Making environmental health a cornerstone of public policy

Environmental health needs to play a central role in public policy decisions, experts said in a panel discussion Monday.

The Alliance for Health Policy hosted an online discussion on environmental health Monday.

Keisha Pollack Porter, vice dean for faculty at Johns Hopkins Bloomberg School of Public Health, described environmental health as an essential component of health equity.

“In order to achieve health equity, we have to remove obstacles to positive health,” Porter said.

She advocated an approach called “Health in All Policies,” ensuring that public policy decisions lead to better public health. Such an approach can place health into decisions on housing and transportation policies, among others.

“All of these policies can be environmental health policies,” she said.

Local governments can integrate health into planning and zoning policies. Porter talked about the need to integrate language about health into requests for proposals and to account for health impacts in grant-scoring criteria.

Lynn Goldman, dean of the George Washington University Milken Institute School of Public Health, outlined some guiding principles on environmental health policies.

“Prevention should be the tool of first resort,” Goldman said. “Cleanup is the tool of last resort.”

She said environmental health policies should focus on children’s health, the protection of ecosystems and the idea that polluters should be picking up the tab of the costs.

Some environmental policy changes have had a profound impact on public health, said Richard Jackson, a professor emeritus at the UCLA Fielding School of Public Health. And he noted changes in public policy are possible, even when the solutions seem daunting.

The former director of the CDC’s National Center for Environmental Health, Jackson cited the removal of lead from gasoline and paint as major contributors in the reduction of lead poisoning and the health impacts on children. He also underscored the importance of data driving public policy, as researchers demonstrated that kids with lead poisoning suffered developmental delays.

Jackson also called for a more robust federal investment in environmental health and climate change to encourage more young researchers to enter the field.

“There has to be a stable funding stream,” he said.

Goldman noted that environmental health experts need to be working with people in other disciplines and elected officials who care about these issues. She also said it’s important to help educate and motivate the public to think about these issues.

“We haven’t done the greatest job in building support from the public,” Goldman said.

Goldman, who previously worked in the U.S. Environmental Protection Agency said healthcare facilities need to do more to reduce the pollutants they produce. She also said manufacturers of medical devices often use harmful products that aren’t necessary. Earlier this month, Rachel Levine, assistant secretary of health in the U.S. Department of Health and Human Services, said hospitals are going to be a key component of the federal government’s efforts to combat climate change.

The panelists noted that President Joe Biden’s Build Back Better plan and the infrastructure package offer some positives to address environmental health, including measures to combat climate change, affordable housing and transportation investments. They also said it’s important to see how the money is utilized.

“It’s certainly a start and we’ll see where things end up,” Porter said.

The panelists also made a call for others to enter the environmental health field. Jackson, who previously served as California’s top health official, said he has never had a boring day in environmental health.

“It’s meaningful work and very gratifying work,” Jackson said.