A longer version of this post can be found at Impact Analysis
The other day, Revere was discussing John Edwards’s presidential platform on cancer, and expressing disappointment that Senator Edwards gives virtually no attention to prevention, including regulatory approaches for reducing carcinogenic exposures and incentives for promoting "green chemistry" in manufacturing. I checked over at Hillary Clinton’s web site, which has a bit more meat on this topic: smoking prevention in young people, getting junk food out of schools, and improving biomonitoring of exposure to toxic substances. However, it’s only a slight improvement over what John Edwards would provide for us. To the credit of both of them, they appeared at Lance Armstrong’s cancer forum earlier this week (most of the Republican candidates bailed on it).
It seems so hard for our politicians to inject the environmental health focus into the debate over health care. Perhaps it’s too difficult for them. Too much of our economic system would have to change. For example, in a paper published last month in Environmental Health Perspectives, the cancer risks from organic hazardous air pollutants were ranked for a non-occupational and non-smoking population. The chemicals providing the largest contribution to total estimated cancer risks in the U.S. were benzene, butadiene, formaldehyde, dioxins and chloroform*. Mobile sources (cars and trucks) are a large part of the emissions of benzene, butadiene and formaldehyde into the air. So, by inference, a key strategy for reducing exposure to these substances could be to reduce the amount that we drive, or ship stuff around by truck. The alterations to our daily lives could range from minor, such carpooling, greater proportion of working from home, or buying locally, to fairly life-changing stuff, including redesigning cities for walking and urban biking, substantially increasing the urban mass transit infrastructure, changing patterns of employment, old industries collapsing while new ones flourish. . . more examples are provided here. There would be collateral benefits, too: redesigning our built environment to be more friendly to pedestrians and bicyclists could create a health benefit, and possibly cut into health care costs, by increasing the amount of exercise people get (NIEHS had a conference on this topic in 2004); in addition, reducing vehicle-miles traveled also reduces our consumption of oil, which promotes energy independence and begin reducing greenhouse gas emissions, both of which pose a risk to national security. Oh, and all of the upgrading of our infrastructure that would be needed to accommodate fewer cars and trucks in our lives would create jobs. . . . Stop me if all of this is making too much sense.
Just as important as what our presidential candidates have said about cancer prevention, is what they haven’t said. Dealing with disease burdens such as cancer is more than just fixing health insurance and giving more money to NIH. It is taking a more holistic view of how physical and socioeconomic factors can affect human health. Environmental health is very much a democratic issue. The Democratic candidates for president should be able to say more about it than they currently are doing.
*Note: I discuss the examples of chloroform and dioxins, and some other toxic substances, in the longer version of this post, over at Impact Analysis