Eliminating exposure to asbestos and addressing the effect of climate change on mental health were two of the fourteen new policy statements adopted by the American Public Health Association’s (APHA) Governing Council at its 2019 Annual Meeting and Expo in Philadelphia this week. The group's ambitious agenda includes topics ranging from environmental justice to drinking water safety and attacks on health workers:

20191 Promoting eye health — Noting the importance of eye health to children, adults and older people, calls on the U.S. Department of Health and Human Services to issue a call to action on reducing the burden of vision impairment and partner with fellow agencies and community organizations to launch a coordinated public awareness campaign on vision health across the lifespan. Encourages the Centers for Disease Control and Prevention to build on and develop the Vision and Eye Health Surveillance System and include questions about eye health in major health surveys. Urges state and local public health agencies to partner with health care systems to promote objectives and strategies on optimal eye health.

20192 Investing in maternal mental health — As maternal mental health issues such as depression, anxiety and psychosis can have serious impacts on women, their children, families and communities, urges U.S. officials to ensure that the nation’s global health programs promote maternal mental health as a core component of their missions. Calls on global, national, regional and community-level health training groups to invest in the development of a global maternal mental health workforce. Encourages public health researchers to conduct research on maternal mental health, with an emphasis on culturally appropriate strategies. Calls on global and U.S. policymakers to implement policies that improve women’s experiences in pregnancy, childbirth and in the postpartum period.

20193 Eliminating exposure to asbestos — With an estimated 255,000 people worldwide dying from asbestos-related cancers and respiratory diseases every year — including 40,000 people in the U.S. — calls on Congress to pass legislation banning all importation, manufacture, processing and distribution of asbestos and asbestos-containing products. Urges Congress to direct the U.S. Environmental Protection Agency to investigate and estimate the prevalence of asbestos in residential, commercial, industrial and public buildings, including all public and private school buildings. Encourages EPA to strengthen enforcement of the Asbestos Hazard Emergency Response Act’s inspection certification process, and urges the U.S. surgeon general to issue an annual warning about asbestos to educate the public about its harms.

20194 Moratorium on concentrated animal feeding operations — Noting that large amounts of manure and other untreated waste created by concentrated animal feeding operations pose a threat to air quality, drinking water and human health, urges the federal government to remove such operations from reporting exemptions related to environmental emissions. Calls on policymakers to enforce the Clean Water Act as it relates to such operations, as well as strengthen regulations on the monitoring of air emissions so that researchers can study the potential risks to health. Encourages federal officials to bring the use of medically important antibiotics in U.S. poultry and livestock into compliance with World Health Organization recommendations that producers stop using such antibiotics in healthy animals.

20195 Drinking water and public health — Noting that millions of people in the U.S. drink water that does not meet public health standards and that investments will be needed to protect water in the face of climate change, calls on CDC and state and local health and environmental protection agencies to facilitate greater involvement of public health professionals in issues related to drinking water and health. Urges such agencies to ensure broader public access to information on drinking water quality, including improvements to consumer right-to-know provisions. Encourages local, state and federal governments to increase funding for research on the links between drinking water contamination and disease.

20196 Climate change and mental health — Noting that the mental health effects of climate change have yet to be equally addressed and prioritized in related preparedness and adaptation activities, encourages federal, state and local governments — as well as public health and other community organizations — to fully implement recommendations from the American Psychological Association and ecoAmerica reports on climate change and mental health. Calls on governments and organizations across sectors to assess and enhance service and system infrastructures with regard to strategies and interventions that address the mental health effects of climate change. Urges professional training in best practices for addressing climate change and mental health, with a focus on resilience, adaptation, constructive action and hope.

20197 Environmental justice and health equity — Because environmental justice communities are comprise marginalized communities who live in areas disproportionately impacted by environmental hazards and historical traumas — all of which drive environmental health disparities — calls on governments, academia, nonprofits and private companies to increase diversity and inclusion in environmental and public health sectors. Encourages public health agencies to form partnerships with social justice actors and organizations. Urges institutions and organizations to meet with, listen to and work with and for environmental justice communities to advance solutions. Calls on public health professionals to advocate for sustained health coverage for environmental justice communities and expanded health care and support in the face of environmental disasters.

