Narrowing the Gap Through Attention to Values and Ethics in Public Health Risk Assessment

Gaps or disparities in health and health care have been widening. The divide between rich and poor people continues to grow in parallel with disparities in health. The prospect of a world in which disparities become history is the ideal under the ethical principle of distributive justice ( or, equity ). The role of professionals in perpetuating disparities or in reducing them is discussed, and the notion of professional standards of conduct is presented. Unless professionals are educated about the foundations of ethical conduct and the fact that ethics is rooted in values, the prospect of their protecting the public interest over any other interest is not likely because they will not be able to present rational argument to distinguish good from bad professional conduct. The fact that ethical conduct is context-related bears directly on ethics applied in the health field. For, the ethical health researcher, practitioner, or provider needs to obey the law of the land. And, where these laws are in conflict with professional norms of good conduct, the professional must work to alter the laws that inhibit ethical conduct. In any country, law constrains that which constitutes professional conduct. In particular, in a country founded on libertarian values, as is the case in the United States, the social context and legal frameworks have a direct bearing on the ability of the health professional to conduct themselves in ways that serve the public interest over other interests. Life, liberty and the pursuit of happiness derive from the Declaration of Independence, adopted in 177 6, and are deemed among the inalienable rights of US citizens. The individual dominates under Libertarian Theory, such that taxation for the common good is not deemed a virtue; survival of the fittest would be a more consistent response under libertarian theory, just as we see acted out today. On the other hand, Canada was founded on egalitarian values. Peace, order and good government derive from the Constitution Act of 1867 (the British North America Act). In Canada, it is expected that the health professional will uphold the principle of equality. The community is the greater concern. So, the challenge for Americans is to find a way to interpret libertarian values in a way that those less fortunate have equal access to health, consistent with what those who have the means can afford

Public health in the face of global ecological and climate change

Research undertaken by members of the International Association of Ecology and Health (IAEH) makes critical linkages between population health and the dynamics of ecosystem damage and climate change. The preservation of human health is indissolubly linked to the health of the environment. The International Ecohealth Forum (2008) helped position the field of ecohealth as a key international advocate for this idea. This book chapter is a call for action from the Forum’s deliberations, advocating global adoption of the ecohealth movement

Ethics guidelines for environmental epidemiologists

Recognition of the importance to environmental epidemiology of ethical and philosophical deliberation led, in 1996, to the establishment of Ethics Guidelines for the profession. In 1999, these guidelines were adopted by the International Society for Environmental Epidemiology. The guidelines were revised in 2012 and again in 2023 to ensure continued relevance to the major issues facing the field. Comprising normative standards of professional conduct, the guidelines are structured into four subsections: (1) obligations to individuals and communities who participate in research; (2) obligations to society; (3) obligations regarding funders/ sponsors and employers; and (4) obligations to colleagues. Through the 2023 revision of the Ethics Guidelines, the International Society for Environmental Epidemiology seeks to ensure the highest possible standards of transparency and accountability for the ethical conduct of environmental epidemiologists engaged in research and public health practice

Suppression of environmental health scientists: real-world examples as a basis for action

Pressures on epidemiologists, toxicologists, and on public health scientists to suppress their work are known to occur worldwide. In this article, we share six stories from environmental health scientists about the pressures they faced in their jobs after bringing public health problems to light. The method used to document each of the stories was to invite scientists who attended meetings of the International Society for Environmental Epidemiology to tell their own stories of having experienced research suppression. We then extracted the salient features of each experience into a coherent story, providing references as corroboration where possible. The specific purpose in going public with the six stories presented in this article is to open a conversation to better equip colleagues to stand up to pressures to suppress their work. By publicly sharing the pressures experienced by these scientists in attempts to suppress their scientific work, including intimidation, harassment, threats and/or bullying, other scientists may be better able to withstand such pressures. In the absence of a larger collection of stories, we are unable to identify common approaches taken against suppression. It appears that a focus on scientific excellence and tenacity are two major factors likely to have contributed to the ability to withstand pressure. We encourage others to tell their stories. Bringing examples of these instances to attention will make them familiar enough to be less intimidating should others experience anything similar. Additional documented experiences will expand the base of stories and thus help colleagues to withstand the pressures wielded by special interests. Shining a light on these pressures will remove barriers, not only to advancing the science, but also to protecting the public interest

The Future of Epidemiology

Abstract In this article, the authors discuss current challenges and opportunities in epidemiology that will affect the field's future. Epidemiology is commonly considered the methodologic backbone for the fields of public health and outcomes research because its practitioners describe patterns of disease occurrence, identify risk factors and etiologic determinants, and demonstrate the usefulness of interventions. Like most aspects of science, epidemiology is in rapid flux. Several factors that are influencing and will continue to influence epidemiology and the health of the public include factors fundamental to framing the discipline of epidemiology (i.e., its means of communication, its methodologies, its access to data, its values, its population perspective), factors relating to scientific advances (e.g., genomics, comparative effectiveness in therapeutics), and factors shaping human health (e.g., increasing globalism, the environment, disease and lifestyle, demographics, infectious disease)