Change Research Program, universities, national laboratories, and key community stakeholders. Chapter 4 discusses various ways in which ORD could further enhance its collaboration and communication efforts within the context of implementing advanced science tools and approaches.
FRAMEWORK FOR PURSUING ANTICIPATORY SCIENCE: APPLYING SYSTEMS THINKING TO ONE ENVIRONMENT–ONE HEALTH
The challenges described above are complex and multi-dimensional and require the best and most advanced scientific tools and methods. But the complexity of these problems also needs to involve systems thinking to design entire scientific approaches that
- Integrate a broad array of interactions between humans and the environment;
- Identify the full range of disciplines needed to conduct the science;
- Integrate considerations of environmental, social, and economic stressors; and
- Ensure that the science is communicated to stakeholders and the general public in the most understandable and effective way possible.
To guide ORD’s decision-making and actions to maintain and enhance a science endeavor that anticipates the highest-priority problems and pursues and implements the most advanced science, the committee has developed an overarching research framework against which it has sought to judge what science and approaches will most benefit ORD and lay the groundwork for continuing innovation and advances. That framework is built around two fundamental elements:
- Viewing all of ORD’s science through a research framework focused on the two-way interactions between society and the environment and
- Applying systems thinking at each step of ORD’s endeavors to advance a comprehensive understanding of human and ecosystem health.
In the sections below, the committee lays out this research framework and its vision for a reimagined and strengthened strategic planning process. The following chapters identify major actions ORD should take to ensure that it can broadly integrate systems thinking and other scientific advances in the most effective way (Chapter 4) and a number of advanced tools and methods to which ORD should give high priority in its research planning and implementation (Chapter 5).
A One Environment–One Health Research Framework
For the past two-plus decades, public health communities in the United States and across the globe have developed and applied a One Health approach to “attain optimal health for people, animals and our environment” (AVMA, 2008). That concept has played an important role in examining and taking action on the interactions among humans, animals, and the environment, especially in understanding the origins and spread of infectious diseases.
There are many definitions of “One Health” in the published literature and among various agencies and other organizations; though originated among the public health community to address the intersections among humans and animals that can result in zoonotic disease transmission, recent definitions have begun to broaden the concept (Adisasmito et al., 2022). EPA has, in recent years, extended the focus of One Health to go beyond the intersection between humans and animals with this definition. One Health is a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.4 The agency folds a number of its existing initiatives under this umbrella, including EnviroAtlas,5 the Report on the Environment,6 and more.
This movement into a broader view by EPA is welcome and valuable; full implementation of it will require development of an integrated approach in which all of these efforts intersect and complement one another. To help integrate the One Health concept into the research context in which ORD must do its work, the committee identified a One Environment–One Health framework for research through which ORD can enhance its scientific capability for considering the complex interactions among environmental, social, and economic systems in support of EPA’s mission (see Figure 3-2). The framework recognizes the role of society broadly as a promoter of human health through economic well-being and technological advances, but also as a source of many of the stressors and unintended consequences that humans and ecosystems face. Likewise, the environment can produce positive or negative effects on health. Consistent with EPA’s One Health concept, the One Environment–One Health framework compels research that is collaborative, multisectoral, and transdisciplinary—working at the local, regional, national, and global levels. Implementation of a One Environment–One Health research framework (as discussed below) requires ORD and the scientific community to look at every environmental challenge through the lens of what it means, not just for human health in response to environmental and other stressors, but what it might mean for all ecological levels from molecular to ecosystem, and in turn to consider the design and implementation of science that takes the same integrated approach. At the same time of course, such a comprehensive assessment may identify an abundance of possible directions for the next stage of research, not all of which can be pursued. But having taken a systematic approach to the full range of stressors and community impacts would best position ORD to systematically identify the highest-priority research to be pursued. In addition, some environmental issues might require a more streamlined approach to provide solutions in rapid fashion, such as in response to some of the needs of EPA regional offices.
