The right to a healthy environment and the right to affordable health care are inextricably linked. The Trump White House and the Republican Congress want to deny both.
Not long ago, the United States was one of the few OECD countries – along with Mexico, South Korea, and Turkey – that did not guarantee universal health care as a basic human right. Instead, we had a system that discriminated against people with pre-existing health conditions as well as low- and middle-income individuals who could not afford insurance premiums. Health care was a commodity that only the affluent among us could be guaranteed access.
The passing of the Affordable Care Act in 2010 was a remarkable achievement for the United States. Recognizing the role government has in ensuring citizens have access to quality health care, more than 20 million previously uninsured people started receiving basic health care coverage. An even greater—but relatively unrecognized—achievement of the ACA was moving our system towards rewarding positive health outcomes that create better health, rather than just paying for expensive treatments and medications to manage conditions.
For the first time, the ACA helped hospitals conduct assessments in their communities to better understand the conditions that detracted from community health, and then direct their community health programs toward addressing those needs.
This was a big achievement, because over the past twenty-five years we have learned that the social and environmental conditions that Americans face in their daily lives are even more important to health than access to care. Poverty, pollution, violence, poor housing, and food deserts are all powerful influencers of health. Today, we can learn more about a person’s health from their zip code than their genetic code.
How does where and how you live influence your health? Scientific research, much of it funded by the federal government, has demonstrated that the expensive burden of chronic diseases Americans face—cancer, obesity, asthma—are worsened by the environmental health conditions in our communities. We face pollution from burning fossil fuels that choke our cities and contribute to asthma and neurological damage for our children. We live in neighborhoods where alcohol is readily available but we can’t find or afford fresh fruits and vegetables. We face toxicants in our daily products that chemically trespass into our food and our homes and our bodies and contribute to cancer. We live with daily doses of violence that cause extreme stress and mental illness. And we are increasingly faced with extreme weather related to climate change that exacerbates all the health conditions and social inequities that already plague our society.
When we add all these factors together, a new reality comes into focus: it is increasingly clear that we can no longer support healthy people on a sick planet. In order to reduce the chronic disease burden in the Unites States and around the world, we need to kick our addiction to fossil fuels, toxic chemicals, and industrial agriculture. The health impacts of fossil fuels alone cost the U.S. economy between $300-800 billion a year.
It is clear that no one in the Trump Administration was thinking about people’s health when they made the decision to kill the Clean Power Plan, appoint a climate denier to head the Environmental Protection Agency, support the coal industry, roll back fuel efficiency standards, and eliminate many of the other environmental protections that have been put in place over many years. And yet the links between clean air, clean water, and a healthy community have never been more clear.
And now, as the Congress rushes to repeal the Affordable Care Act and cut more than 20 million Americans off from basic health care coverage, the link between the health of communities and the health of individuals is again being overlooked.
Linking the Administration’s environmental policies with the health care policies of the Congressional majority, their intention is clear: they are committed to dismantle all the public health and environmental protections that Americans now enjoy – that our health care system now depends on – and then eliminate our ability to access quality, affordable health care when we inevitably get sick. Under this ”leadership”, the United States will become more polluted and Americans will become sicker.
In a world where air pollution kills twice as many people as AIDS, TB, and malaria combined, access to health care is not an “entitlement” — it’s a fundamental right. In a world where newborn babies arrive with toxic chemicals already in their bodies, we are doing violence to future generations by not protecting the environment. In the 21st century, the right to a healthy environment and the right to affordable health care are inextricably linked. The Trump White House and the Republican Congress are dead set on denying both.