Violence: The Connection to Environmental Health and Justice

written by Elise Miller, MEd

Violent events rock families and communities in the U.S. daily. But last week was particularly wrenching as we learned first of two incidents of extrajudicial shootings of black men by police—one in Louisiana, the other in Minnesota—followed by the killing of five police officers by an individual sniper at an otherwise peaceful Black Lives Matter protest in Texas. The complexities and causes of each case may be unique, but at the core is an abiding racism that continues to permeate our country.

Racism is perpetuated in multiple and insidious ways, such as the widening income gap, toxic stress, poor nutrition, lack of access to healthcare and to nature. Another factor intimately interconnected with these, but often overlooked, is exposure to pollutants and other toxic chemicals. We know that being exposed to heavy metals and neurotoxic chemicals can lead to cognitive deficits and developmental delays that in turn have been linked to juvenile delinquency and violent behavior. We know that many kids of color and low-income families are more likely to live in housing stock with lead paint and pipes and close to polluting industries. We know that during pregnancy poorer women are disproportionately exposed to harmful chemicals associated with learning and developmental disorders. We know that working-class parents often have to take the lowest-paying jobs, many of which require regular contact with contaminants linked to cognitive and behavioral problems. We know for most of these families the only food they can afford comes pre-packaged and contains toxic chemicals that can impact neurodevelopment.

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Mental Health and Environment

Elise Miller, MEd

According to the National Institute of Mental Health, one in five children under the age of 18 have or have had a serious debilitating mental illness—that is even more than the proportion of children under 18 who have been diagnosed with a learning, developmental or behavioral disorder (which the CDC indicates in one in six). In this light, I was gratified to attend a meeting of the Northern California Association of Child and Adolescent Psychiatrists last month that focused on not only social stressors, but on toxic chemicals. In fact, this may have been the first time chemical contaminants appeared on the primary agenda at any meeting of a psychiatric association across the country. Given the scientific literature associating a number of chemicals—including pesticides, bisphenol A, flame retardants, lead and mercury found in products used or ingested every day—with learning and developmental disabilities, it would make sense that at least some of these chemicals could also play a role in mental illness (see: Scientific and policy statements on environmental agents associated with neurodevelopmental disorders by Steven G. Gilbert, et al). After all, if a chemical can disrupt the neurological system, the result could range from ADHD to depression depending on a number of other factors for that individual.

But why should a psychiatrist or psychotherapist care about possible chemical exposures? Well, if these health professionals understand that certain contaminants might hinder a person’s mental health, then it may be that a patient’s suffering could be alleviated by reducing their exposures to certain chemicals. No amount of prescriptions for psychopharmaceuticals nor talk therapy is going to ultimately help if the environment in which a person lives, works, studies or plays is contaminated and thereby contributes to a mental health diagnosis.

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A View from the North

In recognition of CHE’s 10th anniversary, colleagues who have been particularly instrumental to shaping CHE this past decade will be invited to write an introduction. This month’s introduction is by Pamela Miller, MS, Executive Director and Founder, Alaska Community Action on Toxics and Coordinator, CHE Alaska Regional Working Group.

As I reflect on the tenth anniversary of the Collaborative on Health and the Environment, I am grateful—grateful for the vision of CHE, the connections with remarkable scientists and health advocates, and the incredible resources and knowledge base that CHE provides. I love that civility is a key underlying principle of every CHE conversation. I remember when I first became a CHE partner in 2002, a few of us at Alaska Community Action on Toxics would huddle together on cold, dark wintry mornings here in Alaska listening to partnership calls with intense interest. Sometimes we would invite the entire staff over to our home and share tea while we all participated in the calls. The calls sparked new ideas about how to engage in our work more effectively, possibilities for new community-based research, enlightened us about new science that informed our efforts to achieve transformative and protective policies. The CHE Vallombrosa Consensus Statement on Environmental Contaminants and Human Fertility Compromise provided the scientific basis for our environmental reproductive health and justice program, affirming much of what is witnessed by health workers and Alaska Native elders in our communities concerning involuntary infertility, miscarriages, and other reproductive health problems.

