I grew up in the suburbs of sunny Southern California then moved to the opposite end of California to a small college town to study Environmental Policy Analysis and Planning at the University of California, Davis. Regardless, living my entire life in California meant that have I never understood or experienced the severity of climate change. This summer, I moved to Washington, D.C. for a 10-week program to be an intern for the Center for Health, Environment, and Justice. To put it simply, I was not ready to experience summers in the city.
I never expected the heat to rise to such high temperatures on the East Coast of all places and it didn’t take me long to realize that I moved into an “urban heat island.” The Urban Heat Island Effect, as explained by the Environmental Protection Agency, “occur[s] when cities replace natural land cover with dense concentrations of pavement, buildings, and other surfaces that absorb and retain heat.” Washington, D.C. is a good example of this effect as temperatures in the city can rise to 10 or 20 degrees hotter than surrounding cities that may have more greenery.
This not only poses a threat to our environment but a threat to the communities living in these heat islands, specifically those in a lower socioeconomic class. I am fortunate enough to be temporarily housed in an apartment building with AC, and I do not have to worry as much about an energy bill for these summer months. However, long-term residents in the city do not have the same luxury. The Washington Paper explains that “wealthier D.C. residents can leave town for the beach or the mountains this time of year” compared to other lower-wealth individuals who do not have similar means to escape the heat. Federal government’s history of discriminatory actions and urban planning segregation only exacerbate this problem amongst communities of color. Historically redlined neighborhoods must put up with dangerously high levels of heat in the summer months.
Environmental justice is social justice, and we must call for our local, state, and federal governments to focus on these environmental issues. Government officials should pass policies that can help us move towards a healthier living environment to continue mitigating climate change to the best of our ability.
CHEJ attended the 3rd National PFAS Conference in Wilmington, NC this past week. The conference was hosted by the North Carolina State University Center for Environmental and Health Effects of PFAS in conjunction with the Cape Fear Community College and funded by the National Institute of Environmental Health Sciences. In attendance were environmental research and advocacy organizations, state and federal agencies, several universities, and representatives of affected communities and tribes. The city of Wilmington was chosen as the venue due to the serious PFAS contamination in the nearby Cape Fear River.
The conference touched upon every aspect of the nationwide (and global) problem of PFAS toxicity and accumulation in the environment and within our bodies. If you need a refresher on PFAS chemicals and the problems they pose to our health, you can catch up here. Researchers from universities here and abroad talked about the new and emerging discoveries of how PFAS impacts our health. For example, it was established that common PFAS compounds such as PFOA and PFOS have very significant associations with kidney cancer, hormone disruption, and immune system suppression. Researchers also emphasized that although we know how a handful of commonly used PFAS affect our health, we know next to nothing about the thousands of other PFAS compounds that make up the majority of PFAS emissions.
Another important aspect explored at the conference was the need for proper treatment or destruction technologies since conventional forms of disposal do not work. Treatment for contaminated drinking water includes the use of reverse osmosis systems, activated carbon filtration, and the use of filtration membranes. Although these treatments show promise, each has drawbacks that remain to be addressed. Among the destruction technologies, those that seek to break the carbon-fluoride bond of the PFAS compounds, a promising one being evaluated by the USEPA is called “supercritical water oxidation.” It is a complex process, but it boils down to heating contaminated water to very high temperatures under great pressure to reach a plasma state of matter. At this stage, PFAS and other contaminants are breakdown and recombine into inert chemicals upon cooling. Again, although promising, there are still some kinks that need to be worked out.
Finally, the conference convened a panel on PFAS disposal. CHEJ participated in this panel and gave a presentation on how landfills are not proper disposal locations for PFAS compounds. This is because landfills are not closed systems. In fact, even a brand-new landfill will leak about 36,500 gallons of contaminated water every year! Couple that with the fact that certain landfills can develop cracks in their bottom liners in less than 5 years, and you have a gradual accumulation of PFAS within the surrounding environment. Any community surrounding the landfill will then be slowly poisoned by these compounds as they leak into the groundwater, drinking water, and even the surrounding air.
(To learn more about landfills, view our landfills publication here.)
