Reprinted with permission from Government Executive

“The Environmental Protection Agency celebrated its 50th birthday last month. While most people at 50 are at their prime, this is not the case for EPA, now greatly weakened after four years in the bulls-eye of the Trump administration. Staff is demoralized by persistent inattention to their recommendations and the administration’s deep antipathy for science. Many career senior staff departed, leaving a workforce of about 14,100 employees, down from 15,400 at the beginning of 2017. Even worse, Americans have lost faith in EPA’s leadership. Although EPA’s mission—“to protect health and the environment”—did not change, the Trump administration never supported it with commensurate actions. Public health demands more than words; it requires actions.

Having worked for more than six years under Presidents Obama and Trump in EPA leadership, I offer three actions that incoming leaders should take to get the agency back on track to protect public health:

1. Demonstrate that “To protect health and the environment” is more than rhetoric.

No formal overall EPA mission statement has ever been enacted by Congress. The EPA was initially created to improve and preserve the quality of the natural environment. The agency’s link with human health was implicit. Now is an excellent time for the incoming administration to reaffirm that dual mission and take actions to show that EPA is serious about protecting human health.

2. Enhance, don’t destroy, the role of epidemiology.

Epidemiology, the study of what causes disease in people, is the core science of public health. It is able to clarify the links between environmental pollution and human health. Epidemiologic studies underpinned some of EPA’s greatest environmental achievements. For example, the agency promulgated foundational regulations such as those under the Clean Air Act based on epidemiologic studies documenting illnesses and deaths from outdoor air pollution. Studies of the adverse effects of lead on children supported EPA’s issuance in 1973 of the first standards designed to phase out the use of lead in gasoline. These regulations, which would not have happened without the crucial epidemiologic studies, saved many lives and are rightfully counted among the most important environmental achievements of the last 100 years.

Ironically, during the COVID-19 pandemic, when the general public has come to appreciate the value of epidemiology, the agency finalized a regulation that effectively eliminated epidemiology at EPA. Known as the “Strengthening Transparency in Regulatory Science” regulation and released on January 4, this regulation excludes most epidemiologic studies from being used to support EPA regulations, requiring the agency to only use studies for which the underlying data are publicly available and findings reproducible by others. This is a step backward according to almost all objective scientists. Because of privacy concerns it will exclude the consideration of many relevant epidemiological studies. It will impair EPA’s efforts to be a preventive public health agency and will result in regulations that are less protective of communities of color and people living in low-income neighborhoods. The regulation should be promptly rescinded.

3. Hire more epidemiologists.

To function as a public health agency, EPA needs a stronger core of public health professionals. The employees at the EPA include lawyers, economists, engineers, biologists, chemists, and a wide variety of basic scientists, but epidemiologists represent less than 1% of the workforce. In 2021, EPA should reverse this trend through a focused public health hiring program with the goal of having 5% of the EPA’s professional workforce trained in epidemiology. Further, EPA should create a new Center of Epidemiology to ensure that staff with public health expertise is at the table for decision-making and to strengthen the role of health experts throughout the agency.

It is time for the EPA to return to its public health roots. By formalizing its mission statement, enhancing the role of epidemiology in decision-making, and strengthening its public health knowledge base by hiring more epidemiologists, EPA can begin to restore the public’s trust in its ability to protect both public health and the environment.

Ruth A. Etzel, MD, PhD, is the former director of EPA’s Office of Children’s Health Protection. From 2009 to 2012, she led the World Health Organization’s activities to protect children from environmental hazards. She is a retired captain in the U.S. Public Health Service, where she received the Distinguished Service Medal. Dr. Etzel lectures at the School of Public Health at George Washington University. The views expressed here are her own and not necessarily those of EPA.“