A few of the recent pieces I’ve liked:
Jim Morris, Lisa Song and David Hasemyer in a collaboration between the Weather Channel, InsideClimate News, and The Center for Public Integrity: Fracking the Eagle Ford Shale: Big Oil and Bad Air on the Texas Prairie
Brigid Schulte in the Washington Post: ‘Mad Men’ era of U.S. family policy coming to an end?
Tom Frieden at The Health Care Blog: CDC: Together We Can Provide Safer Patient Care
Farida Jhabvala Romero at Reporting on Health: California County Seeks to Eliminate Health Safety Net for the Undocumented
Ted Genoways at OnEarth: Hog Wild: Factory Farms are Poisoning Iowa’s Drinking Water
Celeste wrote last week about poultry workers asking the White House and the USDA to abandon the proposed poultry rule that would allow poultry-processing lines to speed up. At rates of up to 175 birds per minute, these faster-moving lines would make work even more hazardous for poultry workers, who already experience high rates of musculoskeletal disorders. Following the visit of a delegation of poultry workers to Washington, DC, Catherine Singley of the National Council of La Raza published a blog post featuring the words of poultry worker Bacilio Castro from the North Carolina Worker Justice Center. He said:
You want to know what’s in the chicken on your plate? Tears. Tears of the mothers who can’t lift their children because of the pain in their wrists and shoulders from working on the line. We are not asking you to stop eating chicken. We are simply asking to be treated as human beings and not as animals.
The Washington Post’s Kimberly Kindy reports that in addition to messages from poultry workers and food-safety advocates, members of Congress are hearing from chicken-industry lobbyists. “The National Chicken Council has been spending an average of more than $500,000 annually lobbying Congress, according to lobbying records,” she notes. A Charlotte Observer editorial contrasts this heavy spending with the often-unnoticed suffering of vulnerable poultry workers:
On Thursday, poultry workers from across the country met with lawmakers and administration officials on Capitol Hill to explain how the current combination of line speeds and repetitive motions already do damage to their hands and wrists. It’s rare that these workers, most of whom are Latino and black, have any voice. At work, they are often reluctant to complain for fear of being fired or turned over to immigration authorities.
… In a 2008 Charlotte Observer investigation, reporters spoke to more than 130 poultry workers, three-fourths of whom complained of hand and wrist injuries. Several suffered from later stages of carpal tunnel syndrome and were unable to straighten fingers or pick up objects like spoons. Some were afraid to use their trembling, weakened hands to pick up their young children.
… N.C. Sen. Kay Hagan, who is running for reelection in 2014, supports the USDA rule changes because they would free inspectors to concentrate on food safety, her office told the editorial board. But the changes also show disregard for the North Carolina workers who are among the most vulnerable. They need more advocacy and more safety – not more chickens, with the pain they surely would bring.
The Charlotte Observer’s 2008 investigative series The Cruelest Cuts should be required reading for anyone who supports allowing poultry-processing lines to speed up.
In other news:
LAist: Oscars television viewers, though evidently not event attendees, saw saw the name of 27-year-old Sarah Jones, a camera assistant killed by a train during a film shoot, during the award ceremony’s “In Memoriam” segment. Despite rules requiring rail-company representatives to be on site (in addition to other safety measures) when films are shot on railroad tracks, no such representative was present when Jones was killed.
The Tennessean: At a Tennessee legislative committee hearing, Rocky Tallent told lawmakers about how his 27-year-old son Michael was killed while working as a temp worker on a construction job for which he was given inadequate training. He spoke in support of two safety-related bills introduced by Representative Mike Stewart; one of them would require employers to fix serious safety hazards even if they are appealing violations, and the other would include information about companies’ safety records in questionnaires to evaluate bidders for state-funded construction projects.
Denver Post (here, too): Those who worked at the Rocky Flats nuclear weapons facility in Colorado between April 1, 1952 and December 31, 1983 and have developed one of 22 types of cancer no longer have to reconstruct their histories of radiation exposure in order to qualify for medical compensation. Many former Rocky Flats workers who’ve spent years fighting for compensation are relieved at the decision, but some say the date range leaves out workers who had dangerous exposures.