The EPA also made a noteworthy announcement at this conference. On June 15, the first day of the conference, the agency released updated interim drinking water health advisories for PFOA and PFOS, and final health advisories for PFBS and HFPO/GenX. These health advisories are several orders of magnitude smaller than the previous ones in place for PFOA and PFOS, and quite small for the newly promulgated PFBS and HFPO/GenX. For PFOA and PFOS specifically, the values are 0.004 and 0.02 parts per trillion (ppt) – numbers that are minuscule and barely above the detection limits of analytical chemistry. In English, this means that values of detection will be so close to zero that the mere presence of a chemical could garner recognition for remediation by the agency. This new measure will undoubtedly protect people’s health from these chemicals. Now, although this is a praiseworthy move by the EPA, these health advisories are not maximum contaminant levels (MCLs) – EPA’s enforceable drinking water standards; they are only guidelines. As such, water utilities and other water treatment entities may choose not to follow them, and the EPA can do nothing to force their hand. That is the next step the EPA needs to take: to make these PFAS health advisories into fully fledged MCLs.
All in all, the 3rd National PFAS Conference was a productive forum for researchers, advocators, and impacted communities to have a voice and move the discussion forward. It was a testament to how well we can all tackle a problem to our collective health, but also a stark reminder of how much more work is needed because polluters have been manufacturing these harmful chemicals for nearly 70 years and continue to do so.
Dr. Sheldon (“Shelly”) Krimsky, internationally esteemed scholar, and pioneer in environmental ethics, passed away unexpectedly in Cambridge, MA, April 23rd, 2022. He was 80. His probing work investigated the connections between science, ethics, and biotechnology, and the pernicious role chemicals play in the environment. A truly adored professor at Tufts University for 47 years, he held the distinguished position of Lenore Stern Professor of Humanities and Social Sciences at the Department of Urban and Environmental Policy and Planning. He also taught ethics at the Tufts University School of Medicine and was a visiting scholar at Columbia University, Brooklyn College, The New School, and New York University. Dr. Krimsky received his bachelor’s and master’s degrees in physics from Brooklyn College, CUNY, and Purdue University, respectively, and a master’s and doctorate in philosophy at Boston University.
In his prolific and inspirational academic career, Dr. Krimsky authored 17 books including Understating DNA Ancestry, Genetic Alchemy, Biotechnics and Society, Hormonal Chaos, and Science in the Private Interest. He also co-authored Environmental Hazards and Agricultural Biotechnology and the Environment and published more than 235 articles on the regulation and social and ethical aspects of science and technology, bringing attention to issues such as DNA privacy, GMOs, and other conflicts of interest in science. Dr. Krimsky served on the National Recombinant DNA Advisory Committee of NIH and chaired the Committee on Scientific Freedom and Responsibility of AAAS and had been a consultant to the Office of Technology Assessment. He was on the Board of Directors of the Council for Responsible Genetics and served on the editorial board of seven noted journals.
Born in Brooklyn, he embraced his New York roots, eventually living part-time in Greenwich Village. He was often seen in Washington Square Park, getting coffee and a bagel at one of his favorite cafés, or at the Green Market where he would often pick up a treat, usually apple pie.He also played guitar and harmonica, sometimes jamming with friends, and writing and improvising songs. Fiercely loyal, kind, and supportive to family and friends, he was thoroughly devoted to teaching and to his students. Survivors include the love of his life, his wife Carolyn Boriss-Krimsky, playwright, visual artist and author, and two adored children Alyssa Krimsky Clossey and Eliot Krimsky, along with their spouses Will Clossey and Lisa Benger, and three cherished grandchildren, Benjamin Perry Clossey, Andrew Krimsky Clossey, and Siona Rose Krimsky. To learn more about his life’s work, please visit the many pages within this website.
While modern science has greatly improved the American way of life, it has also increasingly revealed the human costs of these advances. Of these costs are the large-scale environmental pollution that has the potential to impact the health of people across the world. Kyle Bagenstose a reporter for phys.org, recently published an alarming article emphasizing this impact.