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What’s really behind the increase in autism rates.

CHE partner Alice Shabecoff,  co-author with her husband Philip of the book Poisoned for Profit: How Toxins Are Making Our Children Chronically Ill.

The just-released data on autism shows a count of one in 88 children, up from a rate of one in 100 three years ago, and one in 150 five years ago.  With each change, the response remains the same: Oh, that’s because of better detection and broader definitions.

How, then, to account for the sharp increase in childhood asthma—15.7 percent higher today than ten years ago? Or an increase of the same magnitude in preterm births? Or the indisputable fact that childhood cancer has climbed an inexorable one percent, year after year, over the past thirty years?  As has Down Syndrome. And among rarer illnesses, too, the rates keep going up and up—from the increase in malformations of the penis among newborn boys, to the doubling in a generation of endometriosis, a deformity of the uterus, among girls.

There is no way that these wildly different childhood illnesses can be chalked up to, and written off as, an increase in detection and/or diagnosis.

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The Cost of Toxic Exposures

Elise Miller, MEd

As the health care reform debate continues, little discussion has focused on the  significant cost savings that could be achieved through preventing exposures to toxic chemicals—chemicals that are shown to contribute to numerous health endpoints, including obesity, diabetes, learning and developmental disabilities, Parkinson’s, reproductive health problems, breast cancer, asthma and heart disease. When tobacco use was significantly curtailed, for example, the number of cases of lung cancer and others associated diseases fell dramatically, saving billions of dollars. The downside is that it took decades to persuade industry and government that the scientific data linking smoking and lung cancer was strong enough to warrant such strict regulation—and in the meanwhile, many, many more people became ill.

In this context, we have to ask how much evidence is enough before we switch to safer alternatives and implement regulations that allow only chemicals that have been thoroughly tested for human safety on the market? Do we have to wait years or even decades more, while people become increasingly sick, to reduce toxic exposures? What kind of health care savings might we have if we took preventive action now?

At a meeting of 150 scientists and physicians a couple weeks ago, Dr. Phil Landrigan, from Mount Sinai School of Medicine, stated that chronic childhood diseases linked to exposure to toxic chemicals in the environment have been surging upward, costing the US almost $55 billion a year. Other researchers in children’s environmental health say this number is, in fact, much higher. When you then add in the environmentally attributable fraction of health care costs related to a host of other chronic diseases and disabilities in adults, even conservative estimates suggest that our society could save almost $200 billion a year. 

Currently, the proposed health care reform bill in Congress suggests that the expansion of coverage would cost $829 billion over 10 years. Let’s say we could reduce environmental contributors to chronic disease and save $200 billion a year for 10 years. That would mean a total savings $2 trillion, thus making the current acrimonious debate regarding expanded coverage seem hardly worth it. In other words, if we invested in primary prevention—even in this relatively narrow arena of minimizing hazardous environmental exposures without addressing other pressing concerns such as socioeconomic status, access to health care, nutrition, etc., then full health-care coverage would fiscally achievable without dire predictions of bankrupting future generations.

Fortunately, EPA Administrator Lisa Jackson just announced some groundbreaking principles for establishing a system for testing chemicals that would be more protective of human health than current regulations are. She called on Congress to overhaul the woefully inadequate Toxic Substances Control Act, passed in 1976, that was supposed to regulate chemical manufacturing and use. In the past 30-plus years, only five chemicals out of the 80,000 now on the market were determined to put people at “unreasonable risk” under TSCA. Even asbestos, a substance well-studied and known to significantly impact human health, ultimately could not be banned given TSCA’s limited scope. By contrast, Jackson prescribed a new regulatory structure that would, among other features, promote green chemistry and safer alternatives and ensure manufacturers provide EPA with the necessary information to conclude that new and existing chemicals do not endanger public health or the environment (see the full EPA press release).

Now the question is whether Congressional leaders, embroiled in the politics of health care reform, can connect the dots and see that regulating chemicals to protect human health also means substantially reducing health care costs while increasing the capacity of the US to provide health care coverage to all its citizens. Surely that would be a  ‘win-win.’