Dean co-authors commentary on recent changes in US health leadership and policy
Feb 5, 2020In the March issue of the American Journal of Public Health, ColoradoSPH Dean Jon Samet and his collaborators write:
We are saddened to witness the recent erosion of US international leadership in environmental health. Yale University’s environmental performance index rates countries across a range of environmental health programs. In 2018, the United States ranked 27th out of 180 countries. Controlling for the strong relationship between wealth and environmental programs, the United States now ranks last compared with its affluent peers in Western Europe, Asia/Pacific, and Canada. While the United States ranks high in those areas addressed from the 1970s—for example, air quality, water, and sanitation—it ranks poorly with regard to climate change and other new challenges.
The 1969 National Environmental Policy Act (NEPA), signed on January 1, 1970, signaled Americans that the nation was creating an environmental ethic. NEPA required an environmental impact statement for significant federal government projects and for projects that required federal licenses, permits, and funding. NEPA has served as a model for more than 100 countries and perhaps is the most emulated US law. Also during the 1970s and early 1980s, the US government passed other major laws that established the United States as the international champion of environmental health...
Recent actions affecting the pathways by which science is incorporated into EPA’s regulations have reversed more than four decades of congressional and agency actions. Changing selection processes have led to a replacement on advisory committees of academic scientists with industry consultants. In a recent irrational twist, an academic scientist who receives funding from EPA through a competitive peer-reviewed process, therefore presumably among the most knowledgeable on the subject, is precluded from providing advice to EPA because of an alleged conflict of interest. Yet, the door has been opened for industry scientists to participate without concern for conflict of interest...
It has taken a short time to weaken and in some cases tear down the international leadership position the United States has long held. Environmental and ecosystem health are at risk; continued attention is needed to the “legacy” issues, and we are ill-equipped to deal with the new challenges related to climate change, emerging infectious diseases, food security, and cascading and cumulative environmental health risks. The US public health community needs to deeply engage with the political process as individuals and to act as a strong professional voice in a vigorous effort to re-establish itself as a force guiding actions to curb environmental threats. It needs to engage the public broadly, particularly youths who face the future risks of these threats. We need to collectively work with progressive states and local governments to promote the programs that the federal government has backed away from and work with far-sighted businesses and nongovernment organizations to push for stronger, not weaker, environmental management. We also need to continue to be central players at the international level by writing, joining committees, and engaging with international colleagues and audiences on building science. Tragically, without action, environmental quality could go backward, and we need to slow the acceleration of climate-impacted outcomes and reverse the painful pace of environmental degradation. With future administrations, there may be support for restoring what this administration has damaged. We need to be ready for that opportunity.
Read the entire commentary on the AJPH website.