In this article, Bagenstose reports that during last month, a groundbreaking study from the University of California, San Francisco of 171 pregnant women found more than 9 in 10 had measurable amounts of 19 different chemicals and pesticides in their bodies. This also showed evidence suggesting that babies are born “pre-polluted” with chemicals. The full extent of health effects from such exposures is unknown, but scientists are worried that they could contribute to the rising rates of autoimmune diseases, developmental disorders such as autism and reproductive harms, and the mysterious decline of sperm counts in men amongst the U.S. population. Dr. Tracey Woodruff, co-author of this study states, “Our understanding of exposures is not keeping up. What are these chemicals doing?” Even though the Clean Air Act and Clean Water Act have decreased the amount of many toxins in the environment over the past 50 years, according to Dr. Woodruff, experts are saying regulators remain far behind in catching up to the threats of the modern era. This is partly due to how little the more than 40,000 chemicals in commerce have been robustly studied for their potential human health effects.
Is there anything we can do about this? According to Stephanie Wein of PennEnvironment, states’ efforts to cut down on pollution have often focused on the “end fate” of materials, such as recycling plastics or repurposing materials. This, she says, means that solutions usually misplace responsibility. Says Wein, “The onus should not be on local governments or consumers to deal with the waste. The onus should instead be on the companies that create it.”
Roland Geyer, an ecology researcher at the University of California, Santa Barbara, adds, “There will always be plastic[…] it’s such a cheap and incredibly useful material[.] But we need to agree that this is too much, and we need to bring it down.” Other experts agree that solutions need to come from federal agencies like the EPA, with support from Congress through more funding and newer authorities.
For a community like Port Arthur, Texas, a city rife with cancer, where little is being done to understand and address hazards, such changes are essential. John Beard, of the Port Arthur Community Action Network, notes that in his community, the French-owned Total Energies’ oil refinery is one of 12 facilities that the Environmental Integrity Project calculated as emitting benzene at levels above EPA limits. He thinks, “We need more monitoring along the fenceline communities, and also beyond the fenceline, because the effects are carried downwind. We have to regulate how these refineries go about their business.”
Remediation is the process of removing pollutants from the soil or water of a contaminated location and return it to a healthy state. This process is the desired goal for most environmental endeavors. However, remediation is usually a difficult, dissatisfactory process whereby state or federal government (or their contractors) bungle, delay, or quit during it. Traditional remediation efforts can have big flaws: pollutants or contaminated soils may be relocated to a nearby landfill; chemical wastes from heavy machinery might mix in with the present toxins; or funding could quickly dry up.
One alternative to traditional remediation that is seeing a resurgence of attention among the scientific community is natural remediation. Natural remediation applies living organisms to the clean-up process. It is usually cheaper, less intensive, can be managed by private citizens instead of government actors, and is, obviously, more natural. Two natural remediation processes that are becoming more popular are bioremediation and mycoremediation.
How this works: remediators introduce a microbe into the soil or water via in situ (on-site) or ex situ (off-site) methods. This can be by heating and mixing the microbes into the soil via an aboveground “bioreactor”; pumping air into spaces filled with waste to cultivate bacterial growth; or by creating a “biofilter,” a culture of microbes applied to a biomass (wood or peat moss) which feeds on airborne pollutants. Each method must be finely tuned to each specific pollutant, environment, climate, etc., or else the process runs the risk of either not removing or inefficiently negating the pollutants. Thus, bioremediation can require more maintenance and attention than traditional remediation methods. However, bioremediation has been shown to be more promising in the long run than some traditional remediation methods.
Alternately, mycoremediation is the removal of pollutants via fungi (mushrooms). Some fungi, using their mycelium (fungal root system), can absorb, degrade, and convert environmental toxins into nonharmful chemicals. Specific mushrooms can also absorb the toxins and store them in less dangerous forms inside their fruiting bodies (or caps). For these mushrooms, remediators would need to compost them and reintroduce them into a new generation of growth (doing this repeatedly can remove most toxins).
Mycoremediation has already been effectively applied to wildfire burn zones in California and oil spills in Ecuador. In one study, oyster mushrooms (Pleurotus sp.) were found to be capable of neutralizing or absorbing significant quantities of toxins within their fruiting bodies. Another study found that fungi could remove nearly all toxic products applied to it. However, researchers have yet to find unanimous evidence that heavy metals can be effectively removed by mycoremediation. Despite the lack of extensive research, mycoremediation practices have a solid foundation so far and are quickly becoming a common alternative amongst local organizations. Like the fungi they work with, hundreds of mycoremediation organizations, research teams, and companies are popping up all over the country. All convinced that fungi (and microbes too) are the best, least expensive solution to their environmental issues.
