Who Are We and What Do We Want to Be?
By Fabian, Nelson
I could make this a very short column by simply saying if you’re interested in the answers to these questions, come to Tucson and take in our opening keynote session. We have assembled an expert panel to explore where these questions take us. This session is being billed as a first-time-ever (and arguably long overdue) discussion within the profession about our future and who we want to be. After all, if we can’t define our own future, then we are essentially allowing others to define it for us. But rather than leave it at that, let me expand upon our intentions and give you some background about what led to this unprecedented keynote. We realize that not every NEHA member will be able to attend the annual conference. Given the seriousness of the questions, it is important that all NEHA members.whether you’ll be with us in Tucson or not.be included in this most serious discussion.
My starting point for this discussion is, interestingly enough, the current public policy debate over the idea of creating a new federal food protection agency. It is no secret that between the fear of terrorism and the growing concern about the safety of our nation’s food supply, serious discussions are now taking place about creating some kind of huge federal agency that would oversee food safety in our nation. Even our own members seem to think that this might be a good idea, as evidenced by a recent online survey that NEHA conducted.
But what would this mean for environmental health? Would a new federal food agency prompt the same kind of state and local reorganization that followed the creation of the U.S Environmental Protection Agency (U.S. EPA)? Furthermore, would such an institutional change lead to pulling food safety out from local public health agencies? And even more to the point, what do we think about this, and what would we in environmental health like to see happen?
To get some bearing on how history might repeat itself, let’s briefly go back to when U.S. EPA was created.
Whatever one might think of the rationale behind U.S. EPA’s creation, few people would argue about the impact that this event had on environmental health. Many NEHA members remember well that as a consequence of U.S. EPA’s creation, many longtime environmental health programs (such as air and water pollution) were moved from public health institutions to both the new federal Environmental Protection Agency and many of its new state counterparts. To some people, this change was seen as nothing more than a programmatic transfer from one institution to another. To many others, however, this transfer redefined and even diminished what environmental health was.
We even hear a term in our vocabulary these days.”traditional environmental health”.as if the topics we work on today are those that we have somehow managed to keep over the years. (A corollary to this is that the programs we lost no longer fit within the definition of what environmental health is.) And in fact, many people in our field today no longer even think about air (outdoor ambient air) and water (e.g., streams and lakes) as environmental health issues.
Fast forwarding to 2008, we appear to be in a place that looks eerily similar to the situation that existed in the late ’60s, just before U.S. EPA was created. Editorials across the land proclaim loudly about how safe (or I should say unsafe) our food supplies are. It seems like I can’t read any food quality or food safety materials these days without seeing some stinging criticism of the Food and Drug Administration. And policy makers in Washington now talk about creating a new federal Food Protection Agency.in the mold of U.S. EPA.
Assuming for a moment that such a policy action is pursued, what would its unintended consequences be? For example, would the creation of a new federal food protection agency lead to the creation of counterpart state food protection agencies as happened following the creation of U.S EPA, when state after state christened new state EPAs? If that happened, would we see the emergence.especially within the public sector.of a new food safety profession? To continue down this road, if that happened, would members of this new profession leave environmental health institutions (as the air and water people did before) and the public health context within which their food safety work was performed? What would it mean to have a new army of food safety specialists pursuing food safety for its own sake, rather than treating food safety as an element of an overall environmental and public health strategy and mission? Would “traditional environmental health” further shrink if food safety programs no longer remained as a practice area within environmental health programs?
Finally, if food safety did emerge as a new and separate profession outside of environmental health, what would happen to most of our local environmental health programs that are so heavily concentrated on food safety work?
Now before anyone accuses me of leaping 200 yards ahead of the discussion to suggest outcomes that are intentionally provocative, let me make clear that I am not predicting anything. I am not even all that interested in how this unfolds. My interest (and by that I mean NEHA’s interest) lies much more in how our profession sees all of this.
Today’s policy discussions could go in a number of different directions. The questions that we need to ponder are “What do we think of these directions and what do we want to see happen?” After all, depending on how these discussions go, the way environmental health is practiced and even defined could change significantly.
As this issue unfolds, environmental health finds itself in an odd position. We have never really worked to build a consensus within the profession to define what environmental health is. Even more importantly, as a profession, we have no position on where and how environmental health should be practiced in regards to its institutional base. (For example, should environmental health programs only operate out of public health agencies, or can we envision an institutional arrangement that would allow for the practice of environmental health programs by a variety of different institutions?) When I say that we as a profession have no position on such issues, I should add that as a profession, we haven’t even discussed this!
Therefore, it is difficult for NEHA to join this debate because we have no professionbased position to advocate.
It would seem that we are in the early stages of an immensely important public policy debate that concerns more than just food safety. Taking the experience of U.S. EPA’s creation as a prologue, it is at least plausible that by the time this public policy debate is finished, environmental health as we know it could be turned upside down. Rather than wait for events to decide what we will become, NEHA is taking the lead to stimulate a considered discussion of who we are and what we want to be. It is our intention to garner from this discussion some consensus on how our profession would like to see this public policy debate play out and to push for that outcome as we participate in that debate.
We will be pushing the profession to engage in this discussion through our AEC & Exhibition keynote, and in addition, we will be using this topic as the cornerstone for a series of focus groups involving our affiliate presidents at the AEC & Exhibition. We also welcome whatever thoughts and opinions NEHA members would like to submit on the issues touched on here.or even others that you can think of.
However the present discussion resolves itself, it is important that environmental health has a voice. NEHA has done much in recent years to earn a seat at the table. That is no longer a concern. The issue we face now is what to say with our seat. Our keynote and our focus groups this year will try to draw some of that position out. If you can’t make the keynote but would like to join this discussion, please offer your thoughts via an e-mail to our president, Rob Blake (rgblake@cdc.gov), or to your Denver office (staff@neha.org).
It would seem that we are in the early stages of an immensely important public policy debate that concerns much more than just food safety.
Nelson Fabian, M.S.
Copyright National Environmental Health Association Jun 2008
(c) 2008 Journal of Environmental Health. Provided by ProQuest Information and Learning. All rights Reserved.