PL-
POLICY PAPER
'This supplement to EPA InSight contains up-to-date policy information from the
Administrator/Deputy Administrator to all EPA employees.
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PUBLIC HEALTH -- AN EPA IMPERATIVE
November 1993
EPA-175-N-93-025
Below is a speech given by Administrator Carol Browner to the
American Public Health Association on October 27, 1993:
It is an honor to be with people who are on the front lines
of protecting public health. We know that when the public
health movement began in this country, it was in large part a
movement for environmental sanitation. That movement paid
great dividends in reducing the rate of infant mortality from
infection, reducing the rate of tuberculosis from overcrowding
and malnutrition, and reducing the rate of chronic lung disease
from air pollution and dirty workplaces.
Yet somehow, in the past twenty years, the world of public
health and the world of environmental protection have grown
further apart. It is time to bring public health practice back
into what we do at EPA.
EPA has always dealt with issues that arfect public health-
because whatever we do to our environment has a profound
effect on our own wellbeing. Since coming to EPA, I have
made it very clear that protecting public health is my top
priority. I want to talk briefly today about what EPA and the
Clinton Administration are doing to protect our global
environment, and why these actions are so important to public
health.
Both the President and I are convinced that, if we are truly
to protect public health both in this country and around the
world, we need a new approach.
First, we need good science. Science-including the work
of public health scientists—must be the backbone of every one
of our policies and decisions.
Second, whenever possible we must prevent pollution, not
just clean it up after it happens. Just as public health efforts are
based on the concept of health promotion and disease
prevention, we at EPA must prevent environmental pollution
at its source, rather than simply treating the problems after they
occur.
What's more, when we diagnose environmental problems,
we borrow a technique familiar to medicine: we look at the
entire "body" of our patient—the planet. Just as your patients'
heart conditions may be affected by another bodily system, our
diagnosis must look at air pollution, water pollution, and toxic
contamination of our land, and how they all interact.
Third, we need to fix the process. We must be absolutely
committed to the goal of protecting the health of people and
our natural resources, while incorporating a new measure of
innovation and flexibility in how we reach that goal.
And fourth, we need to involve many, many more people
in protecting their own health and their own environment.
Particularly in minority and low-income communities, which
are often in the most hazardous environments, we need to learn
from the public health model of educating and empowering
communities. We need to build better partnerships with state
and local governments. Thre is no doubt in my mind that a
local community can do a better job of protecting the local
environment than a distant bureaucracy.
My vision is that we must take these principles of change
and forge the most ambitious and aggressive agenda EPA has
ever seen. And in this I have the firm support of our President
and Vice President. Whatever we do will have a
tremendous impact on public health throughout the world. The
U.S. casts a very long shadow. Every day, the average
American consumes most of his or her own weight in fuel,
food, paper, steel, and other basic materials. We account for
less than five percent of the world's population, but we account
for 25 percent of the comsumption of fossil fuels. Americans
throw away twice as much garbage per person as West
Europeans or Japanese. Like other industrial nations, the U.S.
imports raw materials—and exports pollution.
The U.S. could be a leader in cleaning up the world's
environment. We should be. But, to do it, we're going to have
to change what we do at home and what we do abroad.
Let me tell you what we're doing in just a few areas to
make the U.S. a part of the solution, not part of the problem.
First, President Clinton signed the Biodiversity Treaty that
George Bush refused to sign in Rio. This treaty seeks to
protect plants and animals from extinction. To name just one
of the health benefits of this effort, more than half of the drugs
we use to protect human health come from plants.
Second, we've stepped up our effort to reduce ozone
depletion. Scientists believe that depleting the ozone layer
could be one of the most significant threats to public health-
causing more skin cancer, more cataracts, and significant
suppression of the immune system.
On Earth Day, last April, President Clinton signed an
Executive Order requiring the nation's number-one user of
ozone-depleting chemicals to speed up the phase-out of those
chemicals.
Who is the nation's number-one user of these chemicals?
The federal government.
Under the 1990 Clean Air Act, industry across America is
phasing out the chlorofluorocarbons that are thought to be
causing the ozone hole over Antarctica and depletion over other
parts of the globe. In fact, each year, American industry has
done better than required by both the Clean Air Act and the
international treaty governing ozone-depleting chemicals, the
Montreal Protocol. On December 31, we will reach a major
milestone when we completely stop the production of ozone-
depleting Halons, which were once widely used to put out
fires.
The third global protection initiative I want to mention is
the climate change action plan that President Clinton recently
issued. This act re-established the U.S. as the leading nation in
efforts to protect against global warming. Cutting our nation's
emission of greenhouse gases will have direct health benefits—
not just in the country, but around the world, not just in the
future, but starting today.
Scientists have predicted that, if we do nothing to stop the
emission of greenhouse gases, we will see a four- to seven-fold
increase in weather-related deaths. A warmer climate could
also casue a big jump in diseases that are transmitted by
insects—malaria, schistosomiasis, river blindness. In developing
nations, an increase in these diseases would put an unbearable
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strain on public health facilities.