It should be noted that bio- and mycoremediation are not new methods. In fact, the EPA has even tested these methods under the Superfund Innovative Technology Evaluation (SITE) Program from 1989 to 2005. The purpose of SITE was to experiment with alternative remediation technologies and techniques upon existing Superfund sites and to document their progress (or lack thereof). Sadly, the SITE program was terminated, and with it ended most federally sponsored testing. Since then, natural remediation has been almost strictly within the purview of citizen science groups and local clean-up organizations. But maybe this resurgence in natural remediation methods could help elevate governmental application once again?
In the 1980s, the Finley family believed they were moving into a great neighborhood located in Brio, Texas, but were shocked to discover they were living in one of the most polluted parts of the country. Cheryl Finley was horrified to learn they lived dangerously close to the Brio Superfund Site. At the same time, the community noticed an unsettling trend that many children were born with harmful birth defects. As more families suffered and more children became sick, it was evident to the community that urgent action from the Environmental Protection Agency (EPA) was desperately needed. As many of you know, the Superfund act allows the EPA to clean up and regulate contaminated toxic sites. The Superfund permits federal authorities to act when a “qualifying” spill, or an identified risk, occurs through short- and long-term cleanup strategies.
Around 73 million Americans, 22% of the United States population, live in similar conditions as Cheryl Finley. As of 2020, 1,857 Superfund sites were identified, with 1,300 having extremely high hazardous ranking, placing them on the National Priorities List (NPL). Some speculate there are even more sites where families are unknowingly living in a toxic environment. Due to an alarming presence of Superfund sites, approximately one out of six Americans reside within a 3-mile radius of a hazardous waste site. Fenceline communities remain at risk of facing adverse health risks, where studies show that people of color and lower wealth are exceedingly prone to residing near Superfund sites. Superfund has been historically underfunded since its inception in 1980, specifically since the tax on chemical and petroleum industries expired in 1995. After Congress failed to reinstate this polluter tax, it has routinely underfunded the EPA’s ability to mitigate the effects of toxic sites.
Currently, after over 40 years since the enactment of Superfund, only 25% of identified sites have been delisted. Environment America created a 2021 report that shows funding appropriations have gradually decreased since 1995, from approximately $2.3 billion to $1.2 billion in 2020. A statistical model determined that Superfund sites could decrease life expectancy through consistent exposure to toxic chemicals and pollutants. Living near processing plants, landfills, mining sites, or manufacturing facilities can reduce life expectancy by 1.2 years. Unfortunately, many families, like the Finleys, were unaware of their proximity to toxic waste sites until their children became unusually sick. On December 17, 2021, the EPA announced its plan to use an allocated $1 billion investment from the Bi-Partisan Infrastructure Law. Drawing appropriations from this law will stimulate the previously underfunded and laggard cleanup processes of approximately 49 Superfund sites in 24 different states.
The U.S. Supreme Court may soon be taking away the right to an abortion, and it has many across the nation in distress. On Tuesday, May 3rd, 2022, a Supreme Court draft opinion was leaked to the public outlining the Court’s opinion on a case challenging Roe v. Wade (1973). Roe v. Wade is a U.S. Supreme Court case from 1973 that made having an abortion a protected right. With the shift of the Court further to the political right, many of the constitutional laws and federal rulings that are seen as ‘liberal,’ like Roe are in jeopardy. If Roe v. Wade is overturned, it would be up to individual states to determine how to handle abortion laws. As we think about what it would mean if Roe v. Wade were overturned, it’s important to look at how reproductive rights impacts all communities. It is also important to look at how reproductive justice relates to other issues, like environmental justice.
Reproductive justice is defined as: “All people having the social, political, and economic power and resources to make healthy decisions about their gender, bodies, sexuality, and families for themselves and their communities.” While environmental justice is “the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.” What these definitions have in common is that they both address the involvement of all people in decision-making so that all people can represent the needs of themselves and their communities.
Although the overturning of Roe v. Wade will affect all women and individuals able to conceive, the burden of this ruling will be much heavier on the working class than it will be on the wealthy. For states that outlaw abortion, the only safe option would be to travel out-of-state. While an inconvenience, this option would be financially viable for the upper class. This would be a lot harder for members of the working class to manage and would not be financially feasible for many people. As a result, there will likely be an increase in the number of working-class individuals having illegal, unsafe abortions. Possibly creating health crisis amongst working-class individuals across the United States.
