POLICY   PAPER
             'This supplement to EPA InSight contains up-to-date policy information from the
                         Administrator/Deputy Administrator to all EPA  employees.
November 1993
  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
      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
      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
    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
    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

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.