Rachel's Democracy & Health News #867  [Printer-friendly version]
August 10, 2006

JUSTICE AND YOUR HEALTH DEPARTMENT

[Rachel's introduction: Your ENVIRONMENTAL agency is supposed to
protect you and the natural environment from harm. But your local
HEALTH department is supposed to create and maintain conditions that
allow people to be healthy -- a far more powerful mandate. Your
health department is also supposed to maintain vigilance to ensure
social justice. But what if your health department doesn't do these
thing? What then?]

By Peter Montague

Community-based activists may be missing an important opportunity if
they don't explore alliances with their local health department. Some
health departments are like dinosaurs, but many are not. Your local
health department is most likely connected to the national
organization, NACCHO (National Association of County and City Health
Officials). This week let's look at just two of the many resolutions
NACCHO has adopted and published in recent times:

ON HUMAN RIGHTS (Resolution 01-10, dated June 27, 2001)

WHEREAS, the mission of public health is "to fulfill society's
interest in assuring conditions in which people can be healthy";[1]
and

WHEREAS, "the values that underlie public health are the values of
human rights and there is an undeniable relationship between
individual rights, human dignity, and the human condition";[2] and

WHEREAS, Article 25 of the Universal Declaration of Human Rights,
adopted by the United Nations General Assembly in 1948, states
"Everyone has the right to a standard of living adequate for the
health and well-being of himself and of his/her family, including
food, clothing, housing, and medical care";[3] and

WHEREAS, "Vigilance to prevent human rights violations and to ensure
social justice for all people is essential to the advancement of human
development and the prevention of human suffering";[4] and

WHEREAS, according to the World Health Organization, more than 40
percent of all people who died in the world died prematurely, in part
due to major inequalities in access to basic human needs, poverty,
poor sanitary conditions, and violence;[5]

THEREFORE, BE IT RESOLVED that the National Association of County and
City Health Officials (NACCHO) will advocate for the protection of
human rights and social justice as a guiding principle in public
health practice, research and policies; and

BE IT FURTHER RESOLVED that NACCHO will work to incorporate human
rights, social justice, and efforts to eliminate disparities in health
status into public health curricula, workforce development
initiatives, and program evaluation measures; and

BE IT FURTHER RESOLVED that NACCHO will collaborate with partner
organizations, government agencies, global initiatives, and community
groups in the prevention of human suffering and the promotion of
social justice, health, equity, and sustainable development. [End of
Resolution 01-10]

And this one:

SUPPORTING ENVIRONMENTAL JUSTICE (Resolution 00-07 Nov. 12, 2000)

WHEREAS, throughout the nation there is an overrepresentation of toxic
waste sites and contaminated properties in communities of color and
low-income communities[6], and race is the most significant variable
that has been associated with the siting of hazardous waste
facilities, even after controlling for urbanization, regional
differences and socio-economic status[7]; and

WHEREAS, penalties imposed under hazardous waste laws at sites having
the greatest white population were about 500 percent higher than
penalties imposed at sites with the greatest people of color
population[8]; and

WHEREAS, serious health concerns and exposures have resulted from the
siting of toxic waste and other contaminated facilities in communities
of color and low-income communities, adding to other threats posed by
poor quality housing, absence of mass transit, unhealthy working
conditions, poverty, and high levels of pollution production[9]; and

WHEREAS, urban sprawl and discriminatory land use decisions create
economic and racial polarization, segregated neighborhoods and
deteriorating neighborhoods in people of color and low-income
communities,[10] thereby increasing health and safety risks, health
disparities, air and water pollution, poor quality housing, unstable
neighborhoods, unsustainable ecosystems, and poor quality of life;[11]

THEREFORE, BE IT RESOLVED that the National Association of County and
City Health Officials (NACCHO) supports the fundamental right to
political, economic, cultural and environmental self-determination of
all peoples, and the right to be free from ecological destruction; and
affirms the need for urban and rural ecological policies to clean up
and rebuild our cities and rural areas in balance with nature while
assuring healthy communities; and