Applying Systems Thinking to One Environment–One Health
EPA has for some time organized many of its duties around systematically considering each element of the source-to-exposure-to-effects continuum (see Figure 3-3). That requires careful consideration at each stage and understanding that scientific knowledge of causes and effects will be at its strongest if there is supporting evidence throughout. EPA and other organizations apply this approach in many environmental contexts, especially in the case of required activities that stem from congressional mandates and administrative directives and which tend to be related to a single environmental medium (air, water, and land) and individual pollutants. That approach has helped define priorities for multi-year research programs within ORD that have successfully invested in science that has answered many important questions (e.g., NRC, 1998, 1999b, 2001, 2004).
Although the source-to-exposure-to-effects approach has supported many scientific and policy advances, there is a greater understanding today that the health of humans and ecosystems comprises a broader continuum from interactions at the molecular level (where much laboratory investigation first takes place) to community and ecosystem levels. There is also a greater awareness that conducting environmental science to understand the sources of stress and their effects on environmental health requires a much more holistic approach that encompasses a range of scientific disciplines and integration of environmental, social, and economic knowledge to work toward solutions to problems in consideration of different time scales, geographic scales, and other factors. The systematic examination of the connections from the cellular to the community and ecosystem levels will become all the more important as the environmental health community moves to expand the use of New Approach Methods (NAMs) for Human Health Risk Assessment. NAMs are technologies and approaches (including computational modeling, in vitro assays, and testing using alternative animal species) that can inform hazard and risk assessment decisions without the use of animal testing (NASEM, 2022b).
Generally, systems-based approaches seek to describe and understand complex systems comprising interrelated and interacting subsystems (Meadows, 2008; NRC, 2014). Systems thinking applied to environmental problem-solving considers effects of multiple stressors, evaluates full life-cycle implications, and integrates data and knowledge from multiple stakeholders and fields of science including natural, social, behavioral, and decision sciences (Burke et al., 2017; NRC, 2012).
A systems-based One Environment–One Health approach to research on complex problems provides a number of advantages relative to a more narrowly drawn approach that focuses on a single stressor or source. When human health and ecosystem health are evaluated correctly in an integrated and holistic manner, it can result in emergent solutions to problems that would not have been identified through a more siloed approach. By exploring a combination of stressors and exposures comprehensively, there is an opportunity to identify multiple factors driving risk, their relationships, and important and practical intervention-based strategies. This cross-sectoral process helps anticipate potential side-effects and synergies and thus lower the risk of unintended consequences from EPA actions. ORD scientists would build new collaborations with thought leaders in multiple institutions to design innovative tools and approaches. In addition, by encouraging a more long-range and holistic view, ORD can become more anticipatory, making greater use of new science and forecasting activities, and focus on preventing harm rather than dealing with it after it occurs.
An example of a systems approach in addressing climate change might result in assessing the multiple ways in which climate can affect both ecosystem and human health and in prioritizing research that would anticipate impacts that have the largest potential for community exposure and impact, such as the anticipatory research described above that systematically characterizes the implications of extreme weather events for industrial facilities handling hazardous materials and contaminated sites. Also Cains and Henshel (2021) provides an example of the use of an approach for integrated risk and resilience assessments of climate change impacts within the Charleston Harbor Watershed of South Carolina. Another example of a systems approach could involve assessing, in the context of environmental justice and cumulative risk, complex environmental exposures in which multiple stressors can affect the residents of a specific community in disproportionate ways depending on the racial, economic, and other makeup of the communities.
Regarding systems-based ecological risk assessments, Van den Brink et al. (2016) describe an approach for evaluating multiple stressors in a marine ecosystem to inform the development of preventive management policies based on adaptive management processes. Landis et al. (2017) describe a regional scale approach applied to the South River and upper Shenandoah River study area in Virginia. The assessment included consideration of mercury other chemical and physical stressors and four species of fish and birds, as well effects on fishing, boating, and swimming.
