October 2005

Introduction

With the forthcoming publication of Children’s Health and 

the Environment in North America: A First Report on Available Indicators and Measures, North America is on track to 

be the first region in the world to publish a set of indicators 

of children’s health and the environment. The goal of this 

new report is to provide decision-makers and the public 

with periodic, understandable information on the status of 

key parameters related to children’s health and the environment as a means of measuring and promoting change. The 

report also marks an initial step toward the goal of improving reporting over time through trilateral collaboration.

The CEC is working in partnership with the International 

Joint Commission’s Health Professionals Task Force (IJC 

HPTF), the Pan American Health Organization (PAHO) 

and the World Health Organization (WHO) and with the 

active collaboration of the Governments of Canada, Mexico 

and the United States to compile the report. Slated for 

release in Fall 2005, the report will fulfill commitments 

made by the three governments through the CEC’s Cooperative Agenda for Children’s Health and the Environment in 

North America. It also represents an essential contribution 

to the Global Initiative on Children’s Environmental Health 

Indicators launched at the World Summit on Sustainable 

Development (Johannesburg, 2002) and led by WHO.1

Background

Initial direction for the present indicators initiative came from the 

CEC Council in its adoption of the CEC’s Cooperative Agenda for 

Children’s Health and the Environment in North America in June 

2002.2 The Cooperative Agenda calls for the development of North 

American indicators of children’s health and the environment. A 

feasibility study was subsequently commissioned by the CEC 

Secretariat and reviewed by a Steering Group comprised of 

environment and health officials from the three countries and 

representatives of the partner institutions. The Steering Group 

subsequently issued a set of recommendations identifying specific 

indicators taking into account their relevance as well as availability 

of data in the three countries. The Steering Group also recommended that a flexible approach be taken to enable countries to 

report related information if they are not able to present information on any of the recommended indicators. The purpose is not to 

rank or compare countries’ performance, but rather to stimulate 

positive change and improve continent-wide data comparability 

over time.

In June 2003, the CEC Council endorsed a list of recommended 

indicators and directed the CEC Secretariat, with the involvement 

of the Parties and in continued partnership with the IJC, PAHO 

and WHO, to prepare a first report.3 The Council resolved to 

continuously improve the quality and comparability of the indicators and data across North America, and to publish subsequent 

reports on a periodic basis.

Following nearly a year and a half of intense work by the Steering 

Group and a two-staged review by a panel of nine experts, the 

first report is near completion. A draft for public comment was 

released in September 2005 and is available at: http://www.cec.

org/pubs_docs/documents/index.cfm?varlan=english&ID=1813. 

The final report is to be published in fall 2005.

Overview of the Report

The report is composed of two volumes: the North American report and a compilation of the three country reports, which were 

prepared by the countries and served as the source of the indicators contained in the North American report. 

Children’s Health and the Environment 

in North America: A First Report on Available 

Indicators and Measures

1. For more information on the WHO initiative, please see <www.who.int/ceh/indicators/> 

or e-mail <cehindicators@who.int>.

2. The CEC Council is comprised of the top-ranking environment officials from Canada, 

Mexico and the United States. The Cooperative Agenda and Council Resolution 02-06, 

through which the Cooperative Agenda was adopted, can be found at <www.cec.org>. 

3. Council Resolution 03-10, available at <www.cec.org>.

In partnership with
Asthma and Respiratory Disease

Issue Area Indicator Purpose of Indicator

Outdoor Air Pollution Percent of children living in areas where air pollution 

levels exceed relevant air quality standards.

To provide information on children’s potential exposures 

to outdoor air pollution, with a focus on common air contaminants.

Indoor Air Pollution Measure of children exposed to environmental tobacco smoke 

(Canada, United States); Measure of children exposed to emissions 

from the burning of biomass fuels (Mexico).

To provide information on children’s potential exposures to indoor 

air pollution, with a focus on environmental tobacco smoke and 

emissions from the burning of biomass fuels.

Asthma Prevalence of asthma in children. To track asthma in children.

Effects of Exposure to Lead and Other Toxic Substances

Issue area Indicator Purpose of Indicator

Blood Lead Levels Body burden measurements for lead in children. To provide information on children’s exposure to lead

Lead in the Home Children living in homes with a potential 

source of lead.

To provide information on children’s potential exposure 

to sources of lead in the home.

Industrial Releases 

of Lead

Pollutant Release and Transfer Register (PRTR) data 

on industrial releases of lead.

To provide information on industrial releases of lead.

Industrial Releases 

of Selected Chemicals

PRTR data on industrial releases 

of 155 chemicals.

To provide information on industrial releases 

of selected chemicals.

Pesticides Pesticide residues on foods. To provide information on children’s potential exposure to pesticides.

Waterborne Disease

Issue area Indicator Purpose of Indicator

Drinking Water (a) Percentage of children (households) without access to treated water.

(b) Percentage of children living in areas served by public water systems 

in violation of local standards.

To provide information on the percentage of children potentially 

exposed to contaminants and pathogens in drinking water.

Sanitation Percentages of children (households) that are not served 

with sanitary sewers.

To provide information on the percentage of children who are potentially 

exposed to untreated sewage in their immediate surroundings.

Waterborne Disease (a) Morbidity: number of childhood illnesses attributed 

to waterborne disease. 

(b) Mortality: number of child deaths attributed to waterborne disease.

To provide information on children who have been sick from, 

or have died as a result of, waterborne disease.

Following is the list of indicators to be included in the first North American 

report. They fall into three general areas: asthma and respiratory disease, 

the effects of lead and other toxics (including pesticides), and waterborne 

disease. These coincide with the priority areas established by the CEC

Council when it adopted the North American Cooperative Agenda. The 

current list includes 13 indicators, organized under 11 thematic headings. 

North American Indicators for Children’s Health and the Environment, by Issue Area

For More Information

To find out more, please contact: 

Keith Chanon, Program Manager

Commission for Environmental Cooperation

393, rue St-Jacques Ouest, bureau 200

Montreal, Quebec, Canada H2Y 1N9

Tel: (514) 350 4323 Fax: (514) 350 4314

kchanon@cec.org

An extended version of this project description 

is available on the CEC website at 

<www.cec.org/children>. |t includes 

listings of the Steering Group members 

and the panel of experts, as well as 

a timeline outlining the report’s development.