Legislation is needed to close the environmental health gaps in the Polluters Pay Principle

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By Eric Feigen, NCL Health Policy Intern

Today, more than 40% of Americans live in communities with unhealthy levels of air pollution and every year, millions of deaths and chronic illnesses have been found to be directly caused by various pollutant types. This represents the human cost inherent in environmental degradation. Despite this, policy-makers and regulatory agencies continue to ignore public health consequences when crafting legislation designed to address environmental issues nationwide.

The current approach towards addressing both climate change and environmental damage is rooted in the Polluters Pay Principle (PPP). This commonly accepted practice dictates that those who pollute are responsible for not only abatement costs, but also compensating those adversely affected by their actions. From the Clean Air Act to the more recent Inflation Reduction Act, PPP is the fundamental framework for the majority of environmental legislation in the U.S.

The core mechanism used in PPP is cost-benefit-analysis. Due to the fact that polluters receive a benefit from polluting, in the form of profits, they must correspondingly compensate individuals for the negative externality their pollution creates. For example, paying for a water treatment plant in order to ensure a safe water supply for a community.

One of the most significant externalities of pollution is long-term health conditions. High levels of particle air pollutants are linked to a variety of health issues including asthma, cancer, infant mortality, and premature death. However, as previously mentioned, while 40% of Americans live in places with failing grades in air quality, not all of these individuals have asthma. This illustrates the uncertainty inherent in including the costs to humans’ health in the PPP’s cost benefit analysis. Using this logic, Michigan v. EPA set the precedent for omitting the negative impact polluters have on health from PPP-based calculations.

The Public Health Air Quality Act is one solution to the uncertainty dilemma surrounding pollutants and chronic health conditions. This is because the Act sets thresholds for pollutant levels at the point where the pollutant becomes harmful to human health. In essence, while previous legislation has made polluters pay for the right to pollute, the standards in this legislation will prohibit contamination after the air quality reaches a dangerous level. Furthermore, the Act will also mandate new air pollution monitoring programs and allow the EPA to follow the “precautionary principle”, which errors on the side of safety when determining what levels of pollution may be harmful to humans.

Another arena where PPP must be supplemented is equity. While designed to reduce environmental damage nationwide, PPP fails to address how pollution disproportionately harms Black and Brown communities. An example of this is exposure to PM 2.5, an air pollutant responsible for upwards of 85,000 deaths a year. A recent study highlights that while the Clean Air Act has led to a nationwide decrease PM 2.5 related health conditions, the number of deaths this pollutant causes in communities of color has remained constant.

Climate change and environmental degradation are just as much a public health issue as they are an environmental one. Policy-makers have the obligation to create legislation to supplement PPP policies to mitigate the harm polluters inflict on public health and ensure an equitable approach to environmental regulation and cleanup.

 

National Consumers League applauds President Biden’s plan to cancel $10,000 in federal student loan debt to millions of Americans

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August 24, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832 

WASHINGTON, D.C. – The National Consumers League applauds President Biden’s decision to relieve student borrowers of billions of dollars in educational debt and to extend the federal loan repayment moratorium. By cancelling $10,000 in student debt for borrowers earning less than $125,000 and cancelling $20,000 for borrowers who received Pell Grants, this administration is providing direct aid to consumers suffering from the plight of educational debt.

The following statement is attributable to NCL Executive Director Sally Greenberg:

“President Biden is providing critical assistance to millions of borrowers across the country. Importantly, this executive order will work to negate the impact of student debt that disproportionately affects women and Black borrowers. As consumers face increased rents, grocery costs, fuel prices, and even student loan interest rates, educational debt cancellation will help provide relief on strained household budgets by reducing—and in many cases eliminating—student debt costs.”

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

National Consumers League weighs in on FDA’s OTC Hearing Aid Rule, encourages consumers to consult with medical professionals

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August 17, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC – Today, the U.S. Food and Drug Administration (FDA) issued its final rule enabling access to over-the-counter hearing aids for consumers with perceived mild to moderate hearing loss. National Consumers League (NCL) strongly supports expanding access to and affordability of hearing aids. NCL is encouraged by the positive impact these policy changes will have on increasing access to life-altering hearing aids. “We hope this means that more people will proactively assess their hearing loss and seek the help they need for their hearing health needs” said Sally Greenberg, Executive Director of NCL.

