Working to build healthy communities: community environmental health assessments using PACE EH.

W hat is a healthy community? What role do environmental health prac­ titioners play in ensuring that healthy communities are constructed, pro­ tected, and maintained? Healthy communi­ ties can be described in many ways depend­ ing on local values. The commonly accepted public health definition of a healthy com­ munity is one that is “continuously creating and improving those physical and social en­ vironments and expanding those community resources that enable people to support each other in performing all the functions of life and in developing to their maximum poten­ tial.” Healthy communities promote physi­ cal activity, which has been shown to reduce the risk for developing high blood pressure, cardiovascular disease, diabetes, and colon cancer. Well-designed, healthy communities decrease vehicular traffic, which reduces ac­ cident-related injuries and respiratory prob­ lems associated with air pollution. Healthy communities protect green spaces so that outdoor areas are available for recreational activities. However healthy communities are defined, they depend on the services pro­ vided by environmental health practitioners. These services include protecting the safety of food and water, controlling vectors that spread diseases, and preventing exposure to environmental contaminants. Traditional environmental public health prac­ tice has sought to protect against environmental factors that adversely affect human health. This goal has not changed, but new tools and meth­ ods are needed to identify and resolve today’s en­ vironmental public health issues. Environmen­ tal public health specialists must work closely with the communities they serve to ensure that people of all ages can remain healthy and de­ velop to their fullest potential. Increasingly, en­ vironmental health practitioners are required to mobilize community residents, engage the resi­ dents in discussions about what environmental health means for the community, and assess community values and priorities as they relate to environmental health and quality of life. One tool for doing so is the Protocol for Assess­ ing Community Excellence in Environmental Health (PACE EH), which was developed by the National Association of County and City Health Officials (NACCHO) and the National Center for Environmental Health (NCEH) to assist environmental health practitioners to meet the needs of communities. The PACE EH guidebook describes a pro­ cess for conducting a community-based en­ vironmental health assessment (http://pace. naccho.org/DownloadPage.asp). The assess­ ment process consists of 13 tasks (see side­ bar on page 33) that guide communities and environmental public health officials in iden­ tifying local environmental health concerns, implementing action plans, and evaluating progress in reducing environmental problems and improving quality of life. PACE EH en­ gages communities in environmental health planning activities that go beyond conven­ tional regulatory practices. A fundamental value of the PACE EH process is community collaboration, which leads to the develop­ ment of lasting partnerships and community