The BP Oil Spill didn’t make the process of connecting chemical contamination to public health any easier or more clear-cut, but at least it has finally legitimized the conversation on a global scale and made it too big to ignore.
There are so many action efforts (both public and private) in motion to address the widespread need for immediate health care for Gulf Coast citizens, and in particular those still suffering in South Louisiana. From the information I’ve gathered thus far, the lag in immediately addressing health needs of this population lie in three areas:
1) a lack of uniform and centralized public health surveillance (monitoring and reporting of health data) by the state;
2) a shortage of conclusive research defining treatment protocol for toxic chemical exposures (and likewise local providers trained to treat patients);
3) a state-wide public health infrastructure overwhelmed with chronic disease and ill-equipped to address systemic organizational needs.
Because of the ubiquitous nature of environmental chemicals in our country (EPA has fully tested only about 200 of the 84,000 chemicals in circulation), these obstacles present challenges all over the U.S. But Louisiana in particular has had to bear a substantial burden of our nation’s toxic load. Some 40% of the entire continental U.S. drains into the Mississippi River system. Compounded with pollutants from refineries, chemical plants, oil rigs, and manufacturing plants such as Monsanto’s Roundup Ready glyphosate herbicide facility in Luling, South Louisiana simultaneously serves both as a provenance for a majority of the nation’s natural resources and a dumping ground for our country’s toxic runoff.
Public and private industry are slowing awakening to the fact that the environmental health conversation can no longer be ignored, and the federal government is trying to provide frameworks and research funds to integrate our efforts. The CDC/ATSDR released an action agenda on June 6 entitled Addressing Public Health and Chemical Exposures, which calls for collaboration from all sectors to help government agencies and public health professionals protect populations from harmful chemical exposures. Based on some of these action items, information from community members, and previously successful education models, we have created an “Environmental Health Education Needs Assessment” for Gulf Coast providers to engage and inform ongoing medical education.
The short-term goals of the assessment are to gain valuable insight from target providers treating patients suffering from toxic chemical exposures and continue to engage local medical, nursing and public health schools. The long-term goals are to gather valuable data and illustrate the need for environmental health education in Louisiana and use it to offer options such as continuing medical education courses, participation in national and international environmental health medical conferences, and ultimately to advocate for an environmental health department in the new LSU medical complex in New Orleans.
The public health investigative and collaborative process has been time-consuming yet yielded valuable information and resource sharing. Many participants in the Louisiana Public Health Working Group, for instance, were unaware that a medical modifier “CS” was established for Medicare patients seeking care directly related to the BP Oil Spill. Medicare coverage is available to patients over the age of 65 and in some instances those under 65 who have been eligible for disability for the past 24 months or have chronic kidney failure. The modifier may be retroactively included in the patient’s medical record and applied to insurance claims.
In other environmental health news, the EPA finally released a full list of chemical ingredients approved for use in all dispersant products in the U.S. (in response to a lawsuit filed by the Gulf Restoration Network and the Florida Wildlife Federation, read more here). Organizations such as LEAN and toxicologist Wilma Subra are actively engaged in research and testing based on this new information. The EPA also recently announced the “Virtual Liver Project” which is intended to measure long-term risks of chemicals to human health over time.
The NIEHS also announced that in addition to the 30-year Gulf study on oil spill cleanup workers’ health, they have provided $25.2 million to four universities to study birth outcomes, cardiovascular, behavioral and mental health complications among spill victims from the general population.
This is all good news, but I think we need to focus on the systemic issues at hand in order to address our ailing state. The federal government relies on states to report data and illustrate their needs and logistically address them. To my knowledge the only uniform collection of health data still being collected by the state for BP victims is from the mental health “Spirit of Hope” grant being implemented by Catholic Charities and the Louisiana Public Health Institute. When I spoke to a program coordinator for the Spirit of Hope grant, she said they are continually seeing patients with increased medical needs post-spill, but they don’t know where to refer many patients either due to a lack of insurance or a lack of access to knowledgeable providers or both.
And asking the federal government for more medical support is even more challenging when you consider the fact that the Louisiana Department of Health and Hospitals is being audited for the second time by the U.S. Department of Health and Human Services for mismanaging a $50 million post-Katrina grant intended to reinstate health care access to the public. Louisiana may have to pay back up to $13.6 million of funds used as incentives for providers to fulfill a 3-year contract to practice in the area.
Unfortunately, I also believe addressing environmental health requires a healthy skepticism of our entire health care system, not just on a local level. The biomedical health care model in the United States is one that often endorses short-term solutions to chronic disease, and this approach will continually fail. Preventing toxic chemical exposures and the detoxification process necessitates a holistic approach to health care — addressing not only the physical hosts of toxic chemicals — air, water, soil, foods, but also our emotional health, lifestyle habits, and more importantly, patience in treating the root cause of our illnesses.
But if Louisiana has proven anything it is that we are a resilient people. I have a bucket list of items I wish for Louisiana’s public health system, and it begins by having a robust surveillance system and engaging providers to educate and advocate for their patients. But for the time being, I hope we can focus on speaking the same language, collectively advocating for change, and most importantly, continuing to believe that change is possible.
If all this information on toxic chemicals sounds too technical and complex to sift through, The Environmental Working Group offers an excellent online resource created by scientists, engineers, health and legal professionals working to gather government data for the purpose of educating the public on toxic chemicals and human health. http://www.ewg.org/