At the same time, while OTC hearing aids are a promising first step in achieving that goal, NCL remains concerned about potential consumer safety issues surrounding the use of OTC hearing aids without consultation of a trained, medical professional. NCL strongly encourages consumers to first consult with a medical professional before treating their perceived hearing loss with a hearing aid, including those that will be sold OTC.

Safety is the cornerstone of NCL’s mission. This is why NCL, along with 90 leading healthcare and consumer organizations, weighed in during the public comment period and via a group letter to FDA urging the agency to adopt lower the maximum outputs for OTC devices and establish a limit on gain. This limit has been recommended by leading hearing health professional organizations to ensure consumer safety. FDA ultimately lowered the maximum outputs in the final rule but decided against establishing a gain limitation. While we are pleased that the FDA recognized the need to lower the maximum outputs, we believe these devices could have been safer by limiting the amount of gain, as recommended by hearing care professionals. The lack of a gain limit, coupled with excessive amplification of sound for prolonged periods of time, may put some consumers at risk of experiencing increased hearing loss.

Because hearing loss is a medical condition that is unique to each individual, it should be addressed in consultation with a hearing care professional. With OTC hearing aids expected to be in stores as early as mid-October, NCL encourages consumers to purchase hearing aids in consultation with a professional who can help them fully understand the nature of their hearing loss, if any exists at all, and ensure that the treatment plan is appropriate for their needs, including the potential use of OTC hearing aids.

If consumers experience any adverse events or complications related to the use of OTC hearing aids, including worsening hearing after using such a device, NCL encourages consumers to report these events to the FDA. Instructions for reporting adverse events, are available at https://www.fda.gov/safety/medwatch, or by calling (800) FDA-1088.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

The National Consumers League commends the enactment of the Inflation Reduction Act in increasing Medicare and Medicaid beneficiaries’ access to adult vaccines

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August 17, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC – The National Consumers League (NCL) is tremendously encouraged by the enactment of the Inflation Reduction Act (H.R. 5376), which includes important provisions to increase access to adult vaccines. More specifically, the Act will provide all recommended adult vaccines to Medicare and Medicaid beneficiaries at no cost to patients.

NCL has been a longstanding advocate of expanding vaccine access to consumers, and recognizes the importance of vaccines as a life-saving, preventive public health measure. As a member of the Adult Vaccine Access Coalition (AVAC), NCL supports increasing access to all recommended adult vaccines by eliminating no cost sharing policies, which can place an immense financial burden on patients. As with any other health service, cost burden has kept both Medicare and Medicaid beneficiaries from receiving their recommended adult vaccines. Limiting vaccine access is harmful, and keeps adults from protecting themselves and their communities from preventable disease.

The crucial vaccine provisions within the Inflation Reduction Act include language from both the Protecting Seniors Through Immunization Act, and the Helping Adults Protect Immunity (HAPI) Act, both spearheaded by AVAC and advocated for by NCL. The Act will provide free recommended adult vaccines for both Medicare and Medicaid beneficiaries starting in 2023. It also mandates that under Medicare Part D, there will be no copays or any other out-of-pocket expenses for any adult vaccine that is recommended by the Advisory Committee on Immunization Practices (ACIP). In addition, Medicaid and CHIP will increase access to adult vaccines by improving federal reimbursement for providers that immunize those patients. Expanding access to vaccines through these mandates will promote vaccine uptake through the removal of cost burden for both Medicare and Medicaid beneficiaries.

The inclusion of these provisions in the Inflation Reduction Act is a critical step towards increasing vaccine access and coverage to Medicare and Medicaid beneficiaries nationwide. Its enactment will not only promote better health outcomes for consumers, but also represents a significant step towards expanding health equity. NCL appreciates President Biden’s swift action in signing this landmark piece of legislation yesterday.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

My path from strawberry and blueberry fields to college

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By Alma Hernandez, NCL Child Labor Coalition Summer 2022 Intern

Alma attends the University of South Florida, where she is pursuing a Bachelor of Science in Public Health.

Alma Hernandez (far right) is joined by fellow National Migrant and Seasonal Head Start Association  farmworker youth interns Jose Velasquez Castellano and Gizela Gaspar. NCL CLC Coordinator Reid Maki is also in the photo.

