The Washington State Board of Health

1. The Washington StateBoard of Health Priority: Environmental Justice Board Sponsors: Carl Osaki, RS, MSPH Joe Finkbonner, RPh, MHA Final Report of the Environmental Justice Subcommittee June 13, 2001 Washington State Board of Health 1102 SE Quince St Olympia Washington 98504-7990 (360) 236-4110, Fax (360) 236-4088 www.doh.wa.gov/sboh/

2. Overview—Subcommittee on Environmental Justice Carl Osaki, RS, MSPH Joe Finkbonner, RPh, MHA Proposed Final report in Tab 9. Proposed Final report in Tab 9.

3. Definition of Environmental Justice Environmental Justice refers to 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.

4. Overview Board established environment justice as one of its priority issues Board created Subcommittee on Environmental Justice Subcommittee drafted workplan Subcommittee worked with the community to implement workplan and make recommendations

5. Background work Establish Working Definition of EJ Conduct literature review Collect data on disease prevalence and pollution distribution in Washington Survey EJ efforts in other states and agencies Work with Washington’s EJ players Understand Washington’s EJ issues Collaborate with other EJ activities in the state Convene Interagency Workgroup on EJ Needed to do a lot of background work before embarking on our Workplan. Needed to do a lot of background work before embarking on our Workplan.

6. Workplan Goals Raise Consciousness about EJ Create Clearinghouse of Information on Board’s Website Draft EJ Guidelines for Agency Use Raise consciousness in a variety of ways. Attending existing forums, speaking at conferences, writing articles on the topic (some examples are included in Tab 9) Web site established. Guidelines we will be presenting in our recommendations today. Raise consciousness in a variety of ways. Attending existing forums, speaking at conferences, writing articles on the topic (some examples are included in Tab 9) Web site established. Guidelines we will be presenting in our recommendations today.

7. Framework for Understanding Environmental Justice Carl Osaki, RS, MPH

8. Environmental Justice: A public health issue EJ addresses problems associated with the disproportionate burden of pollution in low-income and minority communities. The Subcommittee was interested in the health effects from this disproportionate pollution burden The Subcommittee evaluated what is known about health status in low-income and minority communities and related this to what is known about pollution in those areas

9. EJ/Public Health Analysis Are there health disparities in low-income and minority communities? Is there disproportionate exposure to environmental pollutants? How do patterns of disease disparity relate to environmental exposure disparity?

10. Are there health disparities in low-income and minority communities? Refer to Board's work on Health disparities. Refer to Board's work on Health disparities.

11. Excess Burden of Disease Among Racial/Ethnic Populations in Washington StateRate ratio is shown for each group. Refer to the work of the HD subcommittee that found excess disease burden among racial/ethnic populations in WA. They looked at the diseases identified at the federal level as being those showing the most health disparity. They used Washington State VISTA data. The Asian data does not distinguish among all of the Asian sub-populations (those with the highest disease burden) and therefore is showing Asians as a healthier population. If we were able to identify the under represented Asians (e.g., Vietnamese, Laotian, Cambodian) we would expect to see higher numbers of disease. They also looked at infant mortality and found that Native Americans have over twice the rate and African Americans twice the rate of Caucasians. Refer to the work of the HD subcommittee that found excess disease burden among racial/ethnic populations in WA. They looked at the diseases identified at the federal level as being those showing the most health disparity. They used Washington State VISTA data. The Asian data does not distinguish among all of the Asian sub-populations (those with the highest disease burden) and therefore is showing Asians as a healthier population. If we were able to identify the under represented Asians (e.g., Vietnamese, Laotian, Cambodian) we would expect to see higher numbers of disease. They also looked at infant mortality and found that Native Americans have over twice the rate and African Americans twice the rate of Caucasians.

