My new book from Island Press, A Healthy Union: How States Can Lead on Environmental Health, highlights how many states across the country are taking measures to protect people from environmental exposures.
In my Part 1 blog, I describe several effective state programs and introduce key elements of success. Here I highlight additional examples found in New York and California, as well as regional partnerships that are protecting the public from environmental harms.
Worker clinics & children’s health centers
Many years ago in New York, Dr. Philip Landrigan observed that workplace injuries and illnesses were pervasive, yet existing clinics and health professionals were inadequate to provide diagnosis and treatment. He organized a large workgroup that included labor leaders and physicians from across the state. They analyzed the extent of the problem and predicted a large return on investment for additional clinics around the state.
State legislation was passed, and in 1987 the Occupational Health Clinic Network was established to meet these needs. There are now 11 clinics across the state. In addition to assisting injured and ill workers, clinic staff go into workplaces and communities to develop broad actions to address problems related to worker health.
Following this success, a statewide network of children’s environmental health centers was established. All of the clinics train students and health professionals, who are then prepared to advocate for protective policies. The last section of my book examines the successful effort to ban pesticides in New York City parks – and how clinic physicians were important advocates in this effort.
Air pollution monitoring & action
Another leading policy example is California’s law that requires the state to work with local communities that are highly impacted by air pollution. Regulators conduct local air monitoring and must take action to reduce pollutants.
The state developed the CalEnviroScreen tool (now in its fourth – soon to be fifth – incarnation) to better understand real world pollution exposures and identify vulnerable groups.
Revisions were made to the law in 2022, and Environmental Justice advocates and analysts at University of California, Davis have made recommendations for further improvement.
Overall, however, the law has been “transformative,” said the physician member of the California Air Resources Board (CARB). CARB has published two “Blueprints” that can be consulted by other states or localities that would like to know more about how this program was implemented.
Regional partnership lowers carbon, protects health
In addition to single state policies, regional partnerships to address environmental health are on the rise. It makes sense: Neighboring states typically share climate and culture, and by combining knowledge and resources, they can accomplish more together than each state could alone.
A well-established example is the Regional Greenhouse Gas Initiative (RGGI), a cap-and-trade program that includes 11 states in the Northeast and mid-Atlantic. The states agree on a regional cap on carbon dioxide emissions from power plants. Generators must buy "allowances" for their emissions in quarterly auctions, which are tradable, like currency.
Putting a price on dirtier energy makes it more expensive and supports development of clean energy. Participating states invest proceeds in clean energy development and energy efficiency.
RGGI has reduced CO2 emissions 50 percent faster in participating states than the rest of the country. The health benefits due to reduced fine particulate matter and other contaminants include many averted cases of asthma, bronchitis, heart problems, low birthweight, and more.
A number of the RGGI states had previously worked together on similar initiatives, and energy and environment departments of the individual states already had close working relationships. Additional elements of success include the autonomy and flexibility the structure provides to participants. For example, each state passes its own law (based on a model rule) and decides how to invest its auction proceeds.
States provide a roadmap
RGGI shows that states can successfully move forward with climate policy in the absence of federal leadership – especially relevant now, as federal support continues to recede.
There are many additional examples, including the Southeast Regional Partnership for Planning and Sustainability, an “unconventional partnership” of federal and state military, environmental, and additional agencies covering six southeastern states. Initially successful in protecting the endangered red-cockaded woodpecker, the consortium now addresses a range of issues, including coastal erosion and prescribed fire.
These and other state-level best practices are discussed in detail in my book. My hope is that these examples will provide a roadmap for states across the country as they strive to protect the public from environmental harms.
For more information, see Part 1 and also the webinar CHE Café: How states can lead on environmental health.
Susan Kaplan is an environmental health lawyer, professor, and writer. She has held policy positions in federal and state government, served as assistant director of an energy policy group at Harvard University’s Kennedy School, and taught environmental health policy in the public health programs of the University of Illinois Chicago and Northwestern University.