Beyond a hospital’s walls, there are many opportunities for health care professionals to get engaged and make a difference in preventative care at the policy level.

For years, Health Care Without Harm’s Safer Chemicals program has been organizing and facilitating opportunities for health systems to share their perspectives on chemical policies and regulations that can make a real difference in the health of their patients and community.

“­­­­Health care providers and the organizations through which they care for their patients have the moral authority over matters impacting health, making their voices incredibly powerful in the public policy arena,” said Rachel Gibson, director of the Safer Chemicals program.

Voting with dollars

The health care sector accounts for ­more than $87 billion of the U.S. gross domestic product and is also a significant user of chemicals in the United States. This creates great opportunities for health systems to vote with their dollars and purchase products that do not contain chemicals of concern, such as stain-resistant chemicals in waiting room furniture and hazardous cleaning products used by their employees. Health Care Without Harm and Practice Greenhealth provided an effective framework to drive this change, creating a consolidated and streamlined effort to shape institutional purchasing goals on a broad scale. The organization’s standards have been integrated into the purchasing criteria of institutions beyond health care, including universities, government, and corporations.

Yet, in most cases, buying choices alone won’t usher in greater population health without parallel action to change public policy. By speaking out in the policy arena, through organized letter writing or testimony at public hearings, for example, health care organizations have shaped policies on a larger scale to protect communities, their staff, and patients, and the environment, while furthering their institutional purchasing goals.

One such example is the many years-long Toxics Substances Control Act (TSCA) reform debate, during which Health Care Without Harm sent letters to U.S. senators, articulating principles for effective TSCA reform and, later, critiquing the content of reform legislation. These letters were co-signed by many hospitals and health systems that sought to highlight the significant cost toxic chemicals have on health and the economy and to urge Congress to pass meaningful TSCA reform.

“Our organizations are committed not only to healing, but to prevention,” health care organizations wrote to Congress in 2015. “Addressing the shortcomings of the chemical regulatory system by reforming TSCA is one of the most critical initiatives to prevent disease and to protect public health, but only if it is done right.”

Many health care organizations testified before Congress, met with legislators, and authored op-eds in leading newspapers during this policy debate. Although implementation is currently stalled under the Trump Administration, the Frank R. Lautenberg Chemical Safety for the 21st Century Act was considered a step forward in the effort to achieve comprehensive chemical policy reform.

The impact of advocacy

Letter writing also has been an effective tool in recent collaborative efforts aimed at stopping the National Fire Protection Association’s (NFPA) attempt to develop a new open flame standard for upholstered furnishings called NFPA 227.

Given that open flame standards are universally met through the use of flame-retardant chemicals, a broad coalition came together to oppose this move. The Center for Environmental Health (CEH) organized a range of purchasers from different sectors, including companies, local governments, and firefighter organizations, drawing on their credibility, purchasing power, and name recognition to influence the NFPA. Health Care Without Harm organized health systems that had previously committed to purchasing furniture without flame retardants as part of their commitment to achieve the Healthy Interiors goal of Healthier Hospitals. Also active in the effort was the Business and Institutional Furniture Manufacturers Association, which opposed the development of a new open flame standard for upholstered furniture.

“This was a great partnership because we used the voice of multiple stakeholders, which reinforced the message and made it more powerful,” said Judy Levin, CEH pollution prevention director. “Health care has a very authoritative voice when it comes to health-related issues such as the use of flame retardants in furniture or other chemicals of concern. Health care has a huge vested interest in making sure toxic flame retardants don’t get back into our furniture because of the health implications.”

Since the launch of Health Care Without Harm and Practice Greenhealth’s furniture guidelines, many hospitals have been specifying furniture without the use of flame retardants where code permits. The development of an open flame standard would undermine their ability to purchase such furniture. Institutional furniture companies also were not interested in going backward and having to reintegrate flame retardants into their products due to cost considerations and consumer demand.
Earlier this year, the NFPA decided to halt their effort to develop the new standard. In coming to this conclusion, the organization cited the numerous comments in opposition to NFPA 277 and emphasized the health concerns raised by those who had written letters.

While the NFPA is made up of fire experts and scientists who focus on fire safety, their mandate doesn’t require that human health be taken into account when developing standards.

“The idea of taking into account human health is not something that is currently part of their mission,” says Levin. “Their job is to develop a performance standard that manufacturers will have to meet in any way they chose as long as it performs the way it needs to under the required testing protocol. I think this was an important message to them to say that you can’t ignore human health.”

Getting involved

There are many ways health systems can take part in future advocacy opportunities and make sure that the call to prioritize human health is not overlooked:

• Educate yourself and your coworkers around the topic of concern so when there is a need for action, you are prepared.
• Sign up for the Health Care Without Harm Safer Chemicals newsletter to stay up to date on policy and advocacy initiatives.
• Broaden your coalition with more allies. Listen to their concerns and think about what your health care voice can contribute to their cause.

“By continuing to be informed, organized, and vocal about threats to public and environmental health, health systems can ensure they both do no harm and actively work toward health improvement,” Gibson says.