A valuable visualization has been described in Burke et al. (2017) that highlights the importance of understanding how stressors from various sources in the environment can contribute to exposures and effects that occur at any level of scale from molecular to ecosystem (see Figure 3-4).
Considering this much more complex set of interactions at each stage requires a host of new scientific tools and methods. Fortunately, we have seen the emergence in recent years of a broad range of such tools, including radically enhanced environmental sensors and other means to assess exposure, new genetic and analytical tools to anticipate potential biological effects starting at the molecular level, and rapidly evolving tools for analyzing and modeling massive sources of data. The committee has scanned a range of these tools and identifies a number of high-priority areas for ORD to pursue, in concert with collaborators in other federal agencies and the broader scientific community (see Chapter 5).
At the same time, merely identifying these tools and methods, and equipping the agency to take better advantage of them, is not sufficient. As illustrated in Figure 3-5, systems thinking will require ORD to consider the complex interactions among environmental, social, and economic systems throughout its efforts to develop science relevant to advancing environmental protection. In many respects, this is a logical next step in ORD’s efforts, as presented by then Acting Assistant Administrator Jennifer Orme-Zavaleta to the committee in May 2021, to integrate a strategic approach to sustainability7 into ORD’s actions to
produce science for environmental protection (see Chapter 2). In setting priorities for the most important science to pursue, ORD will need to place its work amidst the social, economic, and environmental pillars of sustainability, and consider the multiple ways in which communities and societies are sources of both benefits and significant stressors, the multiple paths by which exposures from those sources can reach both humans and broader ecological systems, and the effects of those exposures at the cellular, organism, and population levels.
As the committee details below and in Chapter 4, those activities will involve a series of steps to ensure that ORD can not only meet the needs of the EPA program offices in enhancing their environmental protection roles but can lead the agency toward better anticipating what science it will need to meet the scientific and policy challenges of the future. Fortunately, and as also described in the recent StRAPs, ORD is planning to look at some of its work through a systems lens. ORD’s National Research Programs (see Chapter 2) plan to integrate research efforts on six cross-cutting priorities: equity and environmental justice, climate change, cumulative impacts, community resiliency, children’s environmental health, and contaminants of immediate and emerging concern. The StRAPs acknowledge that long-term, innovative, and multidisciplinary research will be needed to make progress on these complex issues.8
In carrying out systems-based research there are several practical considerations and potential barriers to implementation that need to be considered, including:
- Additional skills and knowledge from multiple disciplines required to address the complexity of analysis.
- Guidance in deciding on the spatial and temporal boundaries, kinds of stressors, and range of biological species to be studied.
- Time available for ORD personnel to conduct cross-cutting, forward-looking research can be constrained by the pressing demands for short-term research to meet EPA’s regulatory and research mandates.
- ORD personnel may be risk averse in taking on new initiatives involving unusual research approaches.
- Budget uncertainties and shifting administration priorities can delay progress in developing the capacity for this kind of research.
Research in support of environmental decision-making is most effective when scientists, stakeholders, and decision-makers collaborate to develop research priorities that jointly reflect the sociological, ecological, and political context of environmental problems—what has been dubbed “translational ecology” (Enquist et al., 2017). Translational ecology requires sustained engagement among all parties to build trust, develop ideas, and achieve desired outcomes. In 2019, ORD launched a Translational Science Initiative for “Solutions-Driven Research.” Among other activities, a pilot project testing this approach is under way on Cape Cod where ORD scientists are collaborating with the Barnstable Cleanwater Coalition and other stakeholders to design and implement research to inform watershed-scale solutions to nutrient pollution in Three Bays (Twichell et al., 2019). The unifying theme of ORD’s solutions-driven research initiative is commitment to stakeholder engagement throughout the entire research process, a topic that is discussed in Chapters 4 and 5.
