The Big-Picture Issues and Us.

Two recent reading experiences, along with a surprising incident here in the office, have led me to write this column.

The first of the reading experiences involves a fascinating book called Beyond Evolution. It's a treatise about the ramifications of biotechnology and the genetically altered future that we are heading into.

The second reading experience was a short but well-thought-out column that recently appeared in the journal of our California affiliate. This column, written by a former president of the California Environmental Health Association (CEHA), noted how few registered environmental health professionals in California were also members of CEHA.

The surprising incident in the office involved an analysis of what publications were being purchased from NEHA.

Let me now tie these very different events together and, in so doing, make some observations about our profession. I'll start with the analysis of our publication sales.

As a service both to our members and to this enormous profession, NEHA maintains a rather sophisticated publications program. We spend time going out into the world of publishing to find the best of what is currently available on the topic of environmental health. (Our program also includes publications that NEHA itself develops, like the recent compendium on body art.) The objective is to provide you with one source where you can find the best educational resources available to anyone who practices (or, for that matter, anyone who is interested in) environmental health.

This year, we conducted a thorough analysis of which publications have sold and which haven't. This fairly innocent exercise ended up startling us, primarily because of what wasn't selling.

A substantial number of publications that address what I will call "big-picture issues" have hardly sold at all! That includes publications on topics such as leadership; emerging environmental issues; environmental law; the environmental basis for diseases; policy making; environmental negotiating; future environmental threats to health; environmental auditing, monitoring, and information systems; risk assessment and resource prioritization; and so forth.

What is to be made of this?

For as long as I have been with NEHA--and even before--I have heard the complaint that our profession doesn't receive the attention and compensation it deserves. I've heard much about policy decisions that are made without our input. I've heard that we are not being prepared for the future and that we are always enduring budget cuts.

On the other hand--if we are not taking the initiative to gain insight into the big pictures within which we work, or if we are not polishing our leadership and management skills, or if we are not learning to become effective at shaping policy, then can we be surprised at the circumstances we complain about?

Questions that should never have to be asked suddenly come to mind. Technology, management practices, and the needs of our constituencies are changing. Are we staying up on those important changes? The public frequently comes to us for answers to their fears. Can we properly represent the science we speak for but, at the same time, compassionately touch those who are frightened? Can we speak in ways they can hear? Environmental health is evolving. Can we influence the direction of this evolution--or are we merely content to ride out the changes and accept whatever fate awaits us?

Maybe NEHA is not doing enough to stimulate the profession about its leadership role and responsibilities. Possibly, you are finding your way through these issues with other resources. If, however, the apparent indifference to larger issues is real, then we may have discovered a problem within our profession that deserves serious attention and discussion. In support of that thought comes the column I read in the CEHA journal.

The column notes that there are approximately 3,500 registered environmental health specialists in California, but that CEHA has only 800 members. Assuming that the 800 CEHA members are all registered (which is a generous assumption), that means only 22 percent of the state's professionals are members of their state professional society. (Less than 10 percent are members of their national professional society, according to the same generous logic.) And these professionals, I would hasten to note, are the cream of the crop!

By the way, I am not singling out any type of a special problem in California. I suspect the percentages in that state reflect similar patterns across the country.

If some 80 percent of the people who are credentialed in this profession are not members, even of their state professional societies, then again, should we not be concerned about how well our profession is staying on top of our field and exercising leadership?

The last experience that ties into these concerns involves thoughts I have been having as I turn the pages of the book Beyond Evolution. As the publisher points out, genetic-engineering biotechnology represents what is arguably the single most controversial frontier in modem science. What are the public health, biological, ecological, evolutionary, and even ethical consequences of a genetically altered future? Moreover, if anyone should be raising these questions, shouldn't we? As guardians of the public health, aren't we, the environmental health profession, one of the parties most appropriately positioned to have a say about what is now happening in the incredibly fascinating field of genetic-engineering biotechnology?

Apart from the headline issues of cloning and recombinant DNA, activity in the food industry has been quietly underway for years. According to Beyond Evolution, some 60 percent of all processed food now contains genetically engineered ingredients. When it comes to food protection, NEHA and this profession have historically claimed to be leaders. Are we honoring our professional ethic by learning what we can about the potential consequences of this new field so that we can responsibly carry out our mission to protect public health?

If our people voluntarily choose to stay out of their professional societies (which, at both the state and national levels strive to keep the profession updated and current), and if the ranks of our profession exhibit a lack of passion about the bigger-picture issues that define the very stage we work on, then aren't we (not someone else) essentially creating for ourselves a future of diminished importance and stature? Perhaps, as a profession, we are responsible for more of our circumstances than we are typically willing to acknowledge when we complain about respect.

By the time you receive this Journal, you should already have received NEHA's new publication catalogue. I hope, not for NEHA's sake, but for the sake of our standing as a profession, that you will look at the resources available on the bigger-picture issues. NEHA provides this material with intention. The more we as a profession understand the bigger picture, the more we are able to influence it and, in the process, make our destiny and contribute to society.