12. Many Factors Contribute to Health Disparities: Environmental and Occupational Conditions Poverty Behavioral Choices Genetic Variability Nutrition Access to Medical Care

13. Is there disproportionate exposure to environmental pollutants?

14. Disproportionate Exposure Greater number of facilities in one community than another The concentration of toxic substances coming from the facilities results in greater risk of exposure Mention John Ridgway from Ecology will be speaking to this issue. Mention Mike Letourneau will discuss the problem of cumulative impact from many facilities conscentrated in one area. Mention John Ridgway from Ecology will be speaking to this issue. Mention Mike Letourneau will discuss the problem of cumulative impact from many facilities conscentrated in one area.

15. How do patterns of disease disparity relate to environmental exposure disparity?

16. Exposure and Disease Difficult to establish causal links Methods to evaluate relative contribution of environmental factors to health status and to estimate individual’s risk of disease from exposure -- Epidemiology -- Toxicology Policymakers need to rely on epidemiology, toxicology, and community input to inform their decisions Jim Krieger from SeaKing will being speaking to the contributions that Epidemiology can make to an analysis of EJ issue. He will use asthma as an example. Rob Duff from DOH will discuss the contributions of Toxicology to an analysis of exposure and disease. He will discuss issues at one site in Georgetown to illustrate his points. Underscore need to involve the community in policy decisions because science can only give us a partial view of what is happening. Jim Krieger from SeaKing will being speaking to the contributions that Epidemiology can make to an analysis of EJ issue. He will use asthma as an example. Rob Duff from DOH will discuss the contributions of Toxicology to an analysis of exposure and disease. He will discuss issues at one site in Georgetown to illustrate his points. Underscore need to involve the community in policy decisions because science can only give us a partial view of what is happening.

17. Findings and Recommendations Carl Osaki, RS, MSPH Joe Finkbonner, RPh, MHA Janice Englehart, MPH

18. The Subcommittee found EJ embraced by many community-based organizations EJ poorly understood by government and regulatory agencies Many agency staff with complaints of not knowing how to effectively engage the public in their processes Willingness on the part of agency staff to learn and be more responsive to community needs

19. Subcommittee findings cont. Frustration in agency and community representatives who complain of not having access to one another Frustration in communities where many agencies are working Lack of understanding in the community about different agency roles

20. Recommendations

21. Better Agency Coordination The Department of Ecology and the Department of Health work together to achieve more coordinated efforts among local, state, and federal agencies. Maintain and expand the interagency workgroup Better utilization of NEPA and SEPA Welcome NEJAC to Washington Found many opportunities for Ecology and Health to collaborate on EH issues. Found possitive results from the interagency workgroup, it would be a shame to not continue. Recommendation on NEPA and SEPA came directly from Tribal member (Terry Williams-- Tulalip) who suggested that agencies may have an opportunity to intervene on behalf of communities using the authority of NEPA and SEPA. NEJAC will be in Seattle in December. Found many opportunities for Ecology and Health to collaborate on EH issues. Found possitive results from the interagency workgroup, it would be a shame to not continue. Recommendation on NEPA and SEPA came directly from Tribal member (Terry Williams-- Tulalip) who suggested that agencies may have an opportunity to intervene on behalf of communities using the authority of NEPA and SEPA. NEJAC will be in Seattle in December.

22. Encourage staff participation in GOIA training Incorporate EJ and cultural competency training into existing training programs Distribute NEJAC’s Model Plan for Public Participation Collaborate with federal EJ efforts Improve Agency Capacity through Education Refer to NEJAC's Model Plan for Public Participation in Tab 17. Included in both English and Spanish. May need to describe what NEJAC is, if someone hasn't already. Refer to NEJAC's Model Plan for Public Participation in Tab 17. Included in both English and Spanish. May need to describe what NEJAC is, if someone hasn't already.

23. Adopt EJ Guidelines Ensure community participation in finalizing guidelines Recommend that the Board ask Governor Locke to consider incorporating guidelines into an executive order We checked in with Governor's Policy staff prior to this meeting. While they could commit to nothing, they encouraged the Subcommittee to check back with them after the meeting. We checked in with Governor's Policy staff prior to this meeting. While they could commit to nothing, they encouraged the Subcommittee to check back with them after the meeting.