Strengthening the Role of Public Health in Environmental Policy
Burke, Thomas A., Shalauta, Nadia M., Tran, Nga L., Policy Studies Journal
Over the past 25 years there has been a steady decline in the role of public health agencies in environmental protection. This paper examines the major factors that have contributed to that decline, including the impact of federal environmental laws, the disparity in funding between regulatory and public health activities in environmental protection, and the emergence of risk assessment as a basis for environmental decisions. The methods of risk assessment and traditional public health approaches are contrasted, and the advantages of the involvement of public health agencies are discussed. Recommendations are presented for strengthening the role of public health in environmental decisionmaking to address more effectively public concerns about environmental risks.
The common roots of the public health and environment protection movements may date back as far as the archeological evidence of the drainage systems, toilets, and water systems of the Minoans and Myceneans, from 3000 to 1150 B.C. (Pickett & Hanlon, 1990, p. 21). In the United States, the beginnings of organized environmental protection efforts can be traced to the great sanitary movement of the nineteenth century. Influenced by the work of Edwin Chadwick in London (Richardson 1887), Lemuel Shattuck's 1850 Report of the Massachusetts Sanitary Commission formed the basis for many of the nation's first environmental health programs. The report recognized the role of urban crowding and filth, specifically, the "foulness of the air created by the decay of waste in areas of dense population" (Institute of Medicine, 1988). With recommendations that included regular surveys of health conditions and the supervision of water supplies and waste disposal, the work characterized the focus of the first boards of health as being concentrated on environmental sanitation to combat epidemics of cholera, typhoid, and yellow fever. These early boards, which began in the major cities, became models for the local and state public health agencies that assumed responsibility for controlling disease through sanitation, the protection of water supplies, control of air pollution nuisances, and the inspection of food.
Today, the protection of public health remains a fundamental goal of our national environmental protection programs. However, with the advent of the first Earth Day, in 1970, a dramatic shift has occurred in the organization of the nation's environmental protection efforts. The establishment of the Environmental Protection Agency (EPA), and the subsequent proliferation of similar state environmental agencies, has led to a steady decline in the role of public health agencies in environmental protection. This decline was pointed out in the 1988 Institute of Medicine report, The Future of Public Health which concluded:
The removal of environmental health authority from public health
agencies has led to fragmented responsibility, lack of coordination, and
inadequate attention to the public health dimensions of environmental
issues (Institute of Medicine, 1988).
Ironically, the demise of the role of public health agencies in environmental protection has occurred during a period of steadily increasing federal and state spending on environmental programs. Not surprisingly, it also has coincided with increasing public concern about environmental health effects and growing frustration with the inability of current risk assessment approaches to address basic public health concerns.
In response to concerns about the effectiveness of current environmental policy strategies, the United States Congress currently is working on a number of proposed bills that are aimed at revising agency risk assessment methods (Bureau of National Affairs, 1994). These bills promote a broader characterization of risks, a comparative approach to identify those problems that pose the greatest risks …
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Publication information: Article title: Strengthening the Role of Public Health in Environmental Policy. Contributors: Burke, Thomas A. - Author, Shalauta, Nadia M. - Author, Tran, Nga L. - Author. Journal title: Policy Studies Journal. Volume: 23. Issue: 1 Publication date: Spring 1995. Page number: 76+. © 1999 Policy Studies Organization. COPYRIGHT 1995 Gale Group.
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