Recently, EPA researchers examined the effectiveness of translational research at these ORD units: the Environmental and Public Health Division (the former National Health and Environmental Effects Research Laboratory), the Atlantic Ecology Division, and the Mid-Continent Ecology Division), specifically examining the influence of the social sciences on research processes and outcomes (Eisenhauer et al., 2021).
Study authors concluded that inclusion of social scientists influenced how the research was framed, introduced new methodologies, and increased engagement between scientists and stakeholders. This, in turn, resulted in an improved systems perspective, greater translatability of research findings, and formation of new partnerships.
This analysis at EPA laboratories illustrates that EPA science cannot solely address physical, chemical, and medical science, but also needs to acknowledge and address how mental models, perceptions, norms, choices, structural factors, and culture can shape and inform solutions-driven research. EPA science can benefit from active engagement from social and behavioral scientists to apply system-thinking methods internally and externally in how personnel think through solutions-driven research and the system impacts of the solutions implemented.
Internally, EPA scientists can experimentally test and evaluate how systems-thinking methods help guide solution-driven research. For example, active engagement and collaboration with social and behavioral scientists is now prominent in the Intergovernmental Panel on Climate Change report on climate change mitigation (see Creutzig et al., 2022), illustrating how system feedback between health, well-being, equity, trust, and governance can positively impact mitigation efforts.
Externally, EPA scientists have a bigger role to play in how people respond to and manage risks. Decades of risk perception research show how some people systematically overestimate some highly visible risks and underestimate others (Lichtenstein et al., 1978; Slovic, 2000). Also, many people tend to have a poor understanding of how basic environmental systems work such as misperceptions related to a societal water system (Attari et al., 2017) and carbon dioxide accumulation in the atmosphere (Sterman, 2008). Correcting misperceptions about environmental risks and systems is required but nowhere sufficient to help people and communities navigate the complex information and current media landscape. Misinformation also needs to be addressed as people differentially consume false information that reinforces their political views (Guess et al., 2020). Evidence suggests that the public has little training in detecting bad science and misinformation (West and Bergstrom, 2021), which can have a significant impact on environmental governance and public health outcomes. Thus, EPA has a unique and powerful role in being a trusted source of accurate information and solutions-driven research.
Near the end of 2022, ORD took an important step toward enhancing these skills when it solicited applications for at least eight social science positions. The duties are to include planning and conducting studies that are to be used to inform various EPA programs, policies, and regulations, and communicating and disseminating research results and findings to internal and external EPA partners.9
Changing Boundaries for Research Planning
ORD has made great strides in developing multi-year strategic plans to guide its research priorities, advancing from what had been single-year appropriations-driven planning for individual pollutants to, as described in Chapter 2, six multi-year StRAPs that guide national programs of intramural and extramural research. Having made that progress, however, the context in which this planning takes place has been changing, and fully applying systems thinking to a One Environment–One Health approach will require a new more interactive, cross-media, and transdisciplinary approach.
The rapid pace of scientific developments, the increasing transparency and availability of data, and the growing recognition that individual health and environmental problems are themselves subsets of larger, systemic challenges all point to the need for rethinking—and reimagining—the strategic planning process. Challenges such as those we describe in the first part of this chapter—assessing ecological and human risk holistically, assessing cumulative risk and environmental justice, and understanding the implications of climate change—will require a new level of integration of research planning, and a new level of embedding
that process in the broader community of stakeholders who are the audience for and the collaborators in that research.
