FEATURE SPOTLIGHT : ENVIRONMENTAL HEALTH
Health Equity Through PFAS and Wastewater Surveillance
By Heidi Cox , MPH , public health analyst , National Wastewater Surveillance System , US Centers for Disease Control and Prevention ; Marc Nascarella , PhD , state toxicologist , Massachusetts Department of Public Health ; and Erin Morin , MHS , specialist , Environmental Health
Health equity is achieved when the population has a fair opportunity to be as healthy as possible , regardless of race , ethnicity or social economic status . These social factors often play a role in the levels of exposure to environmental contaminants and infectious diseases . The foundation of addressing health inequities lies in reliable data that captures all populations regardless of social factors , which public health laboratories may have the ability to influence . This article provides a quick look into health equity considerations of two environmental testing areas , per- and polyfluoroalkyl substances ( PFAS ) and wastewater surveillance .
The enormous scale of PFAS contamination provides an opportunity to consider factors of race , power and privilege to ensure the fair treatment of all exposed people . Recently proposed federal regulations will require monitoring for PFAS and notifying the public of the health risks . To prevent harmful levels of exposure , environmental health
systems will need to consider racial equity by prioritizing exposure reducing interventions in communities of racial and ethnic minority populations that face an increased burden of exposure to environmental pollution and experience higher rates of disease and overall poor health to achieve equitable health outcomes . New strategies are needed to engage people using culturally and linguistically appropriate approaches and to assess what systems are available to mitigate exposure in that community . It requires investment in new collaborative systems to respond to needs and questions such as :
• How can a family source enough clean water , if there are limited resources to purchase bottled water or physical ability to transport the needed supplies home ?
• How can people who fish locally for tribal , cultural or economic need access safe food to eat ?
• How can information be used to ensure everyone has access to the types of clinical screening and resources recommended by the National Academies of Sciences ?
• What new systems must be developed to ensure all people can benefit from access to a health care provider trained in the necessary medical or public health intervention ?
Tools that provide locally relevant , practical and sustainable solutions will help make progress toward equitable health outcomes for all people — and not just those who are privileged enough to have the resources and education to benefit from the interventions .
Achieving health equity requires eliminating barriers to participation for population groups and expanding accessibility of public health services to reach socio-culturally diverse communities . The National Wastewater Surveillance System ( NWSS ) is one of the US Centers for Disease Control and Prevention ’ s ( CDC ’ s ) public health programs doing this . Wastewater surveillance addresses a gap in knowledge about where and when active infections are across communities , before confirmed cases are detected and
16 LAB MATTERS Summer 2023
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