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EPA Chief McCarthy: Public Health Is ‘What We Do’

EPA Administrator Gina McCarthy spoke with Kaiser Health News on April 14, 2016. (Francis Ying/KHN)

You may not think about public health when you think about the Environmental Protection Agency. But Administrator Gina McCarthy wants you to.

There are “challenges to our health and well-being that result from exposures to pollution,” said McCarthy. “While we are called the Environmental Protection Agency, our major role is public health. That is what we do.”

The administrator — who has drawn fire from opponents of stricter air pollution standards as well those who say the agency failed to act quickly enough in Flint, Michigan — started her career as a local health officer in Canton, Massachusetts. She was nominated to head the EPA in 2013. She’s now part of an Obama administration effort to focus attention on climate change and its potential effects on health, which could include more air pollution, heat-related medical problems and the spread of insects that carry disease.

During an hourlong meeting with KHN reporters and editors, McCarthy answered questions about what the EPA is doing to protect workers and residents from pollution, its role in helping defend against the mosquito-borne Zika virus and Flint’s ongoing water contamination problems.

“I never want to see a system like Flint, again — never want to see anyone that afraid to drink the water and us having to say, ‘Don’t drink it.’ But I think it’s unrealistic to think that won’t happen again — if we don’t continue investment in our infrastructure,” she said.

The interview has been edited for length and clarity.

The Zika virus, spread by mosquitos, is a growing concern in the U.S. Some critics, often online, have said additional pesticides, perhaps even a return of DDT, are needed to combat this threat. What role will the EPA play in these efforts?

We are part of the larger federal effort to look at Zika. We have two roles to play. One is to work with the states to make sure they take advantage of lessons learned on integrated pest management. If we get rid of these small-water sources where mosquitoes breed, that’s a primary prevention issue. Then we have to make sure there is training in the use of pesticides. We regulate pesticides to make sure [they’re] used in a way that doesn’t add a health burden to the folks using it. We have approved a number of [outdoor] pesticides that are being used to manage this mosquito. There’s no question pesticide use will play a role in management of this. Probably not DDT. We have to selectively look at what’s best to use. No one has suggested the need to use DDT at this point across the federal family. They’ve suggested lots of others that are on the market today.

In California, there are concerns about the environmental factors that contribute to health disparities among low-income residents of the Central Valley, an agricultural community where farm workers are at risk of pesticide exposure. What is the agency doing to protect them?

We are working with the Hispanic Medical Association. We’re also doing a significant amount of work with federally funded community health centers. We are looking at a new worker protection standard, which has a significant impact in California, to make sure we protect the workers from pesticide exposures. We know there are thousands of them reported every year. It’s a way of continuing to look at current science and do training of community health center workers to be able to identify pesticide exposures.

You’ve visited medical schools to encourage them to discuss so-called “upstream” prevention, tackling environmental triggers before they cause health problems, such as asthma. Why?

Air pollution causes cardiovascular disease. We know this. It’s really an opportunity for us to gather together. I’m disappointed there isn’t more acknowledgement of this and that the medical profession isn’t more heavily trained in looking at asthma and, instead of looking at what the treatment regimen needs to be, but also sending someone to the house to talk with parents about the cleaning products they use. People are ready for those discussions. They want to be active in their own health. They want to understand what contributes to their health problems. I think it would be great to have a concerted effort to have public health schools be more engaging and have them work with medical schools. I don’t mean to sound critical of medical schools. But there’s more to health than treatment.

How do the EPA efforts regarding these kinds of messages intersect with the Department of Health and Human Services?

We’re beginning to work with them more successfully in figuring out how we make environmental exposure more apparent and something that needs to be invested in. I’m trying to get the word out that there is whole field of health science that seems to be not as visible as it once was. Just because the pollution is invisible, doesn’t mean it isn’t impacting lives. [We are] working on these issues together to try to bring more vibrancy to that conversation.

I’m [also] trying to enhance the capacity of EPA to speak with a health voice. I think EPA doesn’t have enough health professionals. I have almost no epidemiologists. I have to rely on outside researchers, which are always good, but why I don’t have people inside who can more effectively talk about comparative risk, to talk about putting risk exposure in perspective for people?

Given the polarization of the country and the concerns expressed about whether climate change is even real, how do you get that conversation you want about the connection between public health and environmental issues?

It didn’t take long in Flint to have that point made. I don’t want you to think it’s about scaring people. It’s about reminding them we all have core values. This country has enjoyed and still enjoys the safest drinking water. We continue to do good work on clean air. That’s all I want to remind people of. It continues, but it’s just not done. You have to invest in the infrastructure. That investment was welcomed back in the 1970s. We wanted it. We demanded it.

The EPA is one of the agencies mentioned by some candidates as one we don’t actually need. What’s your response?

Richard Nixon created the EPA. Under George H. Bush, the EPA made the biggest step forward in clean air that has saved thousands and thousands of lives. It does not need to be partisan. Frankly, I take calls from people on the Hill all the time when their constituencies are being threatened and they have concerns about public health. I don’t ask what side of the aisle they are on. And they don’t ask me to treat [their issue] any differently whether they’re Republicans or Democrats. I know things get said on campaign trails. But everyone wants their kids to be safe. I just need to keep reminding people of that. I expect the agency to be strong for decades to come.

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California Public Health