BE IT FURTHER RESOLVED that NACCHO facilitates local public health
agency efforts to ensure that no communities suffer from
disproportional exposures to environmental health hazards; and

BE IT FURTHER RESOLVED, that NACCHO actively supports programs,
policies, and activities that build the capacity to identify
disproportionate sitings of facilities, discriminatory land use and
zoning laws, and to assure nondiscriminatory compliance with all
environmental, health and safety laws in order to assure equal
protection of the public health; and

BE IT FURTHER RESOLVED that NACCHO supports public and corporate
policy based on mutual respect and justice for all peoples, free from
any form of discrimination or bias; and

BE IT FURTHER RESOLVED that NACCHO supports universal protection from
unnecessary radiation exposure resulting from nuclear testing,
extraction, production and disposal of toxic/hazardous wastes and
poisons that threatens the fundamental right to clean air, land,
water, and food; and

BE IT FURTHER RESOLVED that NACCHO supports the principle that
producers of hazardous waste and materials be held strictly
accountable to the people and responsible for containment and
detoxification; and

BE IT FURTHER RESOLVED that NACCHO supports the right of all people
potentially affected to participate as equal partners at every level
of decision-making about hazardous waste and materials, including
needs assessment, planning, implementation, enforcement and
evaluation; and

BE IT FURTHER RESOLVED that NACCHO recognizes a special legal and
ethical relationship of the federal, state, and local governments and
Native Peoples through treaties, agreements, compacts, and covenants
affirming sovereignty and self-determination; and

BE IT FURTHER RESOLVED that NACCHO affirms the right of all workers to
a safe and healthy work environment; and

BE IT FURTHER RESOLVED that NACCHO calls for the education of present
and future generations which emphasizes social and environmental
issues, based on our experience, our concern for health, and an
appreciation of our diverse cultural perspectives; and

BE IT FURTHER RESOLVED that NACCHO supports the right to ethical,
balanced and responsible uses of land and renewable resources in the
interest of a sustainable planet for humans and other living things.
[End of Resolution 00-07]

In sum, NACCHO recognizes that

** Everyone has a right to an environment that promotes health; this
is much more than merely having a right to an environment free of
toxicants. This is the difference between your environmental agency
and your health agency -- the environmental agency aims to "protect"
health from bad things. Your health department has a mandate to
promote health by making good things happen.

** Everyone has a right to a standard of living adequate for health
and well-being; your environmental agency has no mandate to worry
about your standard of living, but your health department does.

** Social justice is the guiding principle of public health practice
and policies;

** Vigilance is necessary to ensure social justice;

** Local health departments "will collaborate" with partner
organizations, including community groups -- perhaps your community
group;

** In communities of color and low-income communities, toxic waste
sites have been piled on top of other threats posed by poor quality
housing, the absence of mass transit, unhealthy working conditions,
poverty, and high levels of pollution. Thus your health department
recognizes that toxic waste and pollution don't occur in a vacuum --
they are part of something now being called "cumulative risk."

** Sprawl and discriminatory land-use decisions (to keep the poor out
of suburbs, mainly by refusing to provide affordable housing) have
increased (a) health and safety risks for the poor and people of
color, (b) health disparities, (c) air and water pollution, (d) poor
quality housing, (e) unstable neighborhoods, (f) unsustainable
ecosystems, and (g) poor quality of life. In other words, your health
department "gets" that sprawl does more than chew up farmland --
sprawl makes people sick and ruins real lives of real people.

** Supports the "fundamental right" to be free from ecological
destruction;

** Facilitates local agency efforts to ensure that no communities
suffer from disproportional exposures to environmental health hazards;

** Supports the right of all people potentially affected to
participate as equal partners at every level of decision-making about
hazardous waste and materials, including needs assessment, planning,
implementation, enforcement and evaluation. In other words, your
health department "gets it" about the importance of democracy.

