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"; 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"; 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"; 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"; 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; 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, 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; 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; 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; 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, thereby increasing health and safety risks, health disparities, air and water pollution, poor quality housing, unstable neighborhoods, unsustainable ecosystems, and poor quality of life; 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. ==============  Institute of Medicine, The Future of Public Health. Washington, DC: National Academy Press; 1988.  Rio Declaration on Environment and Development, July 14, 1992 ILM. 1992; 31:873.  Note, this was also echoed in the constitution of the World Health Organization and was ratified by subsequent international covenants and conventions.  American Journal of Public Health, May 2000, Vol. 90 No. 5, Rosalia Rodriguez-Garcia, PhD, MSc, Mohammad N. Akhter, MD, MPH  World Health Organization. World Health Report. Geneva, 1998  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.  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).  The National Law Journal, "Unequal Protection, the Racial Divide in Environmental Law, " Sept. 21, 1992.  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.  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.  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.