Risk communication and decision tools for children's health protection

Patrice Sutton, Tracey J. Woodruff

Scientific discovery linking the environment to beneficial and adverse health children's health outcomes is rapidly expanding, leading scientists and health professionals to call for timely action to prevent harm and secure benefits. A robust method to synthesize what is known about the environmental drivers of health is a foundational step to making the science actionable by individuals and decision-makers. To meet this need, a methodology called the Navigation Guide was crafted by a collaboration of 22 clinical and environmental health scientists. The Navigation Guide proceeds from methods of research synthesis used in clinical settings but accounts for differences between environmental and clinical health sciences related to the evidence-base and decision-context. The methodology can be used to develop evidence profiles that provide simple, transparent summaries, such as practice guidelines or other evidence-based recommendations for prevention. Establishing proof-of-concept of the method is underway. Development of the Navigation Guide is extremely timely as it coincides with growing recognition of the need for updated methods in risk assessment. The costs in 2008 to the US healthcare system for treatment of childhood illnesses linked to toxic environmental exposures is conservatively estimated to be over $76 billion, and it is anticipated that US healthcare policy decisions will increasingly rely on systematic reviews of the evidence. The Navigation Guide is poised to provide a methodological bridge to link healthcare decision-making to efforts to reduce toxic environmental exposures. The institutionalization of the Navigation Guide would provide a concrete mechanism for linking science to action to protect children's health.