| “Public health isn't only about outbreaks & vaccines. It's about making society healthier outside of clinics. It requires systemic change, equity, a belief in the common good.” Public health reporter Amy Maxmen, PhD, offers this perspective on her social media account to explain her approach to her work. I wish I had such a strong and succinct formulation in my back pocket for the last 35 years since I received my Master of Public Health (MPH)! Public health is a vast field which is home to professionals with areas of expertise from toxicology to epidemiology to health services to reproductive health, and so on. But those three requirements Dr. Maxmen names are fundamental—there is no avenue to public health without them. Individual behavior changes can be important and contribute to collective health, but as we all know, no one is an island. Throughout my career I’ve tried to contribute to efforts that are informed by principles of equity and a belief in the common good, that aim to substantively change the broader conditions that support everyone’s health. We are all witnesses to the assault on the nation’s laws, policies, and institutions that—though imperfectly, indeed inadequately and inequitably—have supported the health of Americans, and the relentless attacks on the federal employees who have devoted their careers to supporting the public health with the structures at their disposal. These assaults continue apace, and the rollercoaster goes on. When, for example, federal personnel are brought back to their positions after mass firings in “dramatic reversals,” we’re obviously relieved. But in every instance, damage has already been done, resources wasted, and the rehirings incomplete. The summer between my two years of public health school, I worked in the Morgantown, West Virginia offices of the National Institute for Occupational Safety and Health (NIOSH). There, staff focused on traumatic injury prevention, respiratory diseases, and mine safety— all matters of great urgency in Appalachian coal country and, of course, not only there. The facility and the staff grew in the interim years. Then came Trump 2.0 and the agency was targeted to lose 900 staff—most of its workforce. In mid-May, over 100 of those at the Morgantown office were reinstated. A recent piece in Occupational Health & Safety says, The reinstatement of NIOSH workers represents a major win for occupational safety advocates and underscores the importance of federal oversight in worker health protections. As of now, operations at the Morgantown facility are resuming, with many employees returning to their posts and resuming critical health surveillance activities for coal miners across the region. Miners can’t protect themselves. Communities can’t monitor everything upstream and in the air. Individuals can’t, in isolation, protect the climate. In spite of some of the reversals we have seen in recent weeks, like the reinstatements at NIOSH, the federal administration is quite literally and aggressively taking apart our systems of oversight that were designed for the common good. Certain states have long been more proactive and more protective of the public’s health than the federal government. For example, states are permitted to have their own occupational safety and health programs, provided they are at least as protective, or more protective, than federal OHSA’s. California’s program has much more stringent requirements in some occupational areas, and Oregon’s is known for charging the highest penalties to corporate violators. In recent years, several states have begun developing climate action legislation, presumably in part because of the inadequate pace of the federal government. In this edition of the Networker, I explore whether New York State, which passed its ambitious Climate Leadership and Community Protection Act (CLCPA) in 2019 but has been slow to implement it, is still within the window of possibility for true climate leadership. If so, this will of course benefit New Yorkers and those far beyond. Sandra’s column this month profiles the work of the Rachel Carson-era activist and Hudson Valley resident Franny Reese. Franny and her women-led group, Scenic Hudson, figured out how to leverage art in service of life and gave us a landmark federal court ruling establishing the principle that citizens have standing to intervene in court cases affecting the environment—and so set a precedent that paved the way for the National Environmental Policy Act. I hope our readers are informed and energized by these two views from the maybe-great State of New York! Warmly,
Carmi Orenstein, MPH, Editor |
