health care

A Prescription for a Healthier Environment

By Dustin Renwick

Many different colored pillsNext time you’re waiting at the doctor’s office, consider how what is prescribed there could also contribute to the health of the environment.

Christian Daughton, an EPA research scientist, does just that by looking at the connection between the examination room and the expansive beauty of the outdoors in his research paper, Lower-dose prescribing: Minimizing “side effects” of pharmaceuticals on society and the environment.

The paper is a result of his Pathfinder Innovation Project that explores the idea of considering the environment and the patient as one entity.

When someone ingests a drug, not all of it is absorbed. The human body excretes parts of that medication, including active pharmaceutical ingredients (APIs) that often end up in the sewers and eventually disperse into the environment.

The most common methods for reducing APIs in nature is by treating wastewater (remediation) and organizing take-back programs, where people in a community drop off unused medications for proper disposal. For example, National Prescription Drug Take-Back Day occurred in late October.

“My interest has long been on solving the upstream problem – minimizing the generation of waste rather than its more costly remediation,” Daughton says. “That aspect has long been discounted.”

Daughton is now directing his attention to identifying and reducing inefficiencies of pharmaceuticals in health care: how they are prescribed, dispensed, and ultimately used by the patients.

His research points to two major changes that could positively affect the types and quantities of APIs that infiltrate aquatic ecosystems.

First, doctors can focus on doses. Based on patient needs, physicians can prescribe lower doses of pharmaceuticals to prevent leftover drugs as well as decrease the excreted amounts. The strategy could keep the environment cleaner, reduce costs for patients and improve therapeutic outcomes.

“The idea isn’t to benefit environment at the expense of possibly jeopardizing the patient,” Daughton says. ”It’s a win-win for environment and health care.”

A second aspect of Daughton’s research involves tracking reliable data about which APIs are extensively metabolized by the body and which are excreted unchanged.

Imagine two similar drugs. The one that the human body thoroughly processes has what’s called an “environmentally favorable excretion profile,” and that drug is likely to do less damage to the local creek.

Unfortunately, that information isn’t easy to find.

“Excretion data submitted for regulatory approval purposes isn’t sufficiently comprehensive for examining the potential for environmental impact,” Daughton says. In other words, drug companies don’t need to scrutinize an API beyond what is relevant for human safety.

“That becomes a major stumbling block” to discovering which APIs could have negative environmental impacts.

As the topic of health care moves to the forefront of national discussions, Daughton’s work points to the environment as one missing component in those conversations.

“That’s where I get this expression – treating the environment and the patient as an interconnected whole.”

About the author: Dustin Renwick works as part of the innovation team in the EPA Office of Research and Development.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

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Breathing Life into a Dead Space

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By Aissia Richardson

For over 31 years, the mission of African American United Fund (AAUF) has been to actively engage Pennsylvania’s African American community to collectively address social, environmental and economic injustices by pooling resources to enhance the quality of life of those most affected by these problems. I created the AAUF African Marketplace Health and Wellness program in 2007 to highlight health disparities in the African American community after my father suffered a stroke and subsequently was diagnosed with heart disease.

After my father had his stroke, he was afraid to leave home. He stopped working, stopped teaching, and stopped exercising. All activities he had previously enjoyed. As a work therapy project, I asked him to help coordinate this new program to educate our family and our community about preventable disease and to connect African American men to traditional health care providers. Sadly, my father lost his battle with heart disease in 2008 and died the day before our first healthy food cooking demonstration took place. As a tribute to him, I vowed to provide access to health care for the poor and in minority communities, to present information about how to maintain health and recognize warning signs of preventable diseases and to work with young men by talking with them early about maintaining their health.

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Students preparing fruit salad

In 2009 I began a community garden on a vacant lot where illegal dumping, prostitution and drug dealing were rampant. After seeing a news clip about gardening at the White House, the Urban Garden Initiative was born and it’s now a meeting space for our community. We’ve hosted film screenings, dance performances, plays, musical productions, farmers markets and an annual health fair. The urban garden is a demonstration model to teach our neighbors how to garden, to grow and distribute produce and to conduct farmers markets with items from small, family owned farms.  In addition, the site is used as a job skills training program for adjudicated minors in the Philadelphia Youth Advocate Program and the formerly convicted, in conjunction with X-Offenders for Community Empowerment, as well as other neighborhood re-entry facilities.

In 2010, I started Garden to Plate cooking classes with adjudicated minors which introduced youth to healthy eating options. My personal philosophy is that all men should know how to cook breakfast, lunch and dinner. It’s what I’ve taught my son and what I pass on to youth who regularly eat cheeseburger specials rather than fruits and vegetables. Over 70 young men have graduated from the program. It costs $23,000 to house a prisoner in state facilities. I estimate the gardening and cooking class has saved taxpayers approximately $1,610,000 and only costs $10,000 per year to maintain. The participants raise their grades, get off probation and have marketable skills once they graduate!

If you live in the Philadelphia area and want to start a community garden, the first place to go is the Pennsylvania Horticultural Society Garden Tenders program. With a little bit of work and effective programming you too can breathe life into a dead space!

About the author: Aissia Richardson, President, African American United Fund, has volunteered with various organizations that address policy issues over the years. Ms. Richardson is a public education and public transit advocate. She serves as the chair of Southeastern Pennsylvania Transit Authority’s 24 member Citizen Advisory Committee and the City of Philadelphia’s appointee to the Delaware Valley Regional Planning Commission Public Participation Taskforce. She is a Pennsylvania native and Philadelphia resident who enjoys connecting organizations to each other to create mutually beneficial partnerships. She has traveled extensively across the Delaware Valley learning about rural, urban and suburban living and working with concerned citizens in the region to ensure their voices are heard when public planning is proposed and implemented.

