November 11, 1971
Page 40709
TENTH ANNIVERSARY OF THE ENVIRONMENTAL HEALTH LETTER
Mr. MUSKIE. Mr. President, on October 15, the Environmental Health Letter celebrated its 10th anniversary. It is an anniversary worth noting and praising.
For 10 years, Gershon W. Fishbein has published his twice a month newsletter as a source of information on what is happening in environmental protection, what isn't happening, and what should happen. His is one of the first of a new generation of environmental publications, and it is one of the best. In its first decade, the Environmental Health Letter has maintained the editorial maxim "that the problems of the environment are interrelated and must be treated together rather than fragmented." Time and again, Mr. Fishbein has reminded us that the object of pollution control is not simply to reduce this or that discharge to a certain level, but to improve the health of men and women through an improvement of the environments in which we live.
I want to take this opportunity to express my gratitude to Mr. Fishbein for the challenge he has provided to me and my colleagues on the Senate Subcommittee on Air and Water Pollution. I know he will continue to challenge us to do better than we have.
I ask unanimous consent, Mr. President, that a paper delivered by Mr. Fishbein at a symposium on environment, health, and population at the 99th Annual Meeting of the American Public Health Association, in Minneapolis, Minn., October 13, 1971, be printed in the RECORD at this point. That paper, "Environmental Health: Does It Have a Future?" provides an eloquent statement of Mr. Fishbein's philosophy, and I commend it to the attention of Senators.
There being no objection, the statement was ordered to be printed in the RECORD, as follows:
ENVIRONMENTAL HEALTH: DOES IT HAVE A FUTURE?
(By Gershon W. Fishbein)
Presentation at Symposium on Environment Health-Population, 99th Annual Meeting of American Public Health Association, Wednesday Morning, October 13, 1971, Convention Hall, Minneapolis, Minn.
An old Arab proverb reminds us that "he who has health has hope, and he who has hope has everything."
It tells us that all of man's endeavors, all of his aspirations, can be achieved only if his health – physical and mental – is protected. It is the indispensable base on which all else in life rests.
Although obvious, it merits restatement today as very relevant to our theme of "Environment- Health-Population," and especially to my discussion of the future of environmental health.
Environmental health is considered to be a relatively recent phenomenon by many. Yet Hippocrates is known to have counseled young physicians, seeking a locale for practice, to consider "the purity of the airs and the waters" in determining the presence of disease in the community.
If we believe that water pollution and supply are the products of 20th century technology, we should remember that the Roman Emperors were much aware of the problem, as their elaborate underground aqueducts, uncovered in archeological expeditions, attest.
Mindful of the adage that fools rush in where angels fear to tread, I nevertheless feel privileged to appear before you today to peer into the future of environmental health and perhaps to foresee some trends. In so doing, let us honor and respect the past – not because it is the past, but because it shapes the present and illuminates the future.
The late Professor Winslow of Yale was the unquestioned giant of environmental health and sanitation in the first three decades of the 20th century. To a degree unmatched by any of his colleagues, I suspect, he expounded the concept of personal sanitation and hygiene as the primary means of preventing disease.
He invites our study and commands our respect for many reasons. So pervasive was his influence that it extended into the 1950's, the era of communicable diseases when medicine turned its attention to viruses and bacteria, seeking to isolate and identify their pathogens and to develop vaccines and antibiotics for their prevention and cure.
By precept and example, through his many students still very active in the field, his contributions represented the forerunner of the present philosophy of environmental health control.
Parenthetically, I might say that the American Public Health Association meeting is an ideal setting to remember the contributions of Prof. Winslow. As many of you know, he served APHA for some time as editor of the American Journal of Public Health.
In the United States, environmental health activities have contributed to virtual elimination of many once-dreaded epidemic diseases such as typhoid fever, cholera, malaria, yellow fever and endemic typhus. In lesser degree, the incidence of the dysenteries and other filth-borne diseases has been greatly reduced by environmental controls.