What if your health department doesn't behave this way?

If your local health department doesn't seem to measure up to the
expectations outlined by NACCHO, there's a new tool you can use to
actually measure your health department's performance -- a set of
minimum functions expected of all local health departments, created
by NACCHO. The minimum "core functions" of a health department are
spelled out officially here -- and you can use them as a benchmark
for measuring the performance of your local health department. You say
they don't measure up?

Well, then -- that's good ammunition for a local political fight,
isn't it? A good health department is worth fighting for -- and worth
going to bat for when their budget is under threat.

==============

[1] Institute of Medicine, The Future of Public Health. Washington,
DC: National Academy Press; 1988.

[2] Rio Declaration on Environment and Development, July 14, 1992 ILM.
1992; 31:873.

[3] Note, this was also echoed in the constitution of the World Health
Organization and was ratified by subsequent international covenants
and conventions.

[4] American Journal of Public Health, May 2000, Vol. 90 No. 5,
Rosalia Rodriguez-Garcia, PhD, MSc, Mohammad N. Akhter, MD, MPH

[5] World Health Organization. World Health Report. Geneva, 1998

[6] Benjamin Goldman, Not Just Prosperity: Achieving Sustainability
with Environmental Justice. Washington, DC: National Wildlife
Federation, 1994; Carita Shanklin, "Comment, Pathfinder: Environmental
Justice," 24 Ecology Law Quarterly 333 (1997); Commission for Racial
Justice, United Church of Christ, "Toxic Waste and Race in the United
States, a National Report on the Racial and Socio-Economic
Characteristics of Communities with Hazardous Waste Sites," Public
Data Access, Inc., 1987.

[7] Paul Mohai and Bunyan Bryant. "Environmental Justice: Weighing
Race and Class As Factors in the Distribution of Environmental
Hazards," 63 University of Colorado Law Review 921 (1992).

[8] The National Law Journal, "Unequal Protection, the Racial Divide
in Environmental Law, " Sept. 21, 1992.

[9] Robert Bullard, Unequal Protection: Environmental Justice and
Communities of Color. San Francisco: Sierra Club Books, 1994;. Charles
Lee, Environmental Justice, Urban Revitalization, and Brownfields: The
Search for Authentic Signs of Hope. A Report on the "Public Dialogues
on Urban Revitalization and Brownfields: Envisioning Healthy and
Sustainable Communities. Washington, DC: National Environmental
Justice Advisory Council Waste and Facility Siting Subcommittee.
December, 1996. EPA 500 R-96-002. Also appears as "Environmental
Justice: Creating A Vision for Achieving Healthy and Sustainable
Communities," in Benjamin Amick and Rima Rudd eds. Social Change and
Health Improvement: Case Studies for Action, forthcoming, 1999; Craig
Anthony Arnold, "Planning Milagros: Environmental Justice and Land Use
Regulation," 76(1) Denver University Law Review 1998: 1.

[10] Michael Gelobter, "The Meaning of Environmental Injustice," 21(3)
Fordham Urban Law Journal (Spring, 1994): 841-56; Robert Bullard,
Glenn S. Johnson and Angel O. Torres. Sprawl City. Washington, DC:
Island Press, 2000; Paul Stanton Kibel, "The Urban Nexus: Open Space,
Brownfields, and Justice," 25 Boston College Environmental Affairs Law
Review (1998): 589.

[11] Carl Anthony, Suburbs Are Making Us Sick: Health Implications of
Suburban Sprawl and Inner City Abandonment on Communities of Color.
Environmental Justice Health Research Needs report Series. Atlanta:
Environmental Justice Resource Center, 1998; David Bollier, How Smart
Growth Can Stop Sprawl. Washington, DC: Essential Books, 1998; Craig
Anthony Arnold, "Planning Milagros: Environmental Justice and Land Use
Regulation," 76(1) Denver University Law Review (1998): 1-152.