Imagine being a five-year-old child – happy and carefree. The age where you either attend pre-K or start kindergarten. But can you imagine a five-year-old working in farm fields in hot 90-degree humid weather with her parents? I was that child. I wore a long-sleeved shirt, jeans, closed-toed shoes, and a hat to protect me from the hot sun. At five years old, I was unaware of how difficult agricultural labor is. My mom had enrolled me at the Redlands Christian Migrant Association (RCMA), a Migrant and Seasonal Head Start program, but she also wanted to teach me to value my education.

My mother’s life lesson started during the weekend after I did not want to wake up for school. My mother remembers that I was full of confidence when asked if I wanted to go to work with her and my father. However, I did not know what was in store for me.

Arriving at the fields around 7:30 am, I first saw endless rows of strawberry fields. I felt enthusiastic. My task: collect as many bright red strawberries as I could and place them in my pink Halloween bucket. After filling my bucket, I would give the strawberries to one of my parents. Around 12, I felt the heat. It was around 90 degrees. The humidity made it feel worse. I felt like I was in 100-degree weather; I did not like that at all and wanted to go home. I was already tired and asked if we could leave. My mom said no; I had to stay until they finished. And so I kept working.

I do not recall what happened the rest of the time I was there, but I remember what happened afterward. I went home and sat on the stairs of the house with a red face, a headache, and clothes covered in dirt, and reflected on the decision I had made to join my parents in the strawberry fields. I went inside. I was so tired that I ignored dinner and skipped a shower and went straight to bed just to wake up the next day, to repeat another day of long, hard work. My parents had me help them one more day; and convinced that my lesson was learned, they let stay home where, in the next few years, I could help take care of younger siblings when my parents could not find childcare.

Although my work in the strawberry fields was short-lived, I have much more experience harvesting blueberries. I started working on blueberry farms when I was 12 years old and worked every summer until I was 16. The blueberry season starts in the summer after school ends in Florida.

My family and I would leave Florida near the end of June and start the 17-hour drive to Michigan. Unlike the strawberry season, I liked picking blueberries because I did not have to bend down low to the ground all day; blueberry plants grow higher. My job was to fill up my six buckets. Once they were all filled, I would carry all the buckets to place them into plastic containers and have them weighed. On average, six buckets would be 42 to 45 pounds, and depending on who we were working for, the average pay was 0.45 to 0.55 cents a pound. I had to pick as many pounds as I could. On good days, I would be able to pick 200 pounds or more; on many other days, I would pick less.

The clothing I wore was also the same: long sleeves, jeans, closed toes shoes, and a hat to protect myself from the sun. The weather in Michigan is not as humid as it is in Florida; usually, it was in the mid-80s to low 90-degrees however it was still hot being there all day. We would go in each morning at 8:30 or later depending on how wet the blueberry plants were and leave the fields around 8 or 9 at night.

I did not like going to a new school in Michigan every September just to leave in late October and return to Florida and start school. The curriculum was very different; I would excel quickly in Michigan since what I was learning I had already studied in Florida. But I also did not like how every time I would go to a new school, I’d be the “new girl,” struggling to make friends but knowing I would soon be migrating. “What is the point?” I would wonder. So I always kept to myself and only spoke when I was spoken to, and to this day I still do.

I also did not like the “what did you do during the summer?” question on the first day of school when I returned to Florida because all I did was work all summer and had no fun. Work caused my parents to miss many school functions that other parents would attend. Sometimes, it felt like a lack of support, but I understood that this type of work was their only way to generate income to provide for the family.

This summer, after four years away, I came back to Michigan with my family for the blueberry harvest one more time. Now that I am 20 and reflecting on my family’s agricultural experience, I appreciate my parents for what they have done for my siblings and me. They wake up early every day, go to work, come home to cook, and still spend a little bit of time with my younger siblings. I help around as much as I can because I know they cannot do everything on their own, especially now that they are getting older. I know they are tired and have no rest days. But thanks to them, I am the first person in my family to go to college and serve as an example to my siblings which proves to them that there is a reason for our parent’s sacrifices.

Ambulance EMS Subscription Bills

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Ambulance Rides Still Aren’t Protected From Surprise Billing — and Subscriptions Do Little to Help

Gun violence is a public health problem

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By Eric Feigen, NCL Health Policy Summer 2022 Intern

We live in a nation where children fear for their lives at school, racially motivated killings are pervasive, and mass shootings have become commonplace. The United States is in the midst of a gun violence epidemic. One promising avenue that could help address this crisis involves approaching gun violence from a public health perspective. By developing strategies aimed at protecting the health and safety of people and communities, we can develop a policy framework for reducing incidences of gun violence and suicide.

