Steve Heilig, MPH
CHE Director of Public Health & Education
Director of Public Health & Education at the San Francisco Medical Society
CHE’s motto is “Science and Civility”—it’s right there on top of our home page. Just below that comes our mission: “… to strengthen the science dialogue on environmental factors impacting human health and to facilitate collaborative, multifactorial, prevention-oriented efforts to address environmental health concerns.”
Fair enough and we think important, for, as our founding chairman and public health icon Dr. Philip Lee notes in his welcome letter, “Compelling scientific evidence increasingly indicates that the proliferation of chemicals in our air, water, soil, food, homes, schools, and workplaces can be an important factor in many human diseases and health conditions.” This is even more true than it was in 2002 when CHE was founded—thanks to the diligent work of many researchers, of course.
But further in his letter, Phil concludes that one goal shared by CHE partners is “better policies and preventive efforts.” It can even be logically argued that this latter aim is the ultimate aim of CHE-like activities. But we also know all too well that “pure” science does not automatically—or even often—lead to healthier, science-based policy.
The intrusion of money and “politics” into environmental science and health is certainly not news, and probably bedevils many if not most CHE partners in at least some manner. But I found myself especially struck by this dynamic while interviewing Professor Nicholas Freudenberg for a recent CHE call titled “Where Health and Profit Meet: How Corporations Influence Public Health.” This call was spurred by Freudenberg’s talk at the University of California, San Francisco and his new book, Lethal but Legal: Corporations, Consumption, and Protecting Public Health.
Freudenberg, Distinguished Professor of Public Health at City University of New York and Hunter College, does not address environmental health in his book as much as he does six other sectors or industries—alcohol, tobacco, automobiles, firearms, food and beverages, and pharmaceuticals. As detailed in Freudenberg’s book, the similarities of events and strategies across these sectors can be striking. From my perspective as a longtime anti-tobacco advocate, that industry seems to have set the model that others unfortunately aspire to—as has been learned by unprecedented access to the tobacco industry’s internal records and plans. But other industries are not far behind, and their “scorecards” show many victories in terms of defeating or at least delaying healthier policies.
On the call, I pressed Professor Freudenberg to “grade” each of the six sectors he examined in terms of how well the efforts for better policy have gone to date; he gamely agreed, and the average was a solid “D+,” When pushed, he agreed to provide a grade for chemical policies as well: “C.” I did not ask him about other issues of concern, such as, say, climate change or antibiotic resistance, but then I’d already guessed those grades.
“Some public health researchers are uncomfortable traveling on both the research and advocacy roads,” Freudenberg observes in his book. And it may be argued that such separation is historically appropriate in the imperative to keep science as “pure” as possible. But Freudenberg argues that science and advocacy are “two paths to the same destination: more just and healthy societies.” And later he throws down something of a gauntlet: “After all, the purpose of public health analysis is to inform action to improve population health. If the best it can offer is to document allegedly immutable trends, then researchers come to resemble the medieval monks who described the unfolding of the epidemic of Black Death in Europe, while praying for salvation in another world.”
Strong words indeed. “Public health analysis” is different than lab science, of course. But it’s also true that each scientist, researcher, and advocate decides for themselves how deep into “advocacy” they will go—if at all. And as the great veteran double-Pulitzer-winning Harvard ecologist E.O. Wilson puts it in his 2013 book, Letters to A Young Scientist, “very few step forward because they really don’t want to get into a squabble.” For, as he also admits, “They’ve got enough to do back home”—meaning, in the lab or other office.
We hope you might find the time to listen to Freudenberg’s challenging talk—it’s about an hour, and could have been much longer—and perhaps read his landmark book, and of course avail yourselves of as many of the resources CHE provides. As for those big questions about the perilous future we face and what each of us might choose to try to do about that, well, to each his or her own. Whatever your own choices, we thank you for being part of CHE.