Environmental Health Aspects of Economic Development NCSL: Health in All Policies Conference Tampa, Florida 30 November,2011

Transcription

1 Environmental Health Aspects of Economic Development NCSL: Health in All Policies Conference Tampa, Florida 30 November,2011 Daniel T. Boatright, Ph.D., FRSPH Senior Associate Dean Fellow, Royal Society for Public Health Professor of Occupational and Environmental Health University of Oklahoma Health Sciences Center College of Public Health

2 Environmental Health National Environmental Health Association Definition of Environmental Health Adopted April, 1996 Environmental health and protection refers to protection against environmental factors that may adversely impact human health or the ecological balances essential to long-term human health and environmental quality, whether in the natural or man-made environment.

3 Key Examples Water, quality and quantity Food safety, domestic and imported from source to table Wastewater management, domestic and industrial Air quality, ambient and indoor Hazardous and toxic wastes Home hazards, radon, lead, mold, carbon monoxide Keeping Schools, day-care, nursing and elderly care centers safe from EH hazards Solid, biomedical and industrial wastes Vector control Radioactive wastes

4 Environmental Health is Basic Public Health PH consists of organized efforts to improve the health of communities Organized and directed to communities rather than individuals Key goal, reduction of disease and improved health at the community level From: Novick and Morrow

5 Orders of Magnitude Food Safety Consumer ready imports to the U.S. are in excess of $80 billion per year Fish and seafood Fruits and nuts Vegetables and vegetable products Grains and grain products Meat and Poultry Dairy Coffee, Tea, Cocoa Spices Sugar Vegetable Oils Source: USDA

6 Where Does Our Food Come From? Across North America and Canada Asia Europe Middle East Africa Oceania Central America South America

7 What are the Potential Health Issues From Imports? As the United States continues to import increasingly more of its food from developing nations, we are putting ourselves at greater risk of foodborne disease as many of these countries do not have the same sanitary standards for production, especially in the case of seafood and fresh produce, say scientists on May 23 at the 111th General Meeting of the American Society for Microbiology in New Orleans. Dr. Michael Doyle of the University of Georgia in comments made during the above meeting makes some critical points from an EH perspective: "Approximately 15 percent of food consumed in the United States in 2006 was imported. Sanitation practices for food production are not universally equivalent throughout the world. Importing foods can move diseases from areas where they are indigenous to locations where they are seldom or do not exist," "The reality is we are going to continue to import foods at a greater rate in large part because labor costs in developing countries are much lower than they are here. We are going to see more food coming from developing countries which frequently have lower standards for producing foods," In 2010 over 80% of fish and seafood consumed in the United States was imported; the majority of Asia. Raw domestic sewage and/or livestock manure are frequently used in fish farming in many Asian countries. In Thailand chicken coops (as many as 20,000 birds per farm) sit in rows suspended over ponds that hold shrimp and fish that feed on the waste that falls from above. In China, crops and seafood are typically grown on small parcels where individual farmers try to produce as much food from their parcels as they can. To do that excessive amounts of pesticides for produce and antibiotics for fish and shrimp production are used.mmany of these compounds are not approved for use in the United States. Untreated human waste and animal manure are often used to treat soils or aquaculture ponds. Not surprisingly, contaminants found in imported foods are those primarily associated with fecal matter. Note: Many U.S. companies import food and produce from these countries only if they can verify that the food was produced under stringent sanitary conditions. "Just because it comes from a particular country that does not necessarily mean it is bad," says Doyle. Part of the problem is there is just so much coming into the country that the government can not inspect it all. The FDA physically inspects less than one percent of more than 10 million imported entries annually. But the onus should not be entirely on the government says Doyle. "It is incumbent on food processors to ensure ingredients or products they import are produced under good sanitary practices. It is the industry that is responsible for producing safe foods. It is the government's responsibility to verify that they are providing safe foods," says Doyle.

8 Financial Aspects U.S. imports of agricultural and seafood products from all countries increased from 35.6 million metric tons in FY 97 to 48.2 MMT in FY The increase by value was 94% from $43 billion in FY1997 to $83.6 billion in FY2007. Agricultural and seafood imports increased again in FY2008, to 50.7 MMT valued at $93 billion, before declining to 49.2 MMT and $86.7 billion in FY 2009 Source: Congressional Research Service, U.S. Food and Agricultural Imports: Safeguards and Selected Issues; March, 2010

9 Critical Question is: So What? U.S. food safety infrastructure is among the best in the world Especially true relative to our own production and management methods Increasing dependency on foreign sources has significant economic as well as potential health issues Pesticide, fecal, adulteration, and other contamination issues are real and commonly encountered Inspection at the national level is not capable of eliminating associated risks.given the small percentage of inspection Protection and prevention responsibility is truly at the local level, and fundamentally on environmental public health system