Jacksonville Daily News (North Carolina): The latest research into the water contamination at the Camp Lejeune military base finds that the contamination began even earlier than previous estimates suggest. This has implications for the many servicemembers and their families who lived on the base while the contamination was present and are now experiencing cancers and other health problems that may be related to those exposures. A USA Today article notes that although President Obama signed a law offering health benefits to exposed former Marines and their families, Obama’s Justice Department is arguing in a Supreme Court case for time limits on lawsuits involving toxic contamination.
In These Times: Several workers have been killed on the construction sites of stadiums and other projects preparing for the 2014 World Cup and 2016 Summer Olympics in Brazil.
Read the interview.
Brian Castrucci, who’s worked in city and state health departments and is now Chief Program and Strategy Director at the de Beaumont Foundation, likes to ask people two questions: Do you know who your primary care provider is? And, Do you know who’s head of your local public health department? The fact that many people can answer the first question but not the second, he says, demonstrates why public health needs to partner with health care.
“US medical providers are giving people some of the best medical care in the world, but if they’re returning patients to communities and environments that are antagonistic to good health, patients will still fare poorly,” Castrucci explains. “Public health can help create environments that are supportive of the medical interventions people are getting from the healthcare system.” For instance, doctors might recommend that patients with diabetes and high blood pressure engage in regular physical activity, but it’s hard for people to follow those recommendations if they live in communities with few safe opportunities for exercise. Public health departments can play a role in identifying such communities and working to make them more supportive of healthy lifestyles.
With a new tool called the Practical Playbook, the de Beaumont Foundation, Duke Community and Family Medicine, and the Centers for Disease Control and Prevention aim to help local and state public health professionals and local, state, and regional primary-care groups collaborate with one another to improve their communities’ health and reduce healthcare costs. It offers tips and resources for partners working through each stage of the integration process: organize and prepare; plan and prioritize; implement; monitor and evaluation; and celebrate and share. The Practical Playbook site also contains a wealth of success stories, including the following:
Indiana’s Asthma Emergency Department Call Back Program conducts outreach to asthma patients seen in the emergency department of Parkview Health emergency rooms in northeast Indiana to help patients improve their asthma management. With support from the Indiana Department of Health, the not-for-profit Parkview Health system has a trained community health nurse or respiratory specialist contact patients soon after an emergency department visit for asthma to assess patients’ needs and offer assistance. Patients who cannot afford medication to control their asthma are enrolled in Parkview’s Medication Assistance Program, and those without a medical home are referred to a Parkview physician, community health center, or free clinic. The program also works with the Fort Wayne-Allen County Department of Health and local school districts to provide families with resources to help manage asthma and avoid future hospital visits. A survey of program participants found that 59% reported missing zero days of school or work since joining. Program resources available on the Practical Playbook website include contact forms that Parkview Health uses for the initial contact with asthma patients following their emergency department visit and six months after the initial contact. A program evaluation found 38 fewer asthma-related emergency room visits and nine fewer hospitalizations after the program’s first year, for an estimated savings of more than $600,000.
Massachusetts’ Mass in Motion program helps 33 communities support healthy eating and active living. In response to an alarming ride in statewide obesity rates, especially among African-Americans and Latinos, the Massachusetts Department of Health partnered with local organizations and healthcare teams (Massachusetts Department of Public Health, the Harvard Pilgrim Health Care Foundation, The Boston Foundation, Blue Cross Blue Shield, Tufts Health Plan Foundation, MetroWest Health Foundation) to provide technical assistance and support for 11 pilot sites to build capacity and establish multi-sector partnerships to increase active living and healthy eating, with an emphasis on health equity. With a federal Community Transformation Grant and funding from Partners HealthCare, the program was able to scale up. Communities are participating in Healthy Corner Store, Adopt-a-Park, Farm to School, and Safe Routes to School Programs; improving sidewalks and roads to encourage walking and biking; and launching community gardens and mobile veggie markets. In an early analysis of body mass index (BMI) levels, five Mass in Motion communities saw a 2.4% decrease in BMI levels classified as overweight or obese, while other communities experienced only a 0.4% decrease. Mass in Motion’s Practical Playbook page links to the program’s annual highlights and information on Community Transformation Grants.
