Environmental Leadership Program: ELP News: Spring 2002: Perspectives on Public Health & the Environment

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newsletter Spring 2002

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Focus On: Public Health by Rachel Morello-Frosch
Program Update by Paul Sabin
Perspectives on Public Health and the Environment
Fellow Profiles: Michelle Alvarez, Jennifer Hill-Kelley
ELP Retreat Highlights
Activity Fund Updates: Alan Hipólito, Brad Guy, Jeff Tomhave
Fellowship Class of 2002-2004
ELP Newsmakers

Perspectives on Public Health & the Environment

We asked five ELP fellows, all of whom work on various aspects of public and environmental health issues, to talk about how public health is influencing the environmental movement, and what trends they have seen in the public and environmental health fields. Their responses reflect the variety of experiences they bring, bridging work with a federal agency to advocating the role of health in environmental justice cases to studying the trends in public health higher education programs. In the following conversation, these five fellows discuss public health and the environment from their individual perspectives, but are in collective agreement that public health is, and should be, intricately intertwined with environmental and social justice concerns.

MAX WEINTRAUB, who moderated and facilitated the following discussion, is polychlorinated biphenyls (PCBs) coordinator for the U.S. Environmental Protection Agency's Region 9 in San Francisco, California, where he oversees the implementation of the Toxic Substances Control Act regulations for the use, storage, and disposal of PCBs in Arizona, California, Hawaii, Nevada, and the Pacific Territories.

LYNN PINDER is founder and executive director of Youth Warriors, a nonprofit environmental justice organization in Baltimore that provides urban environmental education and training, leadership development, and organizing skills to young African Americans. She is also Southern Regional Coordinator for the Northeast Environmental Justice Network.

SWATI PRAKASH is director of environmental health and community-based research programs at West Harlem Environmental Action, where she works to educate and empower community residents to address environmental health issues, promote community-driven environmental health research, and conduct air pollution monitoring and reduction projects.

ALEJANDRA TRES is executive director of the Association of Environmental Health Academic Programs and the National Environmental Health Science and Protection Accreditation Council. Alejandra promotes environmental health education by collecting and disseminating information about education and research in environmental health and by raising awareness of future needs in environmental health education.

TRACEY WOODRUFF is a senior scientist and policy analyst in the National Center for Environmental Economics, Office of Policy, Economics, & Innovation, at the U.S. Environmental Protection Agency. Her research focuses on environmental health issues, including health effects from air pollution, children's health risks, and science policy issues.

How is the thinking on environment and public health changing?

Tracey Woodruff: People's concern about the environment is often really a concern about how the environment might affect their health or the health of their loved ones. This significant, though often unstated, link between the environment and health has been an important impetus for environmental legislation such as the Clean Air Act, Food Quality and Protection Act, Safe Drinking Water Act, and Superfund.

Max Weintraub: However, approaches based on those older environmental laws are becoming more challenging to implement as environmental health shifts from a focus on acute illness due to a single source (such as lead poisoning resulting from eating paint chips) to chronic illness resulting in synergistic interactions (such as lupus resulting from multiple chemical exposures). As the environmental interactions that threaten public health become more complicated, so does the difficulty of explaining them to the public and policy makers.

Alejandra Tres: This challenge represents a real opportunity, though, to get people's attention. For example, immediately following September 11, environmental health leaders were featured in the media as those protecting our health and well-being. People did not know that environmental health included such issues as anthrax and other emergency response actions, as well as food safety, vector control, housing, air quality, etc.

Does that broad-based thinking about the environment affect how we care for individuals or sensitive populations?

Exposures from noxious facilities often fall disproportionately on low-income communities or communities of color. Communication between communities and health professionals is key to increasing responsiveness to the concerns of communities and enhancing communities' understanding of environmental health risks.
Photo: Carlos Rene Perez

Swati Prakash: We are developing a better sense of the unique vulnerabilities of children to environmental exposures. Their metabolism is faster, they are more sensitive, and they are smaller, than adults are. Thus, environmental toxins have a much greater affect on children than adults. We also are gaining a much deeper understanding of the interplay between genetics and environment; and recognizing that the expression of one's genetic makeup is affected by the environment in which one grew.

Lynn Pinder: The environmental justice movement brings some of those pieces together. By focusing on communities at greatest risk of exposure to environmental toxins, and empowering them with knowledge and organizing skills, we can promote a more broad-minded approach to environmental impacts and their affect on people.

Alejandra: Along those lines, there is more acceptance from academia that applied environmental health research is valuable. However, incentives for community involvement are largely missing. Tenure evaluations encourage more esoteric research and publications. Academics, who are accustomed to laboratory research, also would benefit from community-based research and communication in order really to crossover from the ivory tower. Furthermore, recruitment of environmental health professionals is down. The Pew Environmental Commission recently reported that we need 137,000 environmental health professionals. However accredited programs in environmental health only graduate 600 students a year and enrollment continues to drop. Another report by the National Association of City and County Health Officials added that the majority of county health directors lack training in public health. The need for public health education among those working in health and the environment is a pressing area of concern.

Tracey: Many of the people in regulatory agencies who are tasked to address the environment and its impact on public health sometimes do not integrate some of the basic tenets of public health into their work. For example, it is important to act without complete knowledge to protect public health. The classic example is John Snow, a doctor in London during the 1800s, who used mapping techniques during a cholera epidemic to show that those living nearer a particular water pump were more likely to get cholera than those living farther away. By removing the water pump, he contained the epidemic. He did not know exactly through what mechanism cholera was being transmitted in the water or how it made people sick, but he acted anyway and saved many lives.

What is the first step to promoting public health?

Max: Communication is key. Community members and environmental health professionals both have vital information to share. However, given their different training and means of gathering and conveying information, both groups must exercise humility in order to learn from the other. ELP is supporting the creation of the Environmental Justice & Health Union at the Center for Environmental Health as a means to bridge that gap. The goal of EJ&HU - which is my ELP Activity Fund project - is to help activists and professionals better understand each other so they can be more effective in eliminating environmental disease in at-risk communities. Recognizing that race, class, and gender, as well as differences in formal education, are often barriers to solving problems is a critical first step to developing solutions.

Lynn: The failure to communicate can be devastating. I am currently looking at the Kennedy Krieger lead study in Baltimore. It is a situation where poor Black children were essentially used as lead detectors to see what methods could be used to limit lead exposure at the lowest cost to landlords. The children in the study did not benefit. The researchers and the community were not equal partners in designing the study and they should have been. At my organization, Youth Warriors, we have long focused on creating community leadership though a focus on environmental problems. We know that once youth acquire such skills, they can apply them to other challenges they face in the future, such as working in partnership with researchers to improve the health of the community.

Swati: Partnerships between study investigators and subjects remind us of the human dimension of such efforts. They help move us toward the precautionary principle, which emphasizes prevention rather than treatment, and bolsters environmentalists' efforts to promote a regulatory framework that supports human health over scientific certainty.

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