New Scientific Needs Require a New Research Planning Approach
Given these expanded circumstances for how scientific information is developed and applied, research planning at EPA, and specifically ORD, is at a critical inflection point. ORD would strengthen future research by continuing to provide data to support regulatory decision-making, while simultaneously pivoting to a broader stakeholder model of research planning and implementation. The elements of this stakeholder model include:
- Developing engagement activities to inform research planning for a series of high-priority problem topics that EPA will confront presently and during the next 5-10 years. Although ORD has made some efforts to reach out to key stakeholders for its 4-year StRAPs, engagement activities, such as workshops, online communications, or video conference calls, would take these consultations to a new level—and explore a much longer time horizon. EPA’s program offices would be effectively represented in such engagement activities along with ORD scientists, leading independent scientists, engineers and data analysts, EPA program and regional offices, relevant federal science agencies, the private sector, nongovernmental organizations, state and local governments (including environmental quality managers), community organizations (including constituencies of marginalized or underrepresented communities to include people of color, Indigenous populations), and other stakeholders that deliver relevant expertise and institutional credibility to the engagement activities. Engagement planners would be cognizant of potential barriers to participation that stakeholders may encounter and provide them with opportunities to attend. Planners would create inclusive environments for everyone to provide input.
- Focusing the intended output from each engagement activity to be a consensus agenda on high-priority research topics that estimates the resources and skills required to effectively implement the agenda. ORD would make the consensus agenda available on a variety of public communication platforms and actively seek comment and advice.
- Determining the number, size, and location of engagement activities by the nature of EPA’s information needs and stakeholder representation. The results of the engagement activity would provide stakeholder input into EPA’s annual budget development process.
- Soliciting stakeholder input into research planning, accompanied by opportunities to leverage stakeholder expertise and resources on specific research priorities and programs. Where stakeholders co-share in developing new scientific data opportunities, a mechanism to jointly develop research goals, metrics, oversight, and public communication of results would be designed into the research accountability and governance process.
- Enabling ORD, through this process, to identify and enlist stakeholders as key supporters of ORD’s work going forward.
Applying this new model of strategic planning in the context of a One Environment–One Health approach will also involve finding ways to integrate its strategic planning across the currently media-specific StRAPs to ensure systems thinking and an integrated approach to setting research priorities. To that end, approaches such as the Nitrogen Roadmap described above provide tangible examples of how ORD has integrated these efforts in the past and how it might do so going forward. One could envision a small set of cross-program priorities to be identified for this intensive treatment; to a large extent the earlier Roadmap program already began that by building Roadmaps for Environmental Justice (EPA, 2016a), Climate Change (EPA, 2016b), and Children’s Health (EPA, 2015) in addition to the Nitrogen Roadmap. As mentioned above, the current StRAPs indicate that ORD’s National Research Programs will integrate research efforts on six cross-cutting
priorities. Another activity would be to construct a cross-StRAP integrated summary that identifies key cross-cutting priorities and establishes a baseline in each planning cycle against which progress can be judged (similar to that constructed for the 2016-2019 StRAPs).10
Transitioning to this new model of research planning has direct implications for the types of scientific information that ORD will need to develop. In addition to expanding data to support ongoing regulatory mandates, ORD needs a diversified research portfolio to adjust to the growing number of tools used by EPA policy-makers (including life-cycle analysis, health impact assessment, greater use of economic instruments, big-data analysis, and environmental justice assessments). Such a diversified portfolio will necessitate enhancement of skills in the behavioral and social sciences to account for risk assessments that incorporate factors such as location, demography, income, gender, race, and educational levels of those impacted by differentiated risk exposures; greater investment in developing core competencies for developing “smart” technologies ranging from sensors, information systems and infrastructure for compliance, problem definition and trend analysis; and expanding technical support for developing participatory-based science and other data collaboration capabilities across the stakeholder community. The committee describes the needs for these skills and resources in more detail in Chapter 4.
Establishment of Strategic Foresight Capabilities
Major anthropogenic public health and environmental crises usually begin with a set of signals that changes in the status quo are occurring (NASEM, 2020). Such changes are observable in advance and frequently amenable to preemptive interventions by government policy-makers or other actors. Today’s crisis management systems are largely reactive in nature and are not designed to identify, monitor, or respond to crisis precursor events in a timely or effective fashion.
