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Lessons from 12 years of comparative risk projects.

Can an analytical tool for comparing environmental risks and policy activities be used to evaluate their relative efficacy in ultimately changing the allocation of public funds? Some insight is possible through a review of comparative risk projects that have been carried out at the city, state, and national levels, as well as among Indian tribes, over the past 12 years. The lessons from this review should apply to the field of public health. For every comparison of environmental issues, such as clean-air standards with fish consumption advisories, there is a parallel discussion of public health priorities and strategies, such as antismoking and pregnancy prevention programs, immunization programs and disease surveillance efforts, or well-baby clinics and food safety programs. Lessons from comparative risk projects and processes may offer the public health community new ways of thinking about using stakeholder assessment processes in developing public health policy.