Michigan’s Healthy Futures program is a partnership between Munson Medical Center and local health departments to assure pregnant women and new mothers have the healthcare and resources they need. The partners launched the program in response to findings that many women were not able to get necessary prenatal care and that families had complex health needs that could not be addressed within the scope of doctor’s visit. Now, expectant mothers participating in Healthy Futures get support from a registered nurse during pregnancy and during the first two years of their children’s lives. They also receive newsletters covering topics such as immunizations, safety, and nutrition. Research has found that among enrollees, breastfeeding rates and immunization rates for two-year-olds are higher than national, regional, and state averages. The program’s Practical Playbook page includes links to the Healthy Futures newsletters that go to women at various stages of pregnancy and to parents throughout their children’s first two years of life.
The Practical Playbook doesn’t just aim to lengthen the list of success stories, though; it’s part of a larger effort to build a system that integrates primary care and public health in order to address the chronic illnesses that account for a growing share of the US disease burden. In 2012, the Institute of Medicine released the report Primary Care and Public Health: Exploring Integration to Improve Population Health. It recommended bringing the two sectors together and identified a set of core principles for integration efforts. Dr. J. Lloyd Michener, who chairs the Department of Community and Family Medicine at Duke University Medical Center and served on the IOM committee that produced the report, recalls, “In putting the IOM report together, we noticed that there were lots of examples of successful primary care-public health integration, but people didn’t know about them.”
Michener, who also worked on the Practical Playbook, stresses that he and his colleagues are working to “build on local strengths and expertise.” He points out that with the Affordable Care Act starting to reward healthcare providers for prevention (with initiatives such as accountable care organizations and shared-savings models), primary-care practices have new incentives to invest in improving the health of the populations they serve. But they don’t always know that public health can be a key partner. “We’re trying to help public health departments and primary-care providers take advantage of the tools the ACA provides, as well as the knowledge and experience that clinicians and public-health practitioners can share with one another,” he says.
The jump in rates of heart disease, diabetes, and other chronic diseases has also made the integration necessary. “We’ve gone from a time when disease was primarily caused by microbes to a time when it’s originating in social and environmental conditions – but our healthcare system hasn’t necessarily made the switch,” says Castrucci. “We need to allow public health to address some of the upstream concerns – and public health has 300 year old infrastructure and experience to do it.”
by Jonathan Heller
In his farewell address, President Dwight D. Eisenhower famously warned Americans about the growing power of the military-industrial complex. More than 50 years later, Nicholas Freudenberg, Distinguished Professor of Public Health at City University of New York, has issued a warning no less grave about “the corporate consumption complex” – the interconnected web of corporations, financial institutions and marketers that, in the name of individual rights, promote and profit from our unhealthy habits.
In Lethal but Legal: Corporations, Consumption, and Protecting Public Health, Freudenberg argues that “In a global economy that focuses relentlessly on profit, enhancing the bottom line of a few hundred corporations . . . has become more important than realizing the potential for good health.” According to Mark Bittman of The New York Times, “Freudenberg details how six industries — food and beverage, tobacco, alcohol, firearms, pharmaceutical and automotive — use pretty much the same playbook to defend the sales of health-threatening products. This playbook, largely developed by the tobacco industry, disregards human health and poses greater threats to our existence than any communicable disease you can name.”
To turn this destructive calculus around, Freudenberg told Bittman, “What we need is to return to the public sector the right to set health policy and to limit corporations’ freedom to profit at the expense of public health.”
Instead of asking “Do people have the right to smoke?,” Freudenberg and Bittman agree, we should ask: “Do people have the right to breathe clean air?” Instead of “Do junk food companies have the right to market to children?” we should ask: “Do children have the right to a healthy diet?” Instead of “Do we have a right to bear arms?” we should ask: “Do we have the right to be safe in our streets and schools?”
Reframing the debate with these questions, Freudenberg says, has led to changes in the food and beverage, tobacco, alcohol, firearms, pharmaceutical and automotive industries.