Originally, these environmental controls developed as a result of social dissatisfaction with urban sanitary conditions following the industrial revolution. At first, the methods used were largely empirical, but improved knowledge of specific diseases etiology and sanitation technology gradually established bases for more scientific and effective procedures.
Come forward to our times. By 1960 it became evident that national programs in air pollution, water pollution, radiation, occupational health, pesticides and food protection were gaining increasing public attention – particularly water pollution, which has had the longest history of any environmental health problem and served as the training ground for many of the environmental technologists of today.
The rapid spread of industrialization and the coalescence of urban areas into large metropolitan complexes gave rise to many of the environmental health problems which existed then and still persist today. New patterns of living, extending into suburban and ex-urban communities, compounded the sources of environmental hazards and concentrated into a relatively small land area the people affected by them.
While the extent of the problems were recognized, if not fully appreciated by the powers that be, it became equally evident that the organizational capacity of the U.S. Public Health Service, where most of the programs were lodged, to cope effectively to meet them was greatly limited.
The programs themselves rose somewhat independently of each other, usually in response to a specific urgency – a fish kill, a pesticide poisoning, an industrial accident, etc. There was recognition even then that the problems of controlling environmental health hazards were interrelated and must be administered as a whole rather than fragmented.
A 1960 report of the Surgeon General to the House Appropriations Committee noted that this fragmentation has "resulted in a loose grouping of related, but independently treated problems, programs and activities associated with the essential elements of our surroundings – the water we drink, the air we breathe, the food we eat, the shelter which protects us – or with action taken by man in pursuit of a fuller life: his occupation, recreation, transportation and social organization."
To help the Public Health Service provide a central focus for its environmental health responsibilities, Surgeon General Luther L. Terry convened an advisory committee headed by Dr. Paul M. Gross of Duke University.
Ten years ago this month the Gross committee submitted its report recommending several major steps to provide such a centralized focus, including the establishment of a Bureau of Environmental Health, a national center for environmental health research in the Washington area, and a number of other categorical recommendations designed to strengthen and enlarge the Service's responsibilities.
Rereading the Gross committee's recommendations ten years later, considering what
has transpired in the last decade, seems almost like a venture into Alice-in-Wonderland. The recommendations seem Utopian.
This is not the proper time or place for an autopsy to determine who killed environmental health, or even if there is a corpse. It would be unproductive, I believe, to sort out heroes and villains.
Suffice it to say that the environmental health problems of 1961 are still with us – multiplied a thousandfold, of course – and many new ones not foreseen then are in evidence. And, more significantly, the concept of an integrated attack on the problems remains today more valid than ever before.
Environmental health seeks to orchestrate a unified approach to the conflicting claims imposed on man's health from many sources in that environment – air pollution, pesticides, noise, crowding, solid wastes, to name but a few.
Environmental health today is everybody's business. Although it is perhaps the ancestral home of the sanitary engineer, environmental health is now embraced by many disciplines sharing a common objective – protecting man's health and welfare from the deterioration of an environment which is becoming increasingly hostile to his aspirations for a better life.
More than waste treatment facilities, much more than monitoring sulfur dioxide, much more than any technological innovation, environmental health is a sociological phenomenon. It shapes man, and in turn is shaped by him.
The late Whitney Young told the story of how, in ancient Greece, a wise philosopher was once despairingly asked: "When will justice come to Athens?" And he replied that justice would come only when those who are not wronged become more indignant than those who are.
So it is with environment. It is everybody's bag, not just the poor and the dispossessed, not just the aggrieved and the alienated, but also the well adjusted and the comfortable.
Given these forces, is it any wonder that environment has been labeled the issue of the '70's?
Although health protection, in the traditional sense, is now interwoven into environmental agencies at the federal level, and at many state levels, there is still ample opportunity for the environmental health specialist to play an active, if not leading role.
Health may have sacrificed its place in the top box of some organizational charts – but it has not surrendered its prestige or its influence, especially in time of crisis.
Mercury has been in the nation's waters for many years, but only when it entered the food chain and became a threat to public health did it command the headlines and, consequently, the public attention.
Many exotic chemicals which can be assimilated safely in the environment become danger signals when health is at stake. Health is the flash word of the environment, the point at which the public rises in wrath and says "stop, now."
Agencies which contemplate further subordinating health in their environmental structures should pause and consider this reality.
Beyond this, the future of environmental health lies in fostering alliances with other groups with similar objectives – public works agencies, housing agencies, medical care organizations, etc. In advocating this step, I know that history places odds against it. But I sincerely believe that the time has come to bury past differences and to consider how much more unites the disciplines than divides them.
Neither health nor any other aspect of environmental control can prosper in isolation from each other. The complexities of environmental control today are well known to all of you, and it would be presumptuous of me to dwell on them before this sophisticated audience.
There is a place for everyone – and yet I continue to cling to the view that the contribution of health can be uniquely significant, if only for the importance of the target, namely, man. By training and by instinct, the true environmental health specialist understands and appreciates man's diversity and his role in helping nature to cope with it.
To illustrate this point, I should like to quote briefly from one of America's most gifted newsmen, William V. Shannon, writing last week in the New York Times:
"In the whole mysterious gift of life, what most astonishes and excites is diversity. No two human beings are the same. The tiniest snowflake, the most distant star, the intricately veined leaf of a tree are each unique. From jackrabbit to giraffe, from crocodile to swan, from tiger to hummingbird, nature delights in varieties of form and phenomena.
"Overwhelmed by this profusion, man's deepest intellectual drive is to understand, to classify, to find self-consistent structures. But from this drive also springs man's menacing will to power.
"In the realm of understanding, there is always the indeterminacy, the random event, the inexplicable phenomenon which frustrates and beckons. But in the realm of power, human beings know quite enough to exert control and to make themselves and their man-made environment conform to abstract patterns. This human effort moves strongly toward suppressing variety. In law, politics, technology, economics, education and even the ephemeral world of fashion, the greatest danger is always the tendency toward a deadening sameness, toward a loss of variety for the sake of control."
He concludes by saying that "the worldwide ecological movement is not only a response to the life-threatening dangers of pollution but also a belated affirmation of the importance of diversity.
Man, the giant predator, has destroyed countless other species. He menaces every creature from the mighty blue whale to the humble butterfly. Only now does man realize that if he is nature's sole survivor, he will not long outlast his victims."
The future of environmental health lies in broadening its base to include the social consequences of its solutions. The environmentalist must not be content at looking at the automobile through the tailpipe, but must consider the total impact of the automobile on the entire social fabric of our lives. In this context, he may find that pollution is the least objectionable aspect of the automobile. Environmental health must not confine itself to lead in auto exhaust, but must also consider lead in the blood of hungry children eating lead-based paint off the walls of broken-down housing.
Environmental health cannot consider auto pollution without involving itself with mass transit. You cannot be for one and against the other.
We should not diminish our efforts to understand and control such problems as air pollution, radiation and pesticide exposure, and so forth. But we should not forget that two of our biggest environmental health problems are crime and poverty. The relationship is obvious: Pollution fouls man's environment, and poverty chains him to it.
The city will be the arena of the new environmental health action. Crowded, tense, teeming with narcotics and many other manifestations of a turned-off sub-culture, today's city embodies much that is gone wrong in our lives.
Our quest must be to make our cities more hospitable – to ideas as well as to men, to innovation as well as to immigration. Just as urbanization has given rise to many of the environmental health problems of today, so too is the urban area the proving ground for their solutions.
Martin Luther King was fond of reminding audiences of Washington Irving's delightful fable of Rip Van Winkle, who, when the cares of the world became too much for him, simply fell asleep. He slept for 20 years and when he awoke, the American Revolution had taken place.
Today, in the ferment we call our American cities, another environmental revolution is taking place. None of us – physicians, lawyers, engineers or newspapermen – can afford to emulate Rip Van Winkle. We must not, we dare not, sleep through this revolution.