The acceleration of global megatrends in scope and scale necessitates a rethinking of strategic foresight capabilities. In the context of this report, strategic foresight is defined as ongoing assessments of those risks that have the potential to lead to widespread health and environmental degradation of the resilience of people, natural systems, and economic assets. Such assessments focus outside the range of regular acute and chronic exposures or threats that can be managed through existing EPA programs. Strategic foresight assessments identify, track, analyze, and inform researchers and decision-makers of emerging risk incidents or clusters of an unusual aggregation of incidents in time and space that have the potential to be particularly disruptive to public health or the integrity of environmental systems or cause widespread economic and social dislocations.
Analysis of current megatrend data and trends yields a growing awareness of the need for strategic foresight analysis as a major component of health and environmental research planning at EPA. Examples abound of the expanded likelihood of disruptive and destructive events associated with climate change (including extreme heat, loss of water resources, deterioration in energy and transportation infrastructure, and agricultural failures, to name a few); future global and regional health pandemics and the movement of disease vectors; regional conflicts that impede agricultural productivity and stimulate mass migrations; emergence of disruptive technologies; and the persistence of economic inequality that perpetuates disproportionate exposures to risks within individual communities or regions to people of color, Indigenous populations or low-income populations.
The value of a strategic foresight capability within EPA’s ORD would be to
- Evaluate emerging data and trends that contribute to more-informed research planning;
- Understand specific issues that have the potential to evolve from peripheral to high-impact health and environmental problems;
- Conduct targeted research to better understand the behavior, characteristics, and magnitude of potential crises as a means for identifying prevention or risk management strategies;
- Expand the planning and response time for rapidly escalating problems or incipient crises;
- Increase the number of options for policy-makers and other decision-makers to adapt, mitigate, or otherwise manage large-scale impactful events or systemic changes;
- Provide greater flexibility for identifying resource requirements and collaborations with potential partners within and external to EPA, including other federal research agencies; and
- Identify emerging technologies that may impact the environment and/or ORD’s research needs.
To establish a capacity to plan and manage a strategic foresight function, the following steps will prove essential:
- Capacity building: Organizing a core team of individuals with diverse scientific, social science, and institutional backgrounds to assess data and trends of problems that have large-scale health and environmental crisis potential. The team would comprise a mixture of EPA staff from ORD and other parts of the agency, academic fellows or advisors, and personnel seconded from other agencies or nongovernmental institutions on a rotational assignment. The team would report to the Assistant Administrator for Research and Development.
- Assessment: Evaluating trends, processes, and drivers of major health, environmental, and societal changes and their potential to generate systemic changes in the functioning of economic and natural systems and the norms of civil society.
- Identifying barriers and incentives: Taking such actions can greatly shape policy-makers’ ability to improve health and environmental crisis management.
- Testing scenarios and the probability of risks: Conducting periodic exercises to examine specific threat scenarios and risk probabilities and testing the capabilities of systems, knowledge, and personnel in place to effectively respond to them.
- Innovation: Developing proof-of-concept innovations for assessing and managing risks from selected highly complex and/or intractable environmental problems (e.g., PFAS, dioxins, nitrogen).
- Periodic reporting evaluation: As part of the strategic planning process, periodically reporting progress to date and evaluating the activities and results of the strategic foresight analysis team.
In this chapter, the committee has described three major challenges—holistically addressing interconnected human health and ecological risks; characterizing and addressing environmental justice and cumulative risk; and anticipating and responding to the human health and environmental impacts of climate change—which ORD will need to address in its efforts to develop, prioritize, and implement forward-looking science.
We then describe a new, broader research framework—applying systems thinking to a One Environment–One Health approach—to guide how ORD organizes its efforts to be proactive and comprehensive in setting and implementing priorities. The committee then describes several important areas—the integration of social and behavioral sciences, a reimagining of ORD strategic planning, and establishment of strategic foresight capabilities—to take the first steps toward this new approach.