But we must go further. The labor practices of many industries also have huge impacts on health. The unspoken assumption today is business owners have the right to run their businesses as they see fit. Neoliberalism proclaims that reducing government regulation is essential for a healthy economy. But don’t workers have the right to live healthy lives?
In the past, the answer has only sometimes been yes. The once-powerful alliance of labor and workplace safety advocates won a series of rights for workers, including the 40-hour week and weekends off, a minimum wage, and occupational health and safety standards. But the political pendulum has swung back in the direction of corporate power, and dangerously too far.
- Minimum wage hasn’t kept up with inflation, so many people are working but not earning enough to escape poverty. Living in poverty has a huge impact on health and well being. Efforts to raise the minimum wage are in progress across the nation, and public health professionals should be supporting these efforts.
- About 40% of U.S. workers – and 70% of restaurant workers – are not given paid time off for illness. Health Impact Assessments conducted by Human Impact Partners (HIP) on paid sick days legislation show clearly that workers and society as a whole benefit when workers take time off and avoid spreading infectious disease. Visits to emergency rooms also drop.
- Wage theft – the illegal withholding of wages or the denial of benefits rightfully owed to an employee – is a common occurrence among low-income workers. HIP has begun a Health Impact Assessment of wage theft in Los Angeles and are finding that employers stealing their workers’ income has significant negative affects on physical and mental health and well-being for families and children.
- Both in the U.S. and abroad, too many business owners cut corners on worker safety to increase profit. The recent garment factory fires in Bangladesh and Pakistan that killed and injured hundreds of workers are a clear example.
What obligations do corporations have back to society and their workers? Should profits for owners be valued over everything else, including health? The public health community should lend its support to campaigns that seek to ensure that corporations are not allowed to profit at the expense of workers. Asking those questions, and others, is a good start.
Jonathan Heller is co-director of Human Impact Partners, an Oakland, Calif., nonprofit that conducts community-based studies of the health and equity impacts of public policy.
Will farm workers be better protected? EPA proposes new pesticide protection standards but farm worker advocates see some steps backward
“For us it’s personal,” said Jeannie Economos, Farmworker Association of Florida Pesticide Safety and Environmental Health Project Coordinator. “It’s a daily issue for us. Every day with a weaker protection standard is another day a worker is exposed to pesticides,” she said.
On February 20th , the US Environmental Protection Agency (EPA) announced proposed revisions to its Worker Protection Standard for agricultural pesticides, the first since the existing standard was established in 1992 – and the second proposed update to the standard since its introduction in 1974. EPA has called the proposal “long overdue” and “a milestone” that will “protect the people who put food on our tables every day.” Farm worker and environmental advocates have welcomed the proposal that was a decade in the making, yet see both improvements and what some are calling “steps backward” in the proposed changes.
About 900 million pounds of pesticides are used annually in the US, and the US Environmental Protection Agency (EPA) estimates that each year, approximately 10,000 to 20,000 physician-diagnosed pesticide poisonings occur among the country’s two million farm workers. This estimate of harmful exposures, however, is considered low, given that many farm workers don’t report such illnesses and may not connect non-acute, chronic diseases or slow-to-manifest health problems with pesticide exposure. This number also does not account for children and other family or household members who have their health affected by pesticides, either directly – by living near where they’re applied – or indirectly, either prenatally or through exposure to workers’ contaminated work clothing and equipment.
Pesticides currently in use are known to cause a range of short- and long-term adverse health effects. Short-term effects include respiratory, skin and eye problems, nausea and headaches. Cumulative exposures can increase the risk for certain cancers and birth defects and result in reproductive and neurological problems, both for workers exposed directly and for children exposed incidentally or prenatally. There is now compelling evidence that prenatal pesticide exposure can lead to learning, behavioral and reproductive problems that affect not only the children but also the grandchildren of workers exposed.
The EPA proposal would increase pesticide-use and safety training requirements, introduce some pesticide-use training recordkeeping requirements that will help track where specific pesticides are used, add new buffer zones requirements, and require signage for re-entry into areas where pesticides have just been applied. There is currently no age limit for employees handling pesticides and the proposed standard would – with some significant exemptions – bar children under 16 from handling pesticides.
“This is a step in the right direction,” said Amy Liebman, Migrant Clinicians Network Director of Environmental and Occupational Health. But, she said, “there is much work to be done” to strengthen the EPA’s proposal.
The proposed revised standard would increase the frequency of required pesticide use training from once every five years to once yearly. Pesticide use and safety training would also have to include information on how to reduce take-home exposures (on clothing and equipment, including produce containers), something currently not required.
It would reduce the “grace” period during which a newly hired worker could work without such training from five to two days and require that employers keep records of pesticide training for two years. No such recordkeeping is currently required, so this would help document where specific pesticides are used. In fact, apart from in California and to some extent Washington and Oregon, pesticide applications are not officially recorded. A number of states have programs to record pesticide poisonings but only California and Washington have any requirements for medical monitoring related to occupational pesticide use.
The proposed new standard would require that signs be posted to show where applications have occurred for pesticides for which the “restricted no-entry interval” is more than 48 hours. In addition it would create 25- to 100-foot buffer zones around areas where pesticides have been applied, something that only applied previously to nurseries and greenhouses. It would adopt Occupational Safety and Health Administration (OSHA) standards for respirators – an important improvement, say worker advocates who note agricultural workers lack many of the health and safety protection afforded other US workers. It would also prohibit anyone under age 16 from handling pesticides or being allowed early re-entry into treated fields and other areas. The current standard has no minimum age.
Concerns about communication and age limits
What EPA’s proposed standard does not do is require that pesticide information – labels, safety data sheets and signage – be available in any language other than English, even though Spanish is the primary language for the vast majority of US farm workers. Recent National Agricultural Worker Survey data show that only about 30% of US farm workers say they speak English well, while 35% said they did not speak any English. The proposal also does not detail how training is to be conducted, which concerns United Farm Workers National Vice President Erik Nicholson. “Too often,” he said, “training consists of tired workers sitting in front of a video.”
A proposed change prompting particular concern among farm worker advocates is one that would remove required central posting of information about where pesticides have just been applied. “This is the biggest, glaring problem,” said Economos of the proposed revisions. Instead of information being posted in a place visible to anyone walking by, this and other pesticide safety information would be available to workers upon request. “Knowing the farm worker population, having it accessible under an employer’s control is not really making it accessible,” said Virginia Ruiz, Farmworker Justice Director of Occupational and Environmental Health. “Farm workers would be reluctant to ask a supervisor or employer,” she said. “Workers often won’t even complain about an illness, so it’s really unlikely they’ll ask for information on pesticides,” said Economos.
“It’s very frustrating,” said Nicholson, “for things to take so long and produce so little, including some steps backward.” Among his concerns are those for children working on farms. “Young workers continue to be an issue” in terms of farm worker health and safety, said Nicholson.
What he’s referring to is the fact that the standard does not apply to family farms, those that do not employ non-family-member workers. On family farms that do not exceed the Department of Labor’s (DOL) hiring limits for exemption from the Fair Labor Standards Act, children 12 and under are allowed to work in non-hazardous jobs. According to the National Agricultural Statistics Service, hired farm workers make up about a third of those working on farms, the rest being self-employed farmers and their family members. Estimates on the number of family farms – which can range from the very small to very large in size – from the EPA coincide.
Although OSHA is the agency primarily responsible for setting and enforcing workplace standards, agricultural work is excluded from several federal laws and regulations, and EPA, rather than OSHA, is responsible for protecting agricultural workers from harms related to pesticide exposure. The DOL’s Fair Labor Standards Act, however, has child labor rules that restrict hazardous work on farms that apply to all agricultural workers under 16. These specify that workers handling or applying chemicals classified as Toxicity Category I or II by the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) must be at least 16 years old. They do not, however, restrict children from working in proximity to pesticide application or from entering places where pesticides have just been applied.
The proposed new standard requires that all pesticide handlers and workers who enter recently treated areas be at least 16 years old. Yet by exempting members of farm owners’ immediate families from this requirement, it still leaves children at risk of harmful pesticide exposures. And farm worker advocates are concerned about the adequacy of the proposed age limit for pesticide handling. “The difference between 16 and 18 is important, both in terms of adverse developmental effects of pesticides and maturity,” said Ruiz.
