EPA Region 3
Topic: Beyond Translation Series: Healthcare and the Environment
Size: : 6,422k
Date: May 14, 2012
Dr. Walter Tsou: Health care in America is incredibly complex. It is unfathomable. I tell you that in part because I teach this topic and I can’t even figure it out.
Lena Kim: Dr. Walter Tsou, a nationally recognized public health physician and former Philadelphia health commissioner, was keynote speaker at EPA’s 2012 Beyond Translation speaker series. He addressed the topic “Access to Health Care for Asian Americans and Minorities,” with emphasis on health access for immigrants. I’m Lena Kim, and welcome to Environment Matters, our series of podcasts. Enid Chiu, co-chair of our Beyond Translation initiative, set the stage in her opening remarks.
Enid Chiu: The purpose of Beyond Translation is for us at EPA really to expand the conversation on environmentalism to Asian, Hispanic and African immigrant communities. We want to take our outreach initiative to more than just translation, by getting engaged with the actual community members.
Lena Kim: In her introduction of Dr. Tsou, Maryann Helferty,an EPA scientist, described how public health and environmental health are closely linked.
Maryann Helferty: Environmental justice, preparing for pandemics, pesticide chemical exposure, evaluating the source of disease clusters, air pollution or pollution of our drinking water –all of these challenges and other global challenges remind us that the health of our planet’s ecology and our own health are inextricably linked. Solving these problems requires an effective health care delivery system with open and equal access to all people. Effective monitoring of public health is absolutely key to EPA’s success in reducing environmental threats and therefore restoring a clean and comfortable ecos to all in our community.
Lena Kim: Dr. Tsou prefaced his remarks by discussing what he called the determinants of health.
Dr. Walter Tsou: You are born with the blessings of the genes that your parents gave you. In the broader context is that you as an individual live within an environment which has both physical and social components. And so growing up in an environment in many ways dictates much of your own behaviors and how you are able to get into health care services.
Lena Kim: Health care access is key to quality of life, especially for immigrants.
Dr. Walter Tsou: We can do something about the built environment that you’re in. We do that as part of our larger public health agenda, and we can do something about the rules and regulations and about the social environment that you’re in. That is one of the reasons that we have government itself. The larger picture of how we actually live is referred to in the public health world as the determinants of health. And the policies and interventions that we create, our ability to get access to health care in many ways all affects the environment that we live in—the social and physical environment—and they in turn have influence on you as an individual.
Our ability to improve access to health care directly improves the environment that people can live in—and vice versa, the environment that we live in can directly influence our ability to get access to health care. For minorities, the great concern is that it discriminates around immigration and also the kind of insurance that you have. The analogy I think in the environmental world would be the concept of environmental justice—the idea that there are some populations, some subpopulations that are adversely affected by some type of toxins or landfills or things in our environment that would not be seen in other communities.
Lena Kim: Dr. Tsou got specific in talking about the health care access problems facing tens of millions of people in our country who do not have health insurance. He also provided the largely local audience comprised of community leaders and health care advocates with a sketch of good, if oversubscribed, public health care options for uninsured Philadelphians.
Dr. Walter Tsou: The rules that we create are in many ways different for those who are citizens and for those who are immigrants. But in fact it does matter in America. If you look at the census statistics, you can show that specifically Hispanics of any race have much higher chances of being uninsured than that of Blacks, which is around 20 percent, and Asians, which is around 17 percent.
Lena Kim: Dr. Tsou described one of this city’s best kept secrets: Philadelphia’s district health centers.
Dr. Walter Tsou: Perhaps one of the most important safety net programs is the Philadelphia district health centers. And the criteria for going to the health centers is pretty simple: if you live in the city, you can go. It’s that simple. It doesn’t ask you whether you’re legal or illegal. It offers primary care, family planning, prenatal services, lab tests and x-ray, and, significantly, it even pays for prescription drugs. That’s a very, very generous program for Philadelphia. It’s one of the best kept secrets. The other arm of trying to get health care if you don’t have insurance is what they call the federally qualified health centers. The federally qualified health cents are, not surprisingly, funded by the federal government. There are about 25 in Philadelphia. They offer primary care on a sliding scale, but they don’t offer medication and they don’t pay for specialty care. So they’re not as generous as the city health centers, but their waiting lines are not as long and they also provide excellent care.
Lena Kim: Dr. Tsou is clearly a supporter of many features of the Affordable Health Care Act, which is just beginning to impact the lives of Americans.
Dr. Walter Tsou: We’re going to try to move more from treatment model of health care, where all this money gets spent on hospitalization, to spend more money on primary care and prevention and community health centers.
If your employer provides your health insurance, that’s your health insurance plan. If between now and 2014 if you have a pre-existing condition, you have to apply to a high risk pool—and they will cover your cancer, your high blood pressure, your diabetes. Starting in 2014, if you’re self-employed, you have a small business, you’re uninsured, you can go to the state health insurance exchange and buy health insurance. And if you’re really poor—less than 130 percent of poverty—you can get in the Medicaid program. And if you’re between 133 percent and 400 percent of poverty, you can get some subsidies to help pay for health care.
Lena Kim: For more information on how EPA works with communities to expand the conversation on health and the environment, please see our website at www.epa.gov/region03/beyondtranslation.html And thanks to our listeners for joining us on Environment Matters.