Each year in the United States approximately 440,000 babies are born premature. These infants are at greater risk of death, and are more likely to suffer lifelong medical complications than full-term infants. Clinicians and researchers have made vast improvements in treating preterm birth; however, little success has been attained in understanding and preventing preterm birth. Understanding the complexity of interactions underlying preterm birth will be needed if further gains in outcomes are expected. The Institute of Medicinea (TM)s Roundtable on Environmental Health Sciences, Research, and Medicine sponsored a workshop to understand the biological mechanism of normal labor and delivery, and how environmental influences, as broadly defined, can interact with the processes of normal pregnancy to result in preterm birth. This report is a summary of the main themes presented by the speakers and participants.

The purpose of this regional workshop in the Southeast was to broaden the environmental health perspective from its typical focus on environmental toxicology to a view that included the impact of the natural, built, and social environments on human health. Early in the planning, Roundtable members realized that the process of engaging speakers and developing an agenda for the workshop would be nearly as instructive as the workshop itself. In their efforts to encourage a wide scope of participation, Roundtable members sought input from individuals from a broad range of diverse fields-urban planners, transportation engineers, landscape architects, developers, clergy, local elected officials, heads of industry, and others. This workshop summary captures the discussions that occurred during the two-day meeting. During this workshop, four main themes were explored: (1) environmental and individual health are intrinsically intertwined; (2) traditional methods of ensuring environmental health protection, such as regulations, should be balanced by more cooperative approaches to problem solving; (3) environmental health efforts should be holistic and interdisciplinary; and (4) technological advances, along with coordinated action across educational, business, social, and political spheres, offer great hope for protecting environmental health. This workshop report is an informational document that provides a summary of the regional meeting. Table of Contents Front Matter Summary 1 Perspective on Environmental Health 2 Rebuilding the Unity of Health and the Environment 3 Environmental Health: A Fifty-Year Perspective 4 Human Health and the Natural Environment 5 Human Health and the Built Environment 6 Human Health and the Social Environment References Appendix A Agenda Appendix B Speakers and Panelists Appendix C Meeting Participants

This report is the summary of the fourth workshop of The Roundtable on Environmental Health Sciences, Research, and Medicine. Environmental Indicators: Bridging the Chasm Between Public Health and the Environment, continues the overarching themes of previous workshops on rebuilding the unity of health and the environment. The purpose of the workshop was to bring people together from many fields, including federal, state, local, and private partners in environmental health, to examine potential leading indicators of environmental health, to discuss the proposed national health tracking effort, to look into monitoring systems of other nations, and to foster a dialogue on the steps for establishing a nationwide environmental health monitoring system. This workshop brought together a number of experts who presented, discussed, and debated the issues surrounding the implementation of a monitoring system.