The people who cannot travel for abortions are usually members of communities currently impacted by environmental hazards. Some of these environmental hazards contribute to issues such as cancer, birth defects, and infertility. If abortion is outlawed, residents of jeopardized areas will be forced to choose between carrying a potentially unhealthy child to term or risking their own health by having an unsafe abortion. It is a situation in which no one wins. Additionally, environmental hazards can create health effects making it unsafe for the mother to continue their pregnancy.
Environmental justice and reproductive rights are related, and always will be. As we look into our future, we must consider how abortion laws impact communities across the United States, and how these issues will impact the health of generations to come. At CHEJ, we fight for the health of communities across the US, and we hope others will too.
Across the United States, a multitude of parties are dedicated to fighting environmental racism and injustices that unequally affect communities because of their demographics. Towns primarily comprised of people of color, non-English speaking immigrants, and lower-wealth individuals are significantly more likely to be affected by environmental injustices. We have heard of cities with unclean drinking water going unnoticed by state officials for far too long. Polluted air from excessive carbon and greenhouse gases affects the air quality of a given area. The only way to truly combat the injustice is to organize, strategize, realize, and act with the intent to improve the quality of life of those who are less fortunate.
In Orange County, California, a handful of groups are devoted to improving the lives of those subjected to unrestrained environmental injustices, despite risk-assessment strategies implemented by local agencies to identify risks of harmful pollutants and toxins that affect the environment. One of those organizations is the Orange County Environmental Justice (OCEJ). Founded in 2019, OCEJ has acquired attention in the media due to a campaign they spearheaded: “PloNo Santa Ana.”
Santa Ana, CA is facing a severe soil-lead contamination crisis. This crisis is impacting communities of color and those living at or below the poverty line. Due to the lack of testing in the area, both the people and the agriculture struggle with exposure to gigantic quantities of lead. OCEJ collected soil samples with the help of the University of California, Irvine’s Public Health Department in search for the specific amount of present lead. OCEJ also collected samples from roadway land use zones, parks, and residential and commercial areas. Their findings have concluded that over half of these soils contain amounts of lead surpassing state and federal standards. Fortunately, Santa Ana is making updates to its General Plan (GP) and has added a section on environmental justice. To aid in decision-making and policy creation, OCEJ sought to address soil remediation plans and health care endeavors. Furthermore, prominent figures, like Kathleen Treseder, have run for city councils to put environmental justice initiatives at the forefront to ensure that equity is displayed.
Imagine if hundreds of nuclear reactors concentrated in areas encompassing about 700,000–800,000 people in total were to have openly leaked copious amounts of radiation into adjacent neighborhoods for decades –a century even– with no enforced restrictions whatsoever. It would be absurd! Especially since nuclear disasters like Chernobyl and Fukushima have dramatically elevated fears of radiation exposure amongst the public. However, trade out the radiation for carcinogenic toxins and the nuclear reactors for petrochemical plants, and that is exactly what is happening in the “Golden Triangle” of Texas and along Louisiana’s “Cancer Alley.”
Since “black gold” was discovered at Spindletop in 1901, petrochemical plants and refineries have been metastasizing along the Gulf Coast for over one hundred years. Residents within these areas have been virtually locked into a parasitic relationship with companies like Gulf Oil, U.S. Rubber, Texaco, ExxonMobil, Goodrich, Koch Industries, etc. They have depended on petrochemical companies for employment, municipal funding, and education programs, but in exchange have suffered consistent exposure to carcinogenic chemicals like dioxin, benzene, styrene, and butadiene. Such prolonged exposure has resulted in unprecedented levels of breast and ovarian cancers, lymphoma, and leukemia among citizens directly and indirectly affiliated with the refineries.
