The NYSCHECK Centers are committed to supporting healthcare professionals around pediatric patients and their families’ environmental concerns. When a family has a question about the impacts of the environment on their child’s health, there are several resources available to help guide healthcare professionals.
Our environmental health team and partners created “Prescriptions for Prevention” to provide concise guidance to families on common and emerging environmental health concerns such as lead, mold, and climate change.1 They can be used in the clinic as a conversation starter and/or be given to patients as educational materials.
Each prescription’s front page explains steps for reducing the specific environmental exposure. The prescription’s back page details a list of resources that families can use. To tailor the resources to specific areas, some prescriptions were created for New York State and others were made based on the local regions in New York State. Several prescriptions are also available in Spanish to educate Spanish speaking families!
Here are the links to the localized Prescriptions for Prevention:
For families that may be from New Jersey, Puerto Rico, or the United States Virgin Islands, there are specialized Prescriptions for Prevention developed in partnership with the Pediatric Environmental Specialty Unit (PEHSU) Region 2. The PEHSU is a national network of experts committed to creating healthy environments for children. You can find these by following the link: PEHSU Region 2 Prescriptions for Prevention.
Letters from healthcare clinicians are an effective intervention to advocate for families needing repairs or improved housing conditions for environmental exposures such as lead or mold. These letters can be written to landlords and focused on the patient’s health condition(s) and how they are affected by their housing conditions. Standard letter templates can be integrated into the electronic medical record and be accessed easily as a way to support patients and families.
These letters are quick and effective! A New York City study found that most families who gave letters to their landlords reported that the process led to landlord action and improved housing conditions.2 We have found that there are a few basic components that need to be included in these letters.
Basic Components of a Clinician Letter
- Explanation of relationship to the patient including name and address of family
- Identification of the housing concern as described by the patient
- Description of the environmental exposure relevant to the housing condition
- Description of how current housing condition is adversely impacting (or could adversely impact) the patient’s health
- Request the necessary repair or remediation
We have provided letter templates on common environmental housing issues that can be adapted for your patient and their family. We also provide Epic templates for each letter with Epic “smart text” that can pull in your patient information.
All non-legal letter templates can be downloaded as word .docx files:
It can be challenging to identify resources that are focused and scientifically sound that may help patients and their families with questions around environmental issues. While not an exhaustive list, here are some key organizations that have information, resources, and programs that support children and families in keeping their environments safe.
National:
- Agency for Toxic Substances and Disease Registry: A federal agency focused on “determining, preventing, and mitigating the human health effects of exposure to hazardous substances.” They produce ToxFAQs that provide good information on a variety of hazardous substances. These educational materials also come in several languages.
- Consumer Reports: They have historically produced reports and information for consumers on environmental health topics.
- Environmental Working Group: They produce consumer guides which can empower the choices that families make around common household products.
- HealthyChildren.org: This is through the American Academy of Pediatrics, and they have many pages dedicated to environmental health topics.
- How to Quit Smoking: Quitting smoking can create a safer environment for children. These resources are from the Centers for Disease Control and Prevention.
- Medical Legal Partnerships (MLPs): Hundreds of healthcare systems across the US have established MLPs, which can be leveraged to address environmental and social needs in your patients.
- National Pesticide Information Center (NPIC): This is a free hotline that provides evidence-based information about pesticides.
- SOS Radon: They offer information on accessing radon testing and services.
State:
- New York State Health Neighborhoods Program (HNP): They have programming in several counties around New York State as well as in New York City. The environmental issues and related services within each county vary from asthma to tobacco cessation, lead, fire safety, and others. The program provides for in-home assessments and services, such as education, referrals, and products.
- Lead Poisoning Prevention and Management: This is a landing page for information on New York’s efforts around lead testing. It additionally had resources for contacting local health departments regarding lead test results or other questions.
Local:
- New York City:
- New York City 311 municipal hotline: This is a hotline where families can file maintenance complaints for heat, hot water, lead paint, fire safety, and more if their landlord has not addressed the issue.
- New York City Housing Authority (NYCHA): They will do inspections and repairs for environmental issues such as mold, asbestos, lead, and pests. Families should call the Customer Contact Center (718) 707-7771 to schedule an inspection.
For those seeking additional levels of information or support, you can contact a NYSCHECK Center near your area for information localized to specific regions across New York State. For information in other areas of the United States, you can contact a regional PEHSU.
- Bland C, Zajac L, Wilson J, Jr., et al. Prescriptions (Rx) for Prevention: Clinical Tools for Integrating Environmental Health into Pediatric Clinical Care. J Public Health Manag Pract. Mar-Apr 01 2025;31(2):244-251. doi:10.1097/PHH.0000000000002044.
- Lax Y, Cohen G, Mandavia A, Morrin S, Avner JR. Landlord Behavior After Receiving Pediatrician-Generated Letters to Address Poor Housing Conditions. JAMA Netw Open. Oct 1 2021;4(10):e2128527. doi:10.1001/jamanetworkopen.2021.28527.
Statewide Prescriptions for Prevention:
Localized Prescriptions for Prevention: