The Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 North Wolfe Street, Room W6041, Baltimore, MD 21205, USA. E-mail: jsamet{at}jhsph.edu
As this commentary was being written, George W Bush, the 43rd President of the United States, had just entered into the second 100 days of his administration. Most readers of the International Journal of Epidemiology are likely to be familiar with the extraordinary story of the disputed US presidential election, which left Bush gaining the Presidency without having a majority of the popular vote. The campaign rhetoric was stereotyped, pitting continuation of a Democratic administration and tradition against the compassionate conservatism that Bush promised. With regard to the public's health and the environment, the tobacco industry and global warming were among the more prominent issues, but received little emphasis nor serious discussion in the debates. Gore, a previously vigorous champion of environmental protection and global stewardship, backed away from the aggressive stance of his 1993 book, Earth in the Balance: Ecology and the Human Spirit.1 This retreat may have ultimately cost him the Presidency, shifting at least some of the environmentalist vote towards Green Party nominee Ralph Nader. For those concerned with national and global public health, the campaign provided limited insights into the approach that the next administration might take to environmental protection, regardless of the winner.
The candidates' passivity on the environment contrasted sharply with the Clinton Administration, which did support control of greenhouse gas emissions. Carol Browner, Administrator of the Environmental Protection Agency for the full 8 years of the Clinton presidency, had an active public health agenda that included an emphasis on children's health, improving food safety, and the controversial and legally challenged 1997 promulgation of new and more stringent standards for tropospheric ozone and particulate matter. As Commissioner of the Food and Drug Administration, David Kessler aggressively pursued regulation of cigarettes because of the addicting nature of nicotine.
To environmentalists, the first 100 days of the Bush administration have raised serious concerns about the Administration's commitment to environmental health and the influence of industry on its environmental agenda. The indications have come quickly: refusal to sign on to the Kyoto Protocol to the United Nations Framework Convention on Climate Change and a reversal of the Clinton administration's standard for arsenic concentration in drinking water. The electric power crisis in California and the recognition that power shortages and outages may soon occur elsewhere in the US have led to enunciation of an Administration policy favouring increased exploration for fossil fuels and rapid construction of new power plants rather than conservation and sustainable power generation. The warnings extend to public health more generally, as shown by the examples of the cancelling of the ergonomic rule put forth by the Occupational Safety and Health Administration, and uncertainty as to the continuation of the government's lawsuit against the tobacco industry.
Bush's appointments of senior officials have drawn mixed reviews from the environmental community. As former Governor of the State of New Jersey, Christine Todd Whitman's appointment as Administrator of the Environmental Protection Agency was viewed favourably. She comes from a state with a legacy of environmental problems and is understanding of the need for environmental protection, enforcement and remediation. However, already the Administration overrode her stated support for control of greenhouse gas emissions. Bush's appointment of Gale Norton as Interior Secretary was soundly opposed by environmentalists concerned about the impact of her pro-business views on natural resource policies. Another key appointment, John Graham as head of the Office of Information and Regulatory Affairs (OIRA) of the Office of Management and Budget, has been criticized because of industry support for the Harvard Center for Risk Analysis, which he headed, and his likely emphasis on cost-benefit analysis in environmental and public health decision-making. This office oversees the Federal regulations and information requirements, and develops policies to improve government statistics and information management. Policies of this office can have substantial consequences for environmental regulations. Many other key senior positions with regard to the environment remain unfilled at present.
How can a change in the president and the president's party affect the stance of the US on key environmental issues? This question has both general and more specific answers, depending on the environmental or public health issue, the relevant legislation, and the complex interactions between the branches of governmentthe Executive Office, the Congress, the agencies and departments, and the Courts. Environmental protection in the US is effected through a series of laws, such as the Clean Air Act, which give mandates to agencies for promulgation, implementation and enforcement of standards and rules.
The scope of the federal agencies sweeps broadly across public health, covering environmental quality, workplace health and safety, food and product safety, and drugs and devices. Some laws are quite specific. The Clean Air Act, for example, lists pollutants and the process and timetable for periodic review and revision of standards. For others, the Occupational Safety and Health Act, for example, provisions are broader and the rule-making process is more flexible, but consequently, is subject to delay by political influence.
Even in the face of this entrenched network of laws and agencies, the President wields enormous power in shaping the nation's environmental and public health agendas. The environmental values of the President are evidenced at virtually every step of environmental decision-making, from the appointment of agency leadership to the budgeting of environmental programmes. Coordinated by the White House, these critical choices shape the capacity and direction of the agencies. For example, the Administration recently recommended a 6.4% reduction in funding to the Environmental Protection Agency's budget. There may be consequences for public health of appointments outside of the key health and environmental agencies. Litigation has become central in enforcement and legal challenges to regulations are frequent. The appointment of federal judges may have a long-term impact on the future of environmental protection, as the judges are the arbiters between opposing parties in difficult environmental disputes.
The Administration's stance on the environment and public health may be manifest more subtlely than through its direct actions and appointments. Change in risk tolerance and use of cost-benefit analysis can shift policies away from or toward a greater or even lesser degree of public health protection.
While the domestic US environment is covered by this network of overlapping laws and regulations, most global environmental problems fall outside of their scope. National actions to contribute to resolving international problems are accomplished through voluntary measures and treaties, and have been largely driven by the priorities and environmental values of the administration in power. With regard to climate change, the US was the fourth nation to sign the Framework Convention on Climate Change, which took force in 1994. The US also participates in the Intergovernmental Panel on Climate Change (IPCC), established by the World Meteorological Association (WMO) and the United Nations Environmental Program (UNEP) in 1988. Federal agencies have carried out and supported research on global climate change. Under the Global Change Research Act of 1990, the US Global Climate Change Research Program was established to provide for development and coordination of a comprehensive and integrated United States research program which will assist the Nation and the world to understand, assess, predict, and respond to human-induced and natural processes of global change. A number of federal agencies and national laboratories have activities relevant to global climate change, e.g. the Department of Energy, the National Oceanic and Atmospheric Administration, the National Center for Atmospheric Research and others.
The Global Climate Change Research Program coordinated the recently completed National Assessment of the Potential Consequences of Climate Variability and Change.2 This report, based on extensive review and analysis by a number of multidisciplinary teams, concluded that increased warming could be anticipated, assuming continued growth of world greenhouse gas emissions. Ecosystems may be threatened, coastal and permafrost areas may be damaged, and adverse health effects may result. Of course, the Assessment acknowledges the presence of significant uncertainties and the potential for surprises as greenhouse gas emissions perturb the complex and poorly understood dynamics of our planet.
Only months after release of the Overview report of the National Assessment, which gave these conclusions, the Bush administration announced its intent to pull out of the Kyoto Protocol, although the Protocol required only a reduction of greenhouse gas emissions to 7% less than the 1990 level by 20082012. The US had previously signed the 1997 agreement, but it had not been ratified by the Senate, and President Bush wrote to four conservative senators, signalling his intent to oppose the agreement. Harm to the economy was among the cited reasons. This decision was decried throughout the world, given the need for leadership from the US on global climate change and the difficulty of achieving control without limiting emissions of greenhouse gases by the US.
Uncertainties are evident in the scientific foundation for policy actions to restrict emissions of greenhouse gases and scientific debate continues.3,4 There are limitations of the historical measurements and predictions of future climate changes are of necessity model-based. Estimates of health consequences are derived by adding yet another layer of models in an integrated assessment.2 Not surprisingly, as the arguments have played out for and against immediate action on greenhouse gas emissions, uncertainties have figured prominently in the debate, as gaps in the science have been emphasized by critics of emissions reduction. Possibly in the face of uncertainty, the Administration felt justified in moving away from the Kyoto Protocol, particularly because of the immediacies of the economic downturn and of the looming electricity shortage in the US. In facing difficult policy decisions, scientific uncertainty can provide an attractive alternative to action when used to delay progress while seeking to shore up the basis for future policy decisions with further expert review and research.
Unfortunately, the events of the last decade across two presidencies indicate that the US does not have a structure in place that can follow a progressive course on global environmental problems, whether climate change or tobacco smoking. Shorter-term political and economic considerations will inevitably take priority over longer-term environmental concerns like global warming and directions may change as the President changes. Arguably, action on greenhouse gas emissions might be deferred for a few years without identifiable consequences but action cannot be procrastinated for the long run.
Fortunately, Americans so favour preserving environmental quality and have shown that they will not accept its degradation. During the early years of the Reagan administration, regressive policies of the Reagan-appointed administrator of the Environmental Protection Agency, Ann Gorsuch, galvanized public support for the environment. Similarly, a recent Newsweek poll indicates that less than half of the American public approves of Bush's handling of the environment.5 In the long run, the public's view of global change may be a critical determinant of US policies.
We are concerned that the Administration's actions during its first 100 days signal a retrenchment from vigorous stewardship of the environment, both nationally and globally, and a possible move towards a cost-driven approach to environmental management rather than one based in advancing the public's health. In light of persistent scientific uncertainties, the need for more review and research may become the mantra for inaction. We should not interrupt progress in preserving the global environment because of the stance of one administration of one government that holds sway for at most 8 years of our planet's existence. The impetus for continued progress must come from the force of public values and a strong scientific foundation.
References
1 Gore A. Earth in the balance: ecology and the human spirit. Boston: Houghton-Mifflin, 1992.
2 National Assessment Synthesis Team (NAST). Climate change impacts on the United States. The potential consequences of climate variability and change. New York: Cambridge University Press, 2001.
3 Christianson GE. Greenhouse: The 200-year story of global warming. New York: Walker and Company, 1999.
4 Stevens WK. The change in the weather: people, weather, and the science of climate. New York: Delacorte Press, 1999.
5 Fineman H. W's Green War. Newsweek, 23 April 2001.