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Welcome to PSR's Environmental Health Policy Institute, where we ask questions -- then we ask the experts to answer them. Join us as physicians, health professionals, and environmental health experts share their ideas, inspiration, and analysis about toxic chemicals and environmental health policy.

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A healthy environment: Can we get there from here?

By Carol Stroebel

This essay is in response to the question: Which Way Forward for Toxics Advocacy?

Ask anyone if they want a healthy environment in which all children can thrive, and who is going to say no?  But it’s a bit like the old saying, “Everyone wants to go to heaven, but nobody wants to die.”  Yes, we want a healthy environment for all children. What’s the future of the human race if we can’t provide one?  Yet the barriers to that healthy environment can look insurmountable.

The path will not be predictable.  Back in the 1980s, few would have foreseen that the controversy surrounding Alar, a common pesticide, would lead to the creation 20 years ago of the Children’s Environmental Health Network.  Or to the passage of major pesticide reform four years later.  (The controversy was at least a precipitating event if not the direct parent.)

Unexpected factors – like a major disaster, or our increasingly ideology-driven rather than fact- or science-based political discourse – further complicate prediction.  The post-November 2012 political landscape is unknowable until, well, after November 2012.  But a crystal ball is not as important as a clear, long-term vision, which can also guide us in the near term. 

The next hot issue in toxics may be nanomaterials and the fact that we have, once again, released a new category of chemicals into the world, and into our bodies, with no idea of their impact on human health and development.  The federal entity charged with ensuring the safety of nanotech is also charged with promoting nanotech.  That’s not a recipe for public health.  Or the public may awaken to the omnipresence of triclosan, the antimicrobial compound in a wide range of consumer products, or to that of flame retardants. 

The specific trigger may change, but medical and public health must be ready to use such flash points events as a “growth experience.”  That is, to help the public understand the ways in which we are not protecting environmental health.

One barrier is the outdated and ineffective nature of our chemical-by-chemical approach to regulating.  How to get the public and policy makers to recognize that we need to move beyond it?  That’s a goal which is unlikely to be fully achieved in the near future, but we can move in that direction.

Similarly, in a world of limited resources, it’s tempting to circumscribe our actions:  let’s focus only on consumer behavior, for example, or on Federal regulators, or state legislators.  Unfortunately, that sets up a false choice.  These different arenas all intersect.  For example, educating consumers supports better individual choices to drive the market, while it also builds the political will for change.  “What do you mean, BPA is banned in Europe and Japan but not here?”  Consumer (general public) awareness of our issues also expands our alliances and our resources for policy change.

We should be able to build enough interest and alliances to work in all of these areas.  Not to do so deprives us of our ability to seize important opportunities.  For example, if the alternative is, as an example, an exclusive focus on the states, that leads to the inability to maintain basic levels of information and relationships at the federal level.  Thus, when (not if) openings arise at the federal level, our community is not in a position to grasp them.

To move toward healthier environments for all, a paradigm shift is necessary.  The public, especially policy-makers, need to think of more than health care when they think of health.  Access to and quality of health care is to vital to individual and public health, no question.  But the key factors shaping our health go far beyond ‘health care.’  Thus, one part of our long-term vision must be improving environmental health literacy.  Only when policy-makers understand the role that our environment plays in human health will we see policies and programs that remove barriers to a healthy environment.  One description of this approach, called ‘Health in All Policies,’ is to “integrat[e] health considerations into policy making across sectors, and at all levels, to improve our nation’s overall population health.”

Here at the Children’s Environmental Health Network, we’ve always said:  “Put the child in the center.” 

“Consider the impact on human health, especially the health of children and other vulnerable populations, when setting policy  --  or making personal decisions.”  That’s one way to understand ‘Health in All Policies.’  Most of our policies do not do so.  The major U.S. statute for regulating chemicals, the Toxic Substances Control Act (TSCA), is not health-based, to say the least.  Imagine if, when reauthorizing TSCA, or writing any other statute, our lawmakers did indeed take children’s unique vulnerabilities and susceptibilities into account, placing children’s health, development, and future, in the forefront.

Then that unattainable paradise of a healthy environment for all begins to look attainable.

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