ENVIRONMENTAL POLICY AND PUBLIC HEALTH,

ENVIRONMENTAL POLICY AND PUBLIC HEALTH,

SECOND EDITION

By Barry L. Johnson and Maureen Y. Lichtveld

Instructor’s Solutions Guidance Manual for Policy Questions

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POLICY QUESTIONS

NOTE: These questions are designed to promote students' individual thinking and analysis. To the extent possible, the use of critical thinking, as described in Chapter 1, should be encouraged. Moreover, responses to questions in ways that simply regurgitate the book's text are given lesser credit. Instructors are encouraged to elaborate on the themes in each question, using each question as a learning experience for students. The following advice is provided to students at the beginning of the course. Some students have found the advice quite useful in this and other courses.

RESPONDING TO ESSAY QUESTIONS:

 Read the question thoroughly and answer what is asked. Format your answer according to the question's elements. Don't make the instructor search for your responses to the question's elements. Don't simply regurgitate background material. Summarize background material, and then build upon it. Avoid sweeping generalizations. Remember that public health is about facts, decisions, and actions, with the focus on prevention of disease and disability. More depth in detail is better than too little. Think critically where possible.

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• Fundamentals of Environmental Health Policymaking
• Using the definition of policy provided in Chapter 1, discuss: a) who are policymakers? Give examples of those

who affect your daily life, b) how do environmental policies, e.g., environmental protection, affect you? c) a personal policy and its benefits to you. [GUIDE: a) Students should recognize that policy-makers include elected representatives, university officials, parents, siblings, public officials, and themselves, amongst many others. b) One hopes that students recognize that environmental protection policies protect the public's health, improve environmental quality, and help assure personal well-being by reducing exposure to environmental hazards such as air pollutants, water contaminants, and unsafe food. c) Personal policies can run the gamut from personal finances ("1 avoid using a credit card unless absolutely necessary.") to personal growth ("1 spend my free time reading.") to lifestyle ("1 try to exercise my body and mind each day."). The key concept is the definition of policy and how wide ranging and important policies are to us in our everyday lives].

• Using WHO’s definition of environmental health given in Chapter 1, a) give examples of social and

psychological factors that could fit within the definition and b) discuss their importance to you in comparison with chemical and biological factors. [GUIDE: a) Examples could include mental health, job stress, community stress, population density, poverty, lack of access to health care, lack of access to political systems (e.g., voting), discrimination. b) Students usually come to the realization that while chemical and biological factors are well-known environmental factors, psychosocial factors have not been traditionally part of their environmental health calculus. This realization can lead to lively discussions on whether one group is more important than the other and whether psychosocial factors could be incorporated into environmental legislation in the way that chemicals and biological hazards have been].

• If politics is “the complex of relations between people living in society,” discuss what you consider to be the

positive aspects of politics, and then discuss the negative aspects. Be specific and give examples based on your own life experiences. [GUIDE: Few students understand that we are all political beings. The point of this question is to force discussion about the broader and pervasive nature of politics. Positive aspects can include such examples as the use of political systems to bring about positive social change (e.g., anti-smoking ordinances, health care for children), since such changes in a democratic society must occur through dialogue, negotiation, and compromise, which are all political processes. Negative aspects often expressed by students include misconduct by elected officials, discriminatory policies (e.g., environmental injustices), and breach of public trust].

• Discuss the roles of the judicial branch in setting environmental health policy. a) Give examples drawn from this

text and other sources. b) Under what circumstances can the courts change policies set by legislative bodies?[GUIDE: a) The Supreme Court decision in the suit against the Occupational Safety and Health Administration for issuance of their benzene standard is described in the book. In another case, the Court found that EPA could consider greenhouse gases as air contaminants under the provisions of the Clean Air Act. Both court decisions led to positive public health changes in polices. In the OSHA case, the federal government had to change its method of estimating the benefits of workplace standards. The solution, which can be debated as to whether a federal policy based on the Precautionary Principle would be preferable, became known as risk assessment.The EPA case permitted the agency during the Obama administration to issue regulations that controlled the emissions of carbon dioxide, the major greenhouse gas. In 2017 the Trump administration disavowed support for EPA’s greenhouse regulations. Note - Discussions and questions about the structure and performance of the U.S. government's structure are particularly important for international students, few of whom will have had a good grounding in the U.S. Constitution and its ramifications in terms of government structure. b) Courts can set environmental policy through issuance of their judicial decisions. As the chapter describes, the U.S.government consists of three branches, each equal and counterbalancing.].