 

 

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

The Power of Prevention Within Our Communities

Crossposted from Environmental Justice in Action

By U.S. Surgeon General Regina Benjamin, MD, MBA

I am a long-time champion of the power of prevention. As a family physician, I learned there were problems my prescription pad alone couldn’t solve – that if I wanted my patients to be healthier, I had to address issues like low literacy and access to healthy food.

Surgeon General's Walk with students for Munger School in Detroit, MI

Surgeon General’s Walk with students for Munger School in Detroit, MI

Today, prevention is the foundation of my work as Surgeon General. Health does not occur in a doctor’s office alone: health also occurs where we live, learn, work, play, and pray. It is my privilege to chair the National Prevention Council. Established by the Affordable Care Actand Executive Order 13544, the Council was designed to bring federal departments and agencies together to support health and prevention.

In 2011, we released the National Prevention Strategy, which includes four Strategic Directions that provide the foundation for our nation’s prevention efforts: healthy and safe community environments, empowered people, elimination of health disparities, and clinical and community preventive services. Working together, we can achieve the Strategy’s vision of moving from a focus on sickness and disease to one based on wellness and prevention.

Our communities have great potential, but barriers can make reaching that potential challenging. Limited resources, unhealthy housing, pollution, and other environmental justice issues can lead to poorer health. In the United States, health disparities are closely linked with social, economic and environmental disadvantages. Lack of prevention can take a devastating toll on individuals, families and communities. That’s why we need to make sure prevention efforts get to the people and places that need them most.

As I’ve traveled the country talking with communities about the National Prevention Strategy, I’ve been impressed with how communities are coming together to overcome health, safety and environmental challenges through putting prevention to work. We can only succeed in creating healthy communities when air and water are clean and safe; when housing is safe; and when neighborhoods are sustainable, especially in areas that face disproportionate health burdens.

Habitat for Humanity Worksite in Washington, DC

Habitat for Humanity Worksite in Washington, DC

Partnerships are critical to success. Many federal efforts reflect the value of collaborative efforts, like the Partnership for Sustainable Communities and Green Ribbon Schools. I have also seen prevention-focused partnerships at work on the local level, including Fighting D in the D and Maryland Health Enterprise Zones. These examples are only a small sample of the work going on around the country.

In order for communities to be healthy and environments clean and safe, we need to continue to uplift prevention as the greatest opportunity to improve the health of America’s families, now and for decades to come.

About the Author: Regina M. Benjamin, MD, MBA is the 18th United States Surgeon General. As America’s Doctor, she provides the public with the best scientific information available on how to improve their health and the health of the nation. Dr. Benjamin also oversees the operational command of 6,500 uniformed public health officers who serve in locations around the world to promote and protect the health of the American People.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.

The Power of Prevention Within Our Communities

By U.S. Surgeon General Regina Benjamin, MD, MBA

I am a long-time champion of the power of prevention.  As a family physician, I learned there were problems my prescription pad alone couldn’t solve – that if I wanted my patients to be healthier, I had to address issues like low literacy and access to healthy food.

Surgeon General’s Walk with students for Munger School in Detroit, MI

Surgeon General’s Walk with students for Munger School in Detroit, MI

Today, prevention is the foundation of my work as Surgeon General.  Health does not occur in a doctor’s office alone: health also occurs where we live, learn, work, play, and pray.  It is my privilege to chair the National Prevention Council.  Established by the Affordable Care Act and Executive Order 13544, the Council was designed to bring federal departments and agencies together to support health and prevention.

In 2011, we released the National Prevention Strategy, which includes four Strategic Directions that provide the foundation for our nation’s prevention efforts: healthy and safe community environments, empowered people, elimination of health disparities, and clinical and community preventive services.  Working together, we can achieve the Strategy’s vision of moving from a focus on sickness and disease to one based on wellness and prevention.

Our communities have great potential, but barriers can make reaching that potential challenging.  Limited resources, unhealthy housing, pollution, and other environmental justice issues can lead to poorer health.  In the United States, health disparities are closely linked with social, economic and environmental disadvantages.  Lack of prevention can take a devastating toll on individuals, families and communities.  That’s why we need to make sure prevention efforts get to the people and places that need them most.

As I’ve traveled the country talking with communities about the National Prevention Strategy, I’ve been impressed with how communities are coming together to overcome health, safety and environmental challenges through putting prevention to work.  We can only succeed in creating healthy communities when air and water are clean and safe; when housing is safe; and when neighborhoods are sustainable, especially in areas that face disproportionate health burdens.

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Habitat for Humanity Worksite in Washington, DC

Partnerships are critical to success.  Many federal efforts reflect the value of collaborative efforts, like the Partnership for Sustainable Communities and Green Ribbon Schools.  I have also seen prevention-focused partnerships at work on the local level, including Fighting D in the D and Maryland Health Enterprise Zones. These examples are only a small sample of the work going on around the country.

In order for communities to be healthy and environments clean and safe, we need to continue to uplift prevention as the greatest opportunity to improve the health of America’s families, now and for decades to come.

About the Author: Regina M. Benjamin, MD, MBA is the 18th United States Surgeon General.  As America’s Doctor, she provides the public with the best scientific information available on how to improve their health and the health of the nation.  Dr. Benjamin also oversees the operational command of 6,500 uniformed public health officers who serve in locations around the world to promote and protect the health of the American People.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Please share this post. However, please don't change the title or the content. If you do make changes, don't attribute the edited title or content to EPA or the author.