10 Is Food Safety Really an Issue in the U.S. Today? Estimates of Foodborne Illness in the United States CDC estimates that each year roughly 1 in 6 Americans (or 48 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases. Source: Centers for Disease Control and Prevention

11 Where Do People Get FBI? According to the Centers for Disease Control: 52 % in restaurants 18 % at home 4 % at school 4 % unknown 22 % other (e.g. church and social functions, etc)

12 When tallied up, the consequences of foodborne illness including doctor visits, medication, lost work days and pain and suffering cost the U.S. an estimated $152 billion annually. Source: Produce Safety Project, Pew Charitable Trust. Excellent Article: 9, ,00.html#ixzz1evWmtYRe

13 From Pew Charitable Trust Report On average, each case of foodborne illness costs between $1,850 and over $2000 (in Hawaii) The top 10 states with the highest costs: Florida, Connecticut, Pennsylvania, South Carolina, the District of Columbia, Mississippi, New York, Massachusetts and New Jersey.) 9, ,00.html#ixzz1evXQjpn1

14 Some Additional Examples of EH Issues Over 400,000 became sick and 50 died in Milwaukee due to Cryptosporidium contamination. Ultimate cost was over $95 million West Nile virus epidemic in Ohio cost ~$4 million; 150 life threatening illnesses, 1800 hospital days 2003 poultry outbreak of Newcastle disease in California cost the state and federal governments a total in excess of $35 million 2006 Salmonella outbreak cost Cadbury Chocolate Company $20 million Source: National Center for Environmental Health, CDC

15 Ultimately, Environmental Health is a Local Issue Our ability to inspect sources and production facilities as well as the food service industry effectively is critical A well trained environmental and public health workforce; adequately funded and supported by state and local government is axiomatic to minimizing environmental health risks. Workforce must be back-stopped by sound and pragmatic public health policy and regulatory infrastructure.

16 Can We Do the Job? KEY FACTS: Association of Schools of Public Health estimates that 250,000 more public health workers will be needed by The public health workforce is diminishing over time (there were 50,000 fewer public health workers in 2000 than in 1980), forcing public health workers to do more for more people with fewer resources. This challenge is compounded by the fact that 23% of the current workforce almost 110,000 workers are eligible to retire by There are documented and forecasted shortages of public health physicians, public health nurses, epidemiologists, environmental health professionals, health care educators, and administrators. Without enough public health workers protecting us where we live, work and play, we all are vulnerable to serious health risks. To replenish the workforce and avert the crisis, schools of public health will have to train three times the current number of graduates over the next 11 years.

17 Role of State Legislatures You, the policymakers set the stage Supporting the need and providing for the promulgation and enforcement of legislative and local ordinances You make the decisions for funding environmental health services in your states through health department and other agency annual budgets

18 You Have the Ability to Assure That there is a professional educated, appropriately trained (basic and recurrent) and appropriately salaried workforce Through staff and personal involvement whether the physical and human resources to provide for safe water, effective wastewater management, food safety and inspection, etc, are in place and doing the job That your state has your environmental health program can deliver the ten essential services identified by the National Center for Environmental Health at the Centers for Disease Control and Prevention

19 10 Essential Environmental Public Health Services Monitor environmental and health status to identify and solve community environmental public health problems Diagnose and investigate environmental public health problems and health hazards in the community Inform, educate, and empower people about environmental public health issues Mobilize community partnerships and actions to identify and solve environmental health problems Develop policies and plans that support individual and community environmental public health efforts Enforce laws and regulations that protect environmental public health and ensure safety Link people to needed environmental public health services and assure the provision of environmental public health services when otherwise unavailable Assure a competent environmental public health workforce Evaluate effectiveness, accessibility, and quality of personal and population-based environmental public health services Research for new insights and innovative solutions to environmental public health problems

20 Conclusion The relationship between policymakers and environmental public health is critical and has never been more important As the workforce numbers decline and budgetary challenges are faced, decisions regarding how best to meet the public health needs must be predicated on effective collaboration involving the state legislatures To be an effective partner in the collaborative process, the state policymakers must be well informed and have the evidence to support decision making Although the cost of an inadequate EH infrastructure is infinitely higher than an effective system, well organized, well directed, and appropriately supported this is not intuitive to all concerned. What can each of you do personally? Become a cause champion for environmental and public health in your state. Familiarize yourself with what you have available to protect your population and advocate for a gap analysis between where your state is and where it needs to be and base your position on the evidence. Promote and defend the direction of resources to meet those needs in policy-based and fiscal terms Stay informed and involved

21 Honey, Calm Down, Let Me Explain