Of the 24,897 people who have died from gun violence in 2022, 13,530 people have lost their lives to suicide. To compound this loss, National Institutes of Health (NIH) estimates that 45 percent of people who take their own lives visit their primary care physicians within a month of their death. Many Americans are reaching out for support. However, due to the inaccessibility of mental health services, people cannot receive the help they desperately need. According to the American Psychological Association, in 2018, 39 percent of people could not afford the cost of receiving mental health services. Even for those with healthcare coverage, 26 percent choose to forgo treatment because their copays are too high.

There are a wide range of public health policies that could be implemented to remedy this issue. The first task is improving accessibility. A survey by the Health Resources and Services Administration indicates that the demand for mental health services far exceeds the number of professionals in the field and some primary care professionals receive no training in suicide assessment or management. In addition, many Americans have to travel immense distances to receive mental health treatment. The pandemic has illustrated the effectiveness of telehealth as a solution to this issue, however programs such as fellowships, outreach seminars, and more must be put into place to increase the number of health professionals in the field.

Gun violence in America is also an equity issue, disproportionately affecting communities of color. This has created a cycle of violence which places children at an increased risk for gun violence exposure earlier in life. A NIH study indicates that the prevalence of gun violence during childhood increases interactions with firearms later in life to a medium to large effect. This leads to the second policy issue that must be addressed: improving access to quality mental health services in order to break cycles of violence.

To accomplish this, policies designed to incentivize and increase the number of psychiatric practitioners of color must be put into effect. Not only do Black and Brown mental health professionals have a better understanding of the challenges their communities face, but studies indicate that white mental health workers often misdiagnose minority patients leading to counterproductive treatment. In 2019, racial/ethnic minorities made up only 17 percent of the psychologist workforce, illustrating how marginalized communities have disproportionately less access to quality mental health services in comparison to their white counterparts.

The social determinants of health; healthcare, housing, economic mobility, and more are inescapably linked to the root causes of gun violence. In addition to those listed above, policy solutions include:

  • Expanding healthcare coverage to include mental health services
  • Tightening regulations on opioids and other dangerous prescription drugs to create safe and healthy environments
  • Including safeguards against measures intended to limit an individual’s right to treatment such as the lack of affordability of clinically prescribed medication
  • Ensuring that for those currently receiving effective treatment, their medication is not switched to a less effective alternative just because it is cheaper
  • Expanding Extreme Risk Protection Order laws
  • Promoting health equity as those facing adverse health conditions are at higher risk for experiencing violence. This includes increasing access to:
  • vaccines, including COVID-19
  • treatment for chronic conditions, such as diabetes
  • healthy fresh foods and vegetables
  • Increasing research devoted to tackling gun violence as an investment in national public health

While many forms of gun control legislation have been written off as politically impossible, there are other solutions Congress can enact to mitigate the gun epidemic. Approaching the issue from a public health perspective is an effective avenue policymakers can take for ensuring that the gun-related tragedies, which now seem omnipresent in America, harm fewer people in the future.

NCL strongly supports FDA’s proposal to ban menthol

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August 3, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC – The National Consumers League filed comments today with the Food and Drug Administration (FDA) in support of the agency’s proposal to ban menthol products.

“We commend the FDA’s actions, though we believe the ban on menthol cigarettes in the United States should have been implemented years ago,” said Sally Greenberg, Executive Director of NCL. “Nevertheless, this ban on menthol will save hundreds of thousands of lives and will have especially important positive benefits for African Americans because tobacco companies have relentlessly marketed menthol cigarettes to African Americans for decades.”

NCL recently recorded a podcast with the African American Tobacco Control Leadership Council, the country’s leading public health education and advocacy organization taking on Big Tobacco to save Black lives. The podcast can be found here: https://nclnet.org/menthol-cigarettes-going-up-in-smoke/

NCL also noted that the United States is an outlier among nations of the world in its proposal to ban menthol just now. The EU implemented a ban for its 28 member countries in 2020.

“Menthol enhances the addictive effects of nicotine in the brain,” said Greenberg. “The tobacco industry knew this and yet continued to market the product to Americans, especially targeting African Americans. Menthol is associated with progression to regular cigarette smoking in youth and young adults.”

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.