Washington misses opportunity to prioritize health equity | Best countries
As Congress trudges through the final days leading up to the negotiating deadline for the price tags attached to two major multi-billion dollar bills, there is actually a much smaller amount of money that has attracted the attention from many of us working in the health equity sector. Just a relatively meager amount of $ 3 million, which was proposed as an annual budget by the Department of Health and Human Services to fund an exciting new initiative known as the Office of Climate Change and Health Equity. (OCCHE).
The role of the OCCHE, which was announced earlier this year, will be to fulfill President Joe Biden’s vision to ensure that no community is left behind in the government’s efforts to protect the health of American citizens from harm. climate-related events.
In principle, this should be welcomed by those investing in public health. As forest fires rage in the West and hurricanes, tropical storms and flooding continue to expand in their devastating reach, data indicates that the most vulnerable communities suffer the most, especially those who cannot afford to protect themselves or have adequate access to health care. However, this latest initiative to advance health equity is insufficient.
First, the infrastructure bill has stalled. Thus, while the proposed investments are significant, the impasse prevents any actionable cash.
Second, the creation of the OCCHE, which aims to draw attention to health inequalities linked to climate change, appears to be more of a stance deploying symbolic buzzwords than a genuine attempt to develop solutions.
The proposed budget would fund eight employees, which is barely sufficient given the scale of the problem. The resources needed to combat the adverse effects of climate change on our health care system should not be limited to scraping the bottom of the barrel.
When it comes to national and international priorities, money speaks. The amount of funds allocated to the various offices and initiatives indicates the priority of the program. Instead of dreaming big and negotiating down, the proposed budget for this office indicates that the Biden administration is trying to tick something off a list rather than investing in a serious commitment.
This is evident in the shifted focus on the issues. One of the main priorities of the OCCHE is “assisting regulatory efforts to reduce greenhouse gas emissions and benchmark air pollution across the healthcare industry, including participating vendors and providers.” It may seem ridiculous to focus in a limited way on the healthcare sector to reduce its emissions. Nevertheless, the responsibility for mitigating climate change and protecting public health should lie with all sector and all individual. The office could act as a liaison to hold industrial sectors accountable at all levels.
For example, the Environmental Protection Agency cites transport (29%) and electricity generation (25%) as the two main contributors to carbon emissions. As a result, providers that depend on transport and hospitals that depend on electricity are not independent of the larger industrial sectors. If this were part of a larger initiative to cut emissions, perhaps there could be a larger pool of money allocated to the cause that would reflect the scale of the crisis we are facing.
The launch of OCCHE also represents a missed opportunity to highlight the uneven impact of climate change on women. The new office will be headed by Acting Director John Balbus, who has a lot of experience given his other role as Senior Advisor to the National Institutes of Health Director on Climate Change. However, in recognizing the office’s overall mission to reach underrepresented communities, the question must be asked: why have none of the many prominent and experienced women in government been appointed to this post? If money speaks volumes, so do hiring practices.
According to The United Nations, around 80% of those displaced by climate change are women. In the USA, various reports show the gender gap in climate-related diseases, with women experiencing more extreme effects than men. Studies from California wildfires suggest that women’s respiratory function is more affected than men’s, and that higher room temperatures and air pollution caused by greenhouse gas emissions are linked to higher rates of low birth weight, preterm birth and stillbirth. In the aftermath of Hurricane Katrina, women had high levels of post-traumatic stress disorder, especially African American women, as well as a substantial increase in gender-based violence.
Women, even those engaged in recovery and advocacy work to rebuild their lives, felt marginalized, as most of the key decisions were made by men. All over the world, women are the hardest hit by the effects of climate change, so we can be the biggest stakeholders in the fight against it.
If we are to tackle the impact of climate change on public health and seriously advance health equity through this new initiative, it must address the root causes of pre-existing health disparities. It cannot be stressed enough that the effects of climate change on health equity do not happen in a vacuum. Massive health inequalities and disparities already exist in the United States, and these disparities are only exacerbated by climate change.
Since the office’s mission is to “protect the health of people in the United States in the face of climate change, especially those who experience a higher share of exposures and impacts, you have to ask yourself who experiences a higher share of exposure and impact, and why is that?
Maybe once we start asking the right questions and moving the conversations forward, we can dream of future government programs that aim beyond tokenism. Until then, good intentions will only represent false progress.