Based on this discussion, the committee presents the following findings and recommendations:
Finding: The multi-faceted interconnectedness of natural and societal systems calls for a systems-level understanding to address environmental challenges in a more effective manner. One Environment–One Health provides a research framework to enhance ORD’s scientific capability for considering the complex interactions among environmental, social, and economic systems for support of EPA’s mission. This advanced approach would help ORD identify emerging environmental problems and innovative tools through foresight, and planning to take advantage of those tools. Results obtained from implementing this approach
would enable ORD to better address complex challenges in an integrated and holistic manner that helps avoid unintended consequences of agency decisions. In setting priorities for the pursuit of the most important scientific capabilities, ORD will need to consider tools and approaches discussed in Chapter 5, for elucidating the multiple ways in which societal activities are sources of significant stressors to humans and ecosystems; the multiple paths by which exposures from those stressors can occur; and the effects of those exposures at the cellular, organismal, population, community, and ecosystem levels.
Finding: Research in support of environmental decision-making is most effective when scientists, stakeholders, and decision-makers collaborate to develop research priorities that jointly reflect the sociological, ecological, and political context of environmental problems. Research in EPA’s laboratories and in many other settings has illustrated how understanding the roles played by mental models, perceptions, social norms, preferences, and culture can help shape solutions-driven research. As described in Chapter 2, ORD has received and begun to act on advice from the National Academies and many other parties to encourage enhanced integration of social and behavioral science skills into its scientific endeavors, such as problem formulation, development and conduct of scientific studies, and communication of results. The committee applauds these efforts.
Recommendation 3-2: ORD should further enhance its efforts in acquiring and building staff skills in the social and behavioral sciences. ORD should engage those scientists at every stage of the science enterprise, including the application of systems-thinking methods internally and externally as a part of planning solutions-driven research and understanding the system impacts of the solutions implemented.
Finding: The rapid pace of scientific developments, the increasing transparency and availability of data, and the growing recognition that individual health and environmental problems are themselves subsets of larger, systemic-related challenges all point to the need for rethinking—and reimagining—the strategic planning process. This will require conducting planning over a longer time horizon and with enhanced stakeholder involvement as well as finding ways to integrate across the media-specific StRAPs to better apply systems thinking to One Environment–One Health.
Recommendation 3-3: To strengthen future research, ORD should continue providing data to inform regulatory decision-making. Simultaneously, ORD should build on its valuable StRAPs process to adopt a broader, proactive stakeholder model of research planning and management than is used in its current development processes for StRAPs. Key elements of this stakeholder model include:
- Engagement activities with EPA program and regional offices and external stakeholders to identify high-priority research topics that EPA should address during the next 5-10 years.
- Developing a consensus (or summary) statement from the engagement activities that estimates the necessary skills and resources for implementing the research agenda.
- Including external stakeholder input into both EPA’s annual research budget development process and early in its regular StRAP process.
- Identifying opportunities to leverage stakeholder expertise and resources on specific research priorities and to build support for ORD’s efforts more broadly in the stakeholder community.
- Developing effective and efficient ways to include broader cross-media and cross-program integration into the media- and program-specific StRAPs.
Finding: The increasing occurrence of major health, environmental, and societal crises that stem from the exacerbation of megatrends, such as climate change and food supply challenges, necessitates a rethinking of how ORD can better anticipate such crises and inform the development of effective response strategies. This may take the form, for example, of using structured machine learning tools to analyze large environmental, communication media, and societal databases to identify emerging issues of actual and perceived risk from certain pollutants before that concern fully emerges.
Recommendation 3-4: At the mid-point in the period of each StRAP’s existence, the relevant ORD national program director should establish a strategic foresight assessment team that evaluates emerging factors and trends, which may have an important bearing on EPA’s decision-making for protecting human health and the environment. The assessment team should aim to identify emerging, over-the-horizon issues (5-10 years into the future) which the national program director could use for developing preliminary assessments that lead to hypothesis formulation and targeted, early-stage research investments. The assessment team could involve foresight experts from outside the agency, if needed.
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