Reducing North Carolina's health care costs through environmental disease prevention

At a time of unprecedented pressure on the North Carolina state budget, reducing environmental risks to health may provide opportunities for substantial savings in the proportion of the state budget (24%) that is allocated for medical assistance. Recently, the Research Triangle Environmental Health Collaborative held a summit to identify options for increasing attention to environmental impacts on health in the ongoing health care and budget debates. Summit participants included not only public health and environmental experts, but also individuals (such as transportation planners, developers, and industry representatives) whose decisions can have a significant impact on environmental quality. This article summarizes key recommendations from the summit, as well as commentaries in the policy forum of this issue that further elaborate on why environmental quality matters for public health in North Carolina. Key recommendations from the summit include requiring formal health impact assessments (similar to environmental impact assessments but with an emphasis on health) in state and local transportation and land use planning processes, quantifying the total disease burden attributable to environmental hazards in North Carolina, prioritizing environmental risks to health in North Carolina, providing state technical assistance for communities disproportionately affected by poor environmental quality, establishing a new database system to link existing environmental and public health data by geographic location, undertaking North Carolina case studies to test the hypothesis that improving environmental quality also reduces medical care costs, and developing "environment matters to your health" public awareness campaigns.