A Healthy Union - Expanded Table of Contents

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A Healthy Union

How States Can Lead on Environmental Health

Susan Kaplan

Introduction: Creating Healthy Environments

After moving to a city that boasts a reputation as politically and environmentally progressive, Susan Kaplan was taken aback by widespread spraying of weedkiller in her neighborhood and near her children’s school. She began to understand that major gaps in environmental health laws at the federal level mean that many protections exist--or don’t--on the state level

Chapter 1: A Lack of Federal Protections

These gaps have a historical explanation: During both the 1920s and the 1970s, the environmental movement separated into natural resources conservation, which expanded on the federal level, and public health, which focused on sanitation in cities and failed to develop a broad movement. When the EPA was established, many programs that addressed the health impacts of environmental conditions were moved there from health agencies, further reducing attention to the health aspects of pollution. This was replicated at the state level.

Chapter 2: Enter the States

With the federal government largely retreating from protecting environmental health, states moved to the forefront. California took the lead. States can serve as laboratories of innovation, testing new programs and sharing best practices. But some do better than others at filling the gaps left by federal shortcomings, due to history, culture, financial resources, contributors to a state’s economy, and politics It is more complex than a red state-blue state dynamic.

Chapter 3: Partnerships and Technical Assistance: Reducing Toxics in Massachusetts and Texas

Under Massachusetts’ Toxics Use Reduction Act, state entities including the technical assistance office and the University of Massachusetts Lowell’s Toxics Use Reduction Institute equip businesses to reduce use of toxic chemicals. They offer extensive hands-on training, workshops,

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demonstration programs, case studies, and more. Measuring benefits of toxics reduction to industry is key A Texas law uses a similar structure, based at Texas A&M University’s Extension Program, to ensure that schools reduce the use of hazardous pesticides

Chapter 4: Environmental Health Education: Creating Training Centers in New York

Doctors receive little environmental health education during their training. The same is true for occupational health. In New York, physicians developed a proposal to establish an occupational health training center and ultimately secured state funding for such clinics around the state, with pediatric environmental health centers added later. The resulting cadre of specialists treat patients, provide training and education, and stand ready to address crises like environmental exposures of 9/11 first responders and to advocate for protective policies.

Chapter 5. Community Action: Improving Air Quality and Advancing Environmental Justice in California

In addition to children, low-income and Black and Latino communities are especially vulnerable to impacts of pollution. California’s Community Air Protection Program incorporates cumulative impact assessment, which accounts for exposure to multiple sources of pollution, socio-economic factors, and sensitive populations. The law and its follow-up require the state to reduce air pollution in very contaminated areas, with community participation a key component of these efforts. This complex program has yielded many lessons learned.

Chapter 6: Collaboration Across Agencies: Health in All Policies in Tennessee and Colorado

Government agencies often operate in silos. Yet decisions by a wide range of departments affect environmental health. There is typically not an incentive and there may be disincentives for agencies to take time and effort to learn about and work with each other. Tennessee’s Livability Collaborative now numbers 24 agencies that meet regularly. Outcomes include a set of livability indicators facilitated by the group’s connections, less duplication of efforts, and alignment of projects and proposals. Colorado has had similar successes.

Chapter 7: The Need for Federal Guidance: COVID-19 Mitigation in Schools

During the COVID-19 pandemic, states and localities were on the front lines of decision-making when it came to schools. States needed data and guidance from the federal government about how the virus was transmitted, the most effective mitigation techniques, and how best to spend the billions of dollars Congress provided to schools. But guidance was inadequate, pointing to improvements needed on the federal level for next time. This should include considering possible health impacts of mitigation, like microplastics in disposable face masks.

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Chapter 8. Cooperation Across States: Partnering to Cut Greenhouse Gases and Strengthen Environmental Security at the Regional Level

Pollution doesn’t stop at the state line. An approach that sits in between single-state solutions and federal policies is regional pacts. One widely touted arrangement is the Regional Greenhouse Gas Initiative (RGGI), a confederation of east coast states that works to reduce greenhouse gas emissions Another is the Southeast Regional Partnership for Planning and Sustainability (SERPPAS), made up of federal agencies and environmental and military officials from six southeastern states. In both cases, these partnerships have done more to protect environmental health than any of the individual states could accomplish on their own.

Chapter 9: Empowering State Action

A number of policy solutions from increasing environmental health education to carrying out broad economic analyses that account for costs and benefits to families, the health care system, and taxpayers can help lead to improved environmental health protections.

Chapter 10: Advocating for Environmental Health Policy

There are several keys to successfully advocating for environmental health policy enactment and implementation. This chapter examines them in the context of the multi-year, but ultimately successful, effort to pass a pesticide reduction city for New York City’s parks and playgrounds.

Conclusion Sources for Further Information