Susan Kaplan, an environmental health lawyer and research assistant professor at the University of Illinois Chicago School of Public Health, is the author of “A Healthy Union: How States Can Lead on Environmental Health.”
When it comes to protecting communities from pollution and toxic chemicals, cities and counties are confronting a double whammy. The federal government is removing regulatory protections and cutting grants while many state health departments are short-staffed and strapped for funds. Local policymakers and managers can view this as an opportunity to be creative and look around the country at best practice policies and resources they can learn from, adapt and adopt.
Tap federal resources
For example, concerns about pesticides have been included as a Make America Healthy Again priority — although the federal government has been reducing rather than expanding protections. A critical setting for pesticide reduction is schools because children are more vulnerable to health impacts of chemicals like synthetic weedkillers, and exposure at school can cause asthma exacerbations and other problems.
Any school district that does not yet have a pesticide plan in place can adopt the EPA’s model sustainable pest control policy . EPA’s website includes additional guidance to support this policy, such as how to procure a qualified contractor.
The 10 federally funded Pediatric Environmental Health Specialty Units around the country offer information and assistance to doctors and communities on reducing children’s pollution exposures. The Chicago-based unit published “Investigating Environmental Contamination: A Guide for Communities” to help residents of any community identify local pollution sources, understand possible health impacts and take action to reduce risks.
Follow state and local best practices
State and local governments can learn from their peers as well. Texas was one of the first states to require all public schools to implement integrated pest management, a proactive approach to managing pest problems in which pesticides are used only as a last resort. Texas A&M University’s AgriLife Extension Service partners with state agencies to provide information, education and technical assistance on implementation of the IPM law to school IPM coordinators throughout the state. This model can be used by localities, too. Pesticide-reduction policies are often enacted at the local government or school district level, and officials can request assistance from the public university extension service in their state.
Many state health departments, and professional organizations like the American Academy of Pediatrics, also offer resources that can help cities and counties make plans to protect their residents from environmental health hazards.
Incorporate health in all policies
Another way for cities and counties to help offset the reduction in federal and state environmental health assets is to eliminate silos through a “health in all policies” approach. This can increase efficiencies, help launch new ideas and amplify environmental health protections.
Many departments that do not have “health” in their name nevertheless have enormous impacts on health. For example, when a local health department finds that a large number of children in a certain neighborhood have been diagnosed with asthma, identifying and remediating the triggers may require the input and efforts of agencies responsible for buildings, parks, transportation and other sectors. Routinely meeting and getting familiar with each other’s programs will enable a more efficient resolution — and it can help prevent such problems to begin with.
Tennessee’s Livability Collaborative is a national success story in this approach because it has led to increased collaboration, creation of shared data sets and aligned funding opportunities among agencies. In Colorado, state agencies and local departments often partner with each other as well.
One study of eight municipalities in Colorado to understand HiAP at the local level found that successful implementation of HiAP was tied, in part, to education about the distinction between direct health care and population health, as well as education on the impacts of social determinants of health such as access to healthy food and green space. Data sharing was another important tool; in one municipality, a health department shared its public health data system with health care partners, increasing efficiency and improving outcomes.
HiAP efforts encompass a variety of structures. They may be based on laws, resolutions or voluntary efforts. Some localities devote a staff person to this effort, while others depend on volunteers who do this work in addition to their regular duties. The National Association of County & City Health Officials offers guidance on implementing this approach.