Some skeptics say we can't be sure that climate change is
really occurring, and even if it is, we can't really predict what
its effects will be. To thorn, I say that the history of public
health shows that tremendous advances were made because
people forged ahead, even when they didn't know the precise
cause of disease and didn't have the exact cure.
Eiut, let's assume global warming is just a myth. Even so,
cutting down on greenhouse gas emissions will benefit public
health by reducing air pollution. Sulfur oxides, nitrogen oxides,
carbon monoxide, soot and smog—all of these are bad for
human lungs. Based on recent studies, 70,000 deaths a year are
attributable to inhalable particles in the air. And air pollution
is als>o associated with the substantial increase in emergency
room visits by people with asthma, and by the rising rate of
hosp. talization for pneumonia and chronic lung disease.
Cleaning up our air means saving lives.
I should also say that, even though EPA doesn't have any
regulatory authority over secondhand tobacco smoke, we felt it
was s.o critical to public health that, several months ago, I urged
that all workplaces, all day care centers, all schools, and all
home's should become smoke-free.
Let me also mention what EPA is doing to improve food
safety. When I came to Washington, I learned that, of the 600
pesticides now in use, fully two-thirds have not been subject
to an up-to-date, science-based review. Pesticides are risky—to
consumers, to workers, and to our environment. I'm
particulary concerned about the risks for children. At EPA's
request, the National Academy of Sciences studied the risks and
recommended extra protection for children, based on what they
eat and their special vulnerabilities.
Last month, EPA, along with the Department of Agriculture
and the Food and Drug Administration, presented to Congress
a comprehensive plan to impose a rigorous, health-based
standard for all pesticides, covering all foods and all risks to
human health. Currently, the law provides for a slightly stricter
standard that applies only to cancer risks and only to processed
foods. We must do better than that. We must cover all risks
and all foods, because consumers should not accept un-
reasonable health risks for the benefit of small numbers of
agricultural producers.
We also propose stronger legal mandates to enable EPA to
get dangerous pesticides off the market as quickly as possible.
The burden of proof should rest with companies that their
products can be used safely, not with the government to
provide they are dangerous.
And we propose to work with the Agriculture Department
to help farmers use less risky methods of agriculture. Instead
of applying countless numbers of chemicals to our food and
then trying to study the effects of human health, doesn't it
make more sense to grow our food safely in the first place?
The U.S. is a major exporter of pesticides. Right now, if the
U.S. bans a pesticide, the law allows the manufacturer to turn
around and export it to another country. We're proposing to
prohibit the export of any pesticide that has been banned in the
U.S. for health reasons. We also want to supply developing
nations with the information they need to make wises chocies
about pesticides.
NAFTA, the North American Free Trade Agreement, i<-
another issue of public health concern. In March, I visited tht
U.S.-Mexico border. I saw raw sewage floating in the Ric
Grande. I saw children splashing in polluted puddles, people
washing clothes in contaminated water. I smelled the foul air
I talked to mothers about their concern over the possible link
between pollution and birth defects. And I became convmced-
first, that NAFTA was needed to solve the public health
problems at the border, and second, that NAFTA could serve
as an important vehicle for environmental protection
throughout the continent.
With NAFTA, and the environmental side agreement that
President Clinton insisted upon, our environment will
improve. Without NAFTA, it will not.
NAFTA commits the three nations to carry out
environmental planning on a scale never seen before. NAFTA
has tough enforcement mechanisms. NAFTA gives the citizens
of all three nations new ways to participate in cracking down
on polluters. And NAFTA would open up a huge new market
for environmental technology, and that means jobs. For all
these reasons, most national environmental groups support
NAFTA. ,
Finally, of great importance to this audience, is health care
reform. Americans who live in the most polluted environments
suffer from the injustice of bearing more than their fair share of
the burden of industrial life. But, they also suffer from a health
care system that neglects preventive care and makes it difficult
for them to receive the most basic medical treatment at a cost
they can afford.
But, our health care system isn't only a problem for people
in the most impoverished communities. Most people don't
realize that, over the next two years, one in four Americans will
be without health coverage at some point. And health costs
have nearly quadrupled since 1980. We need to reform our
health care system so we can spend those dollars on protecting
our environment and improving the overall health and
wellbeing of all Americans.
A few months ago, 1 was in Mexico meeting with President
Salinas. He spoke movingly about his passionate commitment
to cleaning up the Mexican environment. Then, it was my turn
to speak. I began to describe our own efforts here in the U.S.
to protect our air, our water, and our land. He interrupted me.
"Do you have a child?," he said. I said I did. "That's why you
do what you do," he said. "You feel a moral imperative to fight
to make the world liveable for your child and for the next
generation." He was right. My son Zachary is five-and-a-half.
He understands instinctively that, when we talk about
environmental problems, we're talking about taking care of
where we live. We're talking about protecting ourselves. In
my son's words, "Don't hurt where you live."
At EPA, we take our responsibility for public health very
seriously. We call on Congress, on industry, on
environmentalists, on all people to change, to embrace a new
commitment to environmental protection. Nothing loss than
the health of our families, the health of our economy, the health
of our environment, and the health of our nation are at stake.
Thank you.
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