20198 Public health response after disasters — In response to the public health challenges of high-impact natural disasters, encourages EPA and CDC, in partnership with research universities and faculty, to engage in mid- to long-term health surveillance of disaster-affected populations. Calls for such actions to include the creation of a health risk registry and tracking system on residents’ exposures to chemicals and zoonoses using a One Health framework. Urges that long-term health impacts from high-impact disasters warrant large-scale, longitudinal public health cohort studies that rely on the Life Course Theory or similar frameworks and that should include participants as infants or children. Recommends future short-term, post-disaster response projects by taking advantage of existing health care infrastructures.

20199 Addressing global reproductive health restrictions — As reoccurring U.S policies restrict the use of U.S. global health assistance for comprehensive sexual and reproductive heath services, calls for the repeal of the Protecting Life in Global Health Assistance policy, which requires that foreign nongovernmental organizations receiving U.S. assistance not use U.S. funds or any other funds to provide or counsel on abortion as a method of family planning. Encourages researchers and practitioners to collect and analyze data on the impact of the funding restrictions on access to contraception, unintended pregnancy and health. Urges researchers, practitioners and other global health actors to identify, promote and support service delivery programs that mitigate the harm of such U.S. funding restrictions.

201910 Ending attacks on health workers — Noting that health workers are increasingly under attack in conflict zones, calls on WHO to continue to develop its data collection and dissemination system to monitor attacks on health care. Urges governments and the U.N. Security Council to carry out impartial and independent investigations into uses of force that interfere with the delivery of health care. Calls on all parties in conflicts to adhere to and implement requirements of the Geneva Conventions and human rights law. Urges WHO and other public health groups to condemn attacks on health workers and their facilities, and recommends governments end arms sales to those who use such weapons to attack health workers and facilities.

201911 Enhancing dietary guidelines for Americans — As the Dietary Guidelines for Americans provide the basis for most federal food, nutrition and health policies and programs within federal agencies, calls on public health agencies to partner with academic institutions, foundations, industry and others to invest in research, data collection and evaluation to provide evidence for regular updates of the dietary guidelines. Urges local governments and organizations to implement related public education, nutrition standards and policy approaches that reflect the needs of diverse populations. Recommends federal, state and private research groups gather evidence to ensure the guidelines are culturally appropriate and feasible for all socio-economic levels, lifestyles, literacy levels and existing chronic disease conditions.

201912 Addressing alcohol-related harms — Because alcohol is the third-leading cause of preventable deaths in the U.S and with alcohol consumption rising, calls for increasing federal excise taxes on alcohol. Recommends increasing research funding via Congress to better understand the correlation between alcohol use and the social determinants of health, and expanding federal programs that support community efforts aimed at the prevention of excessive alcohol consumption. Calls for state and local action to restrict or prohibit alcohol promotions and limit the density of alcohol retail outlets in communities, with particular attention to underserved communities. Urges public health practitioners to oppose policies that extend the hours of alcohol sales more than two hours.

LB-19-13 Call to end bombing in Yemen — With more than 91,600 people killed in Yemen since 2015 and more than 2 million people displaced, calls on the U.S. government to end the financing of and military collaboration with warring parties and to hold such parties accountable for attacks on health workers and civilians. Urges the U.S. government to prohibit intelligence sharing and logistic support activities to any members of the Saudi-led coalition for the civil war in Yemen. Calls on all concerned parties to support an immediate end to the blockade of Yemen’s ports and lift barriers to the entry of humanitarian aid. Urges the U.S. government to support efforts to rebuild destroyed health centers.

LB-19-14 Opposing separation, detention of refugees — With the separation of immigrant and refugee children and their families a public health crisis with the potential to inflict harm for generations to come, calls on the federal government and contractual partners to permanently halt child separation and the detention of migrant children and their families unless there is an imminent threat to the children’s safety. Recommends that all facilities meet basic standards for the care of children in residential settings and urges the federal government to minimize detention times for separated and unaccompanied minors. Urges federal officials to collect relevant data to ensure that separated children and parents can be located and reunited as soon as possible.

*To be considered for status as a permanent policy statement by the Governing Council at its October 2020 meeting, latebreakers must be resubmitted into the full policy statement review process next year.

For more information on any of the policy statements, email policy@apha.org.

About APHA

APHA champions the health of all people and all communities; strengthens the public health profession and speaks out for public health issues and policies backed by science in an effort to influence federal policy to improve the public's health. www.apha.org.