“We have no quarrel with protecting people where there are risks but this is an issue related to family farms,” said American Farm Bureau Federation’s Energy and Environment Team director Paul Schlegel, who said his organization would be “looking closely at the 16 year old threshold” to determine if that is “appropriate or overly restrictive.” He also said the Farm Bureau doesn’t “want to see buffer zones that are too large” or “a lot of paper work with no purpose.”
An issue not yet discussed in the roll-out of the revised WPS is enforcement. Snapshots of WPS violations listed in oversight programs in Florida and Oregon suggest that violations are frequent and occur across the range of the standard’s requirements.
The proposed new standard is open for a 90-day comment period. Meanwhile the 2014 growing season – and another round of pesticide application – is getting underway.
Elizabeth Grossman is the author of Chasing Molecules: Poisonous Products, Human Health, and the Promise of Green Chemistry, High Tech Trash: Digital Devices, Hidden Toxics, and Human Health, and other books. Her work has appeared in a variety of publications including Scientific American, Yale e360, Environmental Health Perspectives, Ensia, The Washington Post, Salon and The Nation.Keywords:
It’s probably no surprise that people who experienced foreclosures during the Great Recession may have also experienced symptoms of depression. However, researchers have found that the mental health effects of foreclosure go beyond the individual to the community at-large.
“For the most part, discussion of foreclosure has focused on the individual experience, the people who are in this circumstance, who are at risk of losing their homes, of losing that nest egg,” said Kathleen Cagney, a professor within the Department of Sociology at the University of Chicago. “But we wanted to think about foreclosure in a structural way, at the community level. We wanted to examine (foreclosure) as a neighborhood experience.”
Cagney is the co-author of a study that did just that and which was published in the March issue of the American Journal of Public Health (AJPH). To conduct the study, researchers examined data from the National Social Life, Health and Aging Project, focusing in on older adults ages 57 years old and older in Los Angeles, New York City and Chicago. Cagney, who also directs the Population Research Center at the university’s National Opinion Research Center, said she and her colleagues decided to focus on older adults because they tend to be more connected to their communities — “they spend more of their days in their neighborhoods, pick up signals more readily and can be more susceptible to what’s happening in a neighborhood,” Cagney told me.
The study found a “dramatic uptick” in reports of depressive symptoms among older adults who lived in communities most affected by the foreclosure crisis. In other words, a rise in neighborhood-level foreclosures was found to be a risk factor for depression in older adults. Depressive symptoms were associated with increases in mortgage default notices, with homes coming under the ownership of banks and with increases in properties going to auction. Cagney and co-authors Christopher Browning, James Iveniuk and Ned English wrote:
Interestingly, increases in neighborhood poverty and visible disorder were not statistically significant, suggesting that neither of these contextual factors was important to the mechanism connecting foreclosure and depression. This result is consistent with recent findings in the social sciences suggesting that the impact of foreclosure on communities is independent of disorder. We speculate that foreclosure is a sign of disorder in its own right; a posting of foreclosure, regardless of the quality of the property in arrears, signals instability and disinvestment akin to trash on the street or sidewalks in disrepair. Thus, foreclosure can embody components of disorder even when it may not immediately lead to other visible forms of disorder, such as a dilapidated porch or a broken picture window.
Cagney said that although researchers did expect to find a link between foreclosure and depression in the wider community, “we found a stronger link than we anticipated.” Another surprising finding was the uptick in depression symptoms throughout every stage of foreclosure and not just when visible signs of foreclosure, such as disrepair or unkempt lawns, began to appear.
“Foreclosure is experienced by all of us,” Cagney told me. “It alters all of our daily lives when the world around us feels unstable, as if it’s disintegrating. That’s going to impact our health, emotionally and physically.”