• This chapter provides definition of “hazard” and “risk.” In an essay of appropriate depth discuss the relationship

between the two. Discuss hazards you personally face each day and discuss each hazard in the context of risk assumption. [GUIDE: The chapter defined both terms; in general, hazard is a condition that can produce harm; risk is the probability that harm will result. This is a good topic for open class discussion. Students may respond that they face hazards each day such as transportation to and from school/class; food choices that are not healthful; social media misconduct; theft of personal property; medications that may not be effective; air or water contamination. Students may acknowledge that risk assumption is necessary for one or more of these hazards]. 3 / 4

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• Eleven elements of public policies in the U.S. of relevance to environmental health were presented in Chapter 1.

Select any five and discuss each one’s impact on your life. Give examples. [GUIDE: The eleven expectations consist of accountability, communication of risk, cost-benefit analysis environmental justice, federalism, polluter pays for consequences of pollution, prevention is preferred to remediation, product safety, public's right-to-know, risk assessment, and social support. Students generally have a good grip on accountability, environmental justice, polluter pays for consequences of pollution, prevention is preferred to remediation, product safety, and right-to-know. Less familiar are the terms cost-benefit analysis, federalism, risk assessment, and social support. The instructor may desire to give additional details on these five terms prior to submitting this question to students].

• Do you think that the Public’s Right-to-Know is absolute, i.e., government should never withhold any public

health information from the public? If not, discuss situations where, in your opinion, information should be withheld. Give specific examples and justify your reasons. [GUIDE: Some students find the public's right-to- know to be very appealing and can argue that governments should ''tell all" for the greater good of the people.Arguments against this kind of thinking include information about national defense (although the instructor can make good arguments that the "national defense" posture has been abused from time to time by governments with an agenda to hide from the public, such as plans to make war in unwarranted circumstances). Other examples could include withholding of business confidential information, whose release could cause economic harm to a company or business. Withholding of information by court order would be another example].

• Assume that you are a newly-hired environmental health (EH) specialist working for a county health department

in the U.S. As the only EH specialist, the department’s director asks you to provide a prioritized list of environmental health problems. a) How would you proceed to develop the list? b) What would be your key assumptions in developing the list? c) How would you involve the public, or would you? [GUIDE: The main purpose of this question is to challenge the student's ability to critically think. While students generally lack the knowledge and experience in order to provide a complete answer to this question, they can critically think through a series of logical actions that would be responsive to the question. More specifically for each part of the question: a) This part of the question goes to the matter of what should be on the county's list of environmental hazards and how to rank them. Some students have actually contacted their local health department and asked for their list and priorities. Other students have used material in Chapter 1 in order to develop a list that included hazards such as unsafe food, outdoor air pollution, drinking water contamination, and unsanitary waste management. There are various ways to prioritize the list. For example, number of persons at risk of potential exposure to specific hazards would be one way to rank. b) Some assumptions could include a) identified environmental hazards do in fact portend a risk to human health, b) that data used to compile the list are from accurate sources, c) opinions count less than factual data. c) Interesting point - should the public be involved in compiling the list and the prioritization of individual environmental hazards. The content of Chapter 1 implies that the public's right-to-know is sound political and social policy. But a bit of critical thinking leads to the question of not if but how and when to involve the public. Experience has shown that rushing policy issues to the public without the requisite planning can be a recipe for difficulty. The creation of a public advisory group might be considered by students. At some point, the public must get involved, since they ultimately will bear the cost of any county-wide environmental health plan].

• Given this chapter’s discussion of historical environmental hazards, discuss the significance of historical data on

modern-day environmental problems, as you have personally experienced them. Be specific. [GUIDE: This is a rather open-ended question. Part of the intent of this question is to have the student recognize that many of the historical environmental hazards, e.g., impure water, unsanitary waste disposal, polluted air, are still current day public health concerns. Indeed, in some parts of the developing world, one might argue that environmental conditions have not improved much over those of ancient times].

• Rachel Carson’s book Silent Spring, published in 1962, is given much credit for enhancing concern in the U.S.

public about environmental hazards. Discuss, in your opinion, a) why the book had such a significant effect, b) opine whether such a book would today achieve the same sociopolitical prominence, c) Speculate on what stance Carson would have taken on environmental policymaking in year 2017. [GUIDE: a) The book had a significant environmental protection and public health effect due to the conditions of the 1960s, a time of national uncertainties over the war in Vietnam and civil rights changes that sought to redress longstanding

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