On average, an estimated 1 in 5,000 people in the Golden Triangle and Cancer Alley are at an incremental lifetime cancer risk. The EPA’s upper limit of acceptable cancer risk is 1 in 10,000. According to ProPublica, “an estimated 256,000 people are being exposed to risks beyond this threshold and […] an estimated 43,000 people are being subjected to at least triple this level of risk.” Although institutions like EPA, OSHA, and even Johns Hopkins University have repeatedly studied the correlation between the petrochemical refineries and local cancer rates, official results have been mixed. However, in 1977, the National Institute for Occupational Safety and Health (NIOSH) did report concerning levels of benzene in Texas and pushed OSHA to issue a non-binding guideline lowering the standard of industrial benzene use. This guideline was overturned by the U.S. Supreme Court in 1980, who ruled in favor of petrochemicals. The opinion declared that a “safe” workplace was not guaranteed as being “risk-free.” Thus, workers’ (and thereby surrounding residents’) exposure to toxic chemicals were deemed justifiable “risks.”
Benzene and dioxin have been two of the most prevalent carcinogens produced by these refineries. Benzene, a sweet-smelling, colorless liquid/vapor, can interrupt important cell functions in your body, such as stopping red or white blood cell production. Long-term exposure to benzene can result in leukemia or severe bone marrow damage. Despite being labelled as a carcinogen by the U.S. Department of Health and Human Services, petrochemical companies continuously use –and under-report– it. For example, in 2000, a whistleblower for Koch Industries reported that the company concealed the discharge of 91 metric tons of benzene over Corpus Christi, TX from environmental authorities (Jane Mayer, Dark Money). Dioxin is invisible to the naked eye, usually resembling dust. Dioxin is not intentionally synthesized; however, it frequently forms from burning wastes or dioxin-contaminated products. Refinery flares have been associated with dioxin contamination via reports of glowing ashes raining out from their exhausts. Small towns like Mossville, LA have been decimated by dioxin. Sullivan Ramirez, a local activist, reported that there “wasn’t one block that didn’t have cancer.” An EPA inspection of the average level of dioxins in the blood of Mossville residents was found to be triple that of the general U.S. population. Across in Reserve, LA, Mary Hampton made a similar observation: “Almost every household has somebody that died with cancer or that’s battling cancer… It’s the worst thing you’d ever want to see: a loved one, laying in that bed, pining away, dying.” Reserve’s risk of cancer from air toxicity (which includes dioxin exposure) is 50 times that of the national average.
It is necessary to emphasize that the majority of residents within the Golden Triangle and Cancer Alley are low-income, Black and/or Hispanic people. This is an environmental justice issue compounded by systemic racism and classism. Additionally, a sizable chunk of Cancer Alley is sitting atop some of the world’s most rapidly sinking land (Elizabeth Kolbert, Under a White Sky), layering another existential threat against residents. If the residents were wealthier, whiter, or more radioactive, then this problem would probably be taken more seriously by regulatory authorities. But it is not.
A study published this spring by researchers at Columbia University found that areas redlined by federal loan programs since the late 1930s ended up with more drilling wells, polluting industries, major highways, and shipping ports than non-redlined areas. This research adds to the growing body of evidence showing how communities of color are disproportionately exposed to pollution that results in increased poor health.
“Our study adds to the evidence that structural racism in federal policy is associated with the disproportionate siting of oil and gas wells in marginalized neighborhoods,” said lead author Joan Casey, assistant professor of environmental health sciences at Columbia Mailman School in a press statement. “These exposure disparities have implications for community environmental health, as the presence of active and inactive wells contribute to ongoing air pollution.”
According to an article on this study in the Washington Post, starting in the late 1930s, the federally sponsored “Home Owners’ Loan Corp (HOLC) marked areas across the United States as unworthy of loans because of an ‘infiltration of foreign born, Negro, or lower grade population’ and bordered them in red. This made it harder for home buyers of color to get mortgages; the corporation awarded A grades for solidly White areas and D’s for largely non-White areas that lenders were advised to shun.”
The researchers found that historically redlined neighborhoods that scored lowest in racially discriminatory maps drawn by the government’s loan corporation had twice the density of oil and gas wells than comparable neighborhoods that scored highest. “These wells likely contribute to disproportionate pollution and related health problems in redlined neighborhoods.”
According to the researchers’ press statement, oil and gas wells expose residents to air and water pollution, noise, and other sources of stress that can increase the risk of many types of disease: cardiovascular disease, impaired lung function, anxiety, depression, preterm birth, and impaired fetal growth. An estimated 17 million Americans live within one mile of at least one active oil or gas well.
This study provides a clear example of how institutional racism can define public policy and how it can impact people’s lives and their health for decades.