So how can public health workers use Cagney’s findings in their work with older adults? She said that high rates of foreclosure in a neighborhood might be predictive of problems that come with social isolation, signaling a need for additional support services or interventions. For example, with fewer residents, churches may cancel events, the local community center might get shuttered or the streets are simply less busy with the usual bustle of a thriving neighborhood. Even if it’s simply waving hello to a local business owner who had to close up shop — these are the seemingly insignificant activities that impact social connection and mental wellness, Cagney said. The study recommends that “at the neighborhood level, communities may want to manage distressed and abandoned properties so they do not introduce physically or socially compromised spaces that older adults must navigate.”
“Just going outside and seeing action on the streets, even if you don’t have a conversation, has a social benefit,” Cagney told me. “You feel like a part of something. You don’t feel alone.”
To access the full AJPH study, click here.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
The billion-dollar poultry industry chews up its workers and spits them out like a chaw of tobacco. One of those workers is in Washington, DC this week to make a plea to the Obama Administration. For 17 years, Salvadora Roman, 59 worked on the de-boning line at a Wayne Farms poultry processing plant in Alabama. The production line ran at an incessant pace that forced her (and her co-workers) to make tens of thousands of repetitive motions on each and every work shift. Her hands and wrists eventually became so swollen and painful that she requested to be moved to a less hand-intensive task. Her employer refused. Her symptoms worsened. After missing work to seek medical attention, she was fired. That was two years ago. Her crippling pain and mangled hands have not recovered.
Ms. Roman, along with several other poultry workers from Arkansas, Mississippi and North Carolina, are in the nation’s Capital to plead with policy makers to improve their working conditions. They’ve requested meetings with Obama Administration officials. Some, but not all, of their requests have been granted. With support of the National Council of La Raza, Nebraska Appleseed, Oxfam American, the Southern Poverty Law Center, and Food & Water Watch, they are making a last-ditch effort to ask the Obama Administration to abandon its rule to change the poultry inspection process. The new regulation is expected to be released in just a few weeks.
As we’ve reported here previously, the rule will largely privatize poultry inspection, lead to the elimination of 800 inspectors, and allow producers to increase line speed to 175 birds per minute (which will further cripple poultry workers.) It will do little to improve food safety, and could make matters worse. Piling onto the insult to workers and consumers, the changes endorsed by the Obama Administration are estimated to enhance the industry’s annual revenue by $250 million—just what Tyson, Perdue, Pilgrim’s Pride, Sanderson Farms, Foster Farms, George’s, and other poultry producers want.
The Administration continues to insist the rule will not adversely affect the health of poultry workers. They chose to ignore the substantial body of evidence that shows increasing exposure to intensive repetitive motion tasks leads to more musculoskeletal injuries. The Administration’s own National Institute for Occupational Safety and Health (NIOSH) issued an evaluation last year showing this exact relationship. The NIOSH researchers assessed the work tasks, occupational history and the results of nerve conduction tests of 318 poultry workers at a Pilgrim’s Pride plant in South Carolina. Ninety-four percent of the workers were African-American and 70 percent were female.
Based on each worker’s exposure to repetitive hand activity and force, they were classified into low, medium and high exposure groups. There was a dose-response relationship between exposure and prevalence of carpal tunnel syndrome.
At a press conference today, Congressman Bennie Thompson (D-MS) also called on the USDA to withdraw the rule. He said:
“Increasing line speed not only increases the risk of injury to line workers, but also compromises the health of American consumers. ..the USDA is unnecessarily endangering the lives of millions of Americans. I urge the Administration to move swiftly and stop the USDA from allowing increased line speeds in poultry plants.”
Mr. Thompson was joined by Congresswoman Marcia Fudge (D-OH), Chair of the Congressional Black Caucus (statement here), and Congresswoman Sheila Jackson Lee (D-TX). Ms. Jackson-Lee said, “It is a shame that we are dealing with this as we celebrate the 5oth anniversary of the 1964 Civil Rights Act. We are demanding that the White House stop the rule.”
Poultry industry workers are largely female, and African-American or Latino. Ms. Janet Murguía, president and CEO of the National Council of La Raza, reports that two in five of the workers are Latino. Commenting on the USDA’s rule, Murguía said, “Instead of advancing a proposal that would make already dangerous workplaces even more hazardous, Secretary of Agriculture Tom Vilsack and Secretary of Labor Thomas Perez must work together to improve worker safety in the poultry industry.”
