Environmental Engineer's Xmas Letter: Public Campaign Funding for Lower Health Costs, Safer Children Every year, John Roberts, a pioneer in the science of exposure analysis and tireless advocate for children's safety from avoidable toxic exposures in indoor environments, sends a Christmas letter to friends and relatives that calls for action to protect children. This year, as in the past, he tells us that economic and political barriers block us from applying simple measures that would prevent serious harm to large numbers of children and considerably lower society's health care costs. And he ties together a call for political reform that people of all political backgrounds can support -- reducing special interest money in political campaigns -- with a cause we can all help advance: keeping children safe from needless harm while saving public money.

Last week, a Seattle Times article by Sandi Doughton, Very few children here tested for lead poisoning, reported that Washington state is violating federal law by failing to comply with a mandate to test low-income children for lead exposure. Doughton's article did an excellent job at connecting recent reports of toxic levels of lead in children's toys with the seldom-reported fact that many children in Washington are exposed to small amounts of lead from multiple household sources. These exposures are harmful, avoidable, and costly. This is precisely the point that John Roberts has been devoting the last 20 years to bringing to the attention of media and policymakers: children are being damaged by avoidable exposures. John Roberts is one of the co-authors, along with Steve Gilbert, the toxicologist quoted in the Seattle Times article, of a piece in the January 2008 Seattle Voter. This article, "Protecting Our Children by Monitoring and Preventing Lead Exposure", calls for complying with this federal mandate to test Washington's low-income children for lead exposure, and for lowering the lead blood level that triggers action to reduce exposures. (1) The Seattle Voter story is an informational piece for League members and represents the opinion of the authors rather than any official position of the League.

As I think about this past year, I realize that I have seen the kind of passion to protect children that shines through in John's Christmas letter expressed everywhere around me in the public arena -- by state legislators, by my son's public school teachers and Principal, by public health officials, by citizen activists, and by many others. Innumerable people give with pure generosity to advance the wellbeing of children. This force of love and caring is much more powerful than all the economic greed and political dysfunction that, at times, seems to dominate public life. The letter that appears below the fold, reprinted with permission from the author, reflects his personal views and, except where noted, does not reflect the positions of any of the organizations he names.

Christmas letter from John Roberts, reprinted with his permission, December, 2007

Helping Children - Reducing Health Costs
There is a close link between the care we give our children and their development, between exposure of children to physical and social stressors and present as well as future health costs.

Why is it that we spend more on health per person than any nation and have such poor health?

Why has the percentage of children with a chronic illness that reduces their activity three months out of the year risen from 1.8% to 7% in a little over 45 years with asthma (9%), attention deficit hyperactive disorder (ADHD) (6%), and obesity (17%) being the leading causes? (2)

Why do we rank next to the bottom of 21 rich nations in the UNICEF 2007 Report Card 7: An Overview of Child Well-Being in Rich Countries?.  Some 24% of our children live in poor families that are excluded from a minimum acceptable way of life.  Poverty is a major driving force for an unhealthy environment with our poor children having much higher rates of asthma and lead poisoning. (2)

We are the richest country and rank last in the health and safety of children as measured by an average of three indicators:

1. The 7+ infants per 1,000 who die in the first 12 months
2. The 8% of babies who are underweight (<2500g)
3. The percentage of children who are not immunized against preventable diseases (2)

Why do we rank at the bottom for young people's health and risk behaviors covering exercise, diet, obesity, and a high teenage pregnancy and fertility rate?  We have the highest percentage (23%) of children living in a single parent family.  It appears that as the gap between rich and poor became wider in the US, we began falling behind other rich countries starting in the 1950s (2).

The United Nations, World Health Organization (WHO), and International Labor Organization issued in 2007 the joint Environmental Health Criteria 237: Principles for Evaluating Health Risks in Children Associated with Exposure to Chemicals.  WHO estimates that 30% of the world-wide burden of children's diseases can be related to environmental exposures.  The timing of exposures can be as important as the amount.  Early exposures to chemicals can lead to miscarriages; low birth weight; birth defects, infant mortality, asthma, lead poisoning, ADHD, immune impairment, as well as early or delayed puberty. Puberty is coming two months to two years earlier in girls in the US.(2)  Cancer, asthma, and heart disease in adults can in part be related to early exposure to pollutants.  

WHO suggests we should monitor and reduce the exposure of children to the industrial chemicals where we have evidence even though full proof of causal association is lacking.  Many thousands of chemicals associated with industrial development have not been tested for health effects on infants.(2)  Many are being found in house dust at concentrations that exceed health based standards. (2)

Why did the UNICEF Report Card 7 and the WHO Environmental Health Criteria 237 report on children receive so little coverage in the US press and political discussion?

Potent economic and political barriers
There are potent economic and political barriers to expanding public awareness of poor child health in the US and the application of cost-effective solutions for reducing childhood exposure and health costs. (2)  The media and government do not always operate in the public interest because we have the best government and media that money can buy.  The freedom of the press belongs to those who won the press.   Government and media action is for sale to the highest bidder.  News coverage is affected by the economic interests of the advertisers and the corporate owners of major media.  Advertisers have the power to partially or completely black out news that has an adverse affect on their market.  Reporters have difficulty getting such stories past editors who want to please their advertisers.  Congressional and State legislatures do not want to fund activities that are opposed by major donors to their political campaigns.  The same large sources of money can have a corrupting influence on both government and media such that the health of children and health costs have a low priority.  Media in the public interest (NPR and PBS) must walk a razor's edge to avoid offending legislators and losing their government funding.

It is easier to improve elections and government than to reform private media.  The public funding of political campaigns is a good place to begin.  This is the most important way to remove barriers to protecting the health of children, funding of education, eliminating poverty, action on global warming, and many other needed changes.  Elected leaders who are free from obligations to large campaign donors can sere the public interest.  They will require media that use public airways to devote more time to public service as a requirement for a license.   They will resist efforts of the FCC to allow major media corporations to own both newspapers and TV stations in the same area.

The League of Women Voters of Seattle (LWVS), League of Women Voters of Washington (LWVW), and the US League are doing the hands-on work to safeguard our democracy, including the public funding of campaigns.  They are non-partisan.  They are working to change Washington State law so that cities and counties will have the option of public funding of local campaigns. I encourage you to join the LWV as one of the best ways to become informed and to take action that will make democracy work.  Men are welcome...

The LWVS and LWVW have taken the position that we should reduce exposures to toxics in the home.  They were instrumental in the founding of the Master Home Environmentalist Program (MHE) of the American Lung Association in Seattle that has spread to 16 locations.  You can get a free home assessment by an MHE by calling 206-441-5100.  

John Roberts

1. Protecting Our Children by Monitoring and Preventing Lead Exposure, By Steven G. Gilbert, John Roberts, Charles Bagley, Noemie Maxwell, and Robins Evans-Agnew, appears in the January 2008 Seattle Voter. It does not present an official position of the League but, rather, gives opinion and information for the consideration of League members. It includes the following statement:

   "We recommend the following:  The blood lead level that triggers action to protect a child from continuing exposure should be lowered below the current 10 mg/dL to 2 mg/dL. This would reflect current scientific knowledge and protect children from permanent damage.  High risk infants should be monitored for exposure, as legally required by Medicaid.  Currently, this law is  being  ignored. Finally, policies should aim to prevent lead exposure of all children."

2. John Roberts included footnotes in his letter.  References are available upon request.  I'll be updating this article with those references when I receive them.
3. Also see Washblog stories:
   Visionary Asthma Pilot Program Helps Children Breathe and Learn
   Less Time in Hospitals, More Time in School: Home Visits for Children with Asthma
   Our Buildings Ourselves:  Connecting Human, Community, and Ecological Health