June 10, 2022, 3:22 p.m. News Staff — Building on the Biden administration’s promise to “deliver environmental justice in communities all across America,” HHS on May 31 established the Office of Environmental Justice as part of its larger mission to improve the health of vulnerable populations and disadvantaged communities throughout the United States.
“Health is closely connected to the environments where people spend the most time — neighborhoods, workplaces and outdoor spaces,” said Assistant Secretary for Health Adm. Rachel Levine, M.D. “Millions in the U.S. are at risk of poor health because they live, work, play, learn and grow in or near areas of excessive pollution and other environmental hazards. The Office of Environmental Justice is an important avenue through which their well-being and quality of life are receiving our full attention.”
“The blunt truth is that many communities across our nation — particularly low-income communities and communities of color — continue to bear the brunt of pollution from industrial development, poor land use decisions, transportation, and trade corridors,” noted HHS Secretary Xavier Becerra. “Meeting the needs of these communities requires our focused attention. That’s why HHS is establishing the Office of Environmental Justice.”
The OEJ will reside within the Office of Climate Change and Health Equity, which the Biden administration established on Aug. 30, 2021. Its mission, according to the OEJ website, is “to protect the health of disadvantaged populations on the frontlines of pollution and other environmental hazards that affect health.” Its stated responsibilities include
Margot Savoy, M.D., M.P.H., the Academy’s senior vice president for education, and Bhargavi Chekuri, M.D., of Denver, a practicing family physician, National Climate and Health Science Policy Fellow at the University of Colorado School of Medicine and member of the Academy’s Climate Change and Environmental Health member interest group, weighed in on the importance of the new office and its connections to health equity and social determinants of health in separate conversations with AAFP News.
“When we talk about health equity, we mean that we want to support everyone having the opportunity to attain their highest level of health,” said Savoy, echoing the AAFP’s advocacy focus on the topic. “Health is more than the absence of illness and isn’t restricted to our offices. Health occurs where our patients live, eat, work, pray and play. These spaces need to be safe for everyone without regard to race, color, national origin, gender, ability or income.
“Social determinants of health are not inherently bad things,” Savoy continued. “They are simply the economic and social conditions in the environments where people exist. Historically disadvantaged groups who have persistently been subjected to social barriers or discrimination systematically experience worse health or greater health risks. This doesn’t happen by accident. It happens when we allow systemic and structural racism, sexism and the like to create unjust laws, policies and regulations that create health attainment gaps between communities. Those gaps become health disparity outcomes.”
“Family physicians already know that where you live can drive health outcomes, but are sometimes less fluent with how environmental exposures, climate change and systemic racism are at the root of these differences,” added Chekuri. “Underresourced and overburdened communities such as communities of color or indigenous communities are often exposed to more pollution or heat stress at home or work, which aggravates their health and well-being.
“Additionally, environmental injustice drives intergenerational inequity, with children bearing a disproportionate impact of climate change and pollution. Addressing environmental injustice is a vehicle to achieving health equity of all forms.”
Chekuri considered the establishment of OEJ to be an important step forward in addressing these problems.
“Having an office dedicated to these issues, housed within the Department of Health and Human Services, demonstrates an increasingly modern understanding of the social determinants of health at the federal level. This office, with its priority to ‘mobilize environmental justice efforts’ across HHS can improve our understanding of how to integrate a much-needed environmental lens to existing and novel health equity solutions,” Chekuri said.
Savoy said she viewed OEJ as necessary to ensure the proper development, implementation and enforcement of environmental laws, regulations and policies that protect all people. She also encouraged OEJ to join with the AAFP and other organizations in supporting strategies such as the Academy’s Health in All Policies approach to improve population health and advance health equity.
Savoy also offered suggestions for family physicians who want to become more involved in environmental justice, including by advocating at the local and national levels, as well as individual actions FPs can take.
“Educating yourself about the history of your community can offer incredible insights that may change your perception about which root cause is truly driving the disparities you are seeing today,” Savoy explained. “The uncontrolled asthma you see in some patients today may very well be linked to pollutants in the air because the community is surrounded by highways resulting from redlining policies that only allowed their family to live in that neighborhood.
“You can also make personal choices for yourself and your practice to reduce pollution, waste and environmental strain,” Savoy added. “While it may seem small, individual changes like recycling, use of reusable water bottles to reduce waste and minimizing plastic waste all lessen the burden on our environment.”
Chekuri, meanwhile, recommended a number of organizations for family physicians who want to learn more about environmental justice, such as the Medical Society Consortium on Climate & Health, to which the AAFP belongs, Physicians for Social Responsibility, ecoAmerica and Health Care Without Harm.