Food safety and worker safety experts have been warning the Administration of the serious harm that will result if the USDA’s new poultry slaughter inspection system is adopted. Let’s hope the Obama White House decides to treat poultry workers better than the companies that employ them.
One of the Millennium Development Goals — a set of goals to improve global well-being by 2015 — is to reduce by two-thirds the mortality rate of children under age five. The good news for MDG progress is that the under-five mortality rate has been cut nearly in half, from 90 deaths per 1,000 live births in 1990 to 48 in 2012. The bad news is that 6.6 million young children still die every year, and those deaths are concentrated in the world’s poorest regions. Eight-one percent of these deaths occurred in Sub-Saharan Africa and Southern Asia, many of them in babies’ first 24 hours of life.
A new report from Save the Children proposes a strategy for improving newborns’ survival: assuring the presence of skilled birth attendants. Ending Newborn Deaths: Ensuring every baby survives reports 51% of births in sub-Saharan Africa, and 41% in southeast Asia, “were not attended by a midwife or other properly qualified health worker.” If essential health services were distributed more equitably, they calculate that 950,000 newborn deaths each year could be prevented. Skilled birth attendants with appropriate facilities can help avert and respond to premature birth and birth complications such as prolonged labor, pre-eclampsia, and infections.
The report identifies eight essential services that midwives and other skilled health workers should provide during labor, delivery, and the hours following delivery in order to prevent intrapartum stillbirth and reduce newborn mortality:
1. Skilled care at birth and emergency obstetric care (including assisted vaginal delivery and caesarean section if needed) ensuring timely care for women and babies with complications
2. Management of preterm birth (including antenatal corticosteroids for mothers with threatened preterm labour to reduce breathing and other problems in preterm babies)
3. Basic newborn care (focus on cleanliness including cord care, warmth, and support for immediate breastfeeding, recognition of danger signs and care seeking)
4. Neonatal resuscitation for babies who do not breathe spontaneously at birth
5. Kangaroo mother care (skin-to-skin, breastfeeding support especially for premature and small babies)
6. Treatment of severe newborn infections (focus on early identification and use of antibiotics)
7. Inpatient supportive care for sick and small newborns (focus on IV fluids/feeding support and safe oxygen use)
8. Prevention of mother-to-child transmission of HIV (during pregnancy, labour and the immediate newborn period).
Access to skilled health workers to provide these services is not distributed equally; women in rural areas of low-income countries are least likely to have skilled birth attendance. While some countries, such as Malawi and Rwanda, have made impressive progress over the past decade, global coverage of skilled birth attendance increased at a rate of just 1.1% per year between 2000 and 2009. The report notes that if this rate of progress were doubled, the world could achieve universal coverage of skilled birth attendance by 2025, rather than by 2043 at the current rate of progress.
To reach the Millennium Development Goal and improve birth outcomes worldwide, Save the Children calls on world leaders, philanthropists, and the private sector to commit to a “Newborn Promise” that involves the following steps:
- Governments and partners issue a defining and accountable declaration to end all preventable newborn mortality, saving 2 million newborn lives a year and stopping the 1.2 million stillbirths during labour
- Governments, with partners, must ensure that by 2025 every birth is attended by trained and equipped health workers who can deliver essential newborn health interventions
- Governments increase expenditure on health to at least the WHO minimum of US$60 per capita to pay for the training, equipping and support of health workers
- Governments remove user fees for all maternal, newborn and child health services, including emergency obstetric care
- The private sector, including pharmaceutical companies, should help address unmet needs by developing innovative solutions and increasing availability for the poorest to new and existing products for maternal, newborn and child health.
The World Health Organization has made a draft “Every Newborn Action Plan” available for review online, and an updated draft will be submitted to the World Health Assembly for its May 2014 meeting in Geneva.
Carolyn Miles, President and CEO of Save the Children, commented at the release of her organization’s report, “The first day of a child’s life is the most dangerous, and too many mothers give birth alone on the floor of their home or in the bush without any life-saving help.” She added, “The solutions are well-known but need greater political will to give